text:
New products microwave drying and sterilization oven for condiments
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text:
Reigning world champions India and runners-up Iran will be favourites to make the final when they take on their respective semi-final opponents in the Kabaddi Masters on Friday.
This will be a repeat of the Asian Championship semi-final for India when they had beaten Korea 45-29 to avenge their World Cup 2016 league stage loss in Ahmedabad.
India have beaten Korea four times from five exchanges and the only loss was in the 2016 World Cup.
The six-nation invitational kabaddi tournament, organised by International Kabaddi Federation in association with Star Sports and Dubai Sports Council, is the last tournament before the Asian Games.
This has been a tournament for Indian youngsters as the likes of Rishank Devadiga and Monu Goyat, the most expensive kabaddi player, have been a revelation in their maiden international meet.
Skipper Ajay Thakur spearheads their attack with his top-raiding skills while in defence the likes of Surender Nada, Girish Maruti and Surjeet have lent a fine balance.
Iran will bank on their strong attacking lineup when they face Pakistan in the first semifinal.
Despite coming with a depleted side, Iran have easily outpaced their opponents -- Argentina and Korea -- to win four out of four matches.
When and where will the semi-final matches be played?
There are two semi-final matches scheduled on 29 June. In the first match, Iran take on Pakistan at the Al Wasl Sports Club in Dubai, United Arab Emirates, followed by the 2nd semi-final between India and South Korea at the same venue.
Where can I watch the semi-final matches live?
The match will be broadcast live on television by Star Sports. It will be available on Star Sports 1 Hindi, Star Sports 1 Hindi HD, Star Sports 2 and Star Sports 2 HD.
What time will live coverage of the match start?
The pre-match coverage will start at 7.30 pm IST, with Iran vs Pakistan beginning at 8.00 pm IST, followed by India vs South Korea at 9.00 pm IST.
Where can you follow the matches online?
The match will be streamed online on Hotstar.
With inputs from PTI
Updated Date: Jun 29, 2018 17:43:10 IST

subset: commoncrawl


text:
- Original Title :
- Genre :
- TV Episode / Adult
- Year :
- 2002–
- Cast :
- Peter Paul,Sam
- Type :
- TV Episode
- Rating :
- 6.9/10
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I was walking downtown after work when I came across a young homeless man laying on the sidewalk with cash sticking out of his hand. I noticed that a lot of the people who passed him looked at the money and thought for a second about taking it. I stuck around to see look at people's reactions and bust anyone who tried to steal it. After a close call I couldn't stand it any longer and intervened.
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Boring episode I ever seen bring on the next shitty video. Mammoth Racing Il y a an. 870 street outlaws will destroy them. All the money and time involved How can anyone hate on Chief for using his logic. Betting Big Money On Street Drag Racing Street Outlaws: Memphis.
At the end of each episode, the host sits down to talk with the designers about the room they just finished. lt; Season 10 Episode 4 Trading Spaces. Do not miss the latest episodes of all the hottest TV shows you enjoy watching. They are waiting for you here at Watchseriestv. You can watch the episodes that have been updated the most recently, but you can also go back to some older episodes that you missed or want to see again. There is a grand collection of popular TV shows and all their seasons are included, with all the episodes they contain that are neatly arranged so you can find everything you want to see with a lot of ease.
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|Episode credited cast:
|Peter Paul


text: William comments "This silverback gorilla sits at the edge of the cliff. He sits and thinks. He is desperately trying to understand how he and his kind now face extinction from this earth.There will come a time when the animals are no more but please don't let it be now. Please don't let it be this year."


text:
Learn the States Game
Lovely World Geography Map – Amoxil from Learn The States Game , image source:https://amoxil.me/wp-content/uploads/2018/10/world-geography-map-inspirational-north-america-geography-map-unique-biomes-north-america-ref-geo-of-world-geography-map.jpg
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text:
Part# RAM-HOL-PD3-238AU
The RAM Quick-Grip™ device mount is capable of holding a broad range of electronic devices. The spring loaded mechanism and the adjustable side keepers allow for a secure grip on your device. Whether it is a cell, GPS, blue tooth speaker or anything that will fit in the dimensions of the cradle, your electronics will be secure.
Included is a B Size 1" ball and hardware.
Some assembly required.
Cradle Clamping Dimensions:
Height Range: 4.75" - 5.75"
Width Range: 2.19" - 3.25"
Max Depth: 0.72"


text:
French senior researchers: 3 years is a really short period, you need to be aware of that all the time
Me: *is stressed out*
Not sure being stressed about a deadline is the best way to do a good research work, either
@otini They say "if we knew what we were doing, it wasn't a research" and also "you can't do math research without having a relative peace in your life".
For the former: Yes, planning isn't any efficient for that. But maybe the point is that it's still worth attempting. Failed plan is better than no plan at all, i.e.
For the latter: That's of course very motivating (…), to know that I won't be able to create anything of value before I already have earned the "relative peace in life"…
@otini Anyway, it's all about the "creative discipline", a semi'oxymoron, I would say.
functional.cafe is an instance for people interested in functional programming and languages.


text:
The First Art Newspaper on the Net
Established in 1996
United States
Tuesday, September 17, 2019
Last Week
Special Photos
15th edition of La Gacilly Photo Festival questions time for Earth
What happens when the infinitely tiny meets the infinitely huge? Spike Walkers work uses dizzying, perspective-altering angles to explore the resulting confusion and shake our perception of the world around us. © Spike Walker.
by Cyril Drouhet and Florence Drouhet
15 years ago,
La Gacilly Photo Festival
was created to be a space where images gave us an insight into our planets extremely fragile beauty a beauty which has been perverted by frenetic industrialisation, uprooted by urbanisation and impoverished through over-work of the earth. Either in a spirit of revolt or with a gentler approach, the photographers have set out to magnify, document, capture or simply display the vital connection between humankind and nature. The greatest names in contemporary photography have supported us throughout the years. They are, in their own way, custodians and protectors of our Earth. Without their shots, their drive to let others see what they see, their sensibilities and their implacable vision of the society emerging around us, we would not be able to stand in wonder before wild animals, the last unviolated ancient forests or the miracle of life itself. Neither would we know of the tragedies unfolding, of inhuman cities which crush in ever more inhabitants, of the earthworks which might destroy an entire ecosystem or of the pollution which is endangering our shared heritage.
Since the Festival first started in 2004, it has exhibited more than 300 artists and given visitors the chance to see more than 7000 photographs, opening up thousands of windows onto our world. In our open-air galleries and passageways and our gardens designed so that visitors can wander in amongst the art, we have aimed to share with an ever-growing audience of all ages all the brutality of our times but also images of hope or, quite simply, beauty. We can do this because the renowned photojournalists and artists we present each year all share our wild passion for our Earth as they travel the world looking for shots that reveal an undeniable truth. Many of them have even become friends of the festival, such as Brent Stirton, Pascal Maitre, Michael Nichols, Pierre de Vallom breuse, Sophie Zénon, and Nick Brandt. We extend our sincerest thanks to them for sharing their talent so loyally with us.
Our hope for the 15th anniversary Festival was that it would celebrate our reinvigorated Earth, with humankind having finally devoted all its attention to it out of concern for its future. Alas, as time has ticked on ever faster, the first warning signs have flared up and nation states have endlessly gathered to find solutions for our ailing planet, we are getting inexorably closer to the brink and at an increasing pace, despite us all being aware of how urgent action is if we are to avoid our ruination. Throughout our history, we have looked at nature without really seeing it. We have never sought to love it, but to tame it.
Is there still time to save our burning home?
In 1992, 1700 researchers called on us to act against environmental destruction. They feared that humanity was pushing Earths ecosystems beyond their capacities to support the web of life. Yet things have only worsened, and faced with the gravity of the situation, more than 15,000 scientists put their name to an unprecedented warning 25 years later in November 2017. In it, they stated that, over a quarter of a century, forests have inexorably disappeared, with 1.2 billion km2 of space having been swallowed up, largely by agriculture; numbers of mammals, reptiles, amphibians, birds and fish have fallen by a third; and the use of greenhouse gases has soared and global temperatures with it. Over the same period, areas of the ocean covered by dead zones, where marine life has been smothered by farming waste carried in by rivers and where oxygen has all but disappeared, have expanded by 75%. This damage is being done in lockstep with increases in population growth. Since the first call to action was issued, the number of people on the planet has increased by a third.
As science sees it, our only hope of salvation is if we undergo both a collective and personal change of mind-set. If we do not, we will run out of time. To reverse the dynamics currently underway, scientists have urgently recommended that we halt population growth by making family planning more widely available; create more nature reserves; strengthen laws against poaching; and offer wide-scale support for renewable energies and other green technology.
Take the time to observe, contemplate and respect the natural world which gives us our life force. Refuse to turn away from reality by taking responsibility for the irreversible footprint we leave behind. Declare any sign of progress a source of hope. These are the objectives.
La Gacilly Photo Festival has always strived for. For the 2018 Festival which marks our 15th birthday, we wanted to gather together the finest examples of photographic style, documentarian, photo-journalistic or artistic, so long as they demonstrated an awareness of our world while also expressing its enchanting qualities or beauty.
Astronaut Thomas Pesquet inspired millions of French people during his voyage aboard the European Space Station. There, he revealed himself to be an incomparable photographer and defender of the environment. He speaks eloquently of his cause, telling us Earth is a spaceship with a crew of 7 billion people, all of whom are seeking to survive. My photos are now my way of sharing the heightened awareness I have of this with you. We are exhibiting his images of space, which demonstrate that our planet is magnificent yet fragile. Spike Walkers images come to him in a rather unusual way. This British scientist allows us to delve into the micro-cosmos of living organisms, unveiling a form of life we do not usually get to see. Yet the worlds beauty is just as in evidence in Philippe Bourseillers extraordinary work focussing on ice and water; in Jean Gaumys abstract images of rocks; in Olaf Otto Beckers images of ancient forests; in Matthieu Ricards focus on the Himalayan peoples harmony with nature; in great colour photographer William Albert Allards shots of the America of wide open spaces which we all love; and in the pictures of our world taken by amateur photographers belonging to Image sans Frontière, the best of which we will display. We are also celebrating the animal kingdom which is seeing its natural balance equally threatened, in the wild animals represented by American Michael Nichols, the captivating creatures of Karen Knorr and troubling images by German Jan C. Schlegel.
La Gacilly Photo Festival is not content to simply exhibit great photographers we want to actively support environmental causes. Nations have a role to play, and so does business. Every year, 13 million hectares of forest an area four times the size of Belgium disappear all around the world. The Fondation Yves Rocher has committed to planting 100 million trees by 2020, and it is financing photography projects to raise public awareness of the sheer scale of deforestation. This year, we will exclusively unveil pictures taken with the Fondation Yves Rochers support by Brent Stirton in Ethiopia, Emanuele Scorcelletti in India and Phil Moore in France. Yet our drive to create photos goes even deeper than this. French-Spanish photographer Catalina Martin-Chico has spent a two-month residence in our village focussing on youth in La Gacilly. Edouard Elias, on the other hand, has travelled Le Morbihan to capture images of the local people who make our region so diverse, with support from the Departmental Council. We are also living out our ambition to showcase future talent by continuing a partnership with Fisheye magazine which lets us uncover emerging artists, and by again running the Le Morbihan School Photo Festival.
Our commitment also continues to emerge through the messages we seek to pass on to future generations via the photographers and their finely intelligent work. Chris Jordan makes photographic frescos which are grand in scale yet which defy our sense of perception, displaying the damage wrought by over-consumption. Artist Stéphane Couturier explores the overpopulated urban areas we have built. Patrick Tourneboeuf makes our head spin with images of cities of the future built in double-quick time in India or China. Fausto Podavini exposes how local Ethiopian life has been ravaged by policies encouraging major development. Frédéric Delangle gives us a compassionate glimpse of the teeming human life on the Indian sub-continent. And Robert and Shana ParkeHarrison share their dreamlike, surrealist vision of a shattered Earth.
Solutions exist, and they require us to respect local people and the harmony between humans and their natural environment. They also entail the development of innovative technology that generates less pollution. Miquel Dewever-Plana has set his focus on the tragedy lived out by Amerindians in French Guiana to reveal portraits of a people in search of an identity. The same issue always lies at the heart of Brazilian photographer Claudia Andujars work. She has helped to protect indigenous peoples by sharing in the daily existence of the Amazonian Yanomanis for several decades. We will also see intensely delicate and poetic photos by Russian Emil Gataullin for the first time ever in France. He examines rural life in his home country, and the results bear no relation to our apocalyptic vision of an industrial, desolate Russia.
Slovenian Matjaz Krivic reveals the reality behind lithium, an alkaline metal we all already have in our smartphones which will revolutionise our future by providing the batteries for our electric cars.
La Gacilly Photo Festival is able to run for its 15th year thanks to its wide-reaching appeal, the message it puts across and the quality of the photos it exhibits. Our values, high standards and love for photography will continue to drive our work for as long as the public wishes to engage with it. We are proud to announce that our concept for exposing works themed around environmental issues on a large scale in the open air has stirred envy internationally and that on 8th June, the small town of Baden, Austria, will open up its gardens, streets and parks for the first ever La Gacilly-Baden Photo Festival. Our latest adventure has begun!
Today's News
June 4, 2018
Palazzo della Cultura in Catania exhibits 150 works by Henri de Toulouse-Lautrec
Venet Foundation marks the 90th anniversary of Yves Klein's birth with an exceptional summer show
Navigating land, sea and air through the ages of photography at the Scottish National Portrait Gallery
Kunsthalle Mannheim opens new museum building
New exhibition of works by Iván Argote at Perrotin Paris conceived like an essay
Exhibition at The Phillips Collection celebrates Aboriginal Australian culture with nine leading artists
Jack Rutberg Fine Arts opens an exhibition of works by the Catalan artist Jordi Alcaraz
Finest collection of British paintings in America comes to Joslyn Art Museum
Bundeskunsthalle opens an exhibition on the subject of "Play"
Porsche Super Speedster offered for first time in 50 years at RM Sotheby's Porsche 70th Anniversary Auction
Binoche et Giquello to offer August III's chocolate set at Drouot in Paris
The Natural History Museum of Los Angeles County's 'Becoming Los Angeles' exhibition reopens
Jewels sparkle at Sotheby's this summer
The Ravestijn Gallery exhibits Scheltens & Abbenes' bright and colourful series 'The Workers'
Australasia's premier international art fair Sydney Contemporary announces 2018 gallery list
15th edition of La Gacilly Photo Festival questions time for Earth
New exhibition highlights collage and drawings by artist Benny Andrews, who balanced art with activism
V-A-C Foundation opens "The Explorers, Part One" at Palazzo delle Zattere in Venice
First solo exhibition in a European museum by the Chinese artist Zhang Peili opens at S.M.A.K.
Gammel Holtegaard exhibits works by Mette Winckelmann
Jim Kempner Fine Art opens an exhibition of David Mitchell's most recent photographs
Catherine Southon Auctioneer & Valuers to offer impressive collection of Royal Worcester
Fabrice Gygi presents large works on paper and two sculptures at Galerie Chantal Crousel
Exhibition features a collaboration between Kirsten Tradowsky and gallery owner Paul Kopeikin
Most Popular Last Seven Days
Holocaust 'masterpiece' causes uproar at Venice film festival
To be unveiled at Sotheby's: One of the greatest collections of Orientalist paintings ever assembled
Bender Gallery features paintings by up and coming Chicago artist Michael Hedges
Lévy Gorvy exhibits new and historic works by French master in his centenary year
Artificial Intelligence as good as Mahler? Austrian orchestra performs symphony with twist
Fascinating new exhibition explores enduring artistic bond between Scotland and Italy
Exhibition explores the process of Japanese-style woodblock production
Robert Frank, photographer of America's underbelly, dead at 94
The truth behind the legend of patriot Paul Revere revealed in a new exhibition at New-York Historical Society
Hitler bust found in cellar of French Senate
Digital Art
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From: Roald Audun Flo <EMAIL REMOVED>
Sent: Monday, April 1, 10:22 AM
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Dear Kirsten,
With a mistake, we transferred the payment for invoice 1229GH18 dated 1/25/2019, USD 1,209.60, to The Wells Fargo Bank Arizona N.A. according to enclosed documents.
This is a mistake, as the invoice is paid from before, we kindly ask you to return the money to our bank in Norway, Danske Bank, account no. 8101 42 16448 as enclosed document show.
We are very sorry for this mistake from our side, and kindly ask you to return the money by return.
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text:
Inter Milan Rajian difficulty, Was sank Sunday night in Naples, struggling to qualify in the Champions League, the second in the championship. Heavy 4-1 with 15th goal Kill Meredith. And his 11th season's help. Inter Milan are scheduled to issue next week's C1 ticket to Empoli.
After the success of AC Milan with Frosinone (2-0), Inter had to score on Sunday night to recover a margin for his neighbors during his visit to Naples. If successful lead You can certainly qualify for C1.
In San Paolo, Inter visited the team in Naples. Napoli already had no second place (76 points in the kickoff). Napoli was struck from the beginning of the game thanks to a lavish match from Poland. Piotr Zielinski (16 & # 39;).
Inter did not get aggressive inspiration and will be punished a little more in the second half. After the play, Naples accelerated and followed the center Calais, Dries Mertens comes to head to catch the misguided. Hanano Beach (61 & # 39;).
Then a team member of Mertens came out. Fabian Ruiz The last goal scored twice (71 minutes) and then (78 minutes) with the help of Eubanist. Disappointingly, Inter Icardi Penalty kick (81 minutes).
But, Rajian difficulty (48-minute warning) will finally be 4-1, and Atalanta will take fourth place in a game against Juventus. At 66 points, they have only one unit more than their AC Milan rival. They will have to win the final game against Empoli next Sunday.


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18F-Fluorocholine PET/CT in the assessment of primary hyperparathyroidism compared with 99mTc-MIBI or 99mTc-tetrofosmin SPECT/CT: a prospective dual-centre study in 100 patients
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In this prospective study we compared the accuracy of 18F-fluorocholine PET/CT with that of 99mTc-MIBI or99mTc-tetrofosmin SPECT/CT in the preoperative detection of parathyroid adenoma in patients with primary hyperparathyroidism. We also assessed the value of semiquantitative parameters in differentiating between parathyroid hyperplasia and adenoma.
Both 18F-fluorocholine PET/CT and 99mTc-MIBI/tetrofosmin SPECT/CT were performed in 100 consecutive patients with biochemical evidence of primary hyperparathyroidism. At least one abnormal focus on either 18F-fluorocholine or 99mTc-MIBI/tetrofosmin corresponding to a parathyroid gland or ectopic parathyroid tissue was considered as a positive finding. In 76 patients with positive findings on at least one imaging modality, surgical exploration was performed within 6 months, and the results were related to histopathological findings and clinical and laboratory findings at 3–6 months as the standard of truth. In 24 patients, no surgery was performed: in 18 patients with positive imaging findings surgery was refused or considered risky, and in 6 patients imaging was negative. Therefore, data from 82 patients (76 undergoing surgery, 6 without surgery) in whom the standard of truth criteria were met, were used in the final analysis.
All patients showed biochemical evidence of primary hyperparathyroidism with a mean serum calcium level of 2.78 ± 0.34 mmol/l and parathormone (PTH) level of 196.5 ± 236.4 pg/ml. The study results in 76 patients with verified histopathology and 3 patients with negative imaging findings were analysed. Three of six patients with negative imaging showed normalized serum PTH and calcium levels on laboratory follow-up at 3 and 6 months, and the results were considered true negative. In a patient-based analysis, the detection rate with 18F-fluorocholine PET/CT was 93% (76/82), but was only 61% (50/82) with 99mTc-MIBI/tetrofosmin SPECT/CT. In a lesion-based analysis, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of 18F-fluorocholine PET/CT in the detection of parathyroid adenoma were 93.7%, 96.0%, 90.2%, 97.4% and 95.3%, respectively, and of 99mTc-MIBI/tetrofosmin SPECT/CT were 60.8%, 98.5%, 94.1%, 86.3% and 87.7%, respectively. Although 18F-fluorocholine PET-positive adenomatous lesions showed higher SUVmax values than the hyperplastic glands (6.80 ± 3.78 vs. 4.53 ± 0.40) in the semiquantitative analysis, the difference was not significant (p = 0.236). The mean size (measured as the length of the greatest dimension) and weight of adenomas were 15.9 ± 7.6 mm (median 15 mm, range 1–40 mm) and 1.71 ± 1.86 g (median 1 g, range: 0.25–9 g), respectively. Among the analysed parameters including serum calcium and PTH and the size and weight of parathyroid adenomas, size was significantly different between patients with negative 99mTc-MIBI/tetrofosmin SPECT/CT and those with positive 99mTc-MIBI/tetrofosmin SPECT/CT (mean size 13.4 ± 7.6 mm vs. 16.9 ± 7.4 mm, respectively; p = 0.042).
In this prospective study, 18F-fluorocholine PET/CT showed promise as a functional imaging modality, being clearly superior to 99mTc-MIBI/tetrofosmin SPECT/CT, especially in the detection and localization of small parathyroid adenomas in patients with primary hyperparathyroidism. SUVmax was higher in parathyroid adenomas than in hyperplasia. However, further evaluation of this modality is needed.
Keywords18F-Fluorocholine PET/CT Primary hyperparathyroidism 99mTc-MIBI 99mTc-Tetrofosmin SPECT/CT
Primary hyperparathyroidism (PHPT) is the most prevalent cause of hypercalcaemia in outpatients [1]. PHPT is induced most frequently by a solitary parathyroid adenoma (80–85%) followed by four-gland hyperplasia (10–15%) and double adenoma (4%) [2]. The current way of treating symptomatic or young patients (<50 years of age) is surgical resection of the underlying adenoma [3]. Image-guided minimally invasive parathyroidectomy is preferred over classic bilateral neck exploration since it shows similar efficacy and is associated with less discomfort due to a shorter excision, shorter operation time, fewer complications, faster recovery and overall less expense for the patient [3, 4]. The minimally invasive surgical approach is planned following preoperative detection and localization of all causative adenomas using an accurate imaging modality [5]. Several imaging procedures have been proposed for the detection and localization of parathyroid adenomas. These include anatomical techniques such as ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI), and hybrid functional imaging techniques such as 99mTc-MIBI single photon emission computed tomography (SPECT) in combination with CT (SPECT/CT) [3, 4].
99mTc-labelled methoxy-isobutyl-isonitrile (MIBI) and tetrofosmin are both lipophilic cations that concentrate in the mitochondria corresponding to the transmembrane electrical potential and have shown close biological behaviour and detection values in clinical trials [6, 7, 8, 9]. 99mTc-MIBI SPECT has long been used and is considered the imaging modality of choice for the detection and localization of parathyroid adenomas [4, 10]. Studies have shown variable accuracy for 99mTc-MIBI SPECT with equivocal imaging results in nearly one third of patients [11]. Recent meta-analyses have shown higher detection rates of 84–88% (in both patient-based and lesion-based analyses) for hybrid 99mTc-MIBI SPECT/CT imaging [6, 12, 13]. Recently, the role of positron emission tomography/computed tomography (PET/CT) imaging using specific PET tracers has been highlighted. This approach provides complementary anatomical and functional information and exhibits higher spatial and temporal resolution [5].
Several PET radiotracers have been introduced in recent years for the assessment of PHPT. The most commonly used PET tracer is 11C-methionine. However, the value of 18F-fluorocholine, a marker of cellular proliferation, in the detection and localization of parathyroid adenoma has recently been shown [5]. 18F-Fluorocholine has a longer half-life and provides more flexibility for patient management in PET/CT centres. Previous studies have shown promising results with 18F-fluorocholine PET/CT in the assessment of PHPT. This prospective study was designed to compare the value of 18F-fluorocholine PET/CT with that of 99mTc-MIBI or 99mTc-tetrofosmin SPECT/CT in detecting parathyroid adenomas in a large patient population and to correlate the results of the imaging modalities with histopathological findings and laboratory parameters on follow-up examinations. This work also assessed the value of semiquantitative parameters in differentiating between parathyroid hyperplasia and adenoma.
Materials and methods
In this prospective dual-centre study, 100 patients (21 men, 79 women; mean age 57.4 ± 12.5 years) with clinical evidence of PHPT, i.e. those with elevated serum levels of parathormone (PTH) and/or calcium, were enrolled from October 2015 to October 2017. The inclusion criteria were clinical evidence of PHPT and ability to tolerate both 99mTc-MIBI or 99mTc-tetrofosmin SPECT/CT and 18F-fluorocholine PET/CT. The exclusion criteria were low serum vitamin D levels, other metabolic diseases, known cancer, clinical or laboratory findings suggesting secondary or tertiary hyperparathyroidism, or active inflammatory or granulomatous diseases. The patients underwent imaging with both modalities including 18F-fluorocholine PET/CT and 99mTc-MIBI or 99mTc-tetrofosmin SPECT/CT for preoperative assessment and localization of parathyroid adenomas regardless of the 99mTc-MIBI SPECT/CT results.
The study was approved by the institutional Ethics Committee (415-E/1858/2-2015) and was performed according to the principles of the 1964 Declaration of Helsinki and its later amendments or comparable standards. Written informed consent was obtained from all patients.
18F-Fluorocholine PET/CT
The study was performed using two different PET/CT scanners. A dedicated PET/CT scanner (Discovery 710; GE Healthcare) consisting of an extended field-of-view full-ring high-resolution LSO PET component and a 128-slice spiral CT component was used in 49 patients. Imaging was performed 60 min after intravenous injection of 3.2 MBq/kg body weight 18F-fluorocholine. PET/CT acquisitions were obtained from the base of the skull to the proximal thighs with 2.5 min per bed position using time-of-flight (TOF) mode and a nondiagnostic CT scan (in most patients) for attenuation correction and localization. If tracer uptake in the cervical or thoracic regions was equivocal or unclear, an additional delayed acquisition (100–120 min after injection) was performed. All images were reconstructed identically using the ordered-subsets expectation maximization algorithm (four iterations, 18 subsets) followed by a postreconstruction smoothing gaussian filter (4.0 mm full-width at half-maximum). The slice thickness was 3.75 mm for PET images.
A Philips Ingenuity TF (Philips Healthcare, PC Best, The Netherlands) was used in 33 patients. Imaging was performed 60 min after intravenous injection of 3.2 MBq/kg body-weight 18F-fluorocholine. PET/CT acquisitions were obtained from the base of the skull to the diaphragm to include possible ectopic adenomas. Delayed imaging (100–120 min after injection) was obtained if indicated. Images were reconstructed using a three-dimensional ordered-subsets iterative TOF (BLOB-OS-TF) algorithm after correction for scatter and attenuation. For the CT scan (50 mA, 120 kV), a collimation 64 × 0.625 mm, a slice thickness 3 mm and reconstruction increment 1.5 mm were used. The time between the two scans was not more than 2 weeks.
Images were read separately by two experienced nuclear medicine specialists, who were aware of the patient's clinical diagnosis, previous imaging and laboratory data, using advanced PET/CT review software (Advantage Windows, version 4.6, for the GE Medical Systems scanner; or Philips IntelliSpace, version 8.0, for the Philips Medical Systems scanner) which allowed simultaneous scrolling through the corresponding PET, CT and fusion images in the transverse, coronal and sagittal planes. Images were interpreted separately in each study centre. Any focal 18F-fluorocholine uptake above the background tissue uptake was interpreted as pathological hyperfunctioning parathyroid tissue. Lesions were localized anatomically to six regions: right upper, right lower, left upper and left lower thyroid, intrathyroidal, and ectopic (e.g. mediastinal). The thyroid gland showed mild to moderate physiological tracer uptake on 18F-fluorocholine PET/CT but this did not affect interpretation of abnormal parathyroid lesions especially when assessing transaxial images.
For semiquantitative analysis, the maximum standardized uptake value (SUVmax) was calculated by manually locating a standard (25 × 25 × 25 mm) volume of interest over the detected pathological lesion related to the parathyroid abnormality on 18F-fluorocholine PET/CT images.
The maximum length of the metabolic diameter of the pathological parathyroid lesions was measured manually with a commercial tool provided with the review software.
Neck ultrasonography was performed in all patients for morphological correlation and improvement of image interpretation. However, these data and their analysis are not presented in this article because this was considered beyond the scope of this study.
99mTc-MIBI/tetrofosmin SPECT/CT
Imaging was performed using a dedicated SPECT/CT scanner (Symbia T2 or T6; Siemens Healthineers) after intravenous injection of 740 MBq 99mTc-MIBI (in 49 patients) or 99mTc-tetrofosmin (in 33 patients). Planar imaging of the head/neck and thorax was performed in the anterior and posterior views 15 min, 60 min and 120 min after injection. An additional SPECT/CT acquisition was performed in conjunction with planar 60-min scintigraphy. The SPECT/CT acquisition comprised 64 projections of 20 s each. Images were reconstructed with Flash3D using 14 iterations and four subsets. A low-dose CT scan (130 kV, effective 30 mAs; CARE Dose 4D) was performed for anatomical correlation only.
Images were read using advanced software for multimodality reading (syngo.via; Siemens Healthineers). Focal increasing or persistent uptake associated with parathyroid abnormality was considered as pathological hyperfunctioning parathyroid tissue. The lesions were localized to the same six regions as the 18F-fluorocholine PET/CT scans.
Surgery and histopathology
A consensus multidisciplinary meeting was held before surgery and all clinical and imaging findings were reviewed for final diagnosis by a nuclear medicine physician, a radiologist, an endocrinologist and an endocrine surgeon. The surgical approach primarily consisted of focused microinvasive parathyroidectomy (MIP) with intraoperative intact parathormone (iPTH) assay in patients with a single adenoma based on the consensus imaging reading. In patients with multiple parathyroidal lesions, a classical unilateral or bilateral neck exploration with intraoperative iPTH testing was performed. Surgery was considered successful if there was a decrease in iPTH serum levels of at least 50% from the baseline value; otherwise, bilateral classic neck exploration was performed.
Patients with negative imaging were further evaluated by 24-h urine calcium measurement to rule out familial hypocalciuric hypercalcaemia. Serum calcium and PTH levels were determined at 3 and 6 months after surgery or imaging in all patients. All removed parathyroid gland(s) were evaluated histopathologically as the gold standard, including size, weight and the dominant cell type. Parathyroid hyperplasia could only be defined when multiple gland resection had been performed [7]. The size and weight of almost all resected parathyroid glands were measured.
Statistical analysis
SPSS, version 24.0 for Windows (SPSS Inc. and LEAD Technologies) was used for statistical evaluation of the results. Continuous variables are expressed as mean and median values with standard deviations (SD) as well as minimum and maximum. The normality of distributions was evaluated using the Shapiro-Will test. Student's t test for parametric variables was applied as appropriate to determine the significance of differences in laboratory measurements and SUVs. Categorical variables were evaluated using Fisher's exact test to compare the accuracies between the two different localization techniques with regard to the correct side of the neck (right or left) and the correct quadrant (right upper, right lower, left upper and left lower) or other more specific locations (i.e. intrathyroidal and mediastinal). P values <0.05 were considered statistically significant. Imaging was considered successful if the lesion detected could be anatomically verified and removed on surgery, was histologically confirmed as an adenoma or hyperplasia and the patient was biochemically cured. Findings that could not be histologically verified, or findings that did not result in biochemical cure after surgery to the corresponding site, were considered false-positive.
Of 100 patients who underwent imaging with both modalities, 18 with positive imaging findings refused surgical resection or had an unexpected clinical event that prevented any intervention. Thus, a total of 82 patients (16 men, 66 women; mean age 59.8 ± 14.8 years) with a mean serum calcium level of 2.78 ± 0.34 mmol/dl (normal range 2.10–2.58 mmol/dl; 28 patients within the normal range) and a mean serum PTH level of 196.5 ± 236.4 pg/ml (normal range 11.1–79.5 pg/ml) were included in the final analysis.
In 76 patients (93%) at least one imaging modality was positive; thus surgical resection was performed. Removal of a single parathyroid gland was performed by MIP in 59 of the 76 patients (78%), and 17 of the 76 patients (22%) underwent multiple gland excision using a classical unilateral or bilateral neck exploration technique. In 6 patients (8%) both 18F-fluorocholine PET/CT and 99mTc-MIBI/tetrofosmin SPECT/CT were negative. Three of these patients showed a marked reduction in serum calcium and PTH on the follow-up examinations, and were considered true-negative for statistical analysis. However, in three patients the laboratory parameters showed an increasing pattern and the patients were classified as false-negative. Serum calcium and PTH had normalized at 3 and/or 6 months in all patients who underwent parathyroidectomy.
Serum calcium and PTH levels in PET/CT-negative and SPECT/CT-negative patients and in PET/CT-positive and/or SPECT/CT-positive patients
Laboratory parameter
PET/CT-negative and SPECT/CT-negative (n = 6)
PET/CT-positive or SPECT/CT-positive (n = 76)
p value
Calcium (mmol/dl), mean ± SD
2.54 ± 0.20
2.77 ± 0.32
PTH (pg/ml), mean ± SD
105.6 ± 54.6
174.9 ± 165.3
Laboratory parameters (serum calcium and PTH) in SPECT/CT-negative patients and SPECT/CT-positive patients, and histopathological findings in the adenomas from the two groups
p value
Laboratory parameters
Calcium (mmol/dl), mean ± SD
2.67 ± 0.27 (n = 32)
2.81 ± 0.33 (n = 50)
PTH (pg/ml), mean ± SD
148.3 ± 118.5 (n = 32)
183.6 ± 182.4 (n = 50)
Histopathological findings
Size (mm), mean ± SD
13.3 ± 6.7 (n = 24)
17.6 ± 7.4 (n = 47)
Weight (g), mean ± SD
1.19 ± 1.35 (n = 18)
2.09 ± 1.89 (n = 34)
Histopathological findings (size and weight) in parathyroid adenomas from PET/CT-positive and SPECT/CT-positive patients and PET/CT-positive and SPECT/CT-negative patients
Histopathological findings
PET/CT-positive and SPECT/CT-positive
PET/CT-positive and SPECT/CT-negative
p value
Size (mm), mean ± SD
17.6 ± 7.4 (n = 47)
13.0 ± 6.6 (n = 23)
Weight (g), mean ± SD
2.09 ± 1.89 (n = 34)
1.24 ± 1.38 (n = 17)
Locations of histologically verified adenomas on 18F-fluorocholine PET/CT
Right upper thyroid
Right lower thyroid
Left upper thyroid
Left lower thyroid
Lesion-based sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of each imaging modality based on true-positive, true-negative, false-positive and false-negative results
imaging modality
Sensitivity (%)
Specificity (%)
Accuracy (%)
18F-Fluorocholine PET/CT
99mTc-MIBI/tetrofosmin SPECT/CT
Although 18F-fluorocholine PET-positive adenomatous lesions showed higher SUVmax values in the semiquantitative analysis than hyperplastic glands (6.80 ± 3.78 vs. 4.53 ± 0.40), the difference was not significant (p = 0.236). Nevertheless, in the logistic regression analysis SUVmax was the most significant factor predicting the final histopathology in contrast to preoperative serum PTH level (p = 0.040 vs. p = 0.159, respectively). Furthermore, Fisher's exact test showed a significant association between positive 18F-fluorocholine PET/CT findings and the histopathological result for parathyroid adenoma (p = 0.003). However, there was no significant association between 99mTc-MIBI/tetrofosmin SPECT/CT positivity and the histopathological findings (p = 0.247).
PHPT is newly diagnosed in 100,000 patients in the USA per year and occurs in 0.2–0.5% of the population [14]. There is currently increasing interest in MIP as the optimal surgical approach to the treatment of PHPT. This technique offers several advantages including the ability to use local or general anaesthesia and a reduced risk of recurrent or persistent hyperparathyroidism, a lower incidence and severity of symptomatic and biochemical hypocalcaemia, shorter operative time and similar results to bilateral exploration with better cosmetic outcome, and a favourable operative field in patients who require reoperation for recurrent disease [15, 16, 17, 18, 19, 20]. However, accurate diagnosis and correct localization are mandatory to obtain optimal treatment results with this surgical method [5].
99mTc-MIBI/tetrofosmin SPECT/CT is the current modality of choice for detection and localization of parathyroid adenoma [14, 21]. However, some studies have shown a sensitivity of about 71%, leading to false-negative results in one-third of patients with biochemical evidence of PHPT. Moreover, this approach has limited value in multiglandular disease, which is the cause of hyperparathyroidism in 5–15% of cases and is therefore associated with the risk of surgical failure [22].
A recent meta-analysis showed an estimated pooled sensitivity of 86% (per-patient analysis) for dual-phase 99mTc-MIBI SPECT/CT in the detection of parathyroid adenoma [13]. However, published studies have mainly evaluated 99mTc-MIBI SPECT/CT alone without comparing it with an advanced functional modality. Furthermore, clinical and laboratory parameters, the phase of disease at the time of imaging, whether the SPECT/CT imaging was dual-phase or single-phase, and the patient population are factors that may affect the sensitivity of this modality in the assessment of PHPT.
In addition, 18F-fluorocholine PET/CT was able to detect parathyroid adenoma in 23 patients in whom 99mTc-MIBI SPECT/CT was negative; thus, it could be a better guide to choosing the less-invasive MIP as the surgical technique rather than bilateral neck exploration. Furthermore, 18F-fluorocholine PET/CT offers technical advantages over 99mTc-MIBI SPECT/CT, mainly in relation to its better spatial resolution and shorter total imaging time (20 min vs. 120 min) as well as exposure of patients to less radiation especially with modern scanners [24, 25]. Although, 18F-fluorocholine PET/CT showed better performance than 99mTc-MIBI scintigraphy in this study, whether it can be recommended as first-line imaging needs to be evaluated in future studies particularly in comparison with dual-isotope subtraction and dual-time 99mTc-MIBI SPECT/CT methods. However, in six patients, 18F-fluorocholine PET/CT was negative. In three of these patients, serum PTH and calcium levels had normalized on the follow-up studies (true-negative), and in the other three patients (4%) 18F-fluorocholine PET/CT failed to detect parathyroid lesions (false-negative). This may have been related to the small size or pathological characteristics of the adenomas including a low number of adenoma-like cells corresponding to a low functional status or a fairly low number of oxyphilic cells.
11C-Methionine is the PET tracer that has been most investigated for the assessment of PHPT in the last decade [22, 27, 28, 29]. The sensitivity and specificity found in this study were better than the reported pooled sensitivity and specificity of 86% and 86%, respectively, found in a per patient-based analysis of 11C-methionine PET/CT in the evaluation of patients with PHPT and negative 99mTc-MIBI SPECT [30]. Moreover, the short half-life of 11C limits its wide commercial use.
In this research, the prevalences of solitary parathyroid adenoma, double adenomas and four-gland adenomas were 74% (59/79), 20% (16/79) and 5% (4/79), respectively. In contrast to the findings of previous studies, the prevalence of parathyroid hyperplasia was lower in our study (overall four hyperplastic glands in two patients) [2, 24]. This may be related to the different histopathological definitions and criteria for the differentiation of parathyroid adenoma from hyperplasia in various departments. Adenomas and hyperplasia both mainly consist of chief cells, and are devoid of adipocytes and cytoplasmic lipid. The involvement of a single gland is the widely accepted criterion for the diagnosis of adenoma based on macroscopic and/or microscopic findings in the remaining associated glands [31, 32]. The accurate detection and localization of parathyroid adenomas and performing MIP, that led to a decrease in iPTH levels of more than 50% in 78% of our patients, may be the reason for the low number of parathyroid hyperplastic glands.
Finally, the multivariate analysis showed that the size of the adenomas was significantly different between patients negative on 99mTc-MIBI/tetrofosmin SPECT/CT and those positive on 18F-fluorocholine PET/CT. However, there was no meaningful difference in other laboratory and histopathological findings including serum calcium and PTH or the weight of the adenomas between these two groups.
Limitations of study
In 40% of patients we used 99mTc-tetrofosmin for SPECT/CT examinations which may have affected the sensitivity of this modality [9]. However, in view of the equal detection efficiencies of 99mTc-MIBI and 99mTc-tetrofosmin reported in the literature, this may have caused no meaningful bias in the results of this study [8, 9, 33]. Early SPECT/CT was not performed in this study for ethical reasons and exposure of patients to additional radiation. This may have reduced the sensitivity of 99mTc-MIBI/tetrofosmin SPECT/CT in the detection of small hyperactive parathyroid tissues with rapid washout and may have been a methodological limitation of this study that could have caused a bias in the reported sensitivity. Due to the homogeneity of the patient population of this study, we consider that direct comparison of the imaging modalities used in each study centre would have had no significant influence on the results. Therefore, the data were not analysed separately.
18F-Fluorocholine PET/CT was shown to be clearly superior to 99mTc-MIBI/tetrofosmin SPECT/CT in this prospective study in a large patient population. It shows very promising potential for first-line functional imaging for the early detection and localization of small parathyroid adenomas in patients with PHPT. Semiquantitative analysis may provide additional information in differentiating parathyroid adenoma from hyperplasia, but further evaluation is warranted.
Open access funding provided by Paracelsus Medical University.
This is study received no Funding.
Compliance with ethical standards
Conflicts of interest
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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More Stores Now Selling Jamie's Cracked Corn
Those who frequent farmer's markets across Ontario already know the tongue tantalizing flavours of our kettle corn, but now you won't have to wait the week out to get your hands on a bag. (more…)
New Store Selling Jamie's Cracked Corn
There is a new store selling Jamie's Cracked Corn – it is the Ice Cream Cafe on Main Street in Brampton. Grab a scoop or two of Jamie's flavours in The Ice Cream Cafe's new bulk popcorn section.
The Ice Cream Cafe
23 Main St S, Brampton, ON L6W 2C3
You can now buy Jamie's Cracked Corn at selected retail outlets.
You can now buy Jamie's Cracked Corn at selected retail outlets.
Keep an eye out for our great new packages.
We've added 4 great new locations for you to get your fix!
Look at WHERE TO BUY to find out where.
Share the Joy and give someone a Jamie's Cracked Corn gift basket.
A great gift for teachers, co-workers or for that someone who's hard to buy for.
Also perfect for secret Santa and hostess gifts. NOW Available Jamie's Cracked Corn Maple Kettle Corn. Made the old fashioned way with real Canadian Maple Syrup.
You can't get more Canadian that that eh!


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Mazda Gives $1500 in Wish List Items to SAFE Alliance in Austin to Help Families in Crisis
by Kristin Shaw
When your work gives you the opportunity to give $1500 in wish list items to the local children's shelter and shop for the goodies with fun friends, it's a GREAT day.
On December 12, Thrills and Wheels had the honor of leading an event with Austin Mazda dealership Roger Beasley Mazda to help SAFE Alliance. The SAFE Alliance is a merger of Austin Children's Shelter and SafePlace, both long-standing and respected human service agencies serving the survivors of child abuse, sexual assault and exploitation, and domestic violence.
With the help of local influencers Wendi Aarons, Susanne Kerns, and Jamie Doborek, along with talented and acclaimed photographer Elizabeth McGuire, we picked up two beautiful new Mazda CX-9s for the trip. Chelsea Bancroft from Roger Beasley Automotive joined us, setting up the red and white Santa sleighs – the CX-9s, that is – to transport the gifts to SAFE.
Our event in video (by Susanne Kerns): watch.
A charity close to our hearts, SAFE runs a variety of programs that are critical in our community. The Early Childhood and Teen Parent program, which is a residential program for pregnant and parenting teens in the foster care system with their children, helps families build successful and resilient children through strengthening parents and preserving families. The Strong Start program empowers families through early childhood services and family support. The shelter provides a number of services, including:
Parent education to enable parents to increase positive behaviors in children and use appropriate strategies to decrease children's challenging behaviors.
The Children Support Services program, offered within Strong Start's educational home visiting program, provides families the opportunity for their child (ages 3-5 years old) to participate in 1:1 positive social and emotional development with a Child Support Specialist.
Crisis intervention services, which may include immediate crisis assistance, parenting education and support, home and community visits, and more.
Mental health services for both children and parents.
Support services in addition to parenting classes and counseling by parent support specialists.
Thank you Jamie Kincaid Tinsley, Roger Beasley Mazda Austin, and Mazda USA for sending us on this shopping spree to help kids in need in Austin. We are grateful for the chance to make the lives of a few kids a little bit better this holiday season.
Want to see us loading the back of the CX-9 in rapid speed? Check it out here.
About Roger Beasley Mazda
Roger Beasley Mazda is the #1 Mazda dealership in the Austin area. In 1972 Roger Beasley opened his first car dealership. Roger Beasley Mazda on Burnet Road. In fact, it was one of the first Mazda dealerships in the entire country. Now Roger Beasley Imports includes 3 top tier brands and 7 separate dealerships in and around Austin, Texas. The success and expansion of the Beasley brand can only be attributed to Roger Beasley's consistent belief in his founding principles: take care of the customer no matter what, provide quality products and service, and be an active supporter of the local community.
About the Mazda CX-9
Mazda's CX-9 is a 3-row, 7-passenger SUV. The base model starts at $32,280 and is available in four distinct trim lines: Sport, Touring, Grand Touring, and Signature. The top of the line, Signature, starts at $45,365. Apple CarPlay and Android Auto integration are both available for this model, making communication a breeze. In regards to fuel economy, it logs 28 highway miles per gallon (MPG). When the third row is not in use for seating, there is a *lot* of room in the back for road trips… or gifts for kids and families who need them.


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World Cup Bleeding Macau Dry… Or Is It?
The FIFA World Cup has been blamed for a multitude of sins, but banks say draining Macau's casino takings is not one of them.
Prior to the start of the tournament last month, analysts at investment banks – perhaps with their minds turning towards the subject of football instead of their spreadsheets – had speculated that the World Cup would sap numbers of gamblers in Macau.


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Brock uses his understanding of functional movement, endurance training, muscle building and the ever important balance between performance and health to help people all over the world achieve their goals and improve their quality of life. Brock was a blogger for the Canadian Running magazine iRun.ca and has appeared as a guest and co-host on many health and wellness podcasts, such as: Ben Greenfield Fitness, Primal Endurance, Endurance Planet, and The Whole Athlete. You can also check out his workplace wellness podcast at WorkplaceHero.me.
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to want to consume fewer calories than you expend – without hunger – and lose weight. Several of the tips mentioned above are about fine-tuning your diet to better this effect.
This training plan is designed to help you fall back in love with exercise, easing you into a manageable and sustainable routine. It combines bodyweight exercises (promoting increased strength and fat loss, and improving general conditioning) with progressive cardio workouts that are designed to improve general fitness. The most straightforward exercise in the programme is jogging, but you might prefer swimming, cycling or using a cross-trainer. I have suggested the length of each workout, but if you start and find things too easy, do increase them. For example, you may find that a 10-minute jog is a challenge, but a 10-minute swim is not.
Research demonstrates that eating later can actually lead to slower weight loss, while eating a larger meal at breakfast and smaller meals throughout the day can help you lose more weight! And while we're not going to tell you to restrict yourself to no food after 6 p.m, it's important to consider what time of day you struggle most with temptation.
Have you ever noticed that a couple hours after a big greasy (yet delicious) meal you feel hungry again? That's because you have not turned off your hunger receptors, and as soon as your body starts to process that food your brain will start up again with "we need nourishment"… because you guessed it, that carton of kung-pow did not give you nourishment, just a full belly. Next time go for more veggies, you'll stay fuller longer and thus eat fewer calories.
A sedentary lifestyle is one of the major causes of occurrence of belly fat. If you don't indulge in any physical activity, and spend most of the time sitting, watching T.V., reading, etc., it is known as a sedentary lifestyle. Lack of regular exercise, or not exercising at all can lead to fat storage around the belly area. In other words, being a couch potato will make you fat.
While I wish the smart notification system on the fenix was more interactive when paired with iOS (like on the Apple Watch), it's still nice to be able to check your wrist on the run to see if that buzz on your phone is something you need to pause and take care of. I do miss the coaching available in other apps. Garmin Connect is a top notch way to view your workout data, but you need to bring your own plan.
As funny as it sounds, sleep deprivation may make you fat — and not just because you're susceptible to cases of the late-night munchies (although there's that too). There's tons of research that demonstrates getting less than the desired amount — about 7 hours — of sleep per night can slow down your metabolism. Plus, when you're awake for longer, you're naturally more likely to nosh. So don't skimp on your ZZZs, and you'll be rewarded with an extra edge when it comes to shedding pounds quickly.
Do you even lift, bro? If you're serious about getting rid of that belly fat fast, resistance training might just be the key. A study from the Harvard School of Public Health found that adding weight training to adult male test subjects' workouts significantly reduced their risk of abdominal obesity over a multi-year study period, although doing the same amount of cardio had no such effect. Research from the University of Maryland even found that just 16 weeks of weight training boosted study participants' metabolic rates by a whopping 7.7 percent, making it easier to ditch those extra inches around your middle.
1. Bicycle Crunches are a great ab exercise and work the abs from every angle. It's a combination of the regular crunch, a side-to-side motion that hits the oblique muscles and a reverse crunch that targets the lower abs. You can change the difficulty level by increasing or decreasing the range of motion used and the speed of movement as well as the intensity of the crunch by holding and squeezing.
The sad truth is that conventional ideas – eat less, run more – do not work long term. Counting calories, exercising for hours every day and trying to ignore your hunger? That's needless suffering and it wastes your time and precious willpower. It's weight loss for masochists. Eventually almost everyone gives up. That's why we have an obesity epidemic. Fortunately there's a better way.
3. Exercise Ball Crunch: This is one of the most effective ways to strengthen and flatten abs. Studies show this exercise is 40% more effective than regular ab crunches as it targets smaller muscles for flat toned abs including the oblique's for a small waist and the outermost muscles that your typical ab crunch may miss. To begin, lie down on the ball positioning it under the lower back. Place arms behind your head. Tighten your abs as you lift your torso off the ball while keeping the ball stable. Lower back down and repeat 15 times with 1-3 sets.
Fermented foods: These enhance the function of good bacteria while inhibiting the growth of bad bacteria. Sauerkraut, kimchi, kefir, yogurt, tempeh, and miso all contain good amounts of probiotics, which help to increase good bacteria. Researchers have studied kimchi widely, and study results suggest that it has anti-obesity effects. Similarly, studies have shown that kefir may help to promote weight loss in overweight women.
How much fiber should I eat per day? Most Americans eat less fiber than the USDA daily recommendations suggest. This article looks at the guidelines for fiber intake in men, women, and children. We also talk about how fiber can help with weight loss, and discuss how much fiber is too much. Learn about good sources of dietary fiber and a handy meal plan. Read now
2. Boxing: I let my clients do boxing as I feel that it's a great way to pump up your heart rate and increase sweating. Higher the heart rate the more calories they'll be burning. Usually I instruct my clients to do one minute of punches or combinations usually on boxing pads but can also be done on a punch bag followed by 30 seconds rest. Usually I repeat this exercise several times until my clients are fit. Then I let them hold the plank in between rounds as an active rest.
Listen up: Skipping meals will not make you lose weight faster. If a hectic day makes a sit-down meal impossible, stash an energy bar or a piece of fruit in your car or tote, keep snacks in your office desk drawer, and make a point of getting up to grab a nosh — anything that will keep you from going hungry! Going long periods of time without food does double-duty harm on our healthy eating efforts by both slowing down your metabolism, and priming you for another binge later in the day. (Think: You've skipped breakfast and lunch, so you're ready to takedown a whole turkey by dinner!) Make it your mission to eat three meals and two snacks every day, and don't wait longer than three to four hours without eating. Set a "snack alarm" on your phone if needed.
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About 65 percent of the human body is made up of water, so it's important to replenish the water you lose each day. According to a study conducted among 10,000 adults aged 18 to 64 over a three year period, drinking plenty of water and eating water-filled fruits and vegetables significantly improves your ability to lose weight fast, especially if you are overweight or obese.
The researchers explain that people who cook their own meals may simply have other good-for-you habits, like exercising more. However, they concluded that home cooks simply ate more fruits and vegetables (along with a wider variety of foods), have healthier methods of prepping their food, and splurge less on foods high in calories and sugar. No clue where to start? Try these 25 high-protein chicken recipes for weight loss.
Nuts. It's very easy to eat until the nuts are gone, regardless of how full you are. A tip: According to science, salted nuts are harder to stop eating than unsalted nuts. Salted nuts tempt you to more overeating. Good to know. Another tip: Avoid bringing the entire bag to the couch, preferably choose a small bowl instead. I often eat all the nuts in front of me, whether I'm hungry or not.
Also some research shows that the human body is primed to consume most of its calories during daylight hours. But the lifestyle is problematic for many: Because family meals and dinners with friends often are scheduled for after sunset, "people who try to stop eating after 7pm can't do it every day for the rest of their lives," says Dr. Seltzer, who supports an alternative strategy: Eating a hearty meal at your regular dinnertime.
Nuts, the second food to watch, contain a fair amount of carbohydrate, and it's very easy to unwittingly scarf down large quantities. Cashew nuts are among the worst carb-wise – you'll find that they contain around 20% carbohydrate by weight. For someone following a strict keto diet with a 20 grams of carbs per day allowance, this means that consuming 100 grams (which happens in a flash!) will have filled their daily quota. Peanuts tend to be around 10-15% carbohydrate – not putting them in the clear either.
Loads of research demonstrates people who log everything they eat — especially those who log while they're eating — are more likely to lose weight and keep it off for the long-haul. Start tracking on an app like MyFitnessPal when the pounds start sneaking up on you. It'll help you stay accountable for what you've eaten. Plus, you can easily identify some other areas of your daily eats that could use a little improvement when it's written out in front of you.
It's a one-time investment you'll never regret. Here's why: Strength training builds lean muscle tissue, which burns more calories — at work or at rest — 24 hours a day, seven days a week. The more lean muscle you have, the faster you'll slim down. How do you start strength training? Try some push-ups or a few squats or lunges. Use your free weights to perform simple bicep curls or tricep pulls right in your home or office. Do these exercises three to four times per week, and you'll soon see a rapid improvement in your physique.
Getting rid of your belly bulge is important for more than just vanity's sake. Excess abdominal fat—particularly visceral fat, the kind that surrounds your organs and puffs your stomach into a "beer gut"—is a predictor of heart disease, type 2 diabetes, insulin resistance, and some cancers. If diet and exercise haven't done much to reduce your pooch, then your hormones, your age, and other genetic factors may be the reason why. Read on for 11 possible reasons why your belly fat won't budge.
Carbohydrates are a touchy subject: while some blame them for all fat gain, it's the type of carbs you eat that's key. A 2011 study out of the University of Alabama found that a diet that slightly cut back on carbs, and which comprised mostly low-GI carbohydrates, lost more deep abdominal fat than those who ate a lower-fat diet. GI stands for glycemic index, a measure of how fast carbohydrates supply your body with energy: high-GI foods make you spike then crash, while low-GI foods provide a slow burn.
Science backs these ideas up when it comes shedding belly fat: In one study published in The Journal of Nutrition, researchers had overweight men and women follow a high-protein diet (30 percent protein, 40 percent carbs, and 30 percent fat) or a high-carb diet (15 percent protein, 55 percent carbs, and 30 percent fat). After one year of weight loss and maintenance, they found that the high-protein group experienced a 21 percent greater weight loss and 27 percent greater body fat loss on average than the high-carb group.
2. Sweep: Start with basic abs tuck (standing crunch). For that you have to lift one knee using the abs, and bend the other knee to sit slightly on the ground. Bring the rib cage to the bellybutton so that the spine is in C-curve position. Simultaneously, squeeze the oblique on one side to crunch while reaching down for the opposite foot. Do 10 repetitions for each side, then do 10 again (total of 20, alternating after 10).
As said before, measuring your waist with the tape is the easiest way to check belly fat. Measure your torso at the level of your navel. As per the official guidelines, measure your abdomen from just above the hip bone or the iliac crest, just where it intersects the line dropping down from the middle of the right armpit. Breathe normally while taking the measurement, and don't hold the measuring tape too tight against the skin. Those with a waist size more than 33 inches are at risk of developing chronic heart disease.
Try a diet in which you consume 2200 calories (men) or 2000 calories (women) per day. This should cause a deficit sufficient for you to lose one or two pounds per week, depending on your activity level. Some women may require lower daily calorie intake, such as 1800 or 1500 a day. Start by limiting yourself to a 2000 calorie limit per day, and lower the limit if you do not see progress.
This drug is an injected variant of a satiety hormone called GLP-1. It slows down how quickly the stomach empties and tells the brain that you don't need to eat yet – a great idea for losing weight. As a bonus this drug works fine while one is on the keto diet and it works even better with intermittent fasting – for a rapid weight loss with no hunger.
If shopping for healthy food makes you break out in a cold sweat, rest assured losing weight fast is easier than it appears. Avoid crackers, chips, candy and other processed foods and shop primarily in the produce section for a rainbow of colors to fill your plate instead. This is the simplest and most effective way to maintain stable blood sugar by keeping your body burning fat as fuel.
Stress wreaks havoc on every part of your body, and can lead to breakouts, joint pain, headaches, and yes, even excess belly fat. That's because when you're stressed, your body pumps out extra cortisol, that not-so-great hormone you keep hearing about. Studies show that cortisol not only spikes your appetite, but may also redistribute body fat to your belly area, according to a review published in the journal Obesity.
Have you ever noticed that a couple hours after a big greasy (yet delicious) meal you feel hungry again? That's because you have not turned off your hunger receptors, and as soon as your body starts to process that food your brain will start up again with "we need nourishment"… because you guessed it, that carton of kung-pow did not give you nourishment, just a full belly. Next time go for more veggies, you'll stay fuller longer and thus eat fewer calories.
While the Duke study found no added benefit to resistance training (aka weight or strength training) when it comes to belly fat, a 2014 study from a Harvard University team found otherwise. Twenty minutes of weights a day was linked to less of an increase in belly fat (particularly for older men). "Engaging in resistance training or, ideally, combining it with aerobic exercise could help older adults lessen abdominal fat while increasing or preserving muscle mass," said the paper's lead author Rania Mekary.
Potassium, magnesium, and calcium can help to serve as a counter-balance for sodium. Foods that are rich in potassium include leafy greens, most "orange" foods (oranges, sweet potatoes, carrots, melon) bananas, tomatoes, and cruciferous veggies — especially cauliflower. Low-fat dairy, plus nuts, and seeds can also help give you a bloat-busting boost. They've also been linked to a whole host of additional health benefits, such as lowering blood pressure, controlling blood sugar, and reducing risk of chronic disease overall.
Blood vessels (veh-suls): The system of flexible tubes—arteries, capillaries and veins—that carries blood through the body. Oxygen and nutrients are delivered by arteries to tiny, thin-walled capillaries that feed them to cells and pick up waste material, including carbon dioxide. Capillaries pass the waste to veins, which take the blood back to the heart and lungs, where carbon dioxide is let out through your breath as you exhale.
In what is perhaps the biggest buzzkill of all time, sex doesn't quite count as cardio or burn a significant amount of calories: Women burn about 3.6 per minute. "It's still a good idea," Dr. Seltzer says, citing the activity's other benefits, like increasing the output of the neurotransmitters serotonin and dopamine, which naturally reduce food cravings.
When you drink liquid carbs, like the sugar in soda, your body doesn't register them the same way as, say, a piece of bread, according to a review of studies published in Current Opinion in Clinical Nutrition & Metabolic Care. That means, even though you're taking in calories, your fullness cues aren't likely to signal that you're satisfied once you finish off a can. And that can lead to consuming more overall.
The plan includes four workouts a week, with two rest days. You can swap the rest days if you need to, but make sure you do have two days without exercise: they are there to maximise the results of your training. If you are unsure about whether to start physical activity, please ask your GP for advice first. And if you feel unwell, dizzy or in pain when performing these exercises, stop immediately.


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Can be on the market is one of the choices you may have. One popular background option is stones that can be filtered having flat gravel in the tank, which can make the scenery a lot more lively. Those who are not enthusiastic about recreating marine life can make esoteric categories such as audio instruments or cartoon character types on popular events.
It is possible to directly create unique parts in the living room, dining room, or perhaps wherever you want to place them. The kinds of backgrounds available are very limited. However besides their quality, they likewise have several functional uses. When your aquarium is in the right place for that sun, you can choose the amount that may enter through water that could be configured with fish. Exotic fish also helps add colouring to the naked eye.
It's better to upload fish to friends and visitors. However besides, the background is also just the thing for showing fish that are seen in their native environment. Most of the time, efforts to fill the particular aquarium with native plant life are one of the two main problems. Whether certain plants tend to be too hard to find in stores or perhaps mediocre. For those who like to help give an illusion such as they swim in their house environment.
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How can I extend the warranty for the assets I have received? Do I have a possibility for extension?
How many warranty years has my new Morgui Hood? And a box? And an equipment for control?
The products which Morgui Clima distribute are designed in order to last for many years. However, you can contact us for any doubt or problem and we will try our best to help you.
Do replacement programs exist for components or equipment?
Yes, in order to always assure a high quality for our equipment and services, in some occasion we have replaced components or equipment which require some update in order to give the best performance.
Nowadays there are no products which require a component replacement, if there would be the case we would communicate via email to the affected users.


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