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25 Team Building Activities Infographic Teamwork Collaboration 25 Team Building Activities Infographic Teamwork Collaboration Team
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The central bank was concerned that there is a great degree of variation on any given day between the quotes submitted by the banks, which are the basis for calculating the Emirates interbank offered rate (Eibor), Reuters reported banking sources as saying. The variatioin happens because banks are not following a standard procedure to decide on quotes.
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a r t i c l e i n f o a b s t r a c t
Article history: Objective: Labetalol is often used in severe preeclampsia (PE). Hypotension, bradycardia and hypoglycemia
Received 14 March 2011 are feared neonatal side effects, but may also occur in (preterm) infants regardless of labetalol exposure.
Received in revised form 7 November 2011 We analyzed the possible association between intrauterine labetalol exposure and such side effects.
Accepted 17 December 2011 Study design: From 1 January 2003 through 31 March 2008, all infants from mothers suffering severe PE
admitted to one tertiary care center were included. Severe PE was defined according to the International
Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Infants exposed to labetalol in utero
(labetalol infants) were compared with infants, who were not exposed to labetalol (controls). Neonatal
Bradycardia records were reviewed for hypotension (RR b mean gestational age in weeks), bradycardia (heartrateb 100/
Hypoglycemia min) and hypoglycaemia (glucose b 2.7 mmol/L) in the first 48 postnatal hours.
Patent ductus arteriosus (PDA) Results: Of 109 infants, 55 had been exposed to labetalol, whereas 54 were not (controls). Gestational age at
delivery and birthweight were similar in both groups (31.8 vs. 32.8 weeks (p = 0.06) and 1510 vs. 1639
grams (p= 0.25), respectively for the labetalol vs. control group). Hypotension occurred significantly more in
conjunction with labetalol exposure (16, (29.1%) vs. 4 (7.4%); p = 0.003), irrespective of the route of administra-
tion. Patent ductus arteriosus (PDA) was present in 9 (56%) of hypotensive labetalol infants compared to 1 (24%)
infant in the hypotensive control group (NS). In a multivariate regression model, labetalol exposure, the need for
intubation and PDA appeared independently associated with hypotension (Pb 0.001). Hypoglycemia occurred in
26 (47.3%) of labetalol infants and in 23 (42.6%) of control infants (p= 0.62). Bradycardia occurred in 4 (7.3%) of
labetalol infants and in 1 (1.9%) of control infants (p = 0.18). Hypoglycemia was more common in premature
infants (n = 45 (48,9%) vs. n = 4 (23.5%), p = 0.05) in both labetalol and control infants.
Conclusion: Hypotension is more common after maternal labetalol exposure, regardless of the dosage and
route of administration. The need for intubation and the presence of a PDA also play a role. Hypoglycemia
is a very common finding in this population and is merely related to prematurity and independent of labetalol
exposure as was the incidental occurrence of bradycardia. These findings on the neonatal side effects of maternal
labetalol treatment in preeclampsia underline the importance of frequent blood glucose and blood pressure
measurements in the first days of life, especially in intubated preterm infants with a PDA.
© 2012 Elsevier Ireland Ltd. All rights reserved.
1. Introduction the fetus. Antihypertensive drugs are commonly used for the acute
management of hypertensive episodes in preeclampsia and, in general,
Hypertensive disorders represent the most common medical compli- are considered safe and effective. However, significant maternal and
cation during pregnancy, affecting 3 to 10% of gestations, depending neonatal side effects have been described for such drugs [3,4].
on the population and definitions used [1]. In women with severe Labetalol, a non-selective β and α1 antagonist, is often favored in
preeclampsia perinatal neonatal as well as maternal mortality and the Netherlands and is also worldwide one of the most commonly
morbidity are substantially increased. For neonates, the risk of death administered drugs for both long-term treatment as well as the
and morbidity, including fetal growth restriction, depends mainly on acute management of severe maternal hypertension in preeclampsia
gestational age at onset of preeclampsia as well as on gestational age [5,6]. Because labetalol has not been associated with clinically signifi-
at delivery and the severity of the disease process [2]. cant β-blockade, it is, considered a safe drug in term pregnancies [7,8].
Prolongation of a preeclamptic pregnancy may, depending on the However, β-blockers have been associated with severe symptoms
gestational age and anticipated risk to the mother, be favorable for of β-adrenergic blockade in neonates, especially in preterm infants,
such as hypotension, bradycardia and hypoglycemia, as described
in several case reports [9–14]. However, such symptoms may also
⁎ Corresponding author at: Department of Pediatrics, Division of Neonatology, Beatrix
Children's Hospital, University Medical Center Groningen, Hanzeplein 1, CA 51, 9700 RB
occur in preterm and small for gestational age infants' regardless of
Groningen, The Netherlands. labetalol exposure [15,16]. It has been suggested that labetalol may
E-mail address: firstname.lastname@example.com (C.V. Hulzebos). interfere with catecholamine-mediated circulatory responses and
0378-3782/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved.
504 K.Y. Heida et al. / Early Human Development 88 (2012) 503–507
this may be particularly deleterious in acidotic asphyxiated infants were reviewed for the incidence of hypotension (defined as mean arte-
[17]. However, short-term labetalol infusion should not impair cardiac rial pressure lower than the gestational age in weeks), bradycardia in
function and peripheral vascular resistance [18]. To the best of our the first minutes after birth and during the first 48 h (defined as heart
knowledge, the incidence, severity and consequences of the β-blockade rate b 100 bpm) and hypoglycemia (defined as glucose b 2.7 mmol/L)
effect on the newborn have not been evaluated in a well-described cohort in the first 48 postnatal hours as well as the need for interventions. Ini-
of infants, aside from the aforementioned case reports [9–14]. Because tial glucose delivery rate is 5 mg/kg/min and immediately started after
of the fear of neonatal β-adrenergic side effects for the newborn, it admission. Glucose measurements are performed at 3,6,9,12,18,24 h
is our observation that hypertensive women are sometimes denied postnatally. In case of hypoglycemia glucose delivery rate is increased
sufficient antihypertensive therapy. In addition, in our hospital preterm with 50% until blood glucoses are >2.7 mmol/L. During the study peri-
neonates (gestational age b 37 weeks) exposed to labetalol are routinely od, management of newborn infants admitted to the NICU with hypo-
admitted to the Neonatal Intensive Care Unit (NICU) for monitoring of tension and hypoglycemia has not changed. Echocardiography was
heart rate, blood pressure and glucose during the first 24–48 h of life. considered indicated in neonates with persistent respiratory, circulatory
Such an empiric policy [19], lacks firm evidence and sufficient data and/or metabolic disturbances. Diagnosis of a significant patent ductus
from the literature. arteriosus (PDA) was made by echocardiography and based on patency,
The purpose of this study, is to clarify the relation between labetalol degree of constriction and magnitude of shunting. Small for gestational
exposure and the most important neonatal side effects such as hypoten- age (SGA) was defined as a birth weight below the 10th percentile for
sion, bradycardia and hypoglycemia as well to asses the influence of the gestational age, derived from The Netherlands Perinatal Registry Birth
route and dosage of maternal labetalol treatment. weight percentiles, corrected for parity, sex and ethnicity [20].
Neonates of hypertensive mothers, who were exposed to labetalol
2. Material and methods (cases or "labetalol" infants) were compared with neonates of hyper-
tensive mothers, who were not exposed to labetalol (controls). Con-
The University Medical Center Groningen (UMCG) is one of ten tinuous variables were compared with use of Mann–Whitney, whereas
tertiary perinatal referral centers for high risk pregnancies in The categorical variables were compared with Chi-square. A logistic
Netherlands. The Obstetrics Department has an Obstetric High Care regression model was constructed with all variables (P-valueb 0.05)
Unit (OHC) for those women who are severely ill, for instance women for a possible association with hypotension. Variables entered into
with severe preeclampsia and/or HELLP syndrome. The population in the model included: exposure to magnesium sulfate, labetolol exposure,
the Northern part of the Netherlands is predominantly Caucasian. In gestational age, birth weight, apgar score b 7 after 1 and/or 5 min, pH
our center, labetalol is the first drug of choice for those women umbilical artery b 7.10 and b7.20, the need for intubation and PDA. All
with significant hypertension. Intravenous treatment is started tests were 2-tailed with an alpha set at. 0.05. All statistical analyses
when mean blood pressure (BP) is ≥ 120 mm Hg. According to our were performed with SPSS 17.0 for Windows software (SPSS, Chicago,
protocol an intravenous bolus of 20 mg is administered, followed Illinois).
by a continuous infusion of 20 mg/h. When not effective within
20 min, a 40 mg bolus is administered and the continuous infusion
rate increased to 40 mg/h. When still not effective within 20 min, a 3. Results
80 mg bolus is administered and the continuous infusion increased to
80 mg/h. The maximal cumulative dose in 1 h is limited to 220 mg. Of a total of 109 included infants 55 infants were exposed to labetalol
The primary endpoint is the successful reduction in BP (mean arterial in utero. Of 18 of these newborns, the mother received exclusively
pressure b120 mm Hg) for at least one hour. When effective and deliv- oral treatment. The other 37 were also exposed to intravenously ad-
ery does not seem imminent within the next 24 h, conversion to oral ministered labetalol. Thirty-one infants were exposed to intravenous
labetalol treatment is favored. In our center, all neonates who are magnesium sulfate prior to and around the time of delivery. None of
preterm (gestational age b 37 weeks) and/or exposed to significant the mothers in the control group (n = 54) received antihypertensive
doses (> 600 mg oral maternal labetalol daily as well as all intrave- agents, 17 received intravenous magnesium sulphate.
nous maternal labetalol use within the last 24 h prior to delivery), There were no significant difference in gestational age (GA),
are admitted to the NICU for monitoring of heart rate, blood pressure birth weight and preterm birth between the labetalol group and
and glucose during the first 24–48 h of life. the control group (Table 1) (Fig. 1). Hypotension occurred significantly
Over a 2-year period (January 1, 2005 and December 31, 2006) all more frequent in the labetalol group. Crystalloids and dopamine/
women (n = 95) admitted to the OHC with severe preeclampsia and/ hydrocortisone therapy was used in 8 of the 16 hypotensive "labetalol"
or HELLP-syndrome were included in this retrospective study. Severe infants, 6 received crystalloids only, whereas 2 were not treated. In
preeclampsia and/or HELLP-syndrome were defined according to the
internationally agreed standards [5]. Thirteen women were excluded,
7 due to intrauterine demise of an immature fetus, 4 due to termination
Table 1
of pregnancy at a gestational ageb 24 weeks because of severe maternal Patient characteristics and neonatal symptoms with and without labetalol exposure.
illness, and 2 because of missing records. Of 82 remaining women, 53
Labetalol No exposure to P-value
were treated with labetalol, including two twin gestations. Blood
exposure antihypertensive agents
pressure of the remaining 29 women remained controlled without (n = 55) (n = 54)
use of antihypertensive drugs. The pregnancies of these 29 women
Male/female (n) 28/27 25/29
were considered "controls". In order to extend the control group, Gestational age (week) 31.8 ± 3.8 32.8 ± 3.4 0.06
the NICU database was searched between 1 January 2003–31 March Premature birtha 49 (89.1%) 43 (79.6%) 0.17
2008 to identify all neonates whose mothers were diagnosed with PE/ Birth weight (gram) 1510.6 ± 855.4 1639.1 ± 807.6 0.25
HELLP-syndrome, but who did not need admission to the OHC due to SGAb (n) 12 (21.8%) 12 (22.2%) 0.96
Hypotension (n) 16 (29.1%) 4 (7.4%) 0.003
less severe disease. Medical records were verified for absence of labetalol
PDA (n) 13 (23.6%) 9 (16.7%) 0.37
exposure and other hypertensive agents. Twenty-five of such neonates Hypoglycemia (n) 26 (47.3%) 23 (42.6%) 0.62
were identified, resulting in a total of 54 control infants. Bradycardia (n) 4 (7.3%) 1 (1.9%) 0.18
All maternal medical records were reviewed for accurateness of Mortality (n) 5 (4.6%) 0 (0%) 0.02
diagnoses, labetalol dosage, timing and route of administration as well a
Premature birth = delivery before 37 weeks gestation.
as for gestational age at delivery and birth weight. Neonatal records SGA = birth weight below the 10th percentile for gestational age.
K.Y. Heida et al. / Early Human Development 88 (2012) 503–507 505
hydrocortisone i.v. One hypotensive infant (25%) in the control group Hypotension (n) 8 (21.6%) 6 (33.3%) 0.35
was diagnosed with a PDA and required treatment with crystalloids Hypoglycemia (n) 16 (43.2%) 10 (55.6%) 0.45
Bradycardia (n) 2 (5.4%) 2 (11.1%) 0.39
Incidences of hypoglycemia and bradycardia in the first 48 h after *
Oral labetalol group consists of infants whose mothers used only oral treatment
birth were similar in both groups (Table 1). In the first 10 min after within the last 24 h prior to delivery.
Fig. 1. Birth weight (BW) percentiles of infants exposed to labetalol and infants not exposed to antihypertensive agents.
506 K.Y. Heida et al. / Early Human Development 88 (2012) 503–507
[11] Klarr JM, Bhatt-Mehta V, Donn SM. Neonatal adrenergic blockade following single [22] Dasgupta SJ, Gill AB. Hypotension in the very low birthweight infant: the old, the new,
dose maternal labetalol administration. Am J Perinatol Mar 1994;11(2):91–3. and the uncertain. Arch Dis Child Fetal Neonatal Ed Nov 2003;88(6):F450–4.
[12] Sala X, Monsalve C, Comas C, Botet F, Nalda MA. Cardiac arrest in newborn of [23] Spinazzola RM, Harper RG, de Soler M, Lesser M. Blood pressure values in 500- to
mother treated with labetalol. Rev Esp Anestesiol Reanim May 1993;40(3):146–7. 750-gram birthweight infants in the first week of life. J Perinatol Jun 1991;11(2):
[13] Stevens TP, Guillet R. Use of glucagon to treat neonatal low-output congestive 147–51.
heart failure after maternal labetalol therapy. J Pediatr Jul 1995;127(1):151–3. [24] Launer LJ, Hofman A, Grobbee DE. Relation between birth weight and blood pressure:
[14] Olsen KS, Beier-Holgersen R. Fetal death following labetalol administration in longitudinal study of infants and children. BMJ Dec 4 1993;307(6917):1451–4.
pre-eclampsia. Acta Obstet Gynecol Scand Feb 1992;71(2):145–7. [25] Alves JG, Vilarim JN, Figueiroa JN. Fetal influences on neonatal blood pressure. J
[15] Efird MM, Heerens AT, Gordon PV, Bose CL, Young DA. A randomized-controlled trial Perinatol Dec 1999;19(8 Pt 1):593–5.
of prophylactic hydrocortisone supplementation for the prevention of hypotension [26] Ellison RC, Peckham GJ, Lang P, Talner NS, Lerer TJ, Lin L, et al. Evaluation of the
in extremely low birth weight infants. J Perinatol Feb 2005;25(2):119–24. preterm infant for patent ductus arteriosus. Pediatrics Mar 1983;71(3):364–72.
[16] Holtrop PC. The frequency of hypoglycemia in full-term large and small for gestational [27] MacCarthy EP, Bloomfield SS. Labetalol: a review of its pharmacology, pharmacoki-
age newborns. Am J Perinatol Mar 1993;10(2):150–4. netics, clinical uses and adverse effects. Pharmacotherapy Jul 1983;3(4):193–219.
[17] Woods DL, Malan AF. Side effects of labetalol in newborn infants. Br J Obstet [28] Rogers RC, Sibai BM, Whybrew WD. Labetalol pharmacokinetics in pregnancy-
Gynaecol Sep 1983;90(9):876. induced hypertension. Am J Obstet Gynecol Feb 1990;162(2):362–6.
[18] Jouppila P, Rasanen J. Effect of labetalol infusion on uterine and fetal hemodynamics [29] Crooks BN, Deshpande SA, Hall C, Platt MP, Milligan DW. Adverse neonatal effects
and fetal cardiac function. Eur J Obstet Gynecol Reprod Biol Oct 1993;51(2):111–7. of maternal labetalol treatment. Arch Dis Child Fetal Neonatal Ed Sep 1998;79(2):
[19] Cissoko H, Jonville-Bera AP, Swortfiguer D, Giraudeau B, Autret-Leca E. Neonatal F150–1.
outcome after exposure to beta adrenergic blockers late in pregnancy. Arch [30] Munshi UK, Deorari AK, Paul VK, Singh M. Effects of maternal labetalol on the
Pediatr May 2005;12(5):543–7. newborn infant. Indian Pediatr Dec 1992;29(12):1507–12.
[20] The Netherlands Perinatal Registry. www.perinatreg.nl. [31] Pickles CJ, Symonds EM, Broughton Pipkin F. The fetal outcome in a randomized
[21] Al Aweel I, Pursley DM, Rubin LP, Shah B, Weisberger S, Richardson DK. Variations in double-blind controlled trial of labetalol versus placebo in pregnancy-induced
prevalence of hypotension, hypertension, and vasopressor use in NICUs. J Perinatol hypertension. Br J Obstet Gynaecol Jan 1989;96(1):38–43.
Jul 2001;21(5):272–8.


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- NEW GAMES Next in 01:56:17
Added in 21.05.2018, played 419 times, voted 0 times
It is important for you dear kids to come and try out this Pregnant Elsa Twins Birth because we are sure you are going to enjoy it and htat is what we are looking for, but it is also true that Elsa needs your help in this Frozen game and that is because, as you can see even from the title of it, Pregnant Elsa Twins Birth, she is pregnant and she needs you to help her and take care of it. And that means this is in fact a doctor game and you have to take care of Elsa and make sure she delivers her twins, so be her doctor and pay attention to the instructions because if you are a doctor you have to know how to take care of Elsa and of course take care of her babies, the game will you the directions you need. Good luck!
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The islands that available in Langkawi Island is like Pulau Kasut. A lot of shops, sell souvenirs, clothes, beg and many things that can we buy to give to other people. You will find a number of legends regarding romance, gigantic birds, warriors, and fairy princesses related to this mysterious island. Malaysia owns among the gorgeous islands in the whole world, namely Langkawi, The Isles of Legends, situated in the state of Kedah,which also consists of example essay holiday pulau langkawi. On these days we give thanks for what we have and. Someone would describe something that they saw and we had to guess what they saw. Mikaela Esquivel Advanced Dance Silver 2 Topic 9 Physical appearance Introduction: Include a hook Grab my attention! This is a good example of a folklore that is still very much believed by the locals.
Justice Destinations in Manchester Essay best thesis statement ghostwriting sites for phd. We transfer soft essay holiday to langkawi editing service 247. The bed very soft and it is very comfortable for us to sleep. This new house allowed more space for the members of the family and all lived peacefully. Research: Research at least six 6 information sources.
I've always looked forward to the summer, that cool breeze drifting ashore, the sand moulding to fit my feet, the fresh sweet taste in the air, the trawlers bringing in fresh crab and lobsters. Among the most interesting topographic points in Langkawi is besides a topographic point called Langkawi Book Village. It is a very scenic place. With the wide variety of federal holidays, and the many levels of American government, it can be confusing to determine what public and private facilities are open on or around a given federal holiday. Being born into a poor family, Elenora had very few opportunities. We essay on hardwork and perseverance leads to success our. Our celebrations like others are year round.
It was time for us to start planning our summer vacation. Unlike other trips this one was not going to be. Finger about close contact at pulau langkawi. I remember when I went on a trip to Universal Studios. We tried to look the hotel because we were going to stay at a hotel for two days and one night.
Some of those experiences have been good or bad, but no matter what it is still your childhood. For years, people have been trying to achieve this challenging goal. It guarantees that fitting intercession methods are adjusted to address the wellbeing needs of families whether genuine. The murmuring water runs down a rocky hill. The main island amongst the 99 island is named as Paulau Langkawi. He was part of an extended family, and so was brought up with many of his age.
The islands that available in Langkawi island is like Pulau Kasut, Gua. A girl is walking by the creek, alone in the forest. In the United Sates, holidays are a very superior time that many of us embrace. It is during the holiday season that we begin to see and hear from loved ones that may not always be in touch. In that community, values are taught initially through family.
The island has been developed an all-in entertainment getaway with dolphin and crocodile shows, theme parks, golf, and more hotel rooms. The vineyards really come alive during the summer; most of them have live music on the weekends. I was sleepy on the journey to Langkawi Island. The massive blue sky was filled with a fluffy and huggable clouds while the silence was broken by a cheering sound of colourful birds that were happily chirping their melodious songs from above. Guiding question: How important is physically appearance as opposed to dancing ability in the dance world? We cardinal to went to Pulau Langkawi. Whether it be when you were a child or as an adult.
This holiday was meant to honor the dead and give peace to the departed. Out of the distress of her child hood. The other people have to ask questions to find out what the person is. It business plan template word Pulau langkawi art gold in. It is known far and wide for its beauty. Have you ever been on a trip that changed your entire outlook on life? My father was born quite near our current house on February, 1970.


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How to... make rhubarb lattice tart: Pastry Chef Oliver Peyton's tips on how to make the dessert
Rhubarb, the nation's most colourful vegetable, is back in season. To make the most of it, we spoke to restaurateur and pastry chef Oliver Peyton. Here are his top tips for the perfect rhubarb lattice tart.
You should be familiar with the two varieties of rhubarb. Outdoor rhubarb grows, as its name suggests, outdoors, is a crimson red-purple colour, should be peeled before eating and takes a few minutes in the pan to soften. It is a robust vegetable with a tart, sharp taste.
The second type is forced rhubarb which has been 'forced' to grow earlier in the season in darkened sheds. The restricted light makes the stalks less tart, less fibrous and lighter in colour (a paler pink). Forced rhubarb is more delicate in flavour and appearance, hence its nickname champagne rhubarb.
Delicious: A rhubarb lattice tart is a tasty work of art
Wrapped in a buttery pastry is the best way to appreciate this vegetable. Start off by buttering a tart tin, about 2.5cm deep. Roll out shortcrust pastry into a circle that's large enough to line the dish with a little overhang. Shop-bought pastry is a good time-saver and tastes as good as homemade.
Put the rolled-out pastry circle into the tin and press into the edges. Roll out some more pastry into a rectangle shape. Place the rolled pastry into the fridge for 30 minutes. If warm, your pastry will shrink and create a tough end result.
Cut off the leaves and flowers from the rhubarb's head. The leaves are poisonous. Remove any stringy outer layers of 500g of rhubarb then cut it into 3cm lengths. Pop in a bowl with 200g of sugar and 2tbsp of cornflower. Coat the rhubarb in the mixture.
Take the pastry out of the fridge and fill the tin with your rhubarb mixture. Cut into the rectangle of pastry to make 1cm-wide strips. Arrange in a lattice pattern on top of the rhubarb filling, making sure to leave three strips to lie around the tart's edge. Keep the pastry topping thin. Whisk one egg and a few drops of milk together in a bowl. Dip in a pastry brush and carefully coat the pastry lattice and edges.
Place the dish in the oven for 50 minutes at 200c. The French always make their tarts with a tiny bit of burn on. Obviously be careful not to take this too far or you will end up with charcoal for pudding.
This is an excellent recipe for experimentation. You just need courage. Try dried fruit (apples, pears or peaches) instead of rhubarb. You can re-generate a lot of moisture through the sugar, so they work well. Rhubarb and custard is a classic flavour combination.
My only word of warning is to always use natural ingredients. It makes a big difference to flavour.
If you have leftover rhubarb, there are a million other meals. Rhubarb meringues give a surprisingly zingy flavour. Rhubarb compote can be made in a couple of minutes (if you used the forced type, boil the rhubarb briefly with sugar). Mix yoghurt, granola, nuts, forced rhubarb and sugar in a bowl.
And how can we forget the classic rhubarb crumble. My secret tip is adding ground almonds to the crumble topping. But my favourite is raw rhubarb (the forced variety) dipped in sugar and cream.
Oliver Peyton's book Peyton and Byrne: British Baking is out now
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ByteScout tutorials are designed to explain the code for both VB.NET beginners and advanced programmers. ByteScout Spreadsheet SDK is the library (SDK) that is capable of writing, reading, modifying and calculating Excel and CSV spreadsheets. Most popular formulas can be calculated and reculculated with Excel installed. You may import or export data to and from CSV, XML, JSON as well as to and from databases, arrays. It can add columns into existing spreadsheet in VB.NET.
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Imports Bytescout.Spreadsheet Imports System.IO Module Module1 Sub Main() ' Open Spreadsheet Dim document As New Spreadsheet() document.LoadFromFile("AdvancedReport.xls") ' Get Worksheet Dim worksheet As Worksheet = document.Workbook.Worksheets(0) ' Add new Column worksheet.Columns.Insert(3, 1) ' Set values worksheet.Rows(0)(2).Value = "Age" ' remove output file if already exists If File.Exists("Output.xls") Then File.Delete("Output.xls") End If ' Save document document.SaveAs("Output.xls") ' Close Spreadsheet document.Close() ' open in default spreadsheets viewer/editor Process.Start("Output.xls") End Sub End Module
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Overview (2)
|Birth Name
|Murray Duncan Close
Mini Bio (1)
Working for Stanley Kubrick on 'The Shining' in 1978 was the beginning of an illustrious career that has lasted for over 35 years and continues to this day. It was over the course of these three years that Murray Close worked with Kubrick that Stanley's sense of composition and style influenced his work from then on. Forging a career as a renowned stills and specialist photographer, Close established very early on strong links within the film industry and became first call to esteemed directors and filmmakers.
These early ties with Warner Bros. lead to collaborations with Clint Eastwood and Steven Spielberg and Close relocated to Los Angeles in 1989. It was during this time that he worked on films such as 'Jurassic Park' and 'Mission Impossible', creating some of cinema's most iconic images. In 2003 Close was invited back to London by Alfonso Cuarón to contribute to 'Harry Potter and the Prisoner of Azkaban' and two subsequent Harry Potter productions.
Quick to notice Close's skills on franchise movies, Lionsgate invited him to work on the entire 'Hunger Games' films in 2011 and continued that collaboration with Jennifer Lawrence and Francis Lawrence on 'Red Sparrow' in 2017.
- IMDb Mini Biography By: Osopolar


text: Erin began her yoga journey around 10 years ago. For her, the journey first started out at home, then led to local classes, and eventually to earning her RYT200 and Reiki II certifications. Erin has always been passionate about health and wellness, and found yoga a way to integrate them both, while adding an element of spirituality as well. Erin is also a registered nurse who is constantly learning about alternative and holistic health modalities. In her free time, Erin loves camping, traveling, hiking, biking and most of all, music.


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If you buy a new Roku player or Roku TV between now and January 14, 2017, you will be able to get two free months of Hulu, Showtime, and CBS All Access.
Hulu often has promotions where they offer Hulu Plus free for a month.Hulu, the only online subscription service that delivers streaming video of currently running shows from all of the top television networks, comes in two iterations: Hulu Plus and Hulu.com. Hulu.If you download the app from the Windows Store now you will get double the usual one month free trail, letting you experience unlimited instant streaming of current hit TV shows, exclusive original series, all-time favorites, hit movies, and more.With Netfix, you can be able to stream movies and TV shows from your computer, Wii, Xbox, PS3, Roku and more.
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Last week it was reported a neat Chromecast deal had popped up for new subscribers.You must redeem the offer before January 21, 2017, or the deal will be lost.With all new features including 1-stop search and an amazing remote with a built-in headphone jack for private viewing, the Roku HD streaming.Unlimited streaming available via Roku, Fire TV, Xbox, PlayStation, Wii and many other devices.
Get Up To 75% Off Xbox In Gold Membership with a Xbox Live promo code or coupon. 2016 Xbox Live discount codes now on RetailMeNot.When the Chromecast first launched, it came with three free months of Netflix.
Hulu Plus Promo codes, coupons and free trial for premium account.Hulu also offers a wide array of kids shows, documentaries, anime, and much more.It will allow you to watch movies, TV shows, sports and more on your TV at anytime.


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NORWAY — According to Norway Police Officer James Ventresca, an argument between a homeowner and occupants of a car parked on Route 118 got messy Tuesday.
Ventresca said the landowner confronted two people that were on his property on 61 Lake Road after they dumped food on the ground. The landowner confronted them, and got into a argument. He asked the two to pick up the dumped food. They refused.
"The landowner decided that when she didn't pick up garbage, he threw the garbage back at her," said Ventresca. Initial scanner traffic indicated that the garbage was thrown through the window of a car, and also specifically indicated that the thrown food was a salad.
Ventresca said no one was charged in the incident, but multiple warnings were issued.
Send questions/comments to the editors.
Our View: Loss of doctors leaving hole in rural health care
Our View: Loss of doctors leaving hole in rural health care
Local & State
Red tide monitoring leads to longer-than-usual closures for some harvesters
Local & State
Amy Calder: He dreams of walking on his own two feet
Things to Do
Take out tasty broth, banh mis and bubble tea from Pho Co.


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A quick note about the reviews I do on this site. The product vendors give me access to their products for free in order for me to do my review. However I make no promises to them regarding the results of my tests or what I will write in my review. Should you click a link that takes you to a sales page for a paid product for sale this link will be an affiliate link and I will be paid a percentage of the sales price should you decide to invest in it.
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Half of the Farm to Fork City is a Food Desert
As the population of Sacramento continues to increase, developers take the opportunity to...Read More
Posted by Star Porras | Aug 20, 2019 | Neighborhood News, Top News!
As the population of Sacramento continues to increase, developers take the opportunity to...Read More
Posted by AccessLocal.TV | Aug 19, 2019 | Access Sacramento, AccessLocal Shows, Game of the Week, Neighborhood News, Top News!
by Will James Hometown Sports The CIF Sac-Joaquin Section high school football season kicks-off...Read More
Posted by Melissa Franco | Aug 13, 2019 | Top News!
Every week it seems, a traumatic event happens for millions of American children. What can we do...Read More
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On Monday night, August 5th, the Sacramento Tenants Union screened a documentary by Black Zebra,...Read More
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Hate crimes have been on an increase in the last couple of years. A new report by the University of Santa Barbara from their center for the study of Hate and Extremism has shown that there has been a 9% increase in hate crimes...Read More


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Lpi 117-201 IT Certification | E-Racingmag, 117-201 Questions Answers First-hand Real Exam Study Materials
Lpi 117-201 IT Certification | E-Racingmag, 117-201 Questions Answers First-hand Real Exam Study Materials
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Visiting China's "Cradle of Civilization"
#1 The 8000 Terra Cotta Warriors
Since their discovery in 1974 thousands of the life-size soldiers in the Terra Cotta Army have been unearthed and the government has constructed handsome stone buildings to house them in situ. Visitors can walk around three "pits" to see the individualized soldiers standing in formation to guard the Emperor Qin Shi Huang in his afterlife. Some sections are left only partly excavated so that visitors can see the magnitude of the job that entails carefully digging out the broken fragments of the fully dressed soldiers. In one area set aside as the 'hospital" the pieces are reassembled and glued together and painted areas are wrapped in plastic to protect them. A sound surround film and auxiliary exhibits add to the visitors' experience.
Terra Cotta Army in formation
Terra Cotta soldier
#2 Mausoleum of Han Yang Ling
The Terra Cotta Warriors commemorate only one emperor. Scattered around the hills on the highlands northwest of Xi'an there are more than 72 imperial tombs. Preparing for the afterlife, nobles were buried with entourages similar to the Terra Cotta Army but on a smaller scale. Still grand in scope is that of the sixth Ching emperor Han Yang Ling whose 5000 acre mausoleum includes artifacts, tombs of the emperor and empress, burial pits and a human sacrifice gravesite.
Entrance to the mausoleum mound of Emperor Han Yang Ling
Model of chariot in Han Yang Ling's afterlife entourage
#3 Walk the Wall
Next to the Great Wall, perhaps the most notable mammoth stone fence in China is the Xian City Wall which encloses the old section of Xi'an, now the city center. Almost 40 feet tall, it has been restored with some archways added to allow traffic to pass through and winds almost nine miles around the city with a massive fortress gate facing each direction. Accessed by intermittent stairs, the 40-foot wide top can be walked or cycled and offers views out over the city.
#4 Bell Tower, Drum Tower, Giant Wild Goose Pagoda
Three highlight sites in the city are an historic pagoda and two towers. A favorite of tourists, the seven-story Giant Wild Goose Pagoda is surrounded by fountains and parks. Besides serving as a handy orientation point, the Bell Tower, located on the city's central crossroad, is picturesque and provides an overview of the central business district. A few hundred yards away, the equally quaint Drum Tower marks entrance to the city's bustling Muslim Quarter.
Great Wild Goose Pagoda is a popular tourist site
#5 Muslim Quarter
Descendants of silk road traders who stayed behind, Xi'an's Muslim Hui population is concentrated in a teeming and colorful maze of streets which interrupt the otherwise regular grids of town. A plethora of tradesmen and restaurants hawk souvenirs, sweets, and ethnic meals.
Colorful scene in the Muslim Quarter
#6 Shaanxi History Museum
While no authentic Tang palaces are still standing, the Shaanxi History Museum is based on that historic design. Originally China's most important museum, it has subsequently been superseded by the national museums in Beijing and Shanghai, but is still full of treasures from the first three dynasties. There are Neolithic artifacts more than 7000 years old and one room serves as an introduction to the Terra Cotta Warriors, with some of the actual soldiers on display along with arrowheads, spears, and crossbows.
Shaanxi History Museum
Camel artifact displayed in the Shaanxi History Museum
#7 Beilin Museum
Back before printing presses, writers copying manuscripts couldn't be trusted not to make mistakes. To ensure standardization, in 837 AD Tang Emperor Wenong arranged for the complete works of Confucius to be engraved on 114 stone tables which are preserved and displayed in the "forest of stone stables" Beilin Museum.
Entrance to the Beilin Museum
Stone stele
#8 Hua Shan
One of the five sacred Taoist mountains, the five granite peaks of Hua Shan, 70 miles northeast of Xi'an, is popular with pilgrims and locals who clamor up and down its stone steps lined with big chain guard rails. Taoist temples interspersed with souvenir stands and snack shops offer plenty of diversion and there is a cable car for those who chose to avoid the hike.
Hiking Hua Shan Mountain
Hua Shan cable car
#9 Yuanjiacun Village
Overseen by an enterprising local official, the ecosystem life experience village of Yuanjiacun has been rebuilt in the style of a typical Quin Dynasty town. Snack and souvenir shops are housed in charming buildings which mimic old-style construction and activities give a sense of life in the old days. A circling donkey powers the flour grinder, bakers concoct peanut candies in open air kitchens, craftswoman embroider bags which are sold in their shops.
Yuanjiacun recreates an historic village
Donkey operates the grinding mill
#10 Dinner theater
Performers in colorful costumes present the Tang Dynasty Music and Dance Show, a performance rooted in ancient tradition. A multi-course Chinese meal is served along with the entertainment.
Tang Palace theater
Tang Palace performance on stage
Photos by Sharon King Hoge and Barbara Angelakis


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Genes and Genetics
The risk for development of LE in a sibling in families with a member with LE is 20 times more than in the general population. The relatively high concordance rates for SLE in monozygotic twins (25%-57%) compared with dizygotic twins (2%-9%) supports the importance of the genetic background. It is currently believed that multiple genes confer susceptibility to SLE expression, several of which have been identified to associate with lupus. Most of these associations have been identified while investigating pathogenic mechanisms in the disease. For example, the conjecture that certain
MHC antigens should present autoantigens better than others led to unveiling of associations between the disease or individual manifestations and MHC antigens. On the other hand, the expectation that apoptosis-related genes should be associated with the expression of lupus was not fulfilled.
More recently, genome-wide searches in families with multiple affected members disclosed areas in the genome associated with lupus. Obviously, no single gene is sufficient or necessary for disease expression, and lupus diathesis is conferred by an as-yet-unidentified number of genes that differ in individual patients. Still, the fact that almost all of the rare patients with C1r/C1s and complete C4 deficiency develop lupus suggests that the number of the contributing genes may be limited in some patients. The complexity of deciphering genes involved in the expression of lupus is confounded by the number of additional environmental, hormonal, and immunoregula-tory factors in a given individual or population. Finally, genetic epistasis, the interaction of different genes to produce a disease phenotype, as has been shown in animal models, may occur in patients with LE.
The long arm of human chromosome 1, which was identified in almost all of the genome-wide searches as harboring loci associated with SLE, maps several of the potential lupus loci found in these genome-wide screens as well as others implicated in lupus, such as those encoding for FcyRIIA, FcyRIIIA, TCRZ, FasL, IL-10, complement receptor 1, complement receptor 2, and C1q proteins. These molecules have been implicated in SLE by either small-scale genetic or nongenetic studies.
The impact of genetic factors is also underscored by differences in the incidence and prevalence of the disease in various races. SLE has a higher incidence and prevalence in African Americans, Afro-Caribbeans, and East Asians, and the disease may also have a more severe course and prognosis. Certain clinical (e. g., discoid skin lesions and nephritis) and serologic (e. g., anti-Sm autoantibodies) manifestations are found more frequently in the African American LE population, and the high prevalence of severe nephritis encountered therein is responsible for the severe prognosis. Detailed genetic analysis may reveal the molecular basis for such interracial differences.
In summary, multiple genetic loci or genes contribute to susceptibility for the development of SLE. Genetic analyses may increase our understanding of the disease heterogeneity and provide a molecular basis for the racial differences in disease prevalence, manifestations, severity, and prognosis. The pathogenic contribution and complex interaction of lupus-susceptibility genes needs to be clarified by additional studies, and the precise role and contribution of each of the lupus-related genes should be addressed (Gregersen 1997).
Hair Loss Prevention
The best start to preventing hair loss is understanding the basics of hair what it is, how it grows, what system malfunctions can cause it to stop growing. And this ebook will cover the bases for you. Note that the contents here are not presented from a medical practitioner, and that any and all dietary and medical planning should be made under the guidance of your own medical and health practitioners. This content only presents overviews of hair loss prevention research for educational purposes and does not replace medical advice from a professional physician.


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Many people wait for the right time, the right day to make a decision about their lives. If life is truly impermanent, you may not be able to take the time to do things later.
Later is now. Call whom you want NOW, make those decisions NOW. You could always change your mind, yet it behooves you to be in the NOW, not later.
Who you are right now is what matters. What you do right now is what matters.
The Buddha says everything exists in a state of transition. Nothing stays still, either negative or positive. We all do our best to hold on to the good and to reject the bad. Both the good and both will arise again and dissolve, yet again.
The challenge is that when we try to hold on to the good, which is impermanent, we are disappointed. We think there is something wrong with us, others or the process.
"All conditioned things are impermanent' — when one sees this with wisdom, one turns away from suffering." – The Buddha
Everything has a life cycle. It comes into being, grows, ages, weakens, and decays. Plants do this, people do this, everything does this. All these things and people are impermanent.
If you accept that endings are natural and beginnings are accepted as well, you will also agree that what happiness and joy you achieved today may be different tomorrow.
If you find yourself in a place of joy right now, extend that to others in your work and home life now. No waiting for the right moment because it is at hand right now.
Each day, each moment is different from another and will only cause us suffering if you choose to hold tight to the now. If you do, you will suffer. Suffering is an attachment. Stop holding onto things and people as they are unimportant and this action defines you as being attached. When you hold on to things and people, you hold on to pain. You must release the pain and if someone or something is a part of that attachment, you may need to let that person or thing go, in the spiritual sense. Once you do that, your life will change.
The Be Your Authentic Self Program is here for you now.
Joanne Victoria
Latest posts by Joanne Victoria (see all)
- Every Day You Have a Secret Desire to Take Risks - August 23, 2019
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- Who is on Your Inner Vision Team? - August 20, 2019


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B. First stage of the project require students to make a proposal for their programming project, which include all
the element throughout the courses. Each groups require to present their proposal to their lecturer at WEEK
C. After acceptance of proposal, the groups require to conduct the programming project, including coding and
providing final report of the project. Complete compiling C++ code and full report for the project MUST
submit at the WEEK 12.
Proposal (10%)
2. Algorithm - Pseudocode/Flowchart.
a) Cover Page
b) Introduction
c) Description of hows the program work (shows how do you declare the variables, process involve, user
manual and etc.)
d) Conclusion
e) Appendices (Pictures/Minutes of Meeting/Proof of Discussion/Raw Data)
Presentation (5%)
Each group require to present their project at WEEK 13, after the submission of their complete report. They need
to demonstrate their program during the presentation. The groups may present their project by POWERPOINT
presentation or VIDEO presentation. 10 minutes is given for the group that present using POWERPOINT. Any
group that select VIDEO presentation, duration of the video is between 5 7 minutes. Q & A session will take
about 5 - 10 minutes.


text:
Dr. Tiana Noelle Losinski MD
Family Practitioner146 Medical Park Rd Suite 106 Mooresville NC, 28117
Dr. Tiana Losinski is a family practitioner practicing in Mooresville, NC. Dr. Losinski specializes in comprehensive health care for people of all ages. In addition to diagnosing and treating illnesses, family practitioners also put focus on preventative care with routine checkups, tests and personalized coaching on how to maintain a healthy lifestyle. Dr. Losinski possesses immense general knowledge on maintaining health and today, family practitioners provide more care for the underserved and rural populations than any other medical specialty.
Education and Training
University of Central Florida College of Medicine 2004
Board Certification
Family MedicineAmerican Board of Family MedicineABFM
Provider Details
- Sinusitis
- High Cholesterol
- Allergies
- Type 2 Diabetes
- Hay Fever (allergic Rhinitis)
- Hypothyroidism
- Pain
- Bayfront Medical Center Program
Dr. Tiana Noelle Losinski MD's Practice location
Mooresville, NC 28117Get Direction
MOORESVILLE, NC 28117Get Direction
Dr. Tiana Noelle Losinski MD's reviewsWrite Review
Patient Experience with Dr. Losinski
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text:
App Report for Ringer - Ringtone Maker
App Store Description for Chile
Ringer is the premiere ringtone creation app on the app store. Make a personal ringtone from any unprotected song in your iTunes Library, video in your photo library, or direct recording. Ringer lets you easily make a ringtone from 2 to 40 seconds long. Features: - Fully iOS 12 compatible. - Makes ringtones, text tones, and alert tones. - See the actual waveform to help you find the right part of your song. - Zoom in and out to help you choose the start and end of your ringtone with sub-second accuracy. - Support for fade-in, fade-out and ringtone gap. - Song navigator lets you jump to any part of the song instantly. - Auto volume support makes sure that quiet parts of a song can still be used as a ringtone. - Landscape mode to provide a larger view on your music. Note: - Songs that are protected by DRM cannot be used. - No app can install ringtones on the phone. Ringtones must be imported into iTunes and synced to the phone before they can be used.
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text:
Gallery: Custom Buildings
Click below to view photos of Mueller Custom Buildings.
Custom Buildings
A Place For Everything
A View To Remember
All-In-One Retreat
American Man Cave
Big Red Barn
Blue Waters
Bus Barn
Charcoal Workshop
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Coastal Retreat
Commercial Building
Copper Cove
Countryside Living
Countryside Retreat
Covered Storage
Cowboy's Cove
Cowboy's Dream
Custom Church
Darnell Construction
Dual Purpose Workshop
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Farmer's Dream
Go-To Garage
Green Living
Gulf Getaway
Heritage Haven
High Country Home
Hill Country Haven
Hobby & Horse Barn
Hobby Shop
Home Away From Home
Horse Haven
Island Dream
King Ranch
Lakeside Hideaway
Light Stone Workshop
Lost Maples Winery
Multi-Functional Ranch
Multi-Structure Ranch
Oceanside Haven
Open Spaces
Outdoor Mall
Party Place
Platinum Collision
Poolside Storage
RV Shelter
Recreational Retreat
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Small Workshop
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The Great Escape
The Home Place
The Lodge
The Man Cave
The Patriot
The Work Horse
Traditional Barn
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Woodland Home
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Wrap Around Storage
Colors may vary by monitor settings. Please contact us to get the most accurate color representation.
We will be glad to provide you with color samples. Galvalume Plus has a protective top coat which may possibly change the color of the panels over a period of time, giving a slight brownish tint to the panels. Mueller, Inc. reserves the right to add or discontinue colors without notice.


text:
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text: Wearing my GIRLKING nail polish by admin | Sep 13, 2018 | featured | 0 comments Wearing my #GIRLKINGnail polish shades from @nailsinc. I'm obsessed! 🙌🏼 #ad Available in-store at @nailsinc and online at @Sephora now. #GIRLKING #SEPHORA #NAILSINC Submit a Comment Cancel reply Your email address will not be published. Required fields are marked *Comment Name * Email * Website


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