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President Obama said today that "no issue deserves more attention than global warming." In his Earth Day proclamation, he called the trend of climate change "alarming" but also said that it gives the U.S. an opportunity to create new green technology and stimulate the economy at the same time.
"Doing this not only fulfills a sacred obligation to our children and grandchildren, but also provides an opportunity to stimulate economic growth," he said.
Mr. Obama heads to Iowa today to mark Earth Day in the state that gave him his first caucus victory. To reinforce the connection between his alternative energy infrastructure and employment, he will speak at Trinity Structural Towers, a plant that produces towers for wind turbines and also provides most of the jobs in the town that it's based.
The president called for more investment in green energy, including plug-in electric cars, weatherized homes and an alternative energy infrastructure. He also asked Americans to make small lifestyle changes such as driving their cars less, recycling and buying more energy efficient products.
The full text of the president's release is below:
The story of the United States is inextricably tied to our vital natural resources. As we enter a new era filled with challenges and promise, we must protect our land, wildlife, water and air -- the resources that have fueled our growth and prosperity as a Nation and enriched our lives. Doing this not only fulfills a sacred obligation to our children and grandchildren, but also provides an opportunity to stimulate economic growth.
To achieve these ends, no issue deserves more immediate attention than global warming. Scientists have already observed alarming shifts in the natural world, including thawing permafrost, melting glaciers, and rising sea levels.
Climate change presents a serious test for humankind, but it also provides an opportunity for great innovation and adaptation. The United States has risen to such challenges before, and Earth Day inspires us to transcend differences among nations so we may lead the world in protecting our planet from this global threat.
Americans across the country are working hard to help limit the pollutants that cause climate change and reduce their impact on the environment, but we must do more. Individuals and organizations can plant trees, use energy efficient lightbulbs, drive fuel efficient cars, hold clean-up drives, and teach young people about environmental preservation. Small changes in our daily lives can have a big impact on our environment. Individuals can walk, bike, and use public transportation; buy products with less packaging; and recycle and reuse paper, plastic, glass, and aluminum more often. American families can also save money by choosing energy efficient products, turning lights off, unplugging appliances, and cutting back on heating and air conditioning.
Government and business alike must also take serious and sustained action to protect our valuable natural inheritance. Through investments in scientific research and development, and the vigorous pursuit of alternative and renewable energy, we can create millions of green jobs that allow us to reduce greenhouse gases and excel in a competitive global economy. My Administration is committed to increasing fuel economy standards and putting more Plug-In Hybrid cars on the road, weatherizing millions of homes, and catalyzing private efforts to build a clean energy future. My Administration is also working to achieve a comprehensive energy and climate policy, one that will lessen our dependence on foreign oil, make the U.S. the global leader in clean energy technology, and prevent the worst impacts of climate change.
President Theodore Roosevelt emphasized our obligation to future Americans, saying, "of all the questions which can come before this nation, short of the actual preservation of its existence in a great war, there is none which compares in importance with the great central task of leaving this land even a better land for our descendants than it is for us." Heeding President Roosevelt's call, and carrying forward his spirit of determination, we must commit ourselves to protecting our environment and ensuring the health of our planet so we may share the magnificent blessings of our Earth with our grandchildren.
We do this not only to acknowledge the environment's central role in the development of our Nation but also to recognize the strong ecological interdependence among nations. History has shown that as we sow, so too shall we reap. Let us rededicate ourselves to a world that provides bountiful harvests for us all not just today, but for many generations to come.
NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim April 22, 2009, as Earth Day. I encourage all citizens to help protect our environment and contribute to a healthy, sustainable world.
IN WITNESS WHEREOF, I have hereunto set my hand this
twenty-second day of April, in the year of our Lord two thousand nine, and of the Independence of the United States of America the two hundred and thirty-third.


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- Manufacturer: Fox Racing
The Fox Looney Sasquatch Front Zip Hoody is not the average hoody; it is packed with Fox Logos and some sick styling. Of course this is all brought together with Fox's top quality materials and will be around for a long time.
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subset: commoncrawl


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Advanced Selling Strategies Ebook
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- Description
This Elliott collection dining table emphasize the elegance of brown solid wood top table.
Espresso wood legs finish, featuring dining table a 18" table leaf, thick proportioned tapered legs in four sided of rectangular table.
Some assembly may be required.
Dimension: 42" W X 54"~72" D X 30" H
More from this collection: Elliot
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SKU 15900443 MPN 2328T-4272 GTIN UPC 00784082114335 Brand Crown Mark Collection Elliot Assemble Length No Assemble Width No Assemble Height 30 Assembly Required Yes Material No Finish No Styles Contemporary Shapes No Shipping Time 1-2 Weeks Free Shipping No
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i love star gazing soo damn much. just some seconds ago i was gazing at the stars. i sometimes look at the stars in complete silence before going to sleep, it feels soo amazing that i have no right words to explain how exactly it feels. its in my to do list, to gaze at stars with my future wife when i'll get married
Most Helpful Girl
I adore it. Whenever I'm in my home country, I do it. It makes me so happy and serene. Too bad it's hard to do it well with the light pollution.10|10|0
Most Helpful Guy
big time, wondering what is out there10|10|0


text:
Click on a thumbnail to go to Google Books.
Night Watch (1998)
by Sergei Lukyanenko
Best Urban Fantasy (26)
Russian Literature (35)
» 6 more
No current Talk conversations about this book.
To say that I was feeling adrift after Deborah Harkness's All Souls Trilogy would be an understatement. I missed a good fantasy novel. I wanted fantasy, adventure, worlds in worlds, and above all a good narrative. I dug around online and in book stores trying to find the perfect fit. Nothing really was jumping out at me, and then I came across Sergei Lukyanenko's book The Night Watch. The front of the book boasts that the novel is "J.K. Rowling, Russian style". So I thought, why not. The book starts strong. There is intrigue, mysterious characters, and a classic battle between good and evil (not to mention the age old question: What is good and evil anyway?). I felt connected to the main character Anton and his story was very believable, albeit a little stereotypical. Anton is the basic idea of a character who is good, but feels torn about his own actions and feelings. What is right and wrong?
The hardest part about this book though, is that you feel like you're reading it through Google translate. There are so many sentences, expressions, and sayings that sound clunky and not quite right. There are also some spelling mistakes in the book (mainly homo-phonic ones), but it made things feel a bit off.
The next frustrating aspect about the book is the plot line. The book is split into three stories. Everything is fine until you get to story two, where you realise that the plot line is completely different and big chunks of the plot from the first book are just forgotten. The book in a way, is almost like a series of novellas that are linked with the same character, but are essentially separate. The stories, as Lukyanenko calls them (at least in translation), end of cliff hangers… And then you're just left hanging… and hanging… and hanging…
I really really wanted to like this book. I was, in fact, desperate to like this book, because I wanted another fiction series I could sink my teeth into. However, the book fell short. The series has expanded to five books now, and I'm not sure that I'll be reading any others from the series. I have my sneaking suspicions that something might have gotten lost in translation from Russian to English and that the books are a lot better in their original language. Although, it's a really hard call to make since my Russian consists of well known Vodka brands, and that's about it.
Readers! If there is a fantasy book or series that has you hooked, please let me know! From one desperate fantasy reader to another… I must get my fill of fangs, adventure, and the quest for good and evil!
This review is written with a GPL 3.0 license and the rights contained therein shall supersede all TOS by any and all websites in regards to copying and sharing without proper authorization and permissions. Crossposted at Bookstooge.booklikes.blogspot.wordpress.leafmarks.com & Bookstooge's Reviews on the Road Facebook Group by Bookstooge's Exalted Permission. Title: Night Watch Series: Night Watch Author: Sergei Lukyanenko Rating: of 5 Battle Axes Genre: Urban Fantasy Pages: 498 Format: Kindle Synopsis: There is a War going on, between the Light and the Dark. Humans don't know about this war until they become "Others", people with extraordinary abilities who must then choose either the Light or the Dark. Anton is one such Other and we follow him through several stories as he learns and grows in the bleakest place of all, Russia. My Thoughts: I was all over the place with this book. I thoroughly enjoyed it, hated it in places, was ready to call down the fires of heaven upon Lukyanenko several times and was completely and wonderfully morose through most of the book. I was expecting one story. What I got was 3 or 4 and it worked well. Each story started out from the viewpoint of someone other than Anton and then chapter One would begin from Anton's pov and it was 1st person. It was a jarring change but I found it to fit perfectly with the tone of the whole book. One of the things that made me want to put this down was the utter and complete Dualistic nature of the Light and the Dark. Neither were evil or good, but simply Were. And Light always came off as the weaker [which it usually does in Dualism, see Terry Brooks Word & the Void as another example] and in fact Anton pretty much says so in the first story. That leads into how the Other leaders of the Light and Dark play games with humans, the opposite Side and their own members. Anton encounters this several times and it almost breaks him. I know it would have broken me. Anton. What a fantastic character. Drinking vodka by the *whatever large units one drinks alcohol by*, falling in love, doing his best while not understanding half of what is going on and pondering. I love pondering even while sometimes hating it. Recently, during one of the Classic Club reads, I told someone that I felt like I had a Russian soul, ie, I wasn't happy unless I was miserable. That sums up Anton and in many ways I felt like if I had to be a character, I would have to choose Anton. This was a translated work so it was tough to tell if the rough edges were because of the author or the translator. This book was by no means a wonderful jewel of literature but it was an engrossing look into the Urban Fantasy landscape. And unlike a certain Wizard (filed under W in the telephone directory - That is Harry Dresden, future me, since you'll probably forget), Anton's complaining and misery didn't wear on me. It was him and it fit like a glove. "
Book club pick and I really wanted to like it, but 100 pages in it is still very generic worldbuilding and rule setup. I should say Moscow vampire thriller just wouldn't call out to me in the best of plots, but not a single engaging character...couldn't finish.
A philosophical exploration of good vs evil in a urban fantasy tale set in Russia. The ideas and questions presented in the book a compelling and very deep. The story itself is good and engaging. It is set as 3 short stories, though that are very connected and pull you deeper into the world. The world building has a few holes or unanswered questions, but mostly don't hinder the story or the major themes around the book. Knowledge of Russian culture may help, but otherwise go into the story with an open and accepting mind, just like most fantasy books. The prose is not too great, which may be due to the translation.
Plot sometimes a bit confusing. There are a lot of characters here and I sometimes had to re read in order to follow what was going on. I sometimes felt I'd missed something in translation.
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References to this work on external resources.
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Amazon.com Product Description (ISBN 0434014125, Paperback)The phenomenal Russian bestseller. A vampire novel set in a richly realized post-Soviet Moscow, The Night Watch has sold across Europe and to 20th Century Fox for huge advances.
In The Night Watch, the first of a trilogy, and reminiscent of Philip Pullman's His Dark Materials in its ambitions and achievement, the setting is contemporary Moscow. A small number of Muscovites with supernatural powers — those who are Other, owing allegiance either to the Dark or the Light — co-exist in an uneasy truce, each side keeping a close eye on the other's activities around the city.
Anton, an Other on the side of the Light, is a night-watchman, patrolling the streets and Metro of the city as he protects ordinary people from the vampires of the Dark. On his rounds, Anton comes across a young woman, Svetlana, whom he realizes is under a curse that threatens the entire city, and a boy, Igor, a young Other, as yet unaware of his own enormous power. Partnered by Olga, an Other who is in the form of an owl, he struggles to remove the curse and thereby save the city, while at the same time prevent Igor from falling into the clutches of the Dark.
The Night Watch explores the nature of good and evil and the tensions between the individual and the collective in a gripping narrative that owes as much to The Master and Margarita as it is does to the richly realized worlds of Philip Pullman and Tolkien.
(retrieved from Amazon Thu, 12 Mar 2015 18:09:21 -0400)
The forces of Light and Darkness have co-existed in a delicate balance for hundreds of years...until now. Even as the Night Watch polices the Dark Others--among them vampires, witches and shape-shifters--a chain of mysterious events triggers a dreaded, age-old prophecy: An immortal with special powers will come to switch sides, shattering the balance and unleashing an apocalyptic war unlike any the world has ever known.… (more)
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As reported in the Anniston Star, dozens of scientists descended on Mobile Bay, Alabama this past week, to search the estuarine waters for signs of non-native species. Brought together by the Alabama-Mississippi Rapid Assessment Team (AMRAT) and the Mobile Bay National Estuary Program, the scientists took ballast water samples and scraped around in fouling communities, finding several new species never before seen in Alabama. Next stop for the AMRAT is Mississippi Sound.
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I am easy going, hardworking, reliable and honest person. I am probably the most sincere, thoughtful, gentleman you meet on here. I believe life is all about taking chances and meeting new people, experiencing new things, and having your perceptions altered. My family is important to me as we are pretty close. I am career driven, however I do make time for family and friends and leave my work at the office at the end of the day.
When I am not working I like to travel, hang out with friends, go bowling, shoot pool, darts, go to farmers markets, watch movies, binge watch shows on Amazon / Netflix, and just about anything that interests me. Lately in the Summer I enjoy just getting in the car and driving in any direction and finding something new and interesting.
I try to be goal orientated. My hopes are in 2017 to finally move out of my apartment and something into a house. I'm also hoping I have a stable awesome relationship as well. Could that be you?
Are you funny? Do you like to joke around?
Are you a good communicator?
Are you trust worthy?
Are you looking for a long term relationship?
Do you like to cuddle on cold winter days and just watch the snow fall?
Like a guy who can cook?
Have an Amazon addiction? (Ok this one is optional)
If you have said yes to any of these questions, don't wait any longer and let's get to know each other! Lets make 2017 a memorable year for the both of us!
Im also good with technology.
I am a good listener.
Then I would say my smile.
Movies: I like comedies, action & horror. Favorite movies are The Blues Brothers, Airplane, Monty Python & The Holy Grail, Major League 1, 2,3 Pirates of Carribean & Spaceballs. Bonus points if you like the movie The Pirates of Silicon Valley (Look it up its not what you think it is).
Shows: When I have time its usually the older Simpson episodes, Swamp People, Pawnstars, American Restoration, American Pickers, Hells Kitchen, Master Chef.
Music: Rock / Alternative 80s, and top40. I do like almost everything but those are the main ones.
Food: Whatever I cook. Yes I can cook! Ive made chili, fajitas, chicken wings, casseroles, Bbq Beef Brisket, etc. Never had the fire brigade over at my place yet. I just cant bake....
2. Internet
3. My car
4. GOOD Pizza
5. NFL Football
6. Google (If you Google more than 2 times a day your an addict LOL).
Where do I want to go for my next vacation?
Out & about with friends at a festival, or beer garden.
If your looking for a down to earth man, who is funny, caring, respectable, slightly old fashion (Ie: I hold doors open for women), who cooks, has a good job, a car, can hold his own, & likes to cuddle lets chat!


text:
Welcome to the 2nd experimental VS Blog for Battlefield.
Last time Bad Company won by a landslide. And I know I said a PDW vs would be next but I thought I'd hold that off until I decide if I'll make this a thing on the wiki.
Today instead we are doing VS: Tanks vs. Choppers!!!!
Now this is BC1,BC2,BF3,BF4 Choppers vs. BC1,BC2,BF3,BF4 TanksBad Company 2 Vietnam Tanks and Choppers count too
Tanks or Choppers?
Was this a fair matchup?
Now leave your opinions in the comments below and have a great day! Also leave in the comments if u like these blogs. I will make 1 more until I decide if I will make this a thing on the wiki.
"Love Battlefield 4, Long Live the Megolodon, Pray for BC3 and stay badass!" - Pigpen077 (talk) 20:23, April 15, 2014 (UTC)


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Contact Us 2 months ago
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Ashok Bhowmick, famous Indian Artist, original painting on canvas, framed, measuring 60" x 46", featuring BULLS, with Ashok signature.Financial professionals or investors who like a Bull market, should definitely have this painting.Anyone who likes Ashok's painting should add to your collection.If you don't have one, you should consider it.Best offer, cash only and walk-in pick up.This site will g
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$40, Vintage Wear-Ever Cast Aluminum Hand Juicer Reduced
Vintage Wear-Ever Cast Aluminum Hand Juicer Juice Press Made in USA w/ Strainer 1940\\\'s $40.00 623-975-5956 WearEver Cookware can trace its origins back to 1888 when Charles Martin Hall a young inventor from Oberlin, Ohio discovered an inexpensive way to smelt aluminum by perfecting the electrochemical reduction process that extracted aluminum from bauxite ore. Seeking to fund his contin
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Dec 26, 2010
VB Based Project Report On Offline Examiner
Offline examiner is a VB based project for Computer related branches and is a real time project. The project will be implemented using VB. The aim of the project is to allow teachers to conduct examinations to the students. Use it for your reference and study. This Projects comes with many features which are benefited to both students and teachers. You can also Subscribe to FINAL YEAR PROJECT'S by Email for more such Projects and Seminar.The students are not allowed to go back to the previous question once they click the next question. This option is up to the teachers to decide the teachers can either enable such an option or disable the option.The teachers are also given option to set the time limit of the exam. When the students start their exam, after the allotted time, the exam automatically ends and a grade sheet is printed to the students. The exams can be of single choice or multiple choices and this also the teachers can make the decision.
About : Final-yearproject.com
Final-yearproject.com is one stop for all your project needs. You can find projects and seminars related to Electronics, Electrical, Civil, Mechanical, MBA, Pharmacy, Computer Science, IT, Bio-Tech, Robotics, Telecom, Wireless, Automation, BCA, MATLAB etc. You can Like us at Facebook and follow us on Twitter and Google+.


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We are a licensed and insured moving company in the State of Illinois. Our employees are full-time professional movers; we do not use contractors or day-labor.
Ampol Movers, was founded in 2004 and has been providing low cost, quality moving service to residents in the Chicago area. Thousands of satisfied customers refer us to their friends and family members, because they know that we are dependable, reliable and professional. Besides, how can you go wrong with our starting rate of $65/hr for two movers! (Two men + trip charge).
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Call of Duty: Advanced Warfare - Unlocking exclusive in-game gear
Thursday, October 30 2014 @ 02:31 AM GMT
Contributed by: VRANDAS
Views: 4,211
'FUEL UP FOR BATTLE' with Mountain Dew®, Doritos® and Call of Duty®: Advanced Warfare . The Fuel Up for Battle promotion allows players to customize their Call of Duty: Advanced Warfare multiplayer experience by accessing in-game gear through the new 'Supply Drops' reward system.
Starting October 6, fans in the U.S. can collect codes from specially marked packages of DEW® and Doritos products and enter them online at www.DewandDoritos.com to enhance their gaming experience and create a unique identity for their advanced soldier by unlocking exclusive (until Feb. 15, 2015) Dew and Doritos in-game gear.
Players can customize their character with accessories such as an exoskeleton, loadout vest, helmets, goggles, boots and more. Gamers will also be able to unlock double XP and rapid supply rewards. Every code entered from DEW and Doritos packages unlocks Call of Duty in-game rewards and each code entered will also provide a chance to win an Xbox One, the all-in-one games and entertainment system from Microsoft.


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Join a free Alternative forum (forum category), share with thousands of fans your favorite discussions subjects by participating to the best communities offered by forumotion.
Free forum : Ska Board, the world's fastest growing ska, punk, and alternative rock forum Our community is always looking forward to meeting new people, so join now! We'll be waiting!
Loyal subjects defending the Principalities of R. Toro, M. Way, G. Way, F. Iero and B. Bryar
Song Contest
Free forum : Many solicitors will take you for as much as possible. This is your opportunity to say what you want without recourse. You are expected to name names.
I'm sure you all agree
For those subjects of privacy that you just can't post elsewhere.


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Do you remove body hair because it is a lot of it and hence not good?
Do you shave /wax/use beard trimmer and use it everywhere or just in the chest and belly?
Does it increase your attractiveness and sex appeal and attract lot of girls?
Most Helpful Guy
I am fortunate enough that I barely have chest hair. Other than that, I have never removed body hair, but I have thought about it on occasion. I think most body hair is fine as long as it isn't extreme amounts.
However, I am unsure about pubic hair. I can imagine some women would like it trimmed down there, but I have no idea whether this is in fact true or not.00|00|0
Lucky you
If a guy has got extreme amount is it good to remove them regularly , especially from the torso and shoulders?
- Show AllShow Less
But the prickly and stubbly feeling that comes with closely trimmed or shaved coarse hairs is ok?
I'm afraid I don't know the answer to that.
Shaving obviously is a far from permanent solution. This site may give you some idea": https://www.wikihow.com/Remove-Chest-Hair
Other than that, you can search the web, or ask you doctor for what the best way is. (Doctors get these questions regularly, nothing strange about it).


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Lana Grossa STOCKINETTE PONCHO Allegro Unito
FILATI No. 51 (Frühjahr/Sommer 2016)
Design 39
400 g of Lana Grossa Allegro Unito (58% viscose, 42% cotton; 115 m/50 g) in Silver Grey (col 104). Size 4.5 mm needles.
The model packages do not include any needles, buttons and accessoires, but knitting instructions are delivered by email or in printed form without extra costs.
Product recommendation for this model
|« back


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Advance Auto Parts Locations in CT
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About Advance Auto Parts in Connecticut
For high-quality car parts in Connecticut, shop Advance Auto Parts. We've been in business for over 75 years, and with over 5,200 stores nationwide, we're the largest aftermarket retailer in the United States.
It's our job to help people like you take your machine in your own two hands—whether those hands are experienced or need a few pointers to get started. We do this by stocking our shelves with high-quality car parts and sharing our enthusiasm and knowledge with anyone who wants it.
Our Connecticut auto parts stores are full of the right tools you need to complete everything from a simple air filter change to a full-on transmission replacement. Advance Auto Parts also stocks parts for ATVs and motorcycles, and even lawn and garden needs.
Don't let that project wait around in the driveway any longer—browse our inventory online, and visit an Advance Auto Parts in Connecticut near you. And if you need some help, our team is happy to assist you every mile of the way.


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If you or your organization works with families that don't have health insurance for their children, help us share information about CHIP/Children's Medicaid. Here, you can order printed copies of CHIP/Children's Medicaid outreach materials that you can share with families in your community. You will not be charged for the materials or shipping. You can also download PDF versions of many of the materials immediately online.
To order a quantity not specified, please use the Comments box at the bottom of the form to let us know the exact number of each piece you want. If you have questions, contact HHSC Communications.


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
We are a labour hire company. I am looking for an apps that our staff throughout Australia and use to complete their for hours worked each weekAsked by Robert Bennett on October 20, 2015 at 07:13 PM
The data would then be sent to head office for payment.
Has Jot Form got something like this or are you aware of any such software
JotForm Support
Hello Robert,
I am not sure if I have understand the entire process.
You would like to create a form that will be filled by your staff every week?
Then send this form to the head office for the payment?
How do you want your staff to pay, is it via form online? If yes, you can integrate your form to any of the available payment integrations like Paypal or Stripe. http://www.jotform.com/help/47-Order-Form-Basics
If it's manual payment, here's how to change the form recipient email if in case you want it to be sent to the head office email for their records to collect manual payments http://www.jotform.com/help/41-Finding-out-E-mail-Address-used-for-submission-notifications
If you have further questions or if I have missed something here, kindly add more details so we can understand the entire process.


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INDIANAPOLIS, Ind. – The NCAA announced Friday afternoon the 80 teams and 32-individuals that will compete in the Men's Golf NCAA Regionals where two Saint Leo men's golfers, Ryan Gendron and Riley Goss, were selected to participate in the NCAA South/Southeast Regional May 8-10 at The Fighting Joe Golf Course in Muscle Shoals, Ala.
Gendron, who was named a semifinalist for the Jack Nicklaus Division II National Player of the Year, is currently ranked 61st among Division II players by GolfStat with a 73.08 stroke average. Gendron has finished in the top 10 in four tournaments with a top five finish on the 2017 season. His low round of the season was a 67 (-5) at the Matlock Collegiate Classic during the final round. While at the Sunshine State Conference Championships, Gendron tied for 14th with a 217 (+1) with rounds of 77-70-70.
Goss, who will be making his first NCAA appearance, owns a 74.74 stroke average and has finished in the top 10 at two tournaments during the 2016-17 season. Goss fired off his low round of 69 in the first round of the Sunshine State Conference Championships on April 23. The junior has played in 23 rounds this season for the Lions. Goss tied for seventh after shooting a 215 (-1) with rounds of 69-74-72 at the Duran Golf Club.
The two will make the journey to Alabama to represent the Lions where the SSC is heavily represented in the team portion with Lynn, Barry, Nova Southeastern, Florida Southern, and Rollins.
At a minimum, the top three teams and the top two individuals, not on an advancing team from each regional, will advance to the finals May 22-26 at Reunion Resort in Kissimmee, Fla. The remaining eight spots will be allocated based on the regions represented in the prior year's medal-match portion of the championships, with the maximum number of teams for a given region capped at seven. The finals will be hosted by the Sunshine State Conference and the Central Florida Sports Commission.


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
iFrame Code is not working for me in Godaddy Website builder 7Asked by Sameer on June 20, 2014 at 02:43 PM
IFRAME doesnt work for me.
I am using website builder 7 from Godaddy.
Please help!!
This is a re-post of a comment on Getting the Form iFrame Code
Have you tried using just the Top Part of your iFrame Code leaving out the script? Sometimes that will usually work where the full coding does not. If you are still struggling with this can you please share a screenshot with us and we will try to help you furthermore.
FULL iFrame Code:

iFRAME ONLY (At Top):

i use this
<!DOCTYPE html>

but it never worked
Hello shakkeer,
I copied the code you provided and save it in a html file and the iFrame works just fine. Please see below.
It is possible that it might not be working if your for website is secured. When accessing your website, does it show up with the https:// protocol in the address bar?
If so, your website is secured and you are trying to mix both the https:// and http:// protocol which is being blocked by most browsers. If you have a secure site, you have to ensure that the webiste that will be displayed in the iFrame is also secured.
Can you try this iFrame code and let us know if it works for you.
<!DOCTYPE html>

I will await your response.
For the record, the last suggested response works. Only thing to keep in mind is that you must use the secure form option. GoDaddy does not like non-secure forms (i.e. replace http wit https)
Can someone help me please? I am new to codes and website building. I was given a task to add an I-Frame to a godaddy website builder. Godaddy is not very useful and they are telling me that it won't work. but I cannot tell the company that they cannot implement their iframe into my website. How can I get the Iframe to work in a godaddy website builder. Please call me if you can my number is 925-980-5735. Thanks, I need step by step help!
JotForm Support
@Karen, to give way to the OP of this thread, I'm moving your question to this thread https://www.jotform.com/answers/890047 and we'll have your question answered there shortly.


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"Oooh, wow. It'll take some getting used to, but it'll be great, Cain." - Angie to RoboCain as the two recognize each other.
Angie is one of the main antagonists of Robocop 2. She is played by Galyn Gorg.
Angie was a prominent member of the Nuke Cult, and Cain's lover. Like her lover and mentor, she's totally hooked on nuke. She appears to be Puerto Rican and has black hair. Not much is known about her. During the fight at the abandoned warehouse, RoboCain recognises her and the two briefly bond, but RoboCain's mood changes suddenly, and Angie is snatched by the the face and head and viciously shaken, shattering her vertebrae.


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Joe Arpaio's Longtime Foe Mary Rose Wilcox Earns Supporters' Prayers
Long before the judges and lawyers got into the act (excepting such stalwarts as Danny Ortega and Antonio Bustamante, who've been active since the beginning), Maricopa County Supervisor Mary Rose Wilcox was speaking out, marching and working against Sheriff Joe Arpaio.
Wilcox was instrumental in getting former Mesa Police Chief George Gascon to go to Washington and testify before the House Judiciary Committee against Arpaio's misuse of the 287(g) program, she marched with Sal Reza and Zack de la Rocha protesting Arpaio in the streets of Phoenix, she hosted Al Sharpton's radio show when he came to town to denounce Arpaio, and she's voted against Arpaio time and time again in her capacity as supervisor. This, before the Supes were alienated by Arpaio's harassment and vindictiveness.
Indeed, I remember very clearly Wilcox's words in May as she explained her vote against giving Arpaio $1.6 million from the state Legislature to chase undocumented gardeners and dishwashers.
"What we are doing if the vote is affirmative today is releasing a reign of terror on our community."
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She later added, "We have been threatened. And I am not afraid of Sheriff Joe Arpaio. I will not succumb to his threats. And I know I will suffer because of it. It's not about me. It's about the community and about the misuse of these monies."
Prescient words considering the fact that Arpaio targeted her in an investigation, and Andrew Thomas later brought an indictment against her concerning loans she took out from Chicanos por la Causa.
Apparently, Wilcox received no sweet deal from CPLC, as CPLC has stated that the interest rates on the loans (two of which have been paid back) ranged from 8 to 12 percent. The Supervisors have voted to give CPLC funds to assist HIV/AIDS patients. If there was a conflict, it did not result in anyone benefiting from it, other than the HIV/AIDS sufferers.
In any case, Wilcox has become an icon in the immigrant-rights community, which explains the fact that St. Anthony Catholic Church was packed Monday night with souls praying for Wilcox as a mass was said on her behalf. Later, supporters gathered at El Portal to drink coffee and discuss Wilcox's case.
Some will argue that because Wilcox is Hispanic, her anti-Joe stance is to be expected. However, I would counter that there are a boat-load of Latino politicians and so-called Democrats who never utter a peep in opposition to Arpaio. Wilcox's defiance puts them all to shame.
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AJPW The Power Of Wrestling Charity Show is a professional wrestling event of All Japan Pro Wrestling. It took place on November 1, 2015.
- Numbers in parentheses indicate the length of the match.
- (c) refers to the champion(s) heading into the match.
- Yohei Nakajima defeated Keiichi Sato (7:45)
- Naoya Nomura defeated Yuma Aoyagi (9:02)
- Masanobu Fuchi & Yoshinobu Kanemaru defeated SUSHI & SUSHI Kozou (15:28)
- The Bodyguard, Yutaka Yoshie & Zeus defeated Jake Lee, Kento Miyahara & Takao Omori (18:15)
- Kotaro Suzuki (c) defeated Atsushi Aoki (18:55) to retain the AJPW World Junior Heavyweight Championship
- Kendo Kashin & Masakatsu Funaki defeated Hikaru Sato & Suwama (15:45)
- Jun Akiyama defeated Akebono (c) (13:16) to win the Triple Crown Championship


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The Italian parliament has passed a controversial bill aimed at resolving a perceived clash between the public and private roles of the prime minister.
Prime Minister Silvio Berlusconi is one of Italy's wealthiest businessmen and owns a media empire which controls 95% of Italy's commercial TV channels.
Under the new law, Italian politicians will not be barred from owning companies, but they will have to have to hand over managerial control of their businesses, and make their interests public.
Unlike Britain or the United States, Italy has never had any legislation limiting the financial assets and business interests of the prime minister or head of the executive branch of government of the day, to ensure that there is no confusion between his private and public functions.
A conflict of interest bill has been see-sawing back and forth between the two houses of parliament for three years now without every getting passed into law.
Now, suddenly, with the country on the brink of a political crisis, as Mr Berlusconi's coalition partners are threatening to bring down his government, the bill has finally become law.
The new law was immediately denounced by the opposition as a toothless effort to contain Mr Berlusconi's seemingly boundless political and financial ambitions.
Luciano Violante, a leading opposition figure, said the new law contravenes EU directives and says he will report this to Brussels and to the European Parliament.
The opposition is also uneasy about the prime minister taking over the functions of finance minister, since the forced resignation of Giulio Tremonti last week.
Cannot this also be regarded as a conflict of interest, they have been asking. Mr Berlusconi has no obligation under the new law to dispose of any part of his huge media empire.
The only question mark now hangs over the legality of his continuing in office as president of the AC Milan Football Club, a post he has held for 18 years.
A reminder that the Italian prime minister is not yet beyond suspicion of wrongdoing in his financial affairs came with reports of yet another police search of the offices of his media company, Mediaset, in Milan.
Mr Berlusconi's son and daughter by his first marriage, who hold top executive positions in Berlusconi family-controlled companies, are also included in ongoing investigations for suspected fraud and embezzlement, according to court officials.
Mr Berlusconi has vigorously denied any wrongdoing.


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Australian Asbestos Awareness Campaign Finalist in International AMEC Global Communication Effectiveness Awards
Amid a highly competitive international field, Insight Communications' campaign 'Don't Play Renovation Roulette! - Asbestos Awareness Week 2012', has been announced overnight in London as one of three finalists in the 'Best Use of Communication Management: Not-for-Profit' category at the International Association for Measurement and Evaluation of Communication (AMEC) Awards to be held on 12th June in Amsterdam.
From a record number of entries, Insight Communications is one of four Australian companies announced as finalists in the AMEC Awards and is the only Australian public relations agency represented alongside leading communication intelligence agencies iSentia, iSentia Brandtology and The Mediaverse.
Winner of the Public Relations Institute of Australia's 2013 Golden Target Award: Best Government Sponsored Campaign, 'Don't Play Renovation Roulette! Asbestos Awareness Week 2012' was a national campaign conducted on behalf of the Asbestos Education Committee (AEC) working in partnership with the Asbestos Diseases Research Institute (ADRI). The community education campaign achieved more than 900 media pieces, engaged multiple stakeholders including governments, at all levels and organisations Australia wide and delivered an innovative new experiential marketing and community engagement tool, 'Betty – The ADRI House' in the fight against exposure to asbestos fibres.
Media coverage included print circulation reaching 14+ million Australians with 14 television and 147 radio interviews collectively reaching over 4.5 million Australians to effectively drive traffic to asbestosawareness.com.au and increase traffic by 261% with access via mobile devices increased by 2700%.
Insight's campaign is up against UK's leading media intelligence agency Gorkana for the Stroke Association's 'Action on Stroke Month' and the USA division of Salience Insight, the media measurement division of News Group International – a global provider of business intelligence and media resource services for the National Wildlife Federation's 'National Wildlife Federation Benchmark Study'.
Peter Dunphy, Chair of the AEC said, "Since 2011, Insight Communications has managed the annual Asbestos Awareness Week and other related activities on behalf of the Asbestos Education Committee and has managed not only to raise awareness across NSW, but shared these safety and health messages nationwide thanks to an innovative campaign including diverse community engagement and awareness activities, the development of a valuable community resource, the asbestosawareness.com.au website, and the design and construction of 'Betty - The ADRI House'. This nomination is well deserved recognition of their hard work."
Insight Communications is a fully integrated public relations agency specialising in cause, culture, community and health and managed by Mother/Daughter duo Clare Collins and Alice Collins. This nomination comes off the back of their previous multi-award winning campaigns recognised for successfully positioning brands as national leaders in their field.
Insight's campaigns and public relations expertise has successfully engaged Australians and raised awareness of important health and welfare related issues affectively elevating the brands of many organisations to national significance including the AEC, ADRI, Bravehearts Inc, Cystic Fibrosis Australia (CFA) and Ovarian Cancer Australia (OCA).
"Insight is driven by our passion to actively inform Australians about important health issues and for those not-for-profit organisations we work with, we also create unique business development platforms enabling them to generate funds to sustain their on-going commitment to communities," said Insight's Managing Director, Clare Collins.
"We are truly humbled by the recognition of our peers and are extremely proud to have delivered a national campaign that has great ongoing significance to the health and wellbeing of all Australians."
ENQUIRIES TO: Alice Collins – Director, Insight Communications - P: 02 9518 4744 M: 0414 686 091
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Contact Profile
Alice CollinsP: 61 2 9518 4744
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Jaipur Pink Panthers vs Puneri Paltan are going to played 27th match of Pro Kabaddi League 2015 today on dated 2nd Augugst 2015.The Official match timings are 8:00 PM IST and, match will be held at Patliputra Sports Complex-Patna. Puneri Paltan is lead by captain Wazir Singh whereas Jaipur Pink Panthers team is in the hand of
Navneet Gautam.
Jaipur Pink Panthers vs Puneri Paltan prediction 2nd August
Patliputra Sports Complex-Patna
2nd Augugst Sunday
Jaipur Pink Panthers vs Puneri Paltan 8:00 PM
Where to Watch Live:
Pro Kabaddi League: Jaipur Pink Panthers vs Puneri Paltan, can be caught LIVE on Star Sports.
Live streaming will be available on Hotstar and starsports online
Hindi Coverage – Star Sports 3, Star Sports HD 3, Star Gold
English Coverage – Star Sports 2, Star Sports HD 2
Telugu Coverage – Maa Movies
Kannada Coverage – Suvarna Plus
Marathi Coverage – Star Pravah (Sunday Matches only)
UK viewers can catch the action on Life OK
Jaipur Pink Panthers
Navneet Gautam (C), Sanjay Shrestha, Balbir Singh,Shrikant Jadhav, Sonu Narwal, Kuldeep Singh, C Arun, Dharmendra, Rohit Kumar, C Karnan, Suraj Gurjar G Mallesh, Jasvir Singh, Rajesh Narwal, Raju Lal Chowdhary, Rohit Rana, Gokul Shitole, Prashant Chavan, Samarjeet Singh, Ram Singh,
Puneri Paltan
Wazir Singh (C), Amit Rathi, Mahipal Narwal, Pravin Niwale, Ravi V, Simon Kibura, Surendar Singh,Jitesh Joshi, Kalimuthu B, Manoj Dhull, Manoj Kumar, Nitin More, Ravi Kumar, Tushar Patil, Waleed Al Hasani, Yogesh Hudda, Anil S, Harvinder Singh, Sachin V, Sagar Katale, Vijender Singh, Vikas Tomar, Amit Kumar, Sanjay Kumar
Match Prediction:
Jaipur Pink Panthers will be the Winner
Important Note Must Read:
(This prediction is only for Kabaddi lover who wanna get the Kabaddi Info, not for gambling, betting or any other illegal activities.We will not responsible for any consequence. Thanks for supporting us.)


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Thin DT Pyramid Spike Stud Earrings
The Thin DT Pyramid Spike Studs are handmade in our NYC jewelry studio.
The Thin DT Pyramid Spike length measures 2/3" long and the base is 1/8" wide.
Available in solid 14k Yellow Gold, 14k Rose Gold, 14k White Gold, or Sterling Silver.
Listing is for a pair.
Featured on Beyonce (with the Large DT Pyramid Jacket Back) in her 'Jealous' music video.
Please note that all orders are insured during the shipping process and thus, require a direct signature upon delivery. If you would like to bypass the required signature, please make a note in the "Notes" section during checkout.


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Commuters may face delays this morning due to a signalling problem at Norwood Junction.
All London-bound trains are running at a reduced speed because of the issue.
Southern Rail tweeted: "Due to a fault with the signalling system at #NorwoodJunction, services are running at reduced speeds on all London bound lines."


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A Phase II Study Evaluating the Oral Smoothened Inhibitor PF-04449913 in Patients With Myelodysplastic Syndrome (MDS)
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Overall Response Rate (ORR)
Assessment of response by bone marrow biopsy and aspirate will be performed at weeks 9 and 17 according to International Working Group 2006 criteria as outlined below. The primary endpoint is best response on study, recorded from the start of the treatment until disease progression/recurrence. All responses must last for at least 8 weeks. Complete Remission (CR): Bone marrow: ≤ 5% myeloblasts with normal maturation of all cell lines, Persistent dysplasia will be noted, Peripheral blood: Hemoglobin ≥ 11 g/dL, Platelets ≥ 100 x 10^9/L, Neutrophils ≥ 1.0 x 10^9/L, Blasts 0% ; Partial Remission (PR): All CR criteria if abnormal before treatment, except: Bone marrow blasts decreased by ≥ 50% over pretreatment but still > 5%, Cellularity and morphology not relevant; Marrow CR or Hematological Improvement (HI): Bone marrow: ≤ 5% myeloblasts and decrease by ≥ 50% over pretreatment Peripheral blood: if HI responses, they will be noted in addition to marrow CR.
6 months
Jeffrey Lancet, M.D.
Principal Investigator
H. Lee Moffitt Cancer Center and Research Institute
United States: Food and Drug Administration
August 2013
November 2014
|H. Lee Moffitt Cancer Center and Research Institute
|Tampa, Florida 33612


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MINNEAPOLIS -- Minnesota Timberwolves center Al Jefferson will miss the next two games because of an illness in his family.
The Timberwolves say Jefferson left the team to be with an ill family member in Florida. He will miss the game Friday night against the Dallas Mavericks and on Saturday at Memphis.
Jefferson is expected to rejoin the team early next week. It's a big blow to the Timberwolves, who have lost eight straight games since a season-opening win over the New Jersey Nets.
Jefferson is averaging 15.1 points and 6.1 rebounds this season. He is still not 100 percent from February surgery on his right knee, but the Wolves will sorely miss his presence in the middle.


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Pat Spillane blasts Cork County Board statement
Kerry legend and Sunday World columnist Pat Spillane has taken a swipe at the Cork County Board for blaming a refereeing decision which cost them a place in this season's All-Ireland semi-finals.
The board issued a statement yesterday defending the record of former football manager Brian Cuthbert who stepped down during the week after his side's eight-point loss to Kildare.
The board claim Cuthbert has continued to be subjected to "regular unjustified and personalised abusive criticism from certain elements of the media" since he stepped down.
The statement describes referee Padraig Hughes' decision to award Kerry a penalty after James O'Donoghue and Mark Collins collided as "totally wrong".
They also claimed that the call cost the Rebels a place in the last four of the All-Ireland series as they would have faced minnow Fermanagh in the last eight.
Speaking on RTÉ 2fm's Game On yesterday evening, the pundit slammed the statement.
"The whole statement is a complete joke, really," he said.
"It's laughable.
"First of all, blaming the referee for possibly costing them a place in an All-Ireland semi-final — I would agree that it probably wasn't a penalty but let's deal with facts, it was awarded with 20 minutes to go in the drawn match, it made the game a draw.
"After that, Cork had two great chances from frees and they failed, so that argument doesn't hold water.
"In the replay, the weather conditions were the same for both teams and Kerry won because they learned more from the drawn game. People will say that a seven-day turnaround was difficult but Kildare, who were humiliated by Dublin in the Leinster championship, had a six-day turnaround to play Longford and they won it, so I don't accept that.
"Yes, Brian Cuthbert is a gentleman, but I think that statement serves no purpose at all. Releasing a statement blaming a referee for costing them a place in an All-Ireland semi-final —come off it."
Spillane feels that Cork could benefit from getting a manager in from outside the county.
"Brian was unlucky in that a lot of senior players retired," he said, "but the county has had a lot of U21 success and the potential is there, I wonder if it might be time for Cork to look outside the county.
"The bigger problem is that, in the successful counties, Kilkenny in hurling, Kerry in football and even Donegal in recent years, nobody knows who the chairman or secretary is. The manager is given greater control and they are the better for it."


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Your iPhone is a newsgathering machine! WTOP radio reporter Neal Augenstein knows all about it. He uses his smartphone for all of his assignments. Augenstein uses his iPhone to record sound. He edits with the application, VC Audio Pro, and once he's done, he simply e-mails his report to the … [Read more...]
February 29, 2012 By 2 Comments


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link Do you think she is attractive and is dressed nice and whatever else you want to add. I saw her in this commercial and I think she is gorgeous and I want to see what you guys and girls think.
What do you think of the girl in this commercial?
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What Girls Said 7
she's really pretty. she has pretty eyes and hair and she seems like a warm person when she smiles. people may disagree because of the shape of her nose compared to the shape of her head, and the shape of her head compared to the neck but I think it looks good over all even though those things give her more of a mousy look.10|11|0
I don't think she has a mousy look at all.
your right she doesn't, I just always think "mousy" when I see brown hair. I don't know why :/
She seems so much like one of my friends... the nose, the shape of her face, the way she talks... it's so unbelievably alike :O (the only difference is that my friend is blond and has blue eyes)10|10|0
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What Guys Said 7
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To test whether dynamic susceptibility contrast MRI-based CBF measurements are improved with arterial input function (AIF) partial volume (PV) and nonlinear contrast relaxivity correction, using a gold-standard CBF method, xenon computed tomography (xeCT).
18 patients with cerebrovascular disease underwent xeCT and MRI within 36 hrs. PV was measured as the ratio of the area under the AIF and the venous output function (VOF) concentration curves. A correction was applied to account for the nonlinear relaxivity of bulk blood (BB). Mean CBF was measured with both techniques and regression analyses both within and between patients were performed.
Mean xeCT CBF was 43.3±13.7 ml/100g/min (mean±SD). BB correction decreased CBF by a factor of 4.7±0.4, but did not affect precision. The least-biased CBF measurement was with BB but without PV correction (45.8±17.2 ml/100 g/min, coefficient of variation [COV]=32%). Precision improved with PV correction, although absolute CBF was mildly underestimated (34.3±10.8 ml/100 g/min, COV=27%). Between patients correlation was moderate even with both corrections (R=0.53).
Corrections for AIF PV and nonlinear BB relaxivity improve bolus MRI-based CBF maps. However, there remain challenges given the moderate between-patient correlation, which limit diagnostic confidence of such measurements in individual patients.
Bolus dynamic susceptibility contrast (DSC) MRI provides important information about brain hemodynamics, such as relative cerebral blood volume (CBV), mean transit time (MTT), and cerebral blood flow (CBF) (1, 2). Østergaard et al. laid the theoretical groundwork for non-parametric CBF measurement using singular value decomposition(3) and demonstrated good concordance between spin-echo echo planar imaging (EPI) DSC and H215O PET in 6 normal subjects (4). Further studies using gradient echo (GRE) EPI also found reasonable correlations in individual subjects, but the scaling factor between DSC and gold standard CBF measurements differed between subjects (5-7). This has led many to conclude that DSC CBF measurements are not reliable (8-10), and indeed clinical DSC MRI is generally evaluated qualitatively only. It would be preferable to measure quantitative CBF, as the need for some interventions is predicated on patient-specific absolute CBF measurements (11). Also, absolute CBF measurements would be useful to evaluate whole brain disease.
There are several reasons why DSC CBF measurements are unreliable. Some errors are global (i.e., uncertainty about the relationship between tracer concentration and measured relaxivity, the effects of large and small vessel hematocrit, etc.), while others are patient specific (i.e., related to cardiac output, arterial input function [AIF] and venous output function [VOF] orientation and signal saturation, etc.). Patient specific errors can be further broken down into those that affect the amplitude of the AIF, VOF, and tissue concentration curves, such as choices of scaling coefficients for relaxivity and AIF partial volume (PV), and those that lead to shape changes (12). In the AIF, shape errors arise from either signal saturation to noise levels, signal intensity changes due to vessel orientation (13), and distortion due to inclusion of surrounding brain tissue (5, 14). Additionally, recent studies suggests that contrast relaxivity for voxels composed mainly of blood ("bulk blood" or BB) has a quadratic rather than linear dependence with concentration (13, 15, 16). This would alter the relative concentration relationship between the AIF and tissue, and significantly decrease quantitative DSC CBF measurements (17). The goal of this study was to determine how corrections for BB and PV affect the bias and precision of DSC CBF measurements, using stable xenon computed tomography (xeCT) as a gold standard. We have chosen to focus on conventional gradient echo EPI DSC, since this is still the most common method used in clinical practice.
The study was approved by the Institutional Review Board and was HIPAA compliant. Patients were enrolled if they had symptoms consistent with cerebral ischemia (acute, subacute, or chronic) or transient ischemic attack (TIA), and signed written prior informed consent to participate in the study. Exclusion criteria was a level of consciousness score of 2 or greater as defined by the National Institutes of Health stroke scale; symptoms likely related to psychoactive drugs or patients with symptoms related to an active inflammatory disease such as AIDS, meningitis, or cerebritis; psychiatric or substance abuse disorder or dementia that interfered with evaluation or interpretation of the neurologic and mental assessment; severe coexisting or terminal systemic disease that limited life expectancy or otherwise interfered with the conduct of the study; symptoms related to an alternative diagnosis such as seizures or migraine; or use of any thrombolytic agent or acute stroke investigational drug therapy. Patients were recruited between October 2004 and July 2008.
Eighteen patients (9 men, 9 women; mean age 47±17 yrs, range 19-87 yrs) with cerebrovascular disease (4 acute stroke, 6 subacute stroke, 2 TIA, 6 Moyamoya; of these, 6 had unilateral internal carotid (ICA) occlusion, while 2 had bilateral ICA occlusion) were enrolled in the study and underwent both xeCT and MRI CBF measurements. The mean time difference between the two examinations was 18±10 hrs with a range of -21 to +34 hrs). In 6/18 patients, the MRI study preceded the xeCT study. Diffusion positive lesions representing acute or early subacute cerebral ischemia were seen in 9 of 18 patients (50%). Table 1 describes the demographics of the patients included in the study.
Computed tomography (CT) was performed using a GE Lightspeed 8 detector scanner integrated with a stable xenon enhancer system (Diversified Diagnostic Products, Houston, TX, USA). The xeCT protocol imaged 4 contiguous 10 mm slices (80 kVp, 240 mA) with the lowest slice at the level of the basal ganglia. 8 sets of images were acquired at 45 s intervals. The first 2 timepoints were acquired during room air inhalation, while the remaining 6 timepoints were acquired during 28% Xe gas inhalation. End-tidal Xe concentration was assumed equal to arterial Xe concentration, a reasonable approximation except in patients with severe respiratory disease. CBF was calculated using the Kety autoradiographic method by the manufacturer's commercial software according to reference (18), yielding CBF maps with a nominal in-plane 1 mm spatial resolution. The true in-plane resolution is on the order of 2-3 mm, and all image calculations (see below) were performed on regions-of-interest (ROI's) measuring 10 × 10 mm in-plane.
MRI scans were performed at 1.5T (Signa LX/i, GE Medical Systems, Waukesha, WI, USA). Anatomic imaging was performed in addition to DSC, and always included fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) with an isotropic b-value of 1000 s/mm2. DSC was performed using GRE EPI with the following parameters: 12 slices, thickness 7.5 mm, FOV 24 cm, flip angle 60°, TR/TE 2000/60 ms, matrix 128×128, 40 cine time points. A power injector was used to inject 20 ml of either gadopentetate dimeglumine or gadodiamide followed by 20 ml saline at a rate of 4 ml/s.
CBF maps were created using a block-circulant (delay-insensitive) singular value decomposition (SVD) in line with the work of Wu et al. (19). Transverse relaxivity change (ΔR2*) was calculated using:
where S0 is the mean signal intensity before contrast, excluding the first 3 time points to ensure a steady-state value. To avoid subjective selection of AIF and VOF, we employed automatic selection, based on location, peak value, peak width, and contrast arrival time (20, 21). 10 voxels were used for the AIF and VOF ROIs (17). This algorithm resulted in AIF locations in middle cerebral arteries, anterior cerebral arteries, basilar artery, or ICAs. The VOF locations were typically in the superior sagittal sinus, transverse sinus, or straight sinus. We did not account for possible clipping of the AIF or VOF curves due to MR signal saturation. In our experience, it is difficult to determine the presence of saturation based purely on shape, in accordance with theoretical work (14).
Four separate post-processing corrections were applied to the DSC CBF maps: no corrections, PV correction only, BB correction only, and both PV and BB corrections. PV was defined as the ratio of the area under the AIF and the VOF curves (Figure 1), using trapezoidal integration. These timecurves were sampled over the entire scanning period, with only the post-contrast segment contributing to the area (as the mean tracer concentration before bolus arrival is by definition zero). Corrections for the BB quadratic relaxivity relationship (described below) were applied before deconvolution. Given the linear relationship between the AIF underestimation and CBF (22), the DSC CBF maps were multiplied by the PV level in each patient, such that PV correction led to reduced CBF.
BB correction was performed according to references (13, 15, 16). For the uncorrected images, a linear relationship between relaxivity and concentration was used for both the tissue and vessels (AIF and VOF) (13, 15):
where r = 0.044 (ms mM)-1. For the BB corrected maps, a quadratic relationship was used for the AIF and VOF (13):
where a = 7.6 × 10-3 (ms mM)-1 and b = 574 × 10-6 (ms mM2)-1, while the linear relationship in Eq. 2 was applied for tissue. BB correction leads to a relative increase in the estimated AIF concentration, resulting in decreased calculated CBF.
Rigid body rotation based on mutual information using SPM2 (University College of London, available at www.fil.ion.ucl.ac.uk/spm/software/spm2) was used to co-register the MR and CT images. A 1 × 1 cm square grid were laid over each of the 4 slices, resulting in about 125 individual 1 cc ROIs per slice, such that each patient's mean CBF measurement was calculated as the mean of about 500 small cubic ROIs. Voxels belonging to the ventricles and cortical sulcal CSF were excluded by manual thresholding the diffusion-weighted images. In each patient, scatterplots of the individual DSC and xeCT CBF ROI yielded slope, intercept, and correlation coefficient.
To compare between patients, we chose to examine the global CBF, which we define as the mean CBF of all voxels within the co-registered volumes, as this will be independent of intrinsic spatial resolution. It should be noted that this represents a subset of the entire MR CBF dataset, since it covered a larger volume of brain than the xeCT measurements. For each patient, this yielded a single xeCT measurement and 4 separate DSC measurements, corresponding to each of the correction methods described above. To compare the two measurements, the CBF ratio was used:
Ideally, this value should be 1, representing exact correspondence (i.e., no bias) between the two techniques.
Once the CBF ratios for each of the post-processing conditions were calculated for each patient, comparisons between patients were performed. The precision of the measurement was measured using the coefficient of variation (COV), also known as the normalized between-patients standard deviation:
where the overbar represents the mean of all patients. A low COV represents a more precise measurement. Finally, linear regression was performed between the xeCT and each of the separate DSC CBF measurements.
Bland-Altman plots were created using the xeCT CBF (gold standard) measurement as the x-axis. Mean difference and 95% limits of agreement are reported. To assess for possible bias in the measurement based upon underlying xeCT CBF, we created rank-ordered maps. To test the significance of the global xeCT and various MRI-based CBF measurements in different patients, we have calculated the simple Pearson correlation coefficient and the corresponding p-value.
Mean xeCT CBF was 43.3±13.7 ml/100 g/min. The nine diffusion positive patients all had regions of decreased xeCT CBF, except for one patient, who had elevated CBF in the DWI-positive region, presumably representing reperfusion of a completed infarct. With the exception of 1 case with very low CBF (20.0 ml/100 g/min in an 87 year old man with a subacute infarct) and 1 case with markedly increased CBF (81.1 ml/100 g/min in a 19 year old man with subacute bacterial endocarditis), the xeCT CBF values were clustered around the 40-55 ml/100 g/min range.
A typical example of a co-registered data set is shown as Figure 2. Correlation between all of the MRI DSC correction approaches and the xeCT CBF was significant (p<0.05) in individual patients, with correlation coefficients ranging between 0.15 and 0.64 (Table 2). There was no difference between the mean correlation coefficients with or without BB correction (with BB correction: 0.40±0.15; without BB correction 0.41±0.15). Correlation did not change based on PV correction, as this resulted in only global CBF changes. Also, the slopes on average did not converge around 1 and the intercepts did not go through 0 (and were in fact always positive). An example of the correlation between xeCT and DSC in an individual patient is shown as Figure 3.
The PV of the AIF ranged between 0.49 and 1.0, with a mean value of 0.78±0.15. In two cases, the area under the VOF was smaller than that under the AIF (patients #15 and #16, where the AIF area divided by the VOF area was 1.10 and 1.30, respectively); in both cases, this was due to a higher post-contrast baseline for the AIF compared with the VOF, and the PV was set to 1 in these cases (Figure 4). Bulk blood correction decreased DSC CBF by an average factor of 4.7±0.4.
Global MRI-based CBF ranged between 34.3±10.8 ml/ 100 g/min (both PV and BB correction) and 211.9±73.9 ml/100 g/min (no corrections) (Table 3). The maps with BB but without PV correction had the least bias, overestimating xeCT CBF by 7±34%, while the maps with both PV and BB correction led to underestimation (-19±22%). The COV ranged between 27% and 33%, with the PV corrected maps having the best precision. The best correlations (R=0.52-0.53, p<0.05) were seen after BB correction, which were higher than those seen with either no corrections (R=0.45, p=0.06) or with PV correction alone (R=0.42, p=0.08). Bland-Altman plots for the different MR correction methods are shown as Figure 5. Figure 6 plots the BB corrected MRI-based CBF values versus the xeCT gold standard measurement, and demonstrates the effect of the PV correction.
Accurate CBF measurement in clinical patients with cerebrovascular disease remains a serious imaging challenge. Quantitative CBF may be useful to weigh the risks and benefits of surgical versus medical management (11). This frequently necessitates more invasive imaging tests, such as stable xeCT, H215O PET, or single photon emission tomography, occasionally requiring patients to be imaged at specialized centers distant from their usual outpatient or inpatient setting. Both CT and MR bolus brain perfusion measurements have been criticized as inaccurate, particularly in the setting of large vessel disease, due to regional delay and dispersion of the bolus (23-25). Other errors that impact DSC measurements surround accurate measurement of contrast concentration in the AIF and tissue (16, 26). While some of these problems may be mitigated by the use of parallel and/or multiecho approaches (17), single shot GRE EPI is by far the most common implementation in clinical practice. This paper addresses how correction for AIF partial volume and differences in relative contrast relaxivity between large vessels and tissue affect DSC CBF measurements, using a diffusible tracer method as a gold-standard.
It is critical to accurately determine the contrast concentrations within the AIF and the tissue, as inaccuracies in either of these will cause CBF errors due to the scaling of the tissue residue function using the SVD methodology (22). Tracer kinetic theory states that the area under the concentration-time curve of a ROI consisting completely of blood should be equal regardless of location. Since veins tend to be larger than arteries, the ROI used to define the VOF is more likely to contain 100% blood, and thus the ratio of AIF and VOF timecurves is a reasonable approach to measure PV. We have chosen to integrate the AIF and VOF over the entire time period following the bolus arrival. This leads to a slight overestimation of the PV ratio, since the AIF precedes the VOF by several seconds. Thus, the true VOF integrated area (for equal recirculation times) will be underestimated. However, since the late recirculation part of both the arterial and venous curves is low compared with area contained in the peak, we estimate that this error is small, likely less than 5%. Since this is far smaller than the interpatient variability in PV (15%) and not particularly patient-dependent, we have neglected it in the calculations. Finally, we wish to emphasize that the approach described above can only correct for amplitude effects, and cannot address potential shape errors (14).
Applying this amplitude PV correction reduced DSC CBF by 22% and improved precision, as evidenced by the drop in the COV measurement, though the bias of the measurement became negative (i.e., the PV and BB corrected maps underestimated true CBF as measured by xeCT). Thus, the PV correction is partially effective in alleviating the patient-to-patient variation in CBF. However, it is important to realize that even after correction, the scatter of DSC CBF measurements compared with xeCT CBF is 27% of the mean. Of course, all measurement methods, xeCT included, will have an underlying variation, which should be considered when determining whether the variation seen in the DSC measurements is clinically acceptable. Test-retest measurements could be used to address this question, though the radiation associated with xeCT makes such studies problematic.
Other groups have recognized the importance of PV errors in quantitative DSC CBF measurements. Østergaard et al. studied 6 pigs with DSC and PET (27), and normalized the AIF area by the injected dose on a weight basis, determining a global scaling factor by requiring that the MR and PET measurements be equal. This is equivalent to assuming that the percent of the cardiac output to the brain is uniform among subjects. After this correction, they reported a spread of slopes in the individual correlations of about 10%. Another approach was suggested by Lin et al. (5), who applied a patient-specific correction factor based on the ratio of the VOF area with an average value found in a small series of normal volunteers. Using this method, they report a decrease in the spread in the slopes of individual patient data, with overall improved correlation. It is unclear why this method improves precision, given that it does not address the fundamental issue of the PV error associated with the AIF. They comment that they evaluated a procedure similar to that in the current study for normalization, but that it was not effective. A study of normal subjects using a 133Xe SPECT gold standard (28) used a similar correction strategy to that used in the current study, and found improved correlation, though no data regarding the COV of the CBF ratios were reported.
Previous DSC studies have reported elevated CBF levels compared with both gold standard (5, 7, 8, 28) and literature values (17, 29, 30). For example, the study of Jochimsen et al. measured approximately 4-fold increased CBF compared with literature estimates, even after potential problems with T1 relaxivity and AIF dynamic range were addressed using a parallel multiecho approach (17). One possible explanation is that the standard assumption that contrast relaxivity is a linear function of concentration is flawed. Kiselev (15) suggested that there is a quadratic relationship between relaxivity and concentration in blood-filled voxels. van Osch et al. (13) demonstrated such a nonlinear relationship in experiments on ex vivo human blood.
Correcting for this effect markedly decreased MRI-based CBF measurements, bringing the values into the range of those measured with xeCT. This correction is, in theory, patient dependent, due to the influence of the quadratic relationship on the amplitude of the patient's AIF (which itself is due to the underlying partial volume and the fractional cardiac output that goes to the brain). However, since the peak AIF concentrations in the different patients were similar, this had a smaller effect on the patient-to-patient basis than the PV correction. Thus, including this factor significantly improved the bias of the measurement, but did not improve precision. It should be noted that the coefficients used in the quadratic correction (Eq 3) were obtained from blood in vitro and might be different in vivo. We also neglected the possible changes in the coefficients that might be related to hematocrit, which could also presumably differ in gray and white matter (26). Finally, theoretical and experimental considerations suggest that vessel orientation with respect to the main magnetic field may play a significant role in the relationship between relaxivity and concentration as well as on AIF shape (14, 31, 32), which we did not address (14).
Both the PV and BB correction are problematic in the setting where the peak concentrations of the AIF and VOF are underestimated due to the inherent noise floor of the measurement, a particular concern for GRE EPI sequences with relatively long echo times. We observed some degree of plateau-like appearance to the AIF and VOF concentration time curves in 3 and 9 patients, respectively. Signal clipping is a known problem, which is inherent to single-echo GRE-EPI acquisitions with reasonably long TE. However, for typical injection rates (4 ml/s), clipping at the peak of AIF and VOF can appear even with shorter TE, at which point the SNR of the measurement is compromised. Multiecho approaches, such as PERMEATE (33), may alleviate some of these issues. Such errors would likely cause CBF overestimation, though no obvious trend towards CBF overestimation was seen in these patients.
Instead of manually choosing ROIs on the xeCT and DSC maps, we divided the 4 imaged brain slices of the xeCT into cubic 1 cc regions, excluding the ventricular system and other CSF spaces. This method eliminates potential bias in ROI selection, and uniformly samples the entire co-registered volume, enabling a straightforward measurement of mean CBF. With this approach, we observed marked variation in slopes, intercepts, and correlation coefficients between DSC and xeCT CBF values (Table 2). This finding is consistent with prior studies that have not used post hoc correction schemes (4-6).
When between-patient correlations between DSC and xeCT are examined, a similar trend emerges. While correction for PV and BB improves the correlation between the two techniques, it is still only moderate at best, and significant variation remains even with both corrections. This remains a significant barrier to clinician confidence in individualized measurements. In our institution, when absolute CBF levels are critical for patient care, xeCT is performed despite the inconvenience and radiation dose.
Comparing DSC to xeCT CBF is fraught with several difficulties. xeCT is a diffusible tracer method, while DSC relies on intravascular tracers. In particular, the gradient echo implementation is particularly sensitive to large blood vessels (Figure 3). This was particularly problematic in the setting of focal ischemia, where vasodilation in the periphery tended to decrease conspicuity of low CBF regions in the core. Since vessel size is a continuum, defining a precise threshold for the removal of large vessels is problematic; for this reason, we chose not to attempt to remove large vessels post hoc. It is possible that spin-echo DSC or arterial spin labeling (ASL), each of which are less sensitive to large vessel effects, may offer improved CBF measurements. Difficulties with spin-echo DSC include the need for increased contrast dose and questions surrounding how to measure the AIF concentration. Conventional ASL is hampered by transit delay times caused by stenotic vessels or anastomoses and more advanced ASL methods are warranted. Also, we did not account for possible effects of vessel orientation upon the relationship between measured transverse relaxivity and contrast concentration (14), as the automated method used criteria based solely on peak height, narrowness, and early arrival. Future studies could evaluate the effect of choosing a standard AIF location.
The patient population studied had cerebrovascular disease, as this is a common indication for DSC perfusion imaging. Many had arterial occlusions or stenoses that would lead to spatially dependent delay and dispersion. Block-circulant SVD is accurate in the setting of delay, but not dispersion (19). Local AIF approaches may decrease the effects of delay and dispersion by choosing more proximal AIFs for each voxel (34). However, AIFs in smaller vessels are more susceptible to PV artifacts. While both studies were acquired within 36 hrs, true CBF changes between the two timepoints may also serve to decrease correlations between the two techniques. CBF has a daily variation of about 10% and can be affected by medication and diet, which were not controlled for in this study. Some prior studies suggest that xenon inhalation itself causes a small CBF increase (35, 36). Though these patients were deemed to have stable physiology, CBF changes related to disease course are possible. Finally, given the challenge of acquiring acute xeCT and the associated radiation, the sample size is relatively small.
In conclusion, corrections for partial volume and nonlinear contrast relaxivity improve the bias and precision of DSC measurements compared with a gold standard CBF measurement in patients with cerebrovascular disease. After these corrections, DSC maps still mildly underestimate xeCT CBF, have about 27% patient-to-patient variability, and are only moderately correlated with xeCT CBF. These factors limit diagnostic confidence of quantitative DSC CBF measurements in individual patients using current methodology. Further refinement in algorithms to remove PV artifact and to more accurately convert relaxivity to tracer concentration, coupled with improved AIF morphology achievable with multiecho and/or parallel sequences, may further improve quantitative DSC CBF measurements.
This work was supported in part by the NIH (2R01EB002711, 1R21EB006860, P41RR09784, K23NS051372) the Lucas foundation, and the Oak foundation.
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