text:
Here on this site we have the usual man made universe explained. We note right from the first paragraph the usual and
laughable error of ' science ' arrived at by the usual ' scientific approach ' to discovering facts... ' speculation.'
Scientists conclude that H2O contains no oxygen and therefore we find the poster of this ' scientific approach ' to fact
finding in error. He speaks of " water " but the early earth had no oxygen in it while water can not exist without oxygen as
one part of it's molecule. Crackheads make more sense.
There is no workable explanation of the world we live in other than it is here because the Living God created it by speaking
it into existence. The bottom line is simple enough for a child to grasp but not the ' educated ' Christ hating atheist.
Here's a simple fact of life which passes by the scientist unaware...
Two identical twins. One is in the morgue laying dead on a table while the twin is standing over him. Both persons have a
portion of this element and that element which comprises their both body's except one is alive and one is not. Even a child
can conclude that the dead twin is not dead because of the non-living elements which comprise both the living twin and the
dead twin. Whatever makes one twin alive while the other is dead can certainly not be because of the non-living natural
elements of the earth which comprise both twins. There is no element of life in the Periodic Table.
The only conclusion which can sanely be drawn from this comparison is that life is not of this world... life comes from the
Living God who put of His life into man... man, who is made from the elements of the earth which his dead body testifies
to... the living twin still has the breath of life from God in him while his dead twin brother does not. It's * That *
As we read... " the dust will return to the earth as it was, and the spirit will return to God who gave it." Ecc.12:7.
It is futile to try and prove otherwise. ' Science, ' has already formulated the Periodic Table in which there is no
' Element of life ' and has already mapped the human body finding only the non-living elements of the earth comprising it. By
' scientific ' methods, the ashes of George Washington can be poured into a bronze cast of old George and add to them as much
water as the human body has in it ( even though ' scientific ' water contains no oxygen according to the poster ) ... wait a
billion years or so and bingo... old George will come busting out because * That * is the ' scientific ' way life comes to be
without the Living God.
The whole duty of man, fallen or elect, is to " fear God, and keep the commandments," Ecc.12:13, as both the lost and the saved " hope and quietly wait for the salvation of the LORD," Lam.3:26
This email has been checked for viruses by Avast antivirus software.


text:
|Title: In love and war
Director: Richard Attenborough
Country of production: Usa
Production year: 1996
Run-Time of the Movie: 115′
|Ernest Hemingway at eighteen he enlisted as a volunteer and is ghting on the Italian front during the First World War. Wounded in anticipation of war was taken care of by Agence von Kurowsky. Between the two born a tender feeling that soon turns into an overwhelming love.
The writer will recall the episode in his great novel "Farewell to Arms".
|Richard Attenborough
Richard Samuel Attenborough, Baron Attenborough, (29 August 1923 – 24 August 2014), was an English actor, lmmaker, entrepreneur, and politician. He was the President of the Royal Academy of Dramatic Art (RADA) and the British Academy of Film and Television Arts (BAFTA). Attenborough joined the Royal Air Force during World War II and served in the lm unit. He went on several bombing raids over Europe and lmed action from the rear gunner's position. He was the older brother of Sir David Attenborough, a naturalist and broadcaster, and John Attenborough, an executive at Alfa Romeo. He was married to actress Sheila Sim from 1945 until his death. As a lm director and producer, Attenborough won two Academy Awards for Gandhi in 1983, receiving awards for Best Picture and Best Director. The BFI ranked Gandhi the 34th greatest British lm of the 20th century. He also won four BAFTA Awards and four Golden Globe Awards. As an actor, he is perhaps best known for his roles in Brighton Rock, The Great Escape, 10 Rillington Place, The Sand Pebbles, Miracle on 34th Street (1994) and Jurassic Park.

subset: commoncrawl


text: DolEx Dollar Express, Inc. DolEx provides customer and retail store referral and origination services to a Licensed Lender in four states and growing. To date we have facilitated over 70,000 responsible and affordable installment loans to customers via this innovative and emerging retail referral vendor program. 1845 Satelliute Blvd. Suite 400 Duluth, GA 30097-5218


text:
New Halo 3 maps shipping with ODST
If you hop on over to one of the blogs we heart, Kotaku, you can check out some footage of 3 new Halo3 maps in action. They're gonna be on a separate disc that will come with Halo 3 ODST(Xbox360). I assumed ODST would ship with the Halo 3 multiplayer component and all the previous map updates….I guess I'm not so sure now :-/….well, ODST is due out in a little over a month, so we'll know for sure soon. Man, Halo online still looks fun as hell….
GBU CellPhone Zelda
Couple of days ago I was browsing online for a new free app for my phone. Cause im cheap like that and I don't really want to pay 4 bucks a month to be able to listen to songs online or 3.50 to immediately recognize those songs and have it download the song for me the next time i load my iphone to my itunes. Not that I have an iPhone although I wanted one. Just couldn't get past the price. So I was browsing for a nice little calander app that I could synch with some online things I have going on to be able to access them from my phone. So I accidentally hit last page, and BOOM fate would have it that Zelda was on the last page. So free download BONUS i ended up grabbing it to check it out later.
Good: This is the ultimate of nostalgia on your phone. I have seen pac-man and asteroids on the phones but ZELDA! Come on man who didn't love that freaking game. Now I have it on my FREAKING PHONE! Awesome. The graphics are about par to the original graphics and its the same basic gameplay. Some of the functionality and dungeons arent there yet cause the game isnt totally finished. But it is the zelda you remember same exact layout and same characters. Its great.
Bad: The gameplay is great but the controls are not really easy to get used to although once everything is set up and working correctly for you its wonderful to play.
Ugly: Ehh some of it isnt finished and its a bit rough to play in some areas and its not exactly the game i remember but hopefully once i pull up the old console and wipe out the zelda I will hopefully be impressed by the cellphone port.
GBU game review for Call of Duty World at War Map Upgrades.
Good: Nazi Zombies level. Fight off the invasion from inside a bunker or a mansion house or one of four other locations. OH MY GOOD BABY LORD JESUS. As you can tell this game was indeed MADE FOR ME. This is quite possibly the most perfect game upgrade ever. It doesn't cost a thing to get the first one but the next three are each gonna cost ya pointage. So what though, ZOMBIES! Seriously can anything be better than simplicity of killing zombies and not having to worry about traversing an entire level. You simply have to defend a set position from approaching zombies through as many waves as possible. It's brilliant because its simple and fun. As you kill zombies and fix barriers to keep the nasty undead out you get cash that you can spend to upgrade weapons, buy more ammo, or unlock more areas to exploration.
Bad: Nothing…seriously. The game itself is already on my top ten all time must haves, now it has moved to my top 10 must have never going to trade in games.
Ugly: I haven't played any of the online multiplayer maps because I cannot break away from the zombie levels. I mean seriously so bad I almost didn't go to work this morning. Also I don't believe Ive showered in a few days. Hmm maybe thats why nobody at work will talk to me.
Seriously. LurkerBelow and AtomicZombie fueled by Mountaindew and BBQ sammiches cannot be stopped by Zombies. NOTHING CAN STOP US! Except maybe a severe lack of really good BBQ joints in Philadelphia.
Road trip to Texas?
- September 2013 (1)
- December 2010 (1)
- November 2010 (9)
- October 2010 (16)
- September 2010 (24)
- August 2010 (15)
- July 2010 (22)
- June 2010 (32)
- May 2010 (7)
- April 2010 (7)
- March 2010 (13)
- February 2010 (12)
RSSEntries RSS
Comments RSS


text:
Archive for December 2016
Finding a Therapist in Israel as an Single American Olim-My Role
Is there a place for new American Olim in Israel who are single? Who are not married? (Who don't want to get married or have kids?) What about if your secular/non orthodox? As a therapist who is also new to Israel I am having such interesting experiences over the course of this past week that makes…Read More
Self Advocacy
As a Marriage and Family Therapist who is new to Israel I am facing interesting stigma because my degree and license is not recognized in my new home. This is something I wrote on a fb group I am apart of because I felt like people just don't respect my degree. I understand that certain…Read More
15 Benefits of Online Therapy & Why You'll Like It
15 Benefits of Online Therapy You don't have to sit in traffic to go to your appointment There's more flexibility with scheduling You can be in the comfort of your home For those living in smaller communities no one will see you "entering the therapist office" so effectively you have more privacy If your home…Read More


text:
This shop has been compensated by Collective Bias, Inc. and its advertiser. All opinions are mine alone. #allEssentials #CollectiveBias
Looking for a fun kid's activity? What kid wouldn't love playing in the dirt and making an adorable mini fairy garden?!
This post contains affiliate links.
Spring is here and of course that means it's time to plant some flowers. We needed more color on our lanai and I was looking forward to adding a few new planters. This year my girls really wanted to help and I thought it would be a fun family project for us to do together. However, I knew things were going to get a little messy!
If you're a neat freak, you definitely have to get over that once you have kids! I'm a Virgo through and through and have always been a perfectionist…that includes keeping things neat and clean. That all went out the window once I became a mom. Sure, I still clean…you'd just never know it if you walked in 15 minutes later. Messes just seem to magically reinvent themselves when you have little ones running around. I'm just now getting over the trauma of having blue paint splattered all over the wall last month…who knew it was possible for paint to fly that far through the air?! However, I want to let my kids be kids and if that involves a mess, so be it! That's what cleaning supplies are for, right?
That's why I didn't think twice when my girls wanted to help plant the flowers. They could barely contain their excitement about having their own "gardens" so off to the store we went! We had a quick lesson about annuals and perennials and then I let them choose their flowers. They went with annuals since they're more colorful, which was fine by me since I've never been able to keep flowers alive for longer than a year anyway (if that)!
The next day, we were ready to
make our mess plant our flowers! I already knew potting soil would be everywhere so the first thing I did was to put down a plastic tablecloth. I buy these for a dollar and really need to get them in bulk because they come in handy for everything from painting to play-doh. It makes cleaning up SO much easier!
Next, I set everything out for the girls. They were ready to go with their potting soil, planters, flowers and shovels. After all the trouble I went through to find their beach shovels (I didn't want them fighting over the one "real" shovel we have), they decided that it was more fun to just use their hands. See, I told you kids were messy!
Once the planters had enough soil, and the girls were sufficiently dirty, it was time to add some flowers!
By now even their clothes were a mess and I could tell that I was going to need some extra help with the clean-up! I knew it was all under control though because I had all® Fresh Clean Essentials™ on hand! I love that it's sulfate free to help preserve the clothing color without harshness. I've used sulfate free products to help protect my hair so why not use it my laundry too! It also gives your laundry a good deep down clean, something these clothes are definitely going to need!
You can find the new all® Fresh Clean Essentials™ Fragrance Free and all® Fresh Clean Essentials™ Fresh Scent online at Target.com…so convenient for busy moms! Just follow the directions on the packaging and you'll be all set. But wait, I'm getting ahead of myself here. We're not quite ready to throw all those clothes in the laundry just yet!
Since we still haven't had the chance to rebuild the fairy garden from our old house, we thought our fairies might want to live in our mini gardens for awhile. It's certainly much prettier than the cardboard box they were living in! After the girls flipped a coin for the baby fairy (that's the favorite), they added the fairies to their gardens.
Finally we added some accessories so that our fairies would feel right at home. Every fairy garden needs a wishing well and we also added a bridge and fountain.
We all thought the gardens turned out pretty cute and now we really can't wait to rebuild our large fairy garden! Our fairies seem pretty happy for now though…
Now it's time to get those clothes clean! It was nice to know that I was going to get a great clean from my all® Fresh Clean Essentials™ and that my kids were able to just have fun being kids! It's a win/win for everyone!
Was it hard for you to get used to the messiness that comes with having kids? What's the biggest mess they've ever made? Please tell me it tops having blue paint splattered all over the wall!
Want to make a fairy garden of your own? You can find almost everything we used online:
If you liked this, you may also enjoy…
How To Create A Magical Fairy Garden


text:
Upcoming Speedy Ortiz Events
Discount Speedy Ortiz Tickets for sale! The Ticket Lodge has largest selection of cheap and premium tickets often including VIP Speedy Ortiz tickets and Speedy Ortiz Meet and Greet passes. As a discount supplier of Speedy Ortiz tickets, the Ticket Lodge can often offer the lowest prices around. Also be sure to check our list of Speedy Ortiz Promo Codes to save even more off our already low prices!
We are a resale marketplace, not the venue. Prices are set by sellers and may be above or below face value.
applied filters:


text:
Dancers and musicians combine to create a spectacular and authentic night of flamenco.
Two traditional singers bring alive the intensity, depth and raw energy of flamenco cante, while the company's superb dancers create flurries of impeccably controlled rhythms with hand claps, castanets and lightning foot taps. Paco Peña himself displays his sublime guitar technique across a dazzling array of solo and ensemble pieces.
Find out more about the rich variety of West End shows on offer in Theatreland.


text:
For those who love Narnia and are stimulated by the writing of Rowan Williams look out for The Lion's World: A journey into the heart of Narnia released today. The blurb on the Amazon website Amazon says the following: "Following the appearance … Continue reading →
Reflections on the bread of life – Sunday 5 August
"The bread of God is that which comes down from heaven and gives life to the world." This Sunday we reflect on the things which may truly satisfy and those which are more ephemeral. This poem by Seamus Heaney beautifully … Continue reading →
August Lordsbridge Life
You can download your copy here. This issue includes a poetic editorial from Corin together with news and events around the Lordsbridge villages.
Lordsbridge Life August 2012


text:
Use our thorough list of contract packaging companies and suppliers in Leading Manufacturers to examine and sort top contract packaging companies with previews of ads and detailed descriptions of each product. Any contract packaging companies can provide contract packaging services to meet your companies specific qualifications. An easy connection to reach contract packaging companies through our fast request for quote form is provided as well. This source is right for you whether it's for blister packaging, clamshell packaging, or any other contract packaging needs.
Companies Serving Near Leading Manufacturers
Advanced Concept InnovationsLakeland, FL | 863-688-1200
Advanced Concept Innovations is a contract packager offering kitting and assembly for medical devices. We understand the strict regulations and requirements for the medical field and can design a package that meets all standards. We also offer pouch packaging shrink wrapping, manual pouch sealing, flow wrapping, thermoform packaging and custom packaging with cleanroom controlled environments.$$$
Saddle Creek Logistics ServicesLakeland, FL | 863-665-0966, 888-878-1177
Saddle Creek is a third-party logistics company providing warehousing, transportation, packaging and fulfillment services. We leverage our broad array of capabilities to deliver integrated solutions that support our customers' business objectives. For more information, visit sclogistics.com.$$$
Versatile Packagers, Inc.Tampa, FL | 800-258-8308
Versatile Packagers currently provides a wide array of contract packaging services including, but not limited to, high speed blister packaging, high speed shrink-wrapping, clam shell packaging and other services such as labeling, UPC bar coding, gift set assembly, ink jet coding and more. Whatever product you need packaged, contact us today and allow our expertise bring success to your business.$$$
Contrapac, Inc.Altanta, GA | 877-854-3347
Are you a distributor or manufacturer looking for a contract packaging firm that bundles, kits, and packs (even liquid, granule, or powdered chemicals)? You found the right place. Custom packaging in the form of film pouches happens with us. We also have blending services, the ability to label and ship.$$$
CoregisticsAcworth, GA | 678-453-5900
Here at Coregistics, we know that customers depend on us to deliver the right combination of primary and secondary packaging and logistics solutions. We provide various contract packaging services including designing, sourcing, reconfiguration, customization, and distribution. We serve a variety of industries including health and beauty, high tech, pharmaceutical, food and beverage, automotive, confectionary, and more! If you would like more information about our products and services, please call us today or visit our website to learn more!$$$
Valk Industries, Inc.Greeneville, TN | 423-638-1284
With our longstanding history of being at the top of the market we are committed to bringing our customers only the best in quality, service and reliability. We will work with you from the first steps of the process all the way to the finished product that suits your needs. We are driven and strive to make your experience with us the best it could possibly be. Our contract packaging is among the best that the market has to offer!$$$


text:
Monthly Archives: June 2014
What is American Mortgage Pre Approval Plus?
Posted on June 2, 2014 by Michael Weaver in and Pre Approvals to buy Real Estate in Indianapolis
So, you are a Real Estate professional, and you have been selling homes for years. You know that when you get an offer, it is customary to accompany that offer with at least 2 other pieces of paper. You are looking for an Earnest money check, a copy will do, and you would like to […]
Tags:Pre approval plus
6855 N 200 W Greenfield Indiana- The Vearus Group Greenfield Realtors
Posted on June 1, 2014 by Michael Weaver in Greenfield Real Estate
This 4 bedroom country home has 4 acres of land that will absolutely be perfect for your next move. Greenfield Real Estate company, and first class marketing Realtors, The Vearus Group secured the best new listing in 46140 on Friday May 30th. Currently this is the best new real estate in Greenfield Indiana listed in […]


text:
Petrowsky, Barry Michael was born on January 16, 1950 in Chicago, Illinois, United States. Son of Alexander Michael and Mary Jane (Schultz) Petrowsky.
Petrowsky, Barry Michael was born on January 16, 1950 in Chicago, Illinois, United States. Son of Alexander Michael and Mary Jane (Schultz) Petrowsky.
Bachelor, Drake University, 1972. Master of Arts, Drake University, 1978.
Research intern State Office for Planning and Programming, Des Moines, 1970—1972. State highway safety program coordinator Planning and Programming Office, 1972—1974, assistant to director, 1974—1975. Deputy director development Iowa Lutheran Hospital, 1975—1976.
Stockbroker Radh Govinda Dickinson Company, 1976—1978, Iowa Capital Corporation, Des Moines, 1978—1979, Raymond Jones Investments, Des Moines, since 1981. Broker Hubbell Realty Company, since 1981. President Hubbell Securities Company, since 1981.
Board directors Iowa Student Loan Liquidity Corporation, since 1979, chairman finance underwriting committee, 1979—1984, president board directors, 1984—1985.
President board American Red Cross, 1976—1982. Board directors Boys Club Des Moines, 1975—1979, president board, 1978—1979. Director finance development Convalescent Home for Children, Des Moines, 1979—1981, coord, capital campaign, 1980—1981, president board, since 1981, Des Moines Zoo Foundation, since 1982, vice president, 1983—1984, East Des Moines Chamber of Commerce, 1984.
Precinct committeeman, member central committee Polk County Republican Party, 1974—1982, finance chairman, 1976—1978. Finance committee member Governor Ray Election Committee, Iowa, 1978, Republican State Central Committee, 1983. Board incorporators East Des Moines Improvement Association, 1975—1976.
Board directors Iowa Lutheran Hospital Development Council, Des Moines, 1978—1979, Iowa Hospice Organization, 1981, Convalescent Home for Children Foundation, since 1981, Luther Park Homes for Aging Foundation, Des Moines, 1983—1984, Des Moines Botanical Center, 1983—1984. Committee member Mitchellville Prison Advisory Committee, 1983. President, board directors Convalescent Home for Children Foundation, 1984—1985.
Member of Greater Des Moines Board Realtors, Million Dollar Club.
Married Dana Lee Brown, October 12, 1974. 1 child Todd Joseph.


text:
Tá an chuid seo den suíomh idirlín ar fáil i mBéarla amháin i láthair na huaire.
The NCTS allows you to submit and finalise your transit declarations by electronic means. The following countries can use NCTS:
You can connect into the NCTS system through Revenue's Online Services (ROS). Once you are connected you can:
For further information, see NCTS Traders Guide - Guide to assist traders in the use of NCTS.
The Import, Export and Transit Directory (IET) at OLAF (European Commission Anti-Fraud office) collects information on the movement of goods for customs purposes. This information is collected from NCTS.
The information collected usually refers to companies, but may also refer to individuals. You can find further information on the data collected by the IET in Privacy Statement for IET.
Revenue operates a helpline for queries on NCTS.
Published: 30 September 2019
Please rate how useful this page was to you
Print this page


text:
If you want to get started making your own unique fused glass jewellery, this is the taster course for you. Working mainly with System 96 Fusing Glass, you will develop a basic understanding of glass fusing, and consider the design process, experimenting with colour and shape to create distinctive pieces. You can expect to create a number of experimental glass pendants which will be fired in our electric kilns. Individuality will be encouraged throughout the day and you will be shown a number of techniques including how to apply metal inclusions and the process of layering dichroic glass to make your kiln glass jewellery really stand out!
There will be a maximum of 8 students to ensure individual attention.
This course runs regularly throughout the year. Please see our website for specific dates.
What does the course cover?
Your tutor will begin with an introduction to glass fusing, including cutting skills and technical information. This course is suitable for complete beginners so don't worry if you have never tried anything like this before!
Throughout the day students will experiment with dichroic glass, using metal wire and inclusions. The course will encourage students to think creatively about how the jewellery will be worn and students will be shown how to create holes and fittings incorporated as part of the fused piece and will also experiment with attaching fittings and bails.
We aim to give students a thorough taste of jewellery making skills, and the opportunity to try as many techniques as possible. There will also be a microwave kiln demonstration, which offers a low cost alternative to Kiln Firing that you can use at home. Course jewellery will be fired overnight using our excellent Kilncare Glass Kilns ready for you to collect the next day. Alternatively, we can post these out to you at no extra cost.
What do I need to bring?
Nothing but yourself and a sturdy pair of closed-toed shoes. All of your glass, materials and use of tools are included in the price.
We will provide a delicious cold lunch from Pret a Manger as well as light refreshments throughout the day. Please let us know in advance if you have any special dietary requirements. We will do our best to cater to everyone but this cannot always be guaranteed.
What are the course times?
The course starts at 10am and runs until approximately 4:30pm. There is a chance that it may overrun depending on progress.
We will try to make our courses accessible to all however if you have any disabilities or physical limitations of any kind we ask that you discuss it with us before booking.
For cancellations made 4 weeks in advance we offer a full refund or one free date change. For cancellations made 3 weeks in advance we offer a 75% refund or one free date change. For cancellations made 2 weeks in advance we can only offer a 50% refund. If we receive less than 2 weeks' notice we are unable to offer a refund or date change on course places. If a date change has been requested we cannot offer a refund on a subsequent cancellation.
If you will be redeeming a CraftCourses gift voucher on this course, the voucher code must be provided at the point of booking.
Everything is included in the course price. Materials, tools, lunch, refreshments and postage of completed work.
This craft course provider has been awarded Bronze status for receiving 1 or more 5 star ratings from previous students.
The Students' Choice award ensures that course providers get recognised for their efforts in the teaching and practice of UK craft.
They also allow tutors to gain valuable feedback on their courses and for new students to find the course that's right for them.
1 day
Available dates:
Share this course with your friends


text:
Nestled within Canberra's tightly held established suburb of Weetangera, 'Augustus' is an opportunity you dare not miss.
A boutique offering of only four townhouses, 'Augustus' is well-positioned in a quiet cul-de-sac. Close to excellent schools, major facilities and natural surrounds, 'Augustus' offers the perfect modern lifestyle balancing work and home. Each four-bedroom townhouse offers an endless list of desirable features, contemporary finishes and low maintenance living.
Want to know more?
Get in touch for more details about the overall development or specific properties available and one of our sales people will be in contact soon.


text:
By The Washington Post · Taylor Telford
November was a blockbuster month for Wall Street, as strong earnings and trade hopes yielded 10 record-breaking closes for U.S. indexes. The Standard & Poor's 500 is now up 25% for the year heading into a period that's typically high-performing for stocks. December could also bring progress on the trade front, as the terms of an agreement by the United States, Mexico and Canada could be finalized, while resolution on the first phase of a trade deal with China continues to flit in and out of reach.
The trade picture darkened Monday after President Donald Trump announced on Twitter that he would reinstate steel and aluminum tariffs on Brazil and Argentina. He accused the two nations of weakening their currencies to gain competitive advantage against the U.S., an oft-repeated rebuke that he's cited in his ongoing push for lower or even negative interest rates from the Federal Reserve.
"Brazil and Argentina have been presiding over a massive devaluation of their currencies. which is not good for our farmers," Trump said in Monday morning tweet. He then pivoted to the Federal Reserve, saying the central bank should "act so that countries, of which there are many, no longer take advantage of our strong dollar by further devaluing their currencies. This makes it very hard for our [manufacturers] & farmers to fairly export their goods. Lower Rates & Loosen - Fed!"
Stock futures had been trending up before Trump's early morning announcement. By midmorning, the Dow Jones industrial average had shed more than 200 points, or 0.7%. The Standard & Poor's 500 index was down 0.9% and the tech-heavy Nasdaq was down 1.4%.
"The President's tweets slapping import tariffs back on steel from Argentina and Brazil gave markets the jitters however as it is a reminder that the trade war will not be solved overnight," said Chris Rupkey, chief financial economist of MUFG Union Bank, in a note. "The stock market's early gains in the futures markets melted away after the President's early morning tweet. The President reminded us yet again he is a "Tariff Man" and this long trade battle with America's trading partners isn't over yet."
Futures markets had swung higher on trade optimism and signs of recovery in global manufacturing. Two surveys over the weekend showed that China's manufacturing sector rallied to an eight-month high in November, and European manufacturing data showed a better-than-expected easing in the sector's contraction. The strong data suggested that China's economy could be stabilizing after months of a brutal slowdown, quieting some fears about the trade war's toll on one of the world's most powerful economic engines.
Meanwhile, U.S. manufacturing disappointed in November, according to Monday's report from the Institute for Supply Management. Its manufacturing index dropped to 48.1% in November from 48.3% in October, coming in well below analyst expectations. Readings below 50% indicate business conditions are getting worse.
"Global trade remains the most significant cross-industry issue," Timothy Fiore, chair of the ISM's manufacturing business survey committee, said in the report.
Last week, Trump said that negotiators were in "the final throes" of sorting out a trade deal with China that would bring the first phase of resolution in the 16-month conflict. But over the weekend, China's state-run newspaper, the Global Times, reported that negotiators are optimistic about a deal before the Lunar New Year in January, but that rollbacks of tariffs are essential if a deal is to be reached,
On Friday, a top Mexican trade negotiator said that terms of a replacement for the North American Free Trade Agreement - one of the Trump administration's key goals - could be cemented early this week, fueling hopes that Congress could approve it before the end of 2019. The Trump administration reached an agreement with the governments in Canada and Mexico last year, but it must be approved by the House and the Senate before the changes can become official.
Trump's renewed tariffs on steel and aluminum dealt a surprise blow to one of Brazil's most crucial industries in a vulnerable moment for the economy, as unemployment hovers above 10% and growth continues to slow. Brazilian steel exports to the U.S. accounted for roughly $2.6 billion last year - making the U.S. one of Brazil's biggest markets for steel - and analysts expected the tariffs to be painful.
The flurry of potential trade activity is coalescing during what is typically a period of low volatility and high advances for stocks, said Sam Stovall, president of CFRA Research.
"Seasonal optimism typically gathers additional steam in the final month of the year as investors look to earnings projections for the coming year. Indeed, since 1945, the S&P 500 posted its best average return in December, along with the highest frequency of advance and lowest level of volatility," Stovall wrote in a note to investors Monday. "Trade relations, earnings estimates and valuations will likely influence trading this month, while the angle of ascent for U.S. economic growth, along with the presidential primaries, will garner additional attention as the new year progresses."


text:
Refine your search by choosing a brand and a year then press the view button.
Choose a Brand
Choose a Brand
Alliant Powder
Bee Stinger
Black Cloud
Buck Commander
Butler Creek
Champion Target
Duck Commander
Federal Premium
Gold Tip
M-Pro 7
Night Optics
Shooters Ridge
Simmons Mounts
Speer Ammo
Speer Bullets
Vista Outdoor
Choose a Year
ANOKA, Minnesota - July 18, 2019 - Federal Ammunition sponsored shooter Ashley Carroll wins her first ever International Shooting Sport Federation (ISSF) World Championship. The 24-year-old Californian edged her competitor from China in the finals to secure gold, her first world title in seven appearances at the championships held in Lonato, Italy. Her individual performance also propelled Team USA to the top of the podium in the women's team match that also included another Federal pro staff member in Kayle Browning. In winning the world title, Carroll becomes the first U.S. woman to earn a World Championship medal, along with the world title, since 1999. It's the first Trap medal for Team USA at a World Championship, men or women, since 2006.Federal Ammunition sponsored shooter Katie Jacob made her last year as a junior competitor count as she put fourth another fine showing at the 2019 World Championships, earning an individual silver medal and leading her team to a bronze medal in the process. No stranger to top-notch World Championship performances, it marks Jacob's fourth straight top-seven finish and her third Finals appearance in four tries. Serious shooters have long relied on Federal Gold Medal shotshells to dominate the competition in trap, skeet and sporting clay events worldwide. Year after year, Gold Medal rounds earn the respect of all levels of competitive shooters. The enhanced design of new Gold Medal Grand shotshells, introduced in 2017, builds on that tradition with less felt recoil, more reliable ignition, improved patterns, harder shot and maximum downrange power. The USA Shooting logo is also proudly displayed on boxes of Federal Gold Medal Grand.Federal is the official shotshell ammunition sponsor and supplier of USA Shooting, a non-profit organization that promotes the shooting sports and prepares American athletes to bring home Olympic gold. Learn more about USA Shooting at: www.usashooting.org. For more information on Federal ammunition, visit www.federal.com.
Shotgun Shooters on Team Federal Enjoyed Another Great Year of Success in 2019
Federal Ammunition launches "It's Federal Season" Podcast
Federal Congratulates All Sponsored Shooters on 'Team Federal' for a Great Year of Competition Success
Competition Shooter and Federal Ammunition Employee Casey Reed Finishes Strong at the USPSA National Championship
Federal Ammunition is the Official Ammunition of ACUI Clay Targets Program
Field & Stream Magazine Honors Federal Premium Black Cloud TSS as Best of the Best for 2019
Buckets of Federal's Award-Winning Syntech Range Ammunition Now Available
Federal Ammunition Sponsored Shooter Continues Winning Streak in the Tactical Division of PRS
U.S. Department of Homeland Security (DHS) Awards Federal Ammunition a Tactical Buckshot Duty Ammunition Contract
Federal's Industry-First Custom Shop for Ammunition Launches Online
Federal Ammunition and Ducks Unlimited Launch a Dedicated Partnership
Federal Ammunition to Launch Exclusive Line of MeatEater Ammunition
Federal Ammunition Sponsored Shooters Bring Home World Cup Medals
Federal Ammunition Sponsored Shooters Performing Great across the World
Win Federal Train + Protect Personal Defense Ammunition
Federal Ammunition Sponsored Shooters Shine at Skeet Trials
Federal Awarded $12.9 million MK311 Mod 3 Delivery Order
Sporting Arms and Ammunition Manufacturers' Institute Publishes Accepted 12-gauge 1 ¾-inch Cartridge and Chamber Designs
Federal's Bucks, Bulls & Blades Promotion Going Strong
Federal Strengthens Conservation and Youth Education Program Support with Dedicated Staff
Federal and CCI Sponsored Shooter Cole Busch Continues Strong in Steel Challenge Competitions
Federal's New 224 Valkyrie Loads Stretch Long-Range Horizons
Federal Introduces Syntech PCC for the Heavy Demands of Pistol Caliber Carbine Competition Shooters
Federal's New Upland Steel Loads Are Perfect for High-Volume Hunts
Federal Sponsored Shooter Kurt Miller Takes Home High Honors at the 2019 IPSC World Rifle Championships
Federal's New Shorty Shotshells: Big Performance in Small Packages
Los Angeles Police Department Selects Federal Premium Ammunition For Duty Use
The Gold Rush continues for Federal Sponsored Shooter Ashley Carroll
Federal Ammunition Sponsored Shooter is Ruling the Tactical Division of PRS
Federal Introduces Exclusive Buckmasters Bonded Centerfire Rifle Ammunition
Federal BYOB Buckets and Bottles Make a Party Out of Rimfire Range Time
Federal Ammunition Sponsored Trap Shooter Ashley Carroll Strikes Gold at World Championship
Federal Ammunition Continues Support of Kids & Clays
Federal and CCI are Proud Sponsors for the 2019 Scholastic Action Steel Program and National Championships
Competition Season Off to a Strong Start for Federal and CCI Sponsored Shooters
Federal Ammunition Continues Commitment and Support of Minnesota High School Trap Championship
Federal Presented International Hunter Education Association Volunteer Instructor of the Year Award
Federal Premium Law Enforcement Offers BallistiClean Frangible Slug & Buckshot
Hydra-Shok Bullets Now Available as Components
Federal Ammunition Sponsored USA Shooting Team Athletes Continue to Shoot Strong and Win Major Championships
Hydra-Shok Deep Takes 2019 Golden Bullseye Award for Ammunition Product of the Year
Federal Ammunition Joined the Golden Ring of Freedom at the 2019 NRA Annual Meetings & Exhibits
Federal Ammunition Makes Big Announcements at the 2019 NRA Annual Meetings & Exhibits
Federal to Host Hunting and Shooting Sports Celebrities at 2019 NRA Annual Meetings & Exhibits
Federal Premium Black Cloud TSS Hits Waterfowl Harder, Farther
New Syntech Defense Loads Produce Top Terminal Performance
Federal Adds 6.5 Creedmoor, 6.5 Grendel to Premium Unprimed Brass Lineup
Handloaders Can Make It Their Own With Fusion Component Bullets
Gold Medal Grand Plastic Loads Boost Performance on Clays
Federal Unveils New Top Gun Loads for Sporting Clays Shooters
Get Accuracy Through Any Rifle with Berger Hybrid Hunter Loads
Federal Makes Practice Powerful with Syntech Training Match
Sporting Classics Magazine Honors Federal Ammunition with Excellence Award
Federal Recognized as Today's Top Handgun Ammunition Brand
Popular Federal Premium Barnes Triple-Shock X Loads Return
Federal Ammunition Honored by NWTF with Corporate Achievement Award for More than 35 years of Continuous Support
Federal Introduces Premium HST 10mm Auto Load
Federal Adds 40 S&W, 45 Auto Premium Hydra-Shok Deep Loads
Toms Beware: Federal Expands HEAVYWEIGHT TSS Turkey Line
On Target Magazine Honors Federal Premium Hydra-Shok Deep with Editors' Choice Award
Meet the Expanded Family of Options for the Industry's Number One New Cartridge, 224 Valkyrie
NRA Shooting Illustrated Magazine Honors Federal Premium Hydra-Shok Deep with "2019 Ammunition of the Year" Golden Bullseye Award
Federal Ammunition Announces New Blended HEAVYWEIGHT TSS
Federal Launches New Syntech Ammunition Options
Federal Unveils 'New Look of Authority' with Logo and Packaging Changes
Federal Ammunition Will Launch 25 New Products at the 2019 SHOT Show


text:
Our Website Uses Cookies
We and the third parties that provide content, functionality, or business services on our website may use cookies to collect information about your browsing activities in order to provide you with more relevant content and promotional materials, on and off the website, and help us understand your interests and improve the website.
For more information, please contact us or consult our Privacy Notice.
Your binder contains too many pages, the maximum is 40.
We are unable to add this page to your binder, please try again later.
This page has been added to your binder.
- Home
- News and Insights
- News
- Covingtons Washington Office Awarded LEED Gold Certification
Covington's Washington Office Awarded LEED Gold Certification
October 29, 2015
WASHINGTON, DC, October 29, 2015 - The United States Green Building Council has awarded a Leadership in Energy and Environmental Design (LEED) Gold certification to Covington's CityCenterDC office space in Washington, D.C. CityCenterDC is the largest non-federal LEED Gold certified building for Interior Design and Construction in Washington, DC.
This prestigious designation is given to projects that implement practical and measurable strategies and solutions aimed at achieving high performance in sustainable site development, water savings, energy efficiency, materials selection and indoor environmental quality.
"We are honored to be recognized for the efforts we have made in our new space to improve the workplace quality while enhancing the efficiency of our space and lessening any negative impact on the environment," said John Waters, Covington's executive director. "This award is a reflection of our sustainable practices."
Covington's CityCenterDC offices include 450,000 square feet in two connected office towers and accommodate more than 1,100 Covington lawyers and staff. The office towers were designed by Foster + Partners and the interior design was created by LSM. The interior space reflects a cutting-edge and functional architectural approach.
The LEED rating system, developed by the U.S. Green Building Council, is the foremost program for buildings, homes, and communities that are designed, constructed, maintained, and operated for improved environmental and human health performance.


text:
Exchange Focus
CME Group: Adding Equity Index Futures to your Portfolio
November 2019
No matter your investment vehicle, as a standardized, liquid contract, Equity Index futures may make a strong addition to your portfolio. To help you understand how Equity Index futures can help you, we compare futures and options to alternative investment strategies for different investor types. Dive into the latest research to learn more about key features of Equity Index futures.
Further information:
If you would like further information, please contact CME Group.


text:
Stereotactic body radiotherapy (SBRT) requires rigorous accuracy and precision for delivering high radiation doses per fraction to small treatment volumes to improve tumor control and simultaneously reduce toxicity. Herein, we present a noninvasive and clinically convenient respiratory motion management protocol for SBRT for liver metastases.
The prognosis of patients with metastatic cancers has improved in the past decades due to effective chemotherapy and oligometastatic surgery. For inoperable patients, local ablation therapies, such as stereotactic body radiotherapy (SBRT), can provide effective local tumor control with minimal toxicity. Because of its high precision and accuracy, SBRT delivers a higher radiation dose per fraction, is more effective, and targets smaller irradiation volumes than does conventional radiotherapy. In addition, steep dose gradients from target lesions to surrounding normal tissues are achieved using SBRT; thus, SBRT provides more effective tumor control and exhibits fewer side effects than conventional radiotherapy. The use of SBRT is prevalent for treating intracranial lesions (known as stereotactic radiosurgery); however, it is now also used for treating spinal and adrenal metastases. Because of advancements in image-guided assistance and respiratory motion management, several studies have investigated the use of SBRT for treating lung or liver tumors, which move as a patient breathes. The results of these studies have suggested that SBRT favorably controls tumors in the case of moving lesions.
Four-dimensional computed tomography (4D-CT) with an abdominal compressor (AC) is clinically convenient for effective respiratory motion management. Because this method is noninvasive and allows free breathing, its use reduces complications. Furthermore, patients consider this method convenient. Moreover, it is considered more efficient than other methods of respiratory motion management by physicians and therapists. The use of 4D-CT with an AC for treating pulmonary lesions has also been widely investigated, and the technique is gaining acceptance for treating hepatic lesions. However, the protocols for using 4D-CT with an AC for treating hepatic lesions are different from those used for treating pulmonary lesions. In this article, we describe a new protocol for SBRT with 4D-CT and an AC for treating liver metastases.
Conventionally, metastasis is considered the terminal stage of cancer and is associated with poor prognosis and survival. However, Mountain et al. in 1984 reported that according to their 20-year experience, complete surgical removal of pulmonary metastasis results in a relatively higher survival rate if the primary tumor site is under systemic control at the time of surgery1. Hellman and Weichselbaum in 1995 first proposed oligometastases, an intermediate stage between localized lesions and systemic disease with polymetastases, which can be cured using additional local treatment2,3. Over the past decades, early detection of metastasis, novel surgical methods for treating oligometastases (metastasectomy), and effective chemotherapy have improved the prognosis in patients with metastasis. The liver is one of the most common metastatic organs for solid tumors, and surgical resection of hepatic oligometastases can improve survival. Local ablation methods, including radiofrequency ablation, radioembolization, and radiotherapy, for treating liver metastases have been recommended for some inoperable patients to achieve the necessary local tumor control3,4,5,6,7. In past years, several prospective and retrospective studies have reported effective local tumor control of hepatic metastases through stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy, with tolerable toxicity4,5,8,9.
Improvements have been made in patient positioning and immobilization methods; image acquisition, integration, and transfer to radiotherapy systems; respiratory motion management; high-dose output and fast radiation delivery; and steep dose gradients from target lesions to surrounding normal tissues. Because of these advances, SBRT achieves highly precise and accurate radiotherapy with minimal serious toxicity10,11. Respiratory motion management is fundamental to SBRT, particularly for hepatic and pulmonary lesions. A respiratory management technique that is noninvasive and clinically convenient would substantially increase the popularity of SBRT as a treatment option. This article details an SBRT protocol for liver metastases that uses four-dimensional computed tomography (4D-CT) with an abdominal compressor (AC) for image-guided assistance and liver motion management.
Subscription Required. Please recommend JoVE to your librarian.
Taipei Medical University Joint Institutional Review Board approval was obtained for this study.
1. SBRT Consultation
- Assess patient eligibility for SBRT for the treatment of liver metastases by consulting a multidisciplinary tumor board.
NOTE: The need for local ablation as well as operation and other treatment options must be evaluated by the tumor board. Our selection criteria were as follows: 1) adult patients with a good performance status (Eastern Cooperative Oncology Group 0-1), 2) controlled cancer status through anticancer medication and with only oligometastases in the liver, 3) number of hepatic lesions ≤3 and largest tumor ≤6 cm in diameter, 4) liver volume (liver excluding gross tumor) greater than 700 cm3, and 5) without acute hepatitis or chronic hepatitis B under stable antiviral control.
- Discuss SBRT and its associated risks as well as the differences between SBRT and conventional radiotherapy with the patient9,19.
2. CT Simulation
- Place the patient in a supine position, head-first on the couch with arms over the head.
- Use a system (e.g., BodyFIX) to immobilize the patient. Position the patient in a personalized, evacuated vacuum bag and cover the patient with a cover sheet.
- Apply an abdominal compressor (AC), and mark the depth of the AC.
NOTE: The AC restricts the patient's breathing motion; therefore, some patients may develop dyspnea during this procedure. Oxygen supplementation through the nasal cannula should be provided to relieve their discomfort.
- Place the breath-tracking sensor on the chest wall and monitor the respiratory waveform.
- Acquire CT images for radiotherapy treatment planning.
- Choose 4D-CT scan mode with a 3 mm slice thickness.
- Conduct a surview scan (120 kV, 30 mA) to obtain both anterior-posterior (AP) and lateral view of the patient. Click on "Go" on both the screen and the control panel.
- Determine the CT scanning coverage under "Helical scan" pagination and decide the scanning field of 4D-CT under "Pulmonary gating scan" pagination.
NOTE: The coverage of the helical scan should extend from the apex of both the lungs to a distance of at least 5 cm from the caudal border of the liver. The field of pulmonary gating scan, which is smaller than helical scan, should cover the liver with a 3-5 cm extend from both cranial and caudal borders of the liver.
- Monitor the respiratory waveform until it remains stable for 3 min.
- Inject 100 mL of contrast agent (e.g., Omnipaque), at a rate of 4-5 mL/s, through an 18 G i.v. catheter into antecubital vein.
- Conduct a contrasted contiguous helical CT scan (120 kV, 400 mAs/slice), 15 s after the contrast injection.
- Subsequently conduct a non-contrasted 4D-CT scan (120 kV, 2,000 mAs/slice) by clicking "Next Series".
3. Radiotherapy Treatment Planning
- Import images from the CT simulation and diagnostic scans into the planning system.
NOTE: Diagnostic images may include positron emission tomography (PET)/PET-CT, magnetic resonance image, or diagnostic helical CT scans.
- Contour metastatic tumors into gross tumor volume and adjacent organs at risk (OARs).
- Choose an organ (here, the stomach) and use the brush, pencil, etc. to contour the organ in each slice of the CT image. Circle or define the organ of interest. Use "Up" and "Down" buttons to view each image slice.
NOTE: The OARs include the lungs, stomach, duodenum, spinal cord, liver, small bowel, ribs, and kidneys.
- Choose an organ (here, the stomach) and use the brush, pencil, etc. to contour the organ in each slice of the CT image. Circle or define the organ of interest. Use "Up" and "Down" buttons to view each image slice.
- Contour the internal target volume (ITV) of the tumors according to organ motion observed on dynamic tracking images. Add a 5-mm margin to the ITV to obtain the planning target volume (PTV).
- Choose an organ (here, the stomach) and use the brush, pencil, etc. to contour the organ in each slice of the CT image. Circle or define the organ of interest. Use "Up" and "Down" buttons to view each image slice.
- Prescribe radiation doses of 48 Gy in three fractions or 35 Gy in five fractions to the PTV for relatively large tumors.
NOTE: A treatment plan must consider constraints due to the OARs; a relatively high prescription dose may be acceptable if the radiation dose to the OARs is within the constraints (Table 1).
4. Treatment Delivery
- Reconfirm the radiation beam data by using daily quality assurance and ensure that the data are within the normal range.
- Identify the patient using the patient's name, birth date, and ID card. Position the patient in the vacuum bag, place the cover sheet, and fix the AC according to the procedure described in the CT simulation section.
- Acquire a 4D cone-beam CT (CBCT) image and adjust the couch to correlate the target location obtained on the 4D-CBCT image to that obtained on the simulation CT images.
- Select 4D CBCT mode and confirm setup data. Click "Go" on the panel.
- After 4D CBCT, load the acquired 4D CBCT images into the IGRT system. The upper left and lower right images are from CT simulation as the contouring and treatment planning. The upper right and lower left images are from 4D CBCT, which is performed daily before each fraction.
- Use the software to adjust the set up. Then, manually adjust each parameter on the couch. The couch has only 3 linear motions in X, Y, and Z axes while the system could have adjustment in 6, including rotation, pitch and roll. Therefore, the technicians need to corroborate the adjustment.
- Record and print out the parameters for daily adjustment.
NOTE: If the tumor position shifts beyond the tolerance limit of 5 mm on any one of six axes, the patient should be repositioned.
- Deliver radiation treatment. Confirm treatment plan and the system configuration. Click Go to start the treatment. Monitor the patient using real-time cameras during the entire treatment to ensure patient safety.
Subscription Required. Please recommend JoVE to your librarian.
Representative Results
SBRT can be implemented by intense-modulated radiotherapy (IMRT) (with 6 radiation beams) or volumetric arc radiotherapy (VMAT) (with continuous dose delivery and gantry rotation) to cover all targets in a single treatment because a single surgery may not achieve removal of all the tumors. A representative SBRT treatment plan demonstrated successful radiotherapy planning for two hepatic metastatic tumors when surgery was infeasible. The two metastatic tumors were 3cm (from segment 4 to segment 8) and 4.3 cm (in segment 8) in length, and their volume were 13 cm3 and 22 cm3, respectively. The prescribed dose was 50 Gy in 5 fractions and the beams were directed to avoid the OAR (Figure 1A-C). The sophisticated treatment plan consisted of four partial beam arcs namely 180° to 50°, 260° to 50°, 335° to 35°, and 50° to 180° (Figure 1D). Dose-volume histograms show the coverage over both the tumors, with 100% of the volume of the PTVs covered by >95% of the prescribed dose; the radiation doses to the OARs were within the constraints (Figure 2).
|3 fractions
|5 fractions
|normal liver volume1,2
|>700 cm3 at <15 Gy
|mean <15 Gy
|Stomach, duodenum, small bowel
|D 3 cm3 at <21 Gy
|D 0.5 cm3 at <32 Gy
|Both kidneys
|V 15 Gy at <35%
|mean <12Gy
|Spinal cord
|D 1 cm3 at <18 Gy
|D 0.5 cm3 at <28 Gy
|D 1 cm3 at <30 Gy
|V 32 Gy at <15 cm3
|Both lungs
|V 12.4 Gy at <1,000 cm3
|V 11.4 Gy at <1,000 cm3
|D 30 cm3 at <30 Gy
Table 1: Recommended dose constraints for the organ at risk (OARs). PTV: planning target volume. OAR: organ at risk.1 total liver volume - cumulative gross tumor volume.2 The normal liver volume is suggested to be >700 cm3.
Figure 1: Dose distribution (A-C) and beam direction (D). The purple and light blue lines indicate the planning target volume, whereas the yellow and pink line indicate 50 and 30 Gy, respectively, in (A-C). Please click here to view a larger version of this figure.
Figure 2: Dose-volume histograms. Planning target volume (PTV)1 and PTV2 are colored in purple and light blue. The organs at risk include the normal liver (orange), rib (light pink), Heart (yellow), left lung (fluorescent green), right lung (pink) and spinal cord (ocean blue). Please click here to view a larger version of this figure.
Subscription Required. Please recommend JoVE to your librarian.
Respiration-induced liver deformity and organ motion contribute to the difficulties associated with radiation delivery, as well as contouring (target delineation) problems. Improvements in the techniques used for organ motion management have led to improvements in treatment accuracy and precision, which is fundamental to SBRT. Several image-guided techniques and respiratory motion management systems are currently available. Fiducial marker implantation is a common technique for target localization. A fiducial marker is usually a cylindrical gold seed, 2.5 to 5 mm in length with a diameter of 0.8 mm. Implanting a fiducial marker near a lesion enables X-ray-based image-guided systems to localize targets. However, complications associated with using fiducial markers, including internal bleeding, fever, pain, dislocation, and infection, have been reported in >30% of patients. Patients' acceptance of the invasive procedure is another concern12. Furthermore, the air breath coordination (ABC) and deep inspiration breath-hold (DIBH) technique are regularly used for image-guided radiotherapy; these noninvasive breath-control systems are designed to help patients hold their breath, thus immobilizing the target during radiation therapy. Despite patient training before treatment, however, prolonged treatment time for each fraction, difficulty in breathing, and individual medical conditions have limited the use of ABC and DIBH13,14.
The accuracy of respiration-correlated CT and 4D-CT assisted using an AC for pulmonary SBRT has been widely demonstrated15,16. Several recent studies have discussed the use of this technique for respiration-associated liver motion. Takahashi et al. suggested 4D-CT scans with an AC achieve substantial respiratory motion management and reduce the PTV margin to <5 mm16. In addition, dosimetric evaluation for liver SBRT with 4D-CT integration has been addressed17. Shimohigashi et al. recently reported that 4D-CT with an AC accurately represented tumor motion during SBRT18. The use of 4D-CT with an AC is more advantageous than that of other respiratory motion management techniques because the technique is noninvasive and allows free breathing. Moreover, patients consider this technique more convenient than other management techniques. Physicians and therapists may also benefit from this technique because it creates a convenient work flow. Some recent studies have reported the use of 4D-CT with an AC as a respiratory management technique during SBRT for liver metastases19,20,21. Patients need not hold their breath when 4D-CT with an AC is used (unlike during patient training when DIBH or ABC is used); hence 4D-CT with an AC is considered convenient and is consequently commonly used in SBRT for the lung and liver. However, it should also be emphasized that the protocol of 4D-CT with an AC in liver motion management is different from that used to treat pulmonary lesions.
First, although the image quality of a planning CT scan is still not as high as that of a diagnostic CT scan, we still suggest that contrasted CT enables accurate tumor contouring. Unlike SBRT for the lungs, pulmonary lesions can be easily distinguished from normal lung tissues on CT images of the lungs. However, in noncontrasted liver images, normal and malignant tissues cannot be easily distinguished. Second, daily 4D-CBCT for verification of tumor positions before treatment is essential for significantly increasing the intrafractional accuracy; 3 mm of the PTV margin was previously considered adequate with daily 4D-CBCT scans (although we still comply with the 5 mm of PTV margin criterion)18.Third, a slow CT scan or a cine CT scan should be performed under free breathing. The tumor from all phases of the 4D-CT dynamic tracking images can be contoured as the ITV for tumor motion, while the AC limits organ motion to reduce the irradiation volume. Moreover, radiation dose to the lung should be evaluated. Hepatic lesions close to the diaphragm can result in an increased radiation dose to the lungs. Radiation pneumonitis is a common complication; however, grade I radiation pneumonitis is usually asymptomatic. Dose constraints and CT scans of the entire lung should not be neglected.
Historically, conventional radiotherapy for hepatic carcinomas had minimal curative benefit. However, the liver has a relatively low tolerance for radiation doses, and radiation-induced liver disease (RILD) can be lethal. Although some studies have suggested pretreatment evaluation for preventing RILD during irradiation of hepatocellular carcinomas22, the treatment of hepatic lesions using conventional radiotherapy must be administered with caution. SBRT provides improved tumor control with minimal serious complications; however, only a few studies have reported risk evaluation for preventing RILD while using SBRT for treating liver metastases. Moreover, the eligibility criteria of patients for receiving SBRT for liver metastases are not clearly defined, although some common criteria have been reported in some studies4,5. Our selection criteria were as follows: 1) adult patients with a good performance status (Eastern Cooperative Oncology Group 0-1), 2) controlled cancer status through anticancer medication and with only oligometastases in the liver, 3) number of hepatic lesions ≤3 and largest tumor ≤6 cm in diameter, 4) liver volume (liver excluding gross tumor) greater than 700 cm3, and 5) without acute hepatitis or chronic hepatitis B under stable antiviral control. The histopathology of the original cancer did not have to be limited to the colorectum, breasts, and lungs, but these sites were preferred. A multidisciplinary tumor board discussion is required in the proposed protocol, and an operation should be the first option. Other local ablation therapies may be discussed by the tumor board, and final treatment is based upon the patient's decision.
Although local ablation including SBRT can achieve local tumor control and using 4D-CT with an AC can facilitate motion control, survival and progression-free intervals critically rely on the anticancer effects of chemotherapy, target therapy, or other systemic medications. In other words, without proper systemic control, even the most suitable local ablation therapy will not provide any overall benefit. Therefore, reviewing the effects of systemic therapy facilitates the selection of a local ablation therapy. Furthermore, the correlation between control of oligometastases and progression-free survival or overall survival still requires further investigation. Different factors, such as location and number of oligometastases, histopathology of the original cancer, or therapy-naivety of the patient, may have an effect on outcomes23. Despite the aforementioned limitations, SBRT, which is noninvasive and is as clinically convenient as 4D-CT with an AC for respiratory motion management, provides a considerable local ablation effect for liver metastases.
Subscription Required. Please recommend JoVE to your librarian.
The authors have no disclosures.
This research was supported by Taipei Medical University Hospital (106TMUH-NE-02).
|Catalog Number
|CT scan
|Brilliance Big Bore 16 Slice CT, 7387
|Acquire CT images for contouring and planning
|CT contrast
|GE Healthcare
|Omnipaque 350 mg L/mL
|Enhence lesion in CT images
|Linear accelerator
|Deliver radiotherapy
|Palnning system
|Pinnacle 9.8
|Implement radiotherapy planning
|Immobilization: BlueBag BodyFix
|900 mm x 2325 mm, P10104840
|Immobilize the patient
|Immobilization: BodyFix Cover sheet
|2700 mm x 1400 mm, P10102-304
|Immobilize the patient
|Immobilization: BodyFix abdominal compressor
|diaphragm control, P10102-149
|Restrict breath motion and organ/lesion motion
|Immobilization: vacuum pump
|vacuum pump, p2 120V, P10102-110
|Shape body bag and cover sheet according to the patient
- Mountain, C. F., McMurtrey, M. J., Hermes, K. E. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg. 38, (4), 323-330 (1984).
- Hellman, S., Weichselbaum, R. R. Oligometastases. J Clin Oncol. 13, (1), 8-10 (1995).
- Weichselbaum, R. R., Hellman, S. Oligometastases revisited. Na. Rev Clin Oncol. 8, (6), 378-382 (2011).
- Comito, T., Clerici, E., Tozzi, A., D'Agostino, G. Liver metastases and SBRT: A new paradigm? Rep Pract Oncol Radiother. 20, (6), 464-471 (2015).
- Scorsetti, M., Clerici, E., Comito, T. Stereotactic body radiation therapy for liver metastases. J Gastrointest Oncol. 5, (3), 190-197 (2014).
- Shady, W., et al. Percutaneous Radiofrequency Ablation of Colorectal Cancer Liver Metastases: Factors Affecting Outcomes--A 10-year Experience at a Single Center. Radiology. 278, (2), 601-611 (2016).
- van Hazel, G. A., et al. SIRFLOX: Randomized Phase III Trial Comparing First-Line mFOLFOX6 (Plus or Minus Bevacizumab) Versus mFOLFOX6 (Plus or Minus Bevacizumab) Plus Selective Internal Radiation Therapy in Patients With Metastatic Colorectal Cancer. J Clin Oncol. 34, (15), 1723-1731 (2016).
- Salama, J. K., Milano, M. T. Radical irradiation of extracranial oligometastases. J Clin Oncol. 32, (26), 2902-2912 (2014).
- Rusthoven, K. E., et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 27, (10), 1572-1578 (2009).
- Ricardi, U., Badellino, S., Filippi, A. R. Clinical applications of stereotactic radiation therapy for oligometastatic cancer patients: a disease-oriented approach. J Radiat Res. 57, (Suppl 1), i58-i68 (2016).
- Wild, A. T., Yamada, Y. Treatment Options in Oligometastatic Disease: Stereotactic Body Radiation Therapy - Focus on Colorectal Cancer. Visc Med. 33, (1), 54-61 (2017).
- Gill, S., et al. Patient-reported complications from fiducial marker implantation for prostate image-guided radiotherapy. Br J Radiol. 85, (1015), 1011-1017 (2012).
- Eldredge-Hindy, H., et al. Active Breathing Coordinator Reduces Radiation Dose to the Heart and Preserves Local Control in Patients with Left Breast Cancer: Report of a Prospective Trial. Pract Radiat Oncol. 5, (1), 4-10 (2015).
- Swanson, T., et al. Six-year experience routinely using moderate deep inspiration breath-hold for the reduction of cardiac dose in left-sided breast irradiation for patients with early-stage or locally advanced breast cancer. Am J Clin Oncol. 36, (1), 24-30 (2013).
- Sweeney, R. A., et al. Accuracy and inter-observer variability of 3D versus 4D cone-beam CT based image-guidance in SBRT for lung tumors. Radiat Oncol. 7, 81 (2012).
- Takahashi, W., et al. Verification of Planning Target Volume Settings in Volumetric Modulated Arc Therapy for Stereotactic Body Radiation Therapy by Using In-Treatment 4-Dimensional Cone Beam Computed Tomography. Int J Radiat Oncol Biol Phys. 86, (3), 426-431 (2013).
- Yeo, U. A., et al. Evaluation of dosimetric misrepresentations from 3D conventional planning of liver SBRT using 4D deformable dose integration. J Appl Clin Med Phys. 15, (6), 4978 (2014).
- Shinmohigashi, Y., et al. Tumor motion changes in stereotactic body radiotherapy for liver tumors: an evaluation based on four-dimensional cone-beam computed tomography and fiducial markers. Radiat Oncol. 12, 61 (2017).
- Goodman, B. D., et al. Long-term safety and efficacy of stereotactic body radiation therapy for hepatic oligometastases. Pract Radiat Oncol. 6, (2), 86-95 (2016).
- Scorsetti, M., et al. Is stereotactic body radiation therapy an attractive option for unresectable liver metastases? A preliminary report from a phase 2 trial. Int J Radiat Oncol Biol Phys. 86, (2), 336-342 (2013).
- Andratschke, N. H., et al. Stereotactic radiation therapy for liver metastases: factors affecting local control and survival. Radiat Oncol. 10, 69 (2015).
- Huang, R., et al. Clinical parameters for predicting radiation-induced liver disease after intrahepatic reirradiation for hepatocellular carcinoma. Radiat Oncol. 11, (89), (2016).
- Huang, F., Wu, G., Yang, K. Oligometastasis and oligo-recurrence: more than a mirage. Radiat Oncol. 31, (9), 230 (2014).


text:
Portuguese twice a week - Hosted By Iberlinguas Language School
Add Review Viewed - 173
Promo Video
If you live in Lisbon and have the time to learn Portuguese more peacefully, our Portuguese course twice a week is perfect for you.
Duration: 10 weeks, 40 hours.
Timetable: lessons take place on Tuesdays and Thursdays. You can choose to attend a morning or evening course.
Group Size: up to 8 participants in a course.
The course is available for all levels
Add Reviews & Rate
You must be logged in to post a comment.
Price / Claim :
Price : € 300,00


text:
Festooned Hand Mirror - alias Louis Jackson - show some teeth.
Shaking about with Tin Smoke Box (Alex Cooper) and drummer Red Oak Frame (Jeremy MacCuish).
Box on the board.
More hair-shaking!
Red rocks the beard.
Festooned sings!
Singalong action!
Guitar action!
Overhead action!
Percussion action!
Box works the crowd.
Bumping action!
A wild and hectic show. The band is making their way through France right now.
- Show reminder: The Swingers, We Surrender and The Termites play Zaphod Beeblebrox.


text:
Charly Bliss are a band composed of four long time friends who went to high school together. They describe their sound as "the finest guitar-crunched power pop this side of an old Weezer record with a blue cover" and "a candy-scented safe space for extreme fits of happiness and angsty teen-level explosions of romantic ennui." Whether you're able to decode this or not, we do know one thing – you'll find their songs brimming with infectious and irresistible melodies paired with honest, storytelling lyrics. Whatever you want to call it, it's simply awesome.
We spoke with Spencer Fox, who takes up guitar and backing vocal duties, and found out more about how they got their band name, their influences and life on the road.
Tell us the story behind the name Charly Bliss?
We were killing ourselves trying to think of a band name for months and months, then one night Eva was at a party when someone who happened to be named Charlie Bliss suggested we name the band after him. We added the "y" to avoid identity theft and it stuck.
Who are some of the biggest musical influences that have shaped the sound of the band.
Recently, we've drawn a ton of inspiration from Lorde and Superorganism. Both of these artists make super fun and concise pop music without ever sounding contrived, and I think that's something that we've always tried to hone in on.
Can you tell us a little bit about your approach to the songwriting process?
One of us will come to the group with a demo that ranges anywhere from 5-95% done, and then the four of us all work collaboratively to finish it. For instance, songs like Glitter and Black Hole both started out as simple melodic lines that Eva wrote, and then the four of us worked together to turn that initial idea into a fully fleshed out song.
What was the moment that made you want to be a musician?
I wish I could give a cooler answer but honestly, the Live at Slane Red Hot Chili Peppers concert DVD. I get that they can be a goofy band sometimes, but John Frusciante's guitar playing is something that I will defend until the day I die. I was super into Eddie Van Halen and Yngwie Malmsteen for the longest time, but once I heard John Frusciante play solos that were like three notes long and just as compelling as all the shreddy stuff, it totally recontextualized the way I thought about guitar playing and made it much more interesting to me.
What are some of the most valuable lessons you've learned while on tour?
Patience is always rewarded and Whole Foods will save your life.
What's one piece of music gear you cannot live without on tour?
As far as I am concerned, the most crucial piece of equipment I have is my t1m Pearl. It used to belong to Eva and I more or less accredit the entirety of my live sound to that one pedal. It's a two-stage distortion, and I'm not really sure if it's modeled after anything in particular, but it's incredibly versatile. The first stage of distortion has a really nice AC30-ish bite to it, and then with the second stage kicked in it gets totally blown out.
If you could collaborate with one musician/artist, who would you pick and why?
Judee Sill!!! Her songwriting baffles me. I've been trying to learn her piano parts on guitar lately and it has resulted in a lot of hand cramps and made me realize how little I actually know about music theory. Her music sounds so intuitive and natural, but it's all very complex and out there. I want to know how she does it!
What MONO gear do you use at home, in the studio or on tour?
The MONO Dual is a total monster. It's incredibly light and being able to store two guitars is insanely convenient, especially while you're flying.
What are the big plans we can look forward to for the rest of the year?
You can catch us on tour this May with Skating Polly!!!
To find out more about Spencer's MONO Dual Case, click here and see our full catalogue here.


text:
ICMI is part of the Informa Tech Division of Informa PLC
This site is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.
Watch the webinar video below.
Let's talk CX Metrics: the right mix, dashboards, and leveraging the data.
According to 2018 ICMI Research, customer experience strategy is a top priority for contact center leaders this year. The challenge? Determining which KPIs to use to track success, and interpreting all the data already available to drive meaningful results.
Join us on March 20 as we walk you through the ins and outs of CX metrics, and help you discover new ways to understand even the most complex customer feedback. We'll also show you how the contact center can deliver actionable insights that will fuel success across the rest of the business.
During this webinar, you will learn:
Join us for an interactive and informative hour, filled with practical tips, and complete with live audience Q&A.
Reserve your spot!
Shorit is VP of North America Services at Clarabridge. He manages a team of consulting managers, business consultants and technical architects to help his customers improve their own customer experience, increase revenue and reduce cost and churn.
ICMI/UBM Privacy Statement
Best Practices, Strategy, Maturity


text:
Buy Natural Stress Solutions CBD Deodorant
Natural Stress Solutions CBD Deodorant
CBD Natural Deodorant is an efficient solution to fight the undesirable odor without harming the body. 100% organic ingredients provide you with effective results and are completely non-toxic. Natural CBD elements possess strong antibacterial properties, and since the bacteria are the source of the bad odor, CBD effectively removes the undesired scent. In their turn, natural oils of cypress, tea tree, rosemary and neem take gentle care of the skin by nourishing, soothing and protecting it from irritation. And such ingredients as sweet almond oil, beeswax and cocoa butter nourish the skin with vitamin E and zinc. CBD deodorant is exactly opposite to typical antiperspirants available on the market. Antiperspirants block skin pores with the aluminum salts and thus stop the release of toxins and waste products out of the body. In contrast, CBD deodorants remove the unpleasant odor by neutralizing the bacteria found in sweat.
The rating of 4.9 stars based on 364 reviews.
Price from 45.2 Per unit
Follow this link to Order Natural Stress Solutions CBD NOW!
cbd dosage for anxiety
how to use cbd oil for anxiety
cbd without thc benefits
cbd dosage for cancer
best cbd oil for vaping
- cbd cream – cbd cream
- cbd in hemp
- cbd health benefits for men
- where can i buy cbd hemp oil near me
- how to use cbd oil for pain topical
- cbd mental health benefits
- using cbd for cancer dosage
- 1000mg cbd vape oil reviews
- nuleaf cbd oil drug test
- pets alive cbd drops review
how long does cbd oil stay in your system reviews
what is cbd oil side effects
cbd pills for pain and inflammation
cbd powder uk
cbd interactions with vitamins
cbd drops for depression and anxiety
cbd oils canada
cbd tincture drops side effects
buy cbd oil at walmart
cbd hemp oil ÷òî ýòî


text:
Dodi Tal Trek in Uttarakhand
|Translate this page in your own language.
Home / Dodi Tal Trek
Dodi Tal lake trek in Himalayas is almost a pilgrim trek as this lake is very sacred to Hindus - like several other lakes of Uttarakhand. It is relatively easier trek, but there is no dearth of natural beauty all through the trek. You will also be able to witness the remote Indian culture taking you back in history.
Write to us or call to get more information on Dodi tal lake trek.
Also visit Roopkund lake Trek page
Trek to Dodi Tal
Dodi Tal trek statistics
Trek Route: Uttarkashi- Bewada - Mangi - Dodi tal - Darwa Top - Bewada - Uttarkashi
Trek Grade: Easy


text:
Spletna cena: 12,59 EUR
Redna cena: 13,99 EUR
Avtor: Bosing, Walter
Prevod: —
Področje: Art
Serija: Basic Art
Založba: Taschen
Vezava: trda
Format: 21 x 26 cm
Obseg: 96 strani
If Hieronymus Bosch (1450-1516) remains an enigma today, it is little wonder. Even his contemporaries found the Dutch painter's work difficult to decipher—and it still presents riddles to contemporary art historians.
Part of the problem in decoding his shocking and richly allegorical paintings is that virtually nothing is known of the artist himself, apart from his birthplace. There is no record of his life or training, no personal letters, diaries or notebooks, and no contemporary insights into his personality or thoughts on the meaning of his art. Even his date of birth can only be guessed at, and that based on a drawing assumed to be a self-portrait, made shortly before his death in 1516, which supposedly shows the artist in his late sixties. Bosch remains as mysterious as the worlds he painted.
Although rooted in the Old Dutch tradition, Bosch developed a highly subjective, richly suggestive formal language. With a mixture of religious humility and satanic wit, he illustrated both the joys of heaven and the cruelly imaginative tortures of hell. In his pictorial world teeming with surrealistic nightmares, the medieval imagination catches fire in a moment of final brilliance before succumbing to humanism and modern rationalism. Though the man himself remains a mystery, this book pulls together the elusive threads of Bosch's entire oeuvre into a cohesive and comprehensive analysis of his visionary work and methods.
Za pravilno delovanje tega spletišča se včasih na vašo napravo naložijo majhne podatkovne datoteke, imenovane piškotki. To se zgodi na večini večjih spletišč. Več o piškotkih


text:
Saudi Arabia to cut November crude prices to Asia
15:00, 02 October 2015Economy
145 0
Saudi Arabia is expected to cut the prices of crude it sells to Asia in November after the Dubai benchmark weakened last month, according to Reuters.
Please Subscribe For Full Access
UNIAN Web subscription
Get a complete information picture of the day by subscribing to UNIAN's news feeds.
For more information, please call:
+38 (044) 354-28-06
If you see a spelling error on our site, select it and press Ctrl+Enter


text:
This site is part of the Informa Tech Division of Informa PLC
This is operated by a business or businesses owned by Informa PLC and all copyright resides with them. Informa PLC's registered office is 5 Howick Place, London SW1P 1WG. Registered in England and Wales. Number 8860726.
As in every sector of US life, the telecoms industry is trying to work out what the shock election of maverick candidate Donald Trump to the presidency will mean for its operators and suppliers.
There are few clues, of course – telecoms, even broadband, were not major campaign issues; Trump obviously has no track record of voting on these matters. But some of his stated intentions, if he follows through in policy, would deeply affect this industry, including trade barriers with China or Mexico. And like any new president, he will have a direct impact when a new Federal Communications Commission (FCC) is appointed.
Aneil Rakity, managing director at consultancy Ovum, wrote in a column: "In the short term, there will be a general slowdown of major decisions in capital and investment by US and international firms as they wait to get a better understanding of the new administration's trade, tax, immigration, and foreign policy … The uncertainty will last for at least the next six months, and it won't be until mid-2017 that Trump starts to share more about these topics and proposed changes to policy."
Read the full article here.


text:
23 May This Højskole is really amazing!
I started study here this January.
It was very impressive to see how people here improved their skills in very short period and got strong confidence. Also how people achieve their goal by working hard and supporting each other is very heartwarming.
I am studying electronic music here.
It was very big decision to come here from Japan.
Since I was very beginner of electronic music, I was a bit worried how much I can improve my skills by studying here only for half year.
But result is amazing! I have never expect this massive improvement.
It is even magical for me.
This is all because of amazing teachers and also my class mates here!
Without their help I could not be able to make music!!
Also nice thing about this Højskole is: you can also take classes from another lines as elective subjects.
You can try many things you have never experienced. It is super fun and inspiring!
All teachers has great teaching method, you will have very precious experience. All of them are super cool, friendly and helpful.
I just would like to say that I am very happy to be here and appreciate everyone in this Højskole.
I have learnt so many things here.
If you are thinking of study here I definitely recommend it!
I also decided to take one more semester here. So you might be my Højskole mate!
Eisaku, Japan spring semester 2018 and autumn semester 2018 – electronic music


text:
The Harley-Davidson Street Rod 750 is based on the brand's entry-level model, the Street 750. However, the Street Rod makes more power and torque than the regular Street while also looking sportier.
The motorccycle is priced at Rs 6,55,000 ex-showroom (Delhi) and showcases good performance and a unique riding experience.
Here's a walkaround of the Harley-Davidson Street Rod 750, explaining its features and details.
#HarleyDavidson #HarleyDavidsonStreetRod #StreetRod #HarleyDavidsonIndia #StreetRod750 #DriveSparkReviews #DriveSpark


text: What is Gastrectomy?Gastrectomy is a surgery to remove a portion or the entire stomach. Gastrectomy is performed to treat cancer, non-cancerous tumors, and bleeding and inflammation of the stomach due to ulcers.For the surgery, a urinary catheter is used to monitor urine output. A nasogastric tube is inserted from the nose to the stomach, and an antiseptic solution is used to clean the abdomen.The surgery is performed by making a cut in the abdomen, and a portion or the entire stomach is removed depending on the cause of the surgery.What are the different types of Gastrectomy?The different types of Gastrectomy are as follows:Partial GastrectomyIn partial gastrectomy, only a part of the stomach is removed depending on the ailment. The small intestine may be required to be re-attached to the remaining stomach.Total GastrectomyIn total gastrectomy, the whole stomach is removed depending upon the ailment. The small intestine may need to be connected to the esophagus.Traditional Open SurgeryTraditional open surgery is usually the method by which gastrectomy is performed. A large incision is made in the abdomen just below the breast bone to the navel to conduct the surgery.Laparoscopic SurgeryIn a laparoscopic surgery a small incision is made through which a laparoscope is inserted. A tiny video camera is attached to the laparoscope that makes it possible for the surgeon to view the abdominal contents on a monitor. The surgery is performed through the small incision. However, this type of surgery is limited because it can only treat patients with early gastric cancer or for surgeries that are performed to relieve pain rather than fully cure the disease.What are the preoperative preparations?The patient needs to undergo some tests prior to the surgery which may include: X-ray CT scan Ultrasound Urinalysis Blood test ElectrocardiographySome medications that the patient may be taking are discontinued many days before the surgery.There are some medications that should be avoided a week before the surgery.The stomach should be empty before the surgery to prevent vomiting.Patients should stop eating solid or liquid food since the night before the surgery.How much time is required?Surgery will last 1 to 3 hours and patient will remain 7-10 days in hospital.What type of anethesia will be given?General anesthesiaHow will patient recover?After the surgery, the patient is taken to the post-anesthesia care unit to be closely monitored until the anesthesia wears out. The patient is not allowed to eat or drink immediately after a surgery. Oxygen is given through a mask or nasal prongs. The intravenous line, urinary catheter and nasogastric tube remain attached to the patient. Pain medicine is provided intravenously. The nasograstric tube that keeps the stomach empty is kept attached to the patient until bowel functions return, which indicates healing. This takes 2 to 3 days. The urinary catheter is removed 1 or 2 days after food and liquids are taken by the patient. The process of recovery is gradual. Full recovery may take several weeks or a few months.What should be cared?Postoperative complications can be prevented by getting out of bed and moving around. Movement is required to help in: o Blood circulation o Reducing blood clot o Normalizing bowel function o Lowering the risk of lung infection - Prescribed pain medication should be given to the patient to get relief from post surgery pain. - To get relief from dumping syndromes, the patient needs to eat several small, frequent meals in a day. - Diet should be higher in protein than carbohydrates. - The doctor needs to be informed if vomiting and diarrhea worsen. - Vitamin B12 may be supplemented with regular injections


text:
We did not find results for scifi. Try the suggestions below or type a new query above.
Did you mean sci fi
- Check your spelling.
- Try more general words.
- Try different words that mean the same thing.
- Try asking a question on Yahoo Answers
- For helpful tips on searching, visit the Yahoo Search Help Center.


text:
Valentine's Day is on the way! It's the season of sharing our love with others (which is year round really, but you get the image I'm creating here right?!), and what do I love? SCIENCE! So, here are some fun STEM challenges to share with the ones you love this season. Cupid has been working … Continue reading Cupid Needs Help!
Category: Engineering
Old is New Again
I am a sucker for a DIY project and summer is my time to indulge! This table was passed down to me and was once my parents first piece of furniture. I have memories of working on my homework while my mom prepped dinner, checking in to see if I needed any help. My husband … Continue reading Old is New Again


text:
Balanced education consists of knowledge in the mind, honesty in the heart, and strength in the body, a true human being is an educator not by words alone but by being an example"- these words of Jhoon Goo Rhee highlight the importance of comprehensive learning and practical education in daily life. Listed among the top 10 residential schools in Odisha, Aparna World School is ensuring all-round development of its students beyond books and classrooms. A person's behavioral traits and outlook towards life is as much a mirror of his personality as his intellectual capabilities.AWS is pushing all boundaries and norms to build a better career and character of the students reflecting their upbringing, values and tenor.
Aparnaa World School is one of the popular boarding schools in Odisha. That makes sure that no matter what their age, students should be able to hold conversations with people from every walk of life. They get more opportunities to pursue their interests in different fields and discover their talents. AWS is among the few good boarding schools in Odisha that is actually dedicated and has summoned its campus for many co-curricular avocations and student activity centers.
Parents & Teachers meeting held on 08.03.19
The school has many societies and clubs for activities like dancing, singing, literature, heritage, dramatics supported by infrastructure like practice arena, club rooms, amphitheaters, etc for the budding talents. Being among the most popular boarding and in between top 10 residential schools in Odisha, AWS's hostels are equipped with every amenity and service for a safe and comfortable living of the students. It has access to a well-stocked library, play areas and all kind of recreations that a student can


text:
The Police have arrested a 28-year-old man for his suspected involvement in a case of online purchase scam.
On 16 May 2017, the Police received a report from a victim who was purportedly cheated by an online seller who had offered the purchase of $500 worth of NTUC Fairprice vouchers at a discounted price of $470. After payment was made by the victim, she discovered that the envelope contained only $250 worth of NTUC vouchers. The suspect then became uncontactable.
Through extensive investigations, officers from Tanglin Police Division established the identity of the suspect and arrested him on 29 May 2017 along Kampong Java Road. Police investigations are ongoing.
Anyone found guilty of Cheating may be punished with imprisonment for a term which may extend to 10 years, and shall also be liable to a fine.
Members of the public are advised to adopt the following measures to avoid falling prey to online purchase scams:
Make your online purchases only from reputable vendors;
If advanced payments are necessary, only transact with people you know and trust.
Be mindful that scammers may use a local bank account for the transaction to enhance their credibility. The owner of the bank account may not be the person communicating with you online.
Check that the person or company you are buying from is physically located where they claim to be
Never give your bank account numbers, credit card numbers and personal information to anyone you do not know or have not checked out.
Do not provide any information that is not necessary to make the purchase.
Source: Singapore Police Force


text:
I was suffering from pain in my knees since long and was unable to stand. My daughter told me about the best Orthopaedic Surgeon of India, i.e.., Dr. Shekhar Agarwal. He examined my knees nicely and impressed me with his behaviour so much that I decided to undergo for Total Knee Replacement under his care only. And the decision proved the worth because now I feel very comfortable while standing, sitting and walking. I was very happy with the hospital staff as well.
Dr. Shekhar Agarwal Received Life Time Achievement Award in Health Care - 2019
Times Healthcare Achievers Award - Best in Orthopaedics ( Delhi NCR) 2018 given
to DITO Delhi Institute of Trauma and Orthopaedics, Sant Parmanand Hospital.
Dr. Shekhar Agarwal
Dr. Shekhar Agarwal


text:
J.B. Mauney got his riding arm stepped on last night and broke his hand─ could the timing be any worse? Just when he's in the #1 slot, he's now supposed to be out of competition for 4-6 weeks (best-case scenario, but you know how well J.B. listens to the experts). Robson Palermo re-injured his lower back, Kody Lostroh popped his groin.
Last night's P.O.V. from Luke Snyder's helmet cam.
Hummer the Bummer claims he said to his producer that Stickler's so big it's like you're sitting on a sofa. 'Scuse me, but I said that a few posts ago about some bull or other.
Jory Markiss dressed up his ride on Slider, for 86.75. Local boy Luke Snyder stuck it to Stickler (ha! take that, Hummer!) for 86.60. I will never use the phrase, "able to convert." It means doodleysquat. Able to convert what to what?
Ryan Dirteater, on an 11-buckoff streak, dealt with Tight Rope stumbling down on his front legs, recovered, then got his face mask and helmet knocked off. He sure earned his 86.25.
Real surprise: Matt Bohon riding Rango, who's 1 for 18 (Austin Meier was the 1.) Guess Matt's hips were working fine. 86.25
RMEF Gunpowder and Lead was wild in the chute. He deprived L.J. of a score last week, which supposedly would've given L.J. the win. "Redemption! Revenge! Is ever so sweet!" yells Hummer. JDub's take: "You can see from the look on L.J.'s face, he's still mad from last week!" Being p.o.'d works: L.J.'s 91.50 was definitely legit!
Haven't seen Kasey Hayes in a while; this is a rematch on Flirting with Disaster; last year Hayes scored 88. J.Dub described the bull as having an "itchy trigger finger" ─a hilarious visual. This part, not so hilarious: "If this bull's gonna do anything, he's gonna wanna go upside down and barrel-roll over." Glad the bull decided against it. 86 for a good ride.
Emilio Resende didn't make it this time on Loose Cannon, but I just know he's gonna be a great rider. Marco Eguche─ that's a no-brainer. He already has 6 round wins and 6 Top Five placements.
- "Facebook gives you exclusive behind-the-scenes access." Uh, pardon me, Craig, but Facebook is open to everyone in the whole friggin' universe.
- "It was that move to the right that gets Austin Meier off."–guess who.
- "The Missouri River flows on, as does our telecast." And your mouth.
- "With a razor blade, he cuts through the field," is how The Bummer described L.J. Jenkins. Are ya callin' him a gang banger?
- "But all these guys aren't doing it to win money; they're doing it for the prestige of winning big events," blathered the guy who not only doesn't listen to what bull riders say in their interviews, but also doesn't bruise his ass for a living.
Billy Robinson, who does a lot of Touring Pro events, was on Juice, a Mike White bull, another antsy bovine pogo-ing in the chute. Juice hipped himself on the way out, ruining Billy's ride. "I've seen guys get re-rides for less," said J.Dub. Yeah, if it's a hotshot rider. Billy looked too disheartened to challenge the call.
Douglas Duncan's bull, Ricochet, was doing exactly that in the chute. "The bull had a really good pattern…traveled a little from the chute," was the Hummerblather. Translation: the bull did the same thing over and over, and covered real estate. For most riders, that's a low score or even a reride. But for a guy being touted as someone to watch out for (because J.B.'s injured and They need someone to put some heat on the Killer Bs), it was a 88.75 ride. More of those Gumby rules.
Former Missourian Matt Bohon hasn't been riding well and was matched with a bull that wasn't exactly tough stuff─ gave up leaping and kicking almost immediately, and didn't do much but spin. 86.50 is a hometown boy score, not a real one.
I didn't like the Guilherme Marchi/Rockie Smooth matchup in the first place. Marchi nodded even though the bull was lying down. And what was with that messup at the direction change?? Marchi challenged the 7.89 buckoff time, but the review showed him on the ground at 8–which would conveniently be ignored if he wasn't a Portuguese speaker. Hart said taking the bull lying down shows Marchi's confidence. I say it shows that he wanted to GTF out before the judges start hassling him to hurry up.
Big ol' Freudian slip: Hummer started to call L.J. "J.B." All the recent enthusiasm for Jenkins tells me They're setting him up as the Next Great White Hope, with Duncan.
Train Wreck (1 for 9) handed Kasey Hayes a few seconds of hell: the bull snagged himself on the chute, it wasn't a clean out, Kasey got hung up, bouncing against the bull's side─ but somehow there was no foul? Sorry, Kasey, ya gotta be in the Top 10 for the rules to be applied in your favor.
"I think if you look up the word 'eager' in the dictionary, you see photos of Jory Markiss and Chase Outlaw there; they are two high-energy guys…" Hummer, always on the cutting edge of the news.
Robson Palermo's 87.25 ride on Silver Bullet looked good, but not Robson─ after escaping on his knees, he crawled a little, then stopped and sat back on his heels, then had to be helped, slowly walking out. Rock & Roll made short work of Renato; the World Champion hit the ground hard. That bull is now 0/14.
"This bull is a beast of an athlete─ bar none, the greatest bull of all time." – JDub. "He's got more press than some of our world champions…bovine athletes like him come along once in a lifetime." "Put him up there with Bodacious, Red Rock, Mossy Oak Gunslinger. Asteroid's in that bracket, too." The bull's delivered 41 straight buckoffs─ and they've used him on Touring Pro events?? Man, that's sadistic.
"I know what it takes to get it done; I've got a game plan," said Luke Snyder of his third attempt on Bushwacker─ who got to swinging his hind end like a baseball bat aimed at the sky. The super-hard landing was "powerful enough to weld his helmet onto his face," cracked Craig. Luke gave a very muffled interview through his facemask–and the bull scored 46.25.
Douglas Duncan has ridden thousands of bulls. That must be one sore tushy. Hummer, trying for one of his oh-so-smooth segues, remarked that at this stage of J.W.'s career, he's probably ridden thousands of. "Well, I got on thousands of 'em," said JDub.
Little Willie didn't seem to know what he was doing, or at least resented that Jordan Hupp expected him to do it. "That little bull reminded me of a mad Jack Russell terrier," was Shorty's snapshot.
Renato's too fun for words. He rode Red Hot, then launched off the bull. His backflip now gets as many cheers as his rides. 88─ yeah, baby!
"These bulls feel flies on their back; they know where to swing their tails to get it."— JDub showing Bushwacker on the Telestrator, knowing where to send Jordan.
- "Being a cowboy is more than just wearing a cowboy hat. It's a way of life." ─Cord McCoy… who unfortunately achieved his 12th in a buckoff streak.
- "He dusted me."—Luke Snyder's understatement about Bushwacker.
- "You lose your feet, you lose your seat."—JDub
Colby Yates and Luke Syder visited Luke's father's ranch in nearby Raymore. The plot: using the Ford truck to help clean up trees downed by tornadoes. The running gag: every time Colby performed a task, Luke handed him a dollar. "He musta won a lotta money 'cause he sure doesn't work too hard," Yates tells Luke's pop. The finale: Luke hands Yates another single. "This makes 4. Go wash my truck, I'll make it an even 5."