text: Original Research Journal of Atrial Fibrillation www.jafib.com Incidence of Early Atrial Fibrillation After Transcatheter versus Surgical Aortic Valve Replacement: A Meta-Analysis of Randomized Controlled Trials Haider Altaii1, Ramez Morcos1, Fady Riad3, Halah Abdulameer4, Houman Khalili12, Brijeshwar Maini12, Eric Lieberman12, Yoel Vivas1, Phi Wiegn5, Jose A. Joglar5, Judith Mackall3, Sadeer G Al-Kindi3*, Sergio Thal3 1Division of Cardiology, Florida Atlantic University, Boca Raton, FL.2Tenet Healthcare, Delray Medical Center, Delray Beach, FL.3Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH.4Department of Surgery, Florida Atlantic University, Boca Raton, FL.5Clinical Cardiac Electrophysiology, University of Texas Southwestern Medical Center, Dallas, TX. Abstract Background Post-operative atrial fibrillation (POAF) is common after aortic valve replacement (AVR) and is associated with worse outcomes. We performed a meta-analysis of randomized controlled trials comparing Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR) for incidence of POAF at 30 days. Methods We searched databases from 1/1/1990 to 1/1/2020 for randomized studies comparing TAVR and SAVR. POAF was defined as either worsening or new-onset atrial fibrillation. Random effects model was used to estimate the risk of POAF with TAVR vs SAVR in all trials, and in subgroups (low, intermediate, high risk, and in self-expandable vs balloon expandable valves). Sensitivity analysis was performed including only studies reporting new-onset atrial fibrillation. Results Seven RCTs were identified that enrolled 7,934 patients (3,999 to TAVR and 3,935 to SAVR). The overall incidence of POAF was 9.7% after TAVR and 33.3% after SAVR. TAVR was associated with a lower risk of POAF compared with SAVR (OR 0.21 [0.18-0.24]; P < 0.0001). Compared with SAVR, TAVR was associated with a significantly lower risk of POAF in the high-risk cohort (OR 0.37 [0.27-0.49]; P < 0.0001), in the intermediate-risk cohort (OR 0.23 [0.19-0.28]; P < 0.0001), low-risk cohort (OR 0.13 [0.10-0.16]; P < 0.0001). Sensitivity analysis of 4 trials including only new-onset POAF showed similar summary estimates (OR 0.21, 95% CI [0.18-0.25]; P< 0.0001). Conclusions TAVR is associated with a significantly lower risk of post-operative atrial fibrillation compared with SAVR in all strata. Further studies are needed to identify the contribution of post-operative atrial fibrillation to the differences in clinical outcomes after TAVR and SAVR. Key Words : TAVR, SAVR, Atrial fibrillation, Meta-analysis. Correspondence to: Sadeer G Al-Kindi, MD Assistant Professor of Medicine Harrington Heart and Vascular Institute University Hospitals Case Western Reserve University School of Medicine 11100 Euclid Ave, Cleveland, OH 44106 Introduction Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic valve replacement (SAVR) 1,2 for treatment of patients with symptomatic severe aortic stenosis (AS) in all risk cohorts 3-5 with short-term follow-up indicating durable results with TAVR. Recent trials comparing TAVR vs SAVR also showed that early and late outcomes are better in TAVR vs SAVR, and that stroke risk at one year is notably lower with TAVR vs SAVR 6. Post-operative atrial fibrillation (POAF) is common after TAVR and SAVR7. The incidence of POAF has been reported in 20-40% of SAVR and 5-40% of TAVR patients and has been associated with risk of early and late stroke in both TAVR and SAVR 8-10. POAF is also associated with prolonged hospital stay as well as increased morbidity and mortality11. While prior observational studies reported lower risk of POAF after TAVR vs SAVR, these studies are limited by design. We performed a meta-analysis of randomized trials to examine the incidence of POAF at 30 days after TAVR and SAVR. Methods Data sources and eligibility criteria We conducted and reported this meta-analysis according to the Cochrane Central Register of Controlled Trials (CENTRAL). We performed a systematic computerized search through the MEDLINE, EMBASE, and COCHRANE databases from January 1st, 1990 to January 1st, 2020 using the following search terms separately and in combination: "randomized trial," "TAVR," "SAVR," "Atrial fibrillation," "Complications," and "Aortic stenosis." We performed the same search strategy for abstracts of the major scientific sessions, and ClinicalTrials.gov for any relevant studies. This was complemented with a manual search of PubMed and Google Scholar. Bibliographies of retrieved studies and review articles were searched to identify any additional relevant studies. Authors, country, study population, and affiliated institutions were screened to exclude duplicate studies. Our search was limited to manuscripts in English language. Only randomized studies comparing TAVR vs SAVR were included in this analysis. The search strategy, study selection, and analysis adhered to QUORUM (Quality of Reporting of Meta-Analysis) guidelines for meta-analyses. Data extraction, outcome definition, and quality assessment Two independent investigators (HA, RM) extracted the data, including baseline study characteristics, demographics, and outcomes of interest from the retrieved studies. There was good inter-rater agreement between the reviewers with respect to inclusion of studies, study quality, and data abstraction (κ > 0.85). The outcome was POAF, which was defined as new or worsening AF within 30 days post AVR (TAVR or SAVR). The definition of worsening AF was included in three clinical trials Supplemental Table 1, while the remaining trials did not have a clear definition. Atrial fibrillation was diagnosed as any arrhythmia within hospitalization that has the ECG characteristics of atrial fibrillation (or flutter) and lasts sufficiently long to be recorded on a 12-lead ECG, or at least 30 seconds on a rhythm strip in some of these trials. No specific methods for AF detection were provided in other trials. Supplemental Table 1 lists the definition of POAF in each trial. Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to describe trial bias. Data synthesis and statistical analysis Continuous variables are expressed as means ± standard deviation and categorical variables as counts and percentages. Summary results are presented as mean differences. Random and fixed effects model was used to calculate Odd Ratios (OR) and corresponding 95% confidence interval (CI) given high heterogeneity (I2 > 50% in all analyses). Publication bias was examined by funnel plots and Egger's test.12 Subgroup analysis was conducted for high, intermediate and low risk cohorts, and valve type (balloon-expandable and self-expandable TAVR). Sensitivity analysis was performed by limiting analysis to trials that included only new-onset AF. Data collection, study selection, processing of the data, and reporting of results were performed according to accepted principles of systemic review and meta-analysis 13 All P-values were two-tailed, with statistical significance set at 0.05, and CIs were calculated at the 95% level. Review Manager software (Version 5.3.5. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014) was used to perform the analysis. Results Search Results The database search identified 203 relevant references or citations [Figure 1]. After duplicate removal and title and abstract reading, 182 records were excluded, and 8 were considered for full-text analysis. Of these, 1 article was excluded because it did not report POAF, and 7 studies were selected for the meta-analysis (PARTNER 114, CoreValve15, NOTION16, PARTNER 217, SURTAVI18, PARTNER 319, Evolut20). Figure 1. CONSORT diagram Characteristics of the studies A total of 7 randomized trials with 7,934 patients met our selection criteria. Of these, 3,999 patients were randomized to TAVR and 3,935 were randomized to SAVR. The baseline patient characteristics are listed in [Table 1]. Males constitute 59.0% of the cohort, 29.2% had a previous history of atrial fibrillation (AF), and 8% of patients had known prior history of a cerebrovascular accident. The Society of Thoracic Surgeons (STS) perioperative risk of mortality ranged from low (1.9%) in the "low-risk" TAVR trials to high (11.8%) in the "high-risk" studies. Transfemoral access was used in 90% of patients in the composite analysis. Table 1. Baseline Characteristics of the 7 studies High risk Intermediate risk Low risk Partner 1 CoreValve Partner 2 SURTAVI Partner 3 Evolut Notion TAVR SAVR TAVR SAVR TAVR SAVR TAVR SAVR TAVR SAVR TAVR SAVR TAVR SAVR Trials' characteristics Number of centers 25 45 57 87 71 86 3 Recruitment period 2007-2009 2011-2012 2011-2013 2012-2016 2016-2017 2016-2018 2009-2013 Longest follow-up, year 5 3 2 2 1 2 2 Design Non-inferiority Non-inferiority Non-inferiority Non-inferiority Non-inferiority and Superiority Non-inferiority Superiority ITT patients 348 351 394 401 1011 1021 864 796 503 497 734 734 145 135 As-treated patients 344 313 391 359 994 944 863 794 496 454 725 678 142 134 Patients' characteristics Age, mean (SD) 83.6 ± 6.8 84.5 ± 6.4 83.5 ± 7.1 83.5 ± 6.3 81.5 ± 6.7 81.7 ± 6.7 79.9 ± 6.2 79.7 ± 6.1 73.3 ± 5.8 73.6 ± 6.1 74.1 ± 5.8 73.6 ± 5.9 79.2 ± 4.9 79.0 ± 4.7 Women, n (%) 147 (42.2%) 153 (43.6%) 183 (46.4%) 189 (47.1%) 463 (45.8%) 461 (45.2%) 366 (42.4%) 358 (45.0%) 161 (32.0%) 131 (26.4%) 261 (35.6%) 229 (31.2%) 67 (46.2%) 64 (47.4%) STS, mean ± SD 11.8± 3.3 11.7 ± 3.5 7.3 ± 3.0 7.5 ± 3.2 5.8 ± 2.1 5.8 ± 1.9 4.4 ± 1.5 4.5 ± 1.6 1.9 ± 0.7 1.9 ± 0.6 1.9 ± 0.7 1.9 ± 0.7 2.9 ± 1.6 3.1 ± 1.7 CKD, n (%) 38 (10.9%) 24 (6.8%) 48 (12.2%) 52 (13.0%) 51 (5.0%) 53 (5.2%) 14 (1.6%) 17 (2.1%) 1 (0.2%) 1 (0.2%) 3 (0.4%) 1 (0.1%) 2 (1.4%) 1 (0.7%) PVD, n (%) 148 (42.5%) 142 (40.5%) 163 (41.4%) 169 (42.1%) 282 (27.9%) 336 (32.9%) 266 (30.8%) 238 (29.9%) 34 (6.8%) 33 (6.6%) 54 (7.4%) 56 (7.6%) 6 (4.1%) 9 (6.7%) Prior CVA, n (%) 95 (27.3%) 87 (24.8%) 51 (12.9%) 53 (13.2%) NK NK 57 (6.6%) 57 (7.2%) 17 (3.4%) 23 (4.6%) 74 (10.1%) 80 (10.9%) 24 (16.6%) 22 (16.3%) Prior CABG, n (%) 147 (42.2%) 152 (43.3%) 117 (29.7%) 121 (30.2%) 239 (23.6%) 261 (25.6%) 138 (16.0%) 137 (17.2%) NK NK 18 (2.5%) 14 (1.9%) NK NK Prior CAD, n (%) 201 (57.8%) 198 (56.4%) 207 (52.5%) 187 (46.6%) 548 (54.2%) 560 (54.8%) 498 (57.6%) 438 (55.0%) 335 (66.6%) 323 (65.0%) 464 (63.2%) 449 (61.2%) 78 (53.8%) 71 (52.6%) Prior PCI, n (%) 116 (33.3%) 110 (31.3%) 133 (33.8%) 152 (37.9%) 274 (27.1%) 282 (27.6%) 184 (21.3%) 169 (21.2%) NK NK 103 (14.0%) 87 (11.9%) 11 (7.6%) 12 (8.9%) Known AF or flutter, n (%) 80 (23.0%) 73 (20.8%) 161 (40.9%) 190 (47.4%) 313 (31.0%) 359 (35.2%) 243 (28.1%) 211 (26.5%) 78 (15.5%) 85 (17.1%) 111 (15.1%) 98 (13.4%) 40 (27.6%) 34 (25.2%) Prior pacemaker, n (%) 69 (19.8%) 76 (21.7%) 92 (23.4%) 83 (20.7%) 118 (11.7%) 123 (12.0%) 84 (9.7%) 72 (9.0%) 12 (2.4%) 13 (2.6%) NK NK 5 (3.4%) 6 (4.4%) Intervention's characteristics Valve Type Edwards Sapien NA Corevalve NA Sapien XT NA CoreValve, Evolut R NA Sapien S3 NA Corevalve, Evolut R, Evolut Pro NA Corevalve NA Transfemoral access, n (%) 244 (70.1%) NA 394 (100.0%) NA 775 (76.7%) NA 809 (93.6%) NA 490 (97.4%) NA 727 (99.0%) NA 145 (100.0%) NA Transthoracic access, n (%) 104 (29.9%) NA 0 (0.0%) NA 236 (23.3%) NA 55 (6.4%) NA 0 (0.0%) NA 7 (1.0%) NA 0 (0.0%) NA TAVR = Transcatheter aortic valve replacement; SAVR: Surgical aortic valve replacement; STS PROM= Society of Thoracic Surgery perioperative risk of mortality score; CVA = cerebrovascular accident; CKD = chronic kidney disease; PVD = Peripheral vascular disease; CABG = Coronary artery bypass grafting; PCI= percutaneous coronary intervention; AF= Atrial fibrillation; NA= Not applicable; NK= Not known. Outcomes POAF at 30 days was defined as either new onset AF or worsening of AF. The composite incidence of POAF at 30 days was 9.7% (377/3900) after TAVR and 33.3% (1224/3680) after SAVR [Figure 2]. In a fixed-effect meta-analysis including all 7 trials, TAVR was associated with a lower risk of 30-day POAF compared with SAVR (OR 0.21, 95% CI [0.18-0.24]; P < 0.0001, I2 = 86%) [Figure 3]. The lower incidence of POAF at 30 days was noted across different risk strata: high-risk cohort (23.2% vs 10.2%, OR 0.37, 95%CI [0.27-0.49]; P < 0.0001, I2 = 62%), intermediate-risk cohort (33.4% vs 10.8%, OR 0.23, 95% CI [0.19-0.28]; P < 0.0001, I2 = 77%), and low-risk cohort (39.1% vs 7.8%, OR 0.13, 95% CI [0.10-0.16]; P < 0.0001, I2 = 55%). Similarly, the lower incidence in 30-day POAF with TAVR was significant in trials using both self-expanding valves (41.1% vs 12.9%, OR 0.21 [0.17-0.25], P<0.0001, I2=62%) and balloon-expandable valves (29.2% vs 7.9%, OR 0.21 [0.18-0.25], P<0.0001, I2=92%). The reported incidence of stroke, mortality and readmission at 30 days in TAVR vs SAVR are showed in Supplemental Table 2. Figure 2. Incidence of post-operative atrial fibrillation at 30 days with TAVR and SAVR Across the Randomized Clinical Studies Figure 3. Forrest plot of studies comparing post-operative atrial fibrillation at 30 days in TAVR versus SAVR in high, intermediate, and low risk cohort. CI = confidence interval; TAVR = transcatheter aortic valve replacement; SAVR = surgical aortic valve replacement. Sensitivity analysis Four trials [Evolut20, PARTNER 114, PARTNER 217, PARTNER 319] reported incidence of "new-onset" AF. The risk of new onset AF at 30 days in TAVR group was lower than SAVR group (OR 0.21, 95% CI [0.18-0.25]; P< 0.0001, I2 = 92%), [Figure 4]. Calculation of summary effects with fixed- and random-effects yielded similar results Supplemental Table 3. Figure 4. Forest plot of studies comparing the risk of new onset atrial fibrillation at 30 days in TAVR versus SAVR. TAVR = transcatheter aortic valve replacement; SAVR = surgical aortic valve replacement. Discussion This study demonstrates a lower overall cumulative incidence of worsening and new-onset atrial fibrillation after TAVR compared with SAVR. The lower risk of POAF extends to all risk categories and TAVR valve types. Similarly, we also demonstrate a lower incidence of new onset post-operative atrial fibrillation after TAVR compared with SAVR. The incidence of POAF is reported to be between 20% and 50%, and it varies by the procedure type 21-23. Prior single-center studies consistently showed that TAVR is associated with a lower risk of AF compared with SAVR. In a single center study of 170 patients undergoing AVR (84 TAVR, 86 SAVR), a lower risk of new onset AF was noted in the TAVR group compared with SAVR group (6% vs 33.7%, P<0.05) 24. Non-femoral access routes used in TAVR seemed to be associated with higher risk of POAF. In a retrospective single-center cohort study of 231 patients undergoing TAVR, POAF occurred in 53% after transapical TAVR, 33% after transaortic TAVR, and 14% after transfemoral TAVR. AVR without pericardiotomy was associated with a lower risk of AF, with an adjusted OR (adjusted OR: 0.18; 95% CI: 0.05 to 0.59) similar to the summary effect observed in our analysis. These studies, however, are limited by the different baseline characteristics of patients undergoing TAVR vs SAVR, and the non-randomized nature of the analyses predisposing to significant bias. Only randomized studies were included in the current metanalysis, therefore minimizing bias and balancing confounders. 25 Studying the incidence of POAF is important as it is associated with worse clinical outcomes after AVR (TAVR and SAVR). In a study of 24,076 patients undergoing TAVR in the US, post-TAVR AF was associated with increased risk of stroke and readmission 26. Similarly, other studies showed that new-onset AF after TAVR is associated with increased risks of systemic embolization and stroke 27, and short-term 10 and long-term mortality 25. Our findings have important clinical implications. The key differences in complications rates of TAVR and SAVR, including the risk of POAF, should be part of the shared-decision making process between the patient and the Integrated Heart Team. Furthermore, differences in the incidence of POAF between the two AVR approaches may provide some insight into POAF mechanism. POAF is generally thought to be multifactorial: inflammatory response triggered by pericardiectomy and cardiopulmonary bypass, catecholamine surge, pericardial inflammation, and the overall hemodynamic burden of surgery. Patients with preexisting atrial remodeling seem to have higher risk of POAF after TAVR28. Transfemoral TAVR is a less invasive procedure, with a significantly reduced hemodynamic burden, no compromise of the pericardium, and a reduced inflammation and sympathetic tone. Our findings further confirm the importance of these contributing factors and procedure type on POAF. Notably, there is uncertainty on the role of anticoagulation in post-operative AF. POAF has been linked with early and late stroke after both TAVR and SAVR8,29. Most patients with POAF after TAVR receive anticoagulation whereas anticoagulation for SAVR is much less common30. Whether POAF and/or anticoagulation mediates short and long-term stroke risk and other outcomes after TAVR vs SAVR remains to be elucidated. In the current meta-analysis, the odds ratio of POAF with TAVR vs SAVR is lower with decreasing surgical risk: (high risk OR 0.37 [0.27-0.49]; intermediate risk OR 0.23 [0.19-0.28]; and low risk OR 0.13 [0.10-0.16]). The lower rate of POAF with TAVR vs SAVR may be due to the decreased utilization of "alternative" access use (ex. trans-apical or trans-aortic) in the lower risk population, in addition to the improved overall TAVR techniques in the lower risk studies. As such, differences in POAF between TAVR and SAVR could be magnified. Additionally, patients in the higher risk trials have higher prevalence of comorbidities including cardiomyopathy and atrial remodeling, and peri-procedural AF may reflect paroxysmal AF that was not detected, and thus diluting the effect of post-AVR pericardial inflammation. The contribution of reduced POAF burden to the improved outcomes (especially stroke and rehospitalization) noted with low-risk TAVR compared with SAVR should needs further investigation. Study limitations We acknowledge the limitations inherent to meta-analyses. The validity of our results is dependent on the validity of the studies included. We do not have access to patient level data in order to perform individual-level meta-analysis. Nevertheless, by limiting included studies to RCTs we minimize variability in burden of comorbidities between TAVR and SAVR groups and as a result decrease the possibility that differences could be due to confounding. The included studies did not entirely differentiate between new onset and provoked AF, and none of the included studies reported time to and duration of AF. Finally, not all the patients in these trials had continuous monitoring such as implantable loop recorders or pacemakers, and methods for AF detection may not have been standardized across studies, which may have led to underdiagnosis of AF. While the overall implications for post-procedural management may be similar, there are different implications for underlying mechanism and for the role of long-term anticoagulation. The definition of POAF was not standardized across trials, and thus a level of heterogeneity is expected due to different definitions. We address this shortcoming by conducting a sub-analysis with only the studies that reported new onset POAF specifically and demonstrate that the results are consistent with our overall findings. Conclusions TAVR is associated with a significantly lower risk of post-operative atrial fibrillation compared with SAVR in all risk strata and valve types. Further studies are needed to identify the contribution of post-operative atrial fibrillation to the clinical outcomes observed after TAVR and SAVR. Link for Supplemental Tables References Chen Shmuel, RedforsBjorn, Ben-YehudaOri, CrowleyAaron, GreasonKevin L, AluMaria C, FinnMatthew T, VahlTorsten P, NazifTamim, ThouraniVinod H, SuriRakesh M, SvenssonLars, WebbJohn G, KodaliSusheel K, LeonMartin B. 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Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. N Engl J Med. 2019;380 (18):1706–1715. [ PubMed ] Creswell L L, SchuesslerR B, RosenbloomM, CoxJ L. Hazards of postoperative atrial arrhythmias. Ann Thorac Surg. 1993;56 (3):539–49. [ PubMed ] Aranki S F, ShawD P, AdamsD H, RizzoR J, CouperG S, VanderVlietM, CollinsJ J, CohnL H, BurstinH R. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation. 1996;94 (3):390–7. [ PubMed ] Mathew J P, ParksR, SavinoJ S, FriedmanA S, KochC, ManganoD T, BrownerW S. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. MultiCenter Study of Perioperative Ischemia Research Group. JAMA. 1996;276 (4):300–6. [ PubMed ] Motloch Lukas J, RedaSara, RottlaenderDennis, KhatibRosa, Müller-EhmsenJochen, SeckCatherine, StrauchJustus, MadershahianNavid, ErdmannErland, WahlersThorsten, HoppeUta C. Postprocedural atrial fibrillation after transcatheter aortic valve implantation versus surgical aortic valve replacement. Ann Thorac Surg. 2012;93 (1):124–31. [ PubMed ] Biviano Angelo B, NazifTamim, DizonJose, GaranHasan, FleitmanJessica, HassanDua, KapadiaSamir, BabaliarosVasilis, XuKe, ParvataneniRupa, Rodes-CabauJosep, SzetoWilson Y, FearonWilliam F, DvirDanny, DeweyTodd, WilliamsMathew, MackMichael J, WebbJohn G, MillerD Craig, SmithCraig R, LeonMartin B, KodaliSusheel. Atrial Fibrillation Is Associated With Increased Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Placement of Aortic Transcatheter Valve (PARTNER) Trial. Circ Cardiovasc Interv. 2016;9 (1):–. [ PubMed ] Doshi Rajkumar, PisipatiSailaja, TahaMohamed, DaveMihir, ShahJay, AdaljaDevina, GullapalliNageshwara. Incidence, 30-day readmission rates and predictors of readmission after new onset atrial fibrillation who underwent transcatheter aortic valve replacement. Heart Lung. 2019;49 (2):186–192. [ PubMed ] Yoon Yong-Hoon, AhnJung-Min, KangDo-Yoon, KoEuihong, LeePil Hyung, LeeSeung-Whan, KimHo Jin, KimJoon Bum, ChooSuk Jung, ParkDuk-Woo, ParkSeung-Jung. Incidence, Predictors, Management, and Clinical Significance of New-Onset Atrial Fibrillation After Transcatheter Aortic Valve Implantation. Am J Cardiol. 2019;123 (7):1127–1133. [ PubMed ] Amat-Santos Ignacio J, Rodés-CabauJosep, UrenaMarina, DeLarochellièreRobert, DoyleDaniel, BagurRodrigo, VilleneuveJacques, CôtéMélanie, Nombela-FrancoLuis, PhilipponFrançois, PibarotPhilippe, DumontEric. Incidence, predictive factors, and prognostic value of new-onset atrial fibrillation following transcatheter aortic valve implantation. J Am Coll Cardiol. 2012;59 (2):178–88. [ PubMed ] Nuis Rutger-Jan, Van MieghemNicolas M, SchultzCarl J, MoelkerAdriaan, van der BoonRobert M, van GeunsRobert Jan, van der LugtAad, SerruysPatrick W, Rodés-CabauJosep, van DomburgRon T, KoudstaalPeter J, de JaegerePeter P. 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SANPA inked MoU with SIPG, NSU
SANPA and South Asian Institute of Policy and Governance (SIPG), North South University, signed a Memorandum of Understanding on 23 June 2022. SANPA Chairperson Professor Habib Zafarullah and SIPG Director Professor Sk. Tawfique M. Haque represented the respective side. SANPA Treasurer Dr. Mahfuzul Haque and EC Member Dr. K M Kabirul Islam were present. At the same time, Professor Salahuddin M Aminuzzaman, Adviser, SIPG, Professor Syeda Lasna Kabir, Professor Rizwan Khair, Professor Mahfuzul Haque, and Dr. Hasan M. Baniamin joined the event on behalf of SIPG. A good number of public administration academics were also present.
Both SANPA Chair and SIPG Director expected that the partnership would deliver tangible results in public administration and governance research and advocacy. Professor Habib Zafarullah appreciated the Director, SIPG, for his keen interest in forging the partnerships.
SANPA Chairperson meeting with IUB Pro-VC
Professor Habib Zafarullah, Chairperson, SANPA, had a meeting with the Independent University, Bangladesh (IUB) Pro Vice-chancellor Professor Niaz Ahmed Khan. SANPA Treasurer Dr. Mahfuzul Haque, EC Member Dr. K M Kabirul Islam, and Secretary-General Dr. Mohammad Mizanur Rahman also attended the meeting.
SANPA OCCASIONAL PAPERS: Call for papers
Members are requested to submit their research work pertaining to the broader objectives of the network to publish as occasional papers. All submitted papers will be peer-reviewed before publication. The author(s) are requested to follow the guidelines given below:
- Papers can be single or co-authored
- Papers should be limited to 6000-8000 words, inclusive of references
- Harvard referencing style should be followed
All communications should be made to the occasional paper series editor, Professor Prabhat Datta. He can be reached at email@example.com
SANPA BOOK: Call for papers
SANPA Vice-chair Professor Akhlaque Haque attended the American Society for Public Administration (ASPA) Conference 2022.
Professor Habib Zafarullah at ACSH Annual Conference 2021
SANPA Chairperson Professor Habib Zafarullah attended the Astana Civil Service Hub (ACSH) Annual Conference 2021 as a designated speaker and presented a paper on "the relevance of open government in attaining the SDGs: imperatives of governance reform in the post-pandemic scenario".
SANPA Vice-Chairperson Professor Akhalaque Haque has been named senior Fulbright specialist at World Learning. We congratulate him on achieving this prestigious award.
Please visit the link for details: https://www.uab.edu/news/people/item/12221-uab-professor-named-senior-fulbright-specialist-at-world-learning.
Special Webinar on 'Dr. Akbar Ali Khan: Contribution to Bangladesh State and Society'
A webinar on 'Dr. Akbar Ali Khan: Contribution to Bangladesh State and Society' was organized by the South Asian Institute of Policy and Governance (SIPG) and South Asian Network for Public Administration (SANPA) on 3 October 2022 at NSU.
Dr. Akbar Ali Khan was an influential academic, researcher, active and objective public intellectual and renowned bureaucrat- reaching the position of Cabinet Secretary in Bangladesh. He successfully combined multiple roles in his career- academia, research, and national and international bureaucracies. He died on 8 September 2022. His demise is a great loss for the nation. This webinar was organized to commemorate and discuss his contribution to Bangladesh state and society.
The distinguished panelists were; Mr. Abdul Muyeed Chowdhury, Former Advisor, Caretaker Government; Md. Aminul Islam Bhuiyan, Former Secretary, Economic Relations Division, Finance Division, Government of Bangladesh; Dr. Mohammad Tareque, Director, Bangladesh Institute of Governance & Management (BIGM) & Former Finance Secretary, GoB, and Dr. Debapriya Bhattacharya, Distinguished Fellow, Centre for Policy Dialogue (CPD). The moderator was Professor Salahuddin M Aminuzzaman, Advisor, South Asian Institute of Policy and Governance (SIPG), NSU. Academics, researchers, practitioners, civil servants, journalists, and students from both Bangladesh and abroad participated in the webinar.
Dr. Habib Zafarullah, Founding Chair, SANPA said that he is the pioneer of regulatory governance in Bangladesh. His resignation from the Caretaker government was a brave step. His post-retirement years were productive as he wrote eloquently. He is an epitome of a perfect 'pracademic.'
The webinar started with a video presentation on SIPG and concluded with a vote of thanks by Dr. Mohammad Mizanur Rahman, Secretary General, SANPA.
SANPA Webinar 2022: 3
The third webinar of 2022 was held on 15 October 2022. Dr. Fara Azmat, Deakin University, presented the keynote on "Sustainable Development Goals- where do we stand? Moving forward- challenges and opportunities". Professor Rumki Basu, Institute of Social Sciences, New Delhi; Dr. Mohamed Evren Tok, Hamad Bin Khalifa University, Qatar; Dr. Maria Victoria R. Raquiza, the University of Philippines Diliman; Mr. Trilochan Pokharel, Nepal Administrative Staff College spoke in the webinar as designated speaker. During the floor discussion, SANPA EC member Dr. Aly Shameem commented on the issues. SANPA Chair Professor Habib Zafarullah moderated the webinar, while SANPA EC member Dr. K M Kabirul Islam offered the vote of thanks. Scholars and practitioners from different countries joined the webinar.
SANPA Webinar 2022: 2
The second webinar of 2022 was held on 20 August 2022. 161 academics and practitioners worldwide joined the webinar. The webinar's theme was public administration in developing countries: practitioners' perspectives. Dr. Nivedita P Haran, IAS (Rtd.), former Secretary to the Government of India, presented the keynote. Mr. Mohammad Mejbahuddin, former Senior Secretary to the Government of Bangladesh, Dr. Aly Shameem, former President, Civil Service Commission, Maldives, and Mr. Bokyun Shim, former Vice-Minister, Government of the Republic of Korea, were the designated panelists.
Dr. M Mahfuzul Haque, Treasurer, SANPA Executive Committee, moderated the webinar. Professor Yaamina Salman, SANPA General Member, offered the vote of thanks.
SANPA Webinar 2022: 1
The South Asian Network for Public Administration (SANPA) organized its 1st webinar of 2022 on 7 May 2022. Professor Alasdair Roberts, University of Massachusetts Amherst, spoke as the keynote speaker on STRATEGIES FOR GOVERNING: REINVENTING PUBLIC ADMINISTRATION FOR A DANGEROUS CENTURY. The distinguished panelists were: Professor Ahmed Shafiqul Huque, McMaster University, Professor Catherine Althaus ANZSOG, and Professor Jon Pierre, University of Gothenburg. SANPA Chairperson Professor Habib Zafarullah moderated the webinar, and Dr. Aly Shameem, SANPA EC Member, offered the vote of thanks. Sixty-four public administration academics and practitioners from different continents attended the webinar.
SANPA Webinar 2021: 2
SANPA organized the second webinar on 10 October 2021. Public administration academics and practitioners from different regions and continents attended the webinar. Professor Evan Berman, Sao Paulo School of Business Administration, presented the keynote on the 'pandemic effects: exploring the horizon of public administration as an academic discipline and a field of practice.' Citing examples from different countries in managing the pandemic, Professor Berman argued that strong leadership of the national government, particularly the senior bureaucrats, and effective coordination would play a key role. Meiji University Emeritus Professor Akira Nakamura, Eastern Regional Organization for Public Administration Secretary-General Professor Alex B. Brillantes, Rajiv Gandhi National Institute of Youth Development Professor Inderjeet Singh Sodhi, the Panjab University Associate Professor Sidra Irfan spoke as panelists. The University of Alabama at Birmingham Professor Akhalque Haque moderated the webinar. Moving forward, the panelists opined that public administration experts need to look forward to a new approach. University of Sri Jayewardenepura Professor Lalitha Fernando offered the vote of thanks. SANPA Chairperson Professor Habib Zafarullah thanked all participants, particularly the keynote speaker and panelists, for their contribution and hoped that SANPA would become a significant international platform for advancing knowledge and insights in public administration.
SANPA Webinar 2021: 1
SANPA organized a webinar on "Implementing the UNCEPA Adopted 11 Principles of Effective Governance for Sustainable Development: Why We Need to Talk More Strongly on the Political Insulation of the Bureaucracy" on 26 June 2021.
Professor B. Guy Peters, Maurice Falk Professor of American Government, Pittsburgh University, presented the keynote, while Professor Habib Zafarullah, Chair, SANPA and the University of New England, moderated the webinar.
Professor Akhlaque Haque, The University of Alabama at Birmingham, Professor Lalitha S Fernando, University of Sri Jayewardenepura, Sri Lanka, Professor Ahmed Shafiqul Huque, McMaster University, Dr. Mahfuzul Haque, former Secretary to the Government of Bangladesh, Dr. Aly Shameem, former Chairman, Maldives Civil Service Commission, Professor Niaz Ahmed Khan, Independent University, Bangladesh, Professor Prabhat Datta, former Centenary Chair of Public Administration, University of Calcutta, Dr. Fara Azmat, Deakin University, Professor Yaamina Salman, University of Punjab, Mr. Bokyun Shim, Head of Office, United Nations Project Office on Governance, were the designated panelists. SANPA EC Member Mr. Trilochan Pokharel offered a vote of thanks.
The speakers underscored that bureaucracy requires an autonomous working environment backed by adequate political insulation to be more productive and contribute to national development and improve governance quality, particularly in developing countries. However, alongside political insulation and autonomy, there should be a strong accountability framework to hold the bureaucracy to account.
UN CEPA Consultation
SANPA took part in the virtual interactive dialogue with observers held as part of the 20th Committee of Experts on Public Administration (CEPA) session on 19 April from 9 to 11 a.m. EDT (New York time). Please click on the link below to view the SANPA statement.
SANPA Director (Research and Studies) Professor Niaz Ahmed Khan joined the Independent University, Bangladesh as the Pro-Vice-Chancellor. SANPA family congratulates Professor Khan on his career elevation.Link
EC Meeting 2022: 2
Presided over by Professor Akhlaque Haque, the second meeting of 2022 of the Executive Committee was held on 23 July 2022. The meeting expressed satisfaction over the progress of the book project and thanked the project team. The EC again urged the SANPA members to contribute to publishing occasional papers. The EC highly appreciated the interest of public administration scholars and practitioners from South Asia and beyond in joining SANPA and accordingly inducted 17 scholars and practitioners into the organization as Honorary, General, and Associate Members.
EC Meeting 2022: 1
The first meeting of 2022 of the Executive Committee was held on 5 March 2022, with Professor Habib Zafarullah in the chair. All members of the EC attended the meeting. The EC reviewed the annual work plan for 2022 and approved it. The principal targets of the 2022 AWP include organizing several webinars and a general meeting engaging SANPA Honorary and General members and publishing a book on South Asian public administration. Professor Dr. Akhlaque Haque leads the book project team, while Professor Prabhat Kumar Datta is the lead editor for occasional papers. The EC meeting urged the SANPA members to contribute to publishing occasional papers. The EC meeting appreciated different regional and international public administration networks and platforms for expressing interest in partnering with SANPA. The EC recommended that SANPA should give particular focus on expanding its partnership in 2022.
EC Meeting 2021: 4
The 4th meeting of the Executive Committee was held on 24 December 2021 with Professor Habib Zafarullah in the chair. The meeting reviewed the progress of 2021 and expressed its satisfaction over the progress accomplished in 2021. The EC appreciated the interests of the international and South Asian academics and practitioners in joining SANPA in different capacities and inducted 13 academics and practitioners as Honorary Members, 9 academics and practitioners as General Members and 4 academics and practitioners as Associate Members.
EC Meeting 2021: 3
The third meeting of the Executive Committee was held on 1 August 2021. Professor Habib Zafarullah, Chairperson, SANPA, presided over the meeting. The meeting, among others, conferred honorary membership to five internationally acclaimed scholars of public administration and development and accepted 26 academics and practitioners as general members and three young scholars as associate members. The honorary members are Professor B. Guy Peters, President International Public Policy Association and the University of Pittsburgh; Professor Akira Nakamura, Distinguished Professor Emeritus, Meiji University; Professor Ken Smith AO, CEO, Australia-New Zealand School of Government (ANZSOG) and the University of Melbourn; Professor Catherine Althaus, ANZSOG and Univerity of New South Wales (UNSW) and Professor Geske Dijkstra, Erasmus University Rotterdam.
EC Meeting 2021: 2
The 2nd meeting of the Executive Committee in 2021 was held on 3 April 2021. All members of the EC joined the meeting virtually. Professor Habib Zafarullah presided over the meeting.
EC Meeting 2021: 1
The first meeting of the Executive Committee in 2021 was held on 17 January 2021. Professor Habib Zafarullah, Ph.D., Chair of the Executive Committee presided over the meeting. The meeting was held online. The Vice-chairs and other members of the EC joined the meeting.

subset: commoncrawl


text:
Meeting in Brussels on 14-15 December, heads of state and government will agree to establish a network of 'national energy correspondents' who will exchange information relating to the EU's energy security.
Members of the group, who will come from member states and from the Commission, will be experts in both energy and foreign policy.
It is hoped that the pooling of information will allow the EU better to tackle threats to its energy security – such as Russia's decision in January last year to limit the supplies of gas to Ukraine and Moldova.
According to one diplomat, the crisis in Ukraine, which disrupted supplies in Hungary and Poland, showed the EU was not making the best use of the information it has when formulating policies: "There were different rumours but we did not have a mechanism in place which would have allowed us to collect the information."
The diplomat said that if the network existed today it could be used to assess the potential impact of Russia's plans to increase gas prices in Belarus and to plan the EU's response.
Supporters of the correspondents plan admit that its success will depend on the level of information supplied by member states. For now, the network will not exchange highly sensitive intelligence material. Sources say the information transmitted will be limited to the lowest level of classification – 'restricted'.
The idea was initially floated in June, when it received the tacit support of EU member states. But institutional turf battles are calling into question the project's success.
It is still unclear whether the network will be led by the Council of Ministers' secretariat-general or the Commission, although a paper put forward by the Finnish presidency of the EU yesterday (6 December) called on the Commission and its external delegations to play a co-ordinating role.
At least eight member states and Romania – which will join the EU on 1 January – have voiced concerns that the group will duplicate the efforts of the EU's gas co-ordination group and a separate oil supply group. Others have argued that these two groups, unlike the proposed network of correspondents, simply respond to crises rather than seeking to influence them.
Member states' divergent interests have also been painfully evident during discussions on the focus of the network. Germany has pressed for the correspondents to focus on gas supplies, while Poland has focused on disruptions to supply.
Although the network is voluntary, sources said that no member state has indicated that it would not participate. It is expected to be running in early 2007.


text:
- 1 Can you use dry ice with fog machines?
- 2 How do you make a fog machine with dry ice?
- 3 Is dry ice the same as a fog machine?
- 4 Can dry ice go in ceramic?
- 5 Will dry ice work in a fog chiller?
- 6 What can be used instead of dry ice?
- 7 What is the difference between a fog machine and a smoke machine?
- 8 How long does dry ice last in liquid?
- 9 Can you use a fog machine as a snow machine?
- 10 What goes in a smoke machine?
- 11 How much is a Hazer?
- 12 How much do dry ice pellets cost?
- 13 How do you make fog last longer?
- 14 Can you make homemade dry ice?
- 15 How do you make Smokey drinks without dry ice?
- 16 Can you put low-lying fog juice regular fog machine?
- 17 Does dry ice fog leave residue?
- 18 What type of glycerin is used in fog juice?
- 19 How do you make a fog machine without dry ice?
- 20 How do you make fog for a fog machine?
- 21 Is liquid nitrogen dry ice?
- 22 Is it safe to put dry ice in drinks?
- 23 How long will 10 pounds of dry ice last?
- 24 Will dry ice explode in a cooler?
- 25 Can you put dry ice in a freezer?
- 26 Can you put dry ice in a styrofoam cooler?
- 27 How long do Omaha Steaks last in dry ice?
- 28 Can you put dry ice in a refrigerator?
- 29 Can you use smoke fluid in a haze machine?
- 30 How do you make a homemade snow machine?
- 31 What chemical is used in fog machines?
- 32 How can I make my fog machine smoke thicker?
- 33 What is haze vs fog?
- 34 What is hazing in a rodeo?
- 35 Is Hazer a valid Scrabble word?
- 36 What happens when you put salt on dry ice?
- 37 Can you put dry ice in a cardboard box?
- 38 How long does 5lbs of dry ice last?
- 39 How do you make dry ice pellets?
Can you use dry ice with fog machines?
Fill a metal or plastic container half full of hot water and add a few pieces of dry ice every 5-10 minutes. As the water cools, you will need to add more hot water to maintain the fog effect. As a rule of thumb, one pound of dry ice will create 2-3 minutes of fog effect.
How do you make a fog machine with dry ice?
Consider using a fog generator – the next question "How is a dry ice fogger operated?" If you are looking to cover a large area, such as a dance floor, you will need 20kg of dry ice which will last for 8-10 minutes. Add dry ice to a container with hot water (50C) and the fog effect will be spontaneous.
Is dry ice the same as a fog machine?
A low fog machine (similar to dry ice machines) produces a thick, opaque fog that remains close to the ground to create a 'walking on air' effect. Fog machines create this effect by cooling fluid to liquid particles.
Can dry ice go in ceramic?
Choose a container appropriate to the amount of water you need – a plastic bucket or container is ideal, ceramic and pyrex bowls are also fine, but do not use normal glass as it may crack. Place the container on a towel – you will get moisture depositing on nearby surfaces so make sure computers etc.
Will dry ice work in a fog chiller?
Empty the cooler as soon as possible after each use, to avoid water leaking out of the two holes that you put in the cooler. Dry ice provides a much colder fog that will stay lower for longer, and it leaves no liquid because it sublimates (that is, changes to gas) rather than melts.
What can be used instead of dry ice?
Hydro-Freeze ice packs offer a safer way to deliver frozen goods than traditional dry ice shipments, at an equivalent price and with no supply shortage. Hydro-Freeze packs are available on a range of sizes and pockets and are fully printable with your company logo, for a minimum run as low as just 2 pallets.
What is the difference between a fog machine and a smoke machine?
Dry ice is made by liquefying carbon dioxide and injecting it into a holding tank, where it's frozen at a temperature of -109° F and compressed into solid ice. Depending on whether it's created in a pelletizer or a block press, dry ice can then be made into pellets or large blocks.
How long does dry ice last in liquid?
Most of the items that have to be kept cold and insulated are shipped inside of styrofoam boxes. A 1-pound bag of dry ice can last anywhere between 12 to 24 hours inside of these boxes. Having 2 of these bags inside of the shipping box and you could get between 18 to 36 hours before the dry ice evaporated.
Can you use a fog machine as a snow machine?
Nope, The machines use two different types of fluids. A fog machine heats its specifically designed fluid to the point of vaporization. A snow machine injects air into its room temperature fluid to create small foamy particles, which realistically mimic snow flakes.
What goes in a smoke machine?
The active ingredient can be propylene glycol, triethylene glycol, glycerin or a mixture of these. The vaporization temperature varies for these ingredients, so you should use a fog machine that is compatible with the fluid you have.
How much is a Hazer?
Dry ice lasts approximately 18-24 hours in a regular sized styrofoam cooler with 1-2 dry ice blocks. Dry ice can last up to 3 or 4 days in a larger cooler and when more blocks of dry ice are used in conjunction with each other.
How much do dry ice pellets cost?
Dry ice will last anywhere from 2-7 days in a Yeti cooler depending on the size of the cooler and how much dry ice you use. 15 lbs of ice in a Yeti 65 will last about 2.5 days but if you filled the same cooler to capacity with dry ice you could expect 7 days of dry ice retention.
How do you make fog last longer?
Use the right water-to-dry-ice ratio
The ideal water to dry ice ratio for long-lasting fog effects is about 1/2 gallon of hot water per pound of dry ice. Using the right amount of hot water will help maximize the fog.
Can you make homemade dry ice?
It's extremely cold and sublimates into carbon dioxide gas, so it's useful for a wide variety of projects. While it's almost certainly less expensive to get dry ice from a store, it's possible to make it yourself using a CO2 fire extinguisher or pressurized carbon dioxide in a tank or cartridge.
How do you make Smokey drinks without dry ice?
These machines are specially designed to not allow the fog to rise up into the air, creating an eerie image for anyone daring to step through it. They have a compartment for ice or dry ice, which helps keep the fog low to the ground so you can achieve the perfect scary look.
Can you put low-lying fog juice regular fog machine?
If you have a ground fog machine, you will achieve the best results by always using a low-lying fog juice. In most instances, using regular fog juice will suit your needs nicely.
Does dry ice fog leave residue?
Dry ice fog has no odor, contains no chemical, and leaves no oily residue. Actors and singers and are comfortable with it and understand its safety.
What type of glycerin is used in fog juice?
Make fog fluid by mixing distilled water and vegetable glycerine. The total glycerine concentration should be between 15 to 30 percent.
How do you make a fog machine without dry ice?
Add a couple drops of blue food coloring to 1 cup of warm water. Pour this in the jar. Mix with a spoon.
How do you make fog for a fog machine?
Dry ice blasters range in price from $15k to $45k USD.
Is liquid nitrogen dry ice?
The difference between dry ice and liquid nitrogen is that the dry ice is the solid form of carbon dioxide whereas the liquid nitrogen is elemental nitrogen in a liquid state.
Is it safe to put dry ice in drinks?
Dry ice is safe to use in cocktails, it will not alter the flavor in any way. The ice will sink to the bottom of your glass, but take extra precaution not to ingest it or touch it in any way. You'll need a hammer, screwdriver, and goggles to chisel your block of dry ice into 'cubes'.
How long will 10 pounds of dry ice last?
Generally speaking, 10 pounds of dry ice will last up to 24 hours in a standard 25-quart cooler—but there are a lot of factors at play. You'll also want to consider the types of food you're storing (frozen or refrigerated), the size of your cooler, any ambient conditions and the duration of storage. 25 qts.
Will dry ice explode in a cooler?
When dry ice "melts" it releases carbon dioxide gas which could build up inside an airtight cooler and make it explode. Users must adhere to special usage instructions and safety precautions when using dry ice.
Can you put dry ice in a freezer?
A: No. Dry ice turns to a gas at –109.3° F, so even a freezer will be far too warm to prevent that from happening. And dry ice should never be kept in a walk-in freezer, because it produces carbon dioxide that can be hazardous in poorly ventilated areas.
Can you put dry ice in a styrofoam cooler?
Storing it in the freezer or an airtight container.
Follow this tip: The best place to store dry ice is in a styrofoam or insulated cooler with its lid ajar. That will help maintain its temperature while allowing it to have some ventilation for the gas to escape.
How long do Omaha Steaks last in dry ice?
"The dry ice used in the food products we offer usually lasts between 24 to 36 hours. Since we ship our products in 2 days, it is common for little or no dry ice to remain by the time you receive your package.
Can you put dry ice in a refrigerator?
The quantity of dry ice used in a regular freezer or refrigerator is unlikely to produce carbon dioxide gas in sufficient quantity to cause a health problem. Dry ice can readily be used to keep foods cool in those types of containers.
Can you use smoke fluid in a haze machine?
Haze fluid cannot be used in a fog or faze machine and fog fluid cannot be used in a haze machine. Use of incorrect fluids will damage machines and either void the manufacturers' warranty or result in an expensive repair bill.
How do you make a homemade snow machine?
Ambient Thaw
The first (and most obvious) cause of snow-melt is simply the temperature of ambient air. When snow accumulates on a roof, ambient air is typically at or below freezing. As ambient air rises above freezing, the snow blanket melts from the top down.
What chemical is used in fog machines?
A large majority of fog machines that are available on the market today water-based. This term means that the fog chemical is water miscible, in the main these fluids are based on glycols and glycerol.
How can I make my fog machine smoke thicker?
NEVER use essential oils in your fog machine. It can clog the machine.
What is haze vs fog?
Fog and haze differ in that fog is a thick, opaque effect that lasts a short time, while haze is a thin, translucent effect that lasts a long time. Fog is used as a special effect, whereas haze is used for lighting/atmosphere enhancement.
What is hazing in a rodeo?
In the sport of steer wrestling, a hazer is the bulldogger's right-hand man, literally. Hazers back into the box on the timed-event side of the arena parallel to the steer wrestler on the other side of the timed-event chute.
Is Hazer a valid Scrabble word?
Yes, hazer is in the scrabble dictionary.
What happens when you put salt on dry ice?
These chloride ion molecules easily bond with ice molecules. After the salt contacts the ice, the salt molecules begin bonding with the ice molecules, converting the ice into a salt water solution called "brine". This solution then runs off the surface or evaporates in the air, leaving a safe dry surface.
Can you put dry ice in a cardboard box?
Packing With Dry Ice
Use an EPS foam container for its insulating properties, and place it inside a sturdy, corrugated cardboard box. Try to keep your contents separate from the dry ice. "The only use for the dry ice is to keep your shipment cold," says Marini. "You don't want anything touching the dry ice.
How long does 5lbs of dry ice last?
The following table for how long dry ice lasts is based on an average five-pound brick of dry ice that remains whole (not broken into pieces): In a cooler – 18-24 hours. Outdoors – 3-5 hours. In liquid – 15-45 minutes.
How do you make dry ice pellets?
Dry ice is made by taking pressurized Liquid CO2 (LCO2) and allowing it to expand into the natural atmosphere. This causes the LCO2 to expand into both a gas vapor and solid snow. The snow is then either compressed to form blocks or compressed and extruded to form pellets or nuggets.


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Because today is National Haiku Poetry Day, our Sunday Scribblings prompt for this week is Haiku. If you decide to write a post based on this week's prompt, be sure to go back here and share your link so everyone can see how you interpreted things! Here's what I did with it…
I've never much been into poetry. I'm good with reading the poetry that others have written. But when it comes to writing my own poetry… It's just not how my mind operates. Maybe that's because I've never pushed myself or stretched that mental muscle. But haiku has always felt easy to me. I guess it's because it's the one form of poetry that I remember from elementary school. And I guess I easily remember it because the rules are simple.
Three lines. First line has five syllables. Second line has seven syllables. Third line has five syllables. Done.
Haiku poems are
easy when you know how to
follow all the rules.
Technically… that was a haiku. But it's not exactly expressive. You know… as poetry tends to be.
Spring is beautiful
Flowers blooming, trees budding
Pollen ev'rywhere
And since it's Easter…
The stone rolled away
Son of God resurrected
See the empty grave
Think I'll stick to non-poetry from here on…
Thanks to everyone who participated this week and shared your links! Please visit their blogs, give them a follow, and take a look at how they interpreted the prompt.
Be sure to come back on Wednesday for the next Sunday Scribblings prompt! Encourage other bloggers to challenge themselves with the prompt! Remember that there are no rules for what you write, other than responding to the prompt! You can write fiction, non-fiction, poetry, prose, biography, instruction… it's all up to you!
Feature Photo by Derek Baumgartner on Unsplash


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This post contains affiliate links. Affiliate disclosure: As an Amazon Associate, we may earn commissions from qualifying purchases from Amazon.com and other Amazon websites.
Off-roading in an ATV or your Jeep Wrangler is a fun and thrilling experience. Many people hesitate to take their Jeeps off-roading because they think that it's dangerous. However, one of the reasons Jeeps are perfect for off-roading hobbyists is because they are safe and reliable, even on the toughest terrain. If you want to take your Jeep for an off-road spin, you should visit the unique off-road trails in the Lone Star State. Check out the top five places to go off-roading in Texas.
1. Hidden Falls Adventure Park
When discussing off-road trails in Texas, you have to mention Hidden Falls Adventure Park. Located in Marble Falls, TX, this park is a popular destination for 4×4 vehicles, ATVs, and motorbikes. Hidden Falls Adventure Park is every off-roader's dream destination, with stunning scenery, rocky trails, and muddy terrain. If you want a fun and unique off-roading experience, try off-roading at night under the stars.
2. Tree Ranch Offroad Park
The second of the top five places to go off-roading in Texas is Tree Ranch Offroad Park. For 5,500 acres of daring off-road trails, visit Tree Ranch Offroad Park. The trails at this park are rough, rugged, and challenging, so they are perfect for experienced off-roading enthusiasts.
3. Wolf Caves
Wolf Caves only offers trails for 4×4 vehicles, so you won't see any motorbikes at this park. This park, located just outside of Mason, TX, has a mix of trails for both beginners and experts. Additionally, it's an excellent area to go rock-climbing if you and your Jeep are up for a challenge!
4. River Run ATV Park
If you have some off-roading experience but don't consider yourself an expert, you should visit River Run ATV Park. Despite the name, this park is not exclusively for ATVs and allows 4×4 vehicles. This trail is around 12 miles and has various mud pits.
5. Katemcy Rocks
Wolf Caves isn't the only place for off-roaders in Mason, TX. Katemcy Rocks is an off-road destination that has over 800 acres of large granite rocks. It's a fun location for beginner, intermediate, and experienced off-roaders, especially those who enjoy rock-crawling.


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February 12, 2013 9:15 pm
We Want Your Organization to Join Our Cosmic Community
More exciting news from StarTalk. We're building an online "Cosmic Community" of academic and scientific organizations, programming groups, schools and astronomy clubs that will promote excitement and interest in STEM education. And we can't do it without you!
Our goal is to create a destination where anyone who loves science can come to find out about the different groups they can join, and for those groups to get free exposure to potential new members.
If you represent an organization that would like to join our Cosmic Community, just click on this link to complete and submit a short application form and we'll be in touch.
The community is still under development, but elements of the program will most likely include:
- An organization listing, description, and link on our website
- Blog Post: Monthly Cosmic Community guest post on our blog from a selected community organization
- The StarTalker Newsletter: One Community member will be Spotlighted in each weekly issue
- Retweets and posts of your upcoming events
- Mentions on air
- The opportunity to pose a question to Neil deGrasse Tyson (one organization per show during Cosmic Queries)
StarTalk is all about science, and we're very excited about building this new type of community – but it can only exist with you!
That's it for now. Keep Looking Up!
–Jeffrey Simons
Get the most out of StarTalk!
Ad-Free Audio Downloads
Ad-Free Video Episodes
Stickers & Mugs
Live Streams with Neil
Priority Cosmic Queries
Early-Access Videos
Learn the Meaning of Life
...and much more


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Annie has some great tips here and in case anyone needs more inspiration check out some of the rather surprising jobs of classic authors. I'm still marveling over JD Salinger being a luxury cruise activities director.
Recently, I came across this list of bizarre day jobs of famous authors. Although I think for most writers, this list doesn't seem all that bizarre. Most of us need some source of income that's not writing-related, and I'd wager that almost all of us have had some kind of random job in our past. (My resume includes ice cream scooping, doll selling, wrangling costumed characters, and television production.)
Writing is pretty much the best career ever, but unfortunately it's not one that usually comes with health benefits attached. My advice for finding a writer-friendly job:
- Be honest with yourself and your needs.
Your career is writing. A day job can (and hopefully will) be fulfilling on its own, but you don't need to feel pressured to climb the corporate ladder. Think about what kind of schedule you need, what your priorities are financially, what flexibility you might need…
View original post 402 more words


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Keeping your home running is not easy. You'd have to make sure that every system in your house is working properly so you won't have to deal with mishaps or accidents later on. One way to allow your systems to work at peak efficiency all year round is to invest in preventive maintenance. A well-maintained system will generally experience fewer breakdowns than an unmaintained one, reducing the need for and cost of unnecessary repairs.
Of course, this standard also applies to HVAC systems. HVAC systems, which are comprised of heating, ventilation, and air conditioning systems, provides necessary heating and cooling to your home. HVAC systems are the reason you can stay warm indoors even though it is freezing outside. Now, like any other system, it is susceptible to damage. To ensure that your HVAC systems function as they should, you should invest in preventive maintenance and schedule it regularly. It goes without saying that you should at least get your HVAC system annually maintained.
Why Is Yearly Maintenance for HVAC Important?
The main purpose of preventive maintenance is to prevent breakdowns from happening at an inconvenient time for you and your family. Regular maintenance generally keeps your HVAC system up and running all season long at top efficiency. Even though preventive maintenance doesn't come cheap, in the long run, you'll definitely save more money investing in your home HVAC system's upkeep than replacing it all at once when it inevitably stops working.
Still not convinced? Well, here at Heat Wiser, we're confident we can change your mind. Here are some reasons why annual HVAC maintenance is a good idea for your New York home.
- Preventive maintenance catches minor issues before they become costly problems
- A well-maintained HVAC system offers consistent air temperatures and all season long comfort.
- A well-maintained HVAC system reduces your energy bill significantly.
- Investing in preventive maintenance saves you money on parts and repairs in the long run.
- If your HVAC system is well-maintained, you can expect your home to have better air quality.
- Additionally, air conditioners, furnaces and other HVAC equipment function best when they're regularly serviced and cleaned, resulting in longer equipment life.
What Can You do to Maintain Your HVAC System?
Now that you're aware of all the benefits of having your HVAC system regularly cleaned, here are some basic tips on how you can maintain your HVAC system.
- Regularly change your filters.
- Clean your condensing unit.
- Visually inspect and create clearance around your outdoor unit.
- Inspect your air conditioner refrigerant lines for leaks.
- Check your evaporator coil's drain pipe and drain pan.
- Turn off water to the furnace humidifier in the summer.
- Replace the humidifier filter and turn water back on in the fall.
- If you'd rather not maintain all of your HVAC equipment yourself, it would be best to reach out to a professional for regular HVAC maintenance.
If you want home HVAC maintenance in Liverpool, New York, look no further than Heat Wiser. We are a HVAC maintenance company servicing Liverpool, NY and its surrounding areas. Enjoy well-maintained HVAC systems in your Liverpool, NY home functioning at top-efficiency all year round when you choose to partner with us today.
Get In Touch With Us for Your HVAC Maintenance Needs!
Keep your HVAC system running like new by having it maintained and serviced by a top-notch Liverpool, NY HVAC company like Heat Wiser. We are a full service heating and air conditioning company servicing Liverpool and the surrounding area. We service and repair all brands of heating and air conditioning products including air conditioners, furnaces, heat pumps, and all heating and cooling equipment. We can help with repair, service, install or replacement. We offer high-quality services at affordable and competitive prices, so you know you're getting the best value for your money.
How Can You Reach Heat Wiser?
Here at Heat Wiser, we have over 25 years of experience in the heating and air conditioning industry. We also believe in quality customer service, so rest assured our friendly customer service team will strive to provide you with the best service possible. We can provide expert service 365 days a year for all your heating, ventilation and air conditioning (HVAC) needs. We can help with repair, service, install or replacement. We also provide annual inspections and indoor air quality-related services.
For free estimates of our services, call us now at 315-457-4100. For any other HVAC-related concerns, send us an email at email@example.com and we'll try to address your concern as soon as possible.


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There are many mods out there that provide you with increased inventory slots and the like, but none of them slot in with Minecraft's aesthetic and elegance like Helpful Backpacks does. There are numerous map mods on the market, and JourneyMap is superior to most of them: but Antique Atlas is properly value a point out simply because of its fantastic aesthetic. Flans Mod is one of the best Minecraft mods of all time. Monsters as well. So, be prepared to have among the best Minecraft Skins applied. Putting in Minecraft mods is not too arduous, however it isn't straightforward should you have no idea much about modifying recordsdata and folder and holding backups as effectively. There's https://minecraft-survival-servers.co/ to play Minecraft. And apparently there are numerous who share this opinion, because SwingThroughGrass has turn out to be one of the downloaded Minecraft mods. Whis this not just a part of vanilla Minecraft by now?
All rights reserved. No a part of this site or its content may be reproduced with out the permission of the copyright holder. It is probably not as efficient as OptiFine in some circumstances. OptiFine is one of the best Minecraft Mods ever. Not only does this super-helpful little mod tell you how a lot hunger a meals merchandise will replenish when you hover over it, however it will also give you the saturation degree of each merchandise too - a stat which Minecraft hides by default. It's top-of-the-line helpful Minecraft Mods that you will find across the Internet. You can also obtain these Minecraft Mods following the supplied obtain hyperlinks for each of those Minecraft Mods. Can you get Minecraft for DS lite? Sodium is built to be used with Fabric, and gives a terrific many extra choices for customising the look of your Minecraft world and toning down or disabling the extra efficiency-expensive elements of vanilla Minecraft's graphics rendering. If you have been enjoying Valheim just lately and lament the truth that vanilla Minecraft does not provide you with the power to immediately teleport to totally different areas, then Waystones is the mod for you. Instead, it solves one explicit problem which tends to cause FPS drops in vanilla Minecraft: numerous experience orbs floating around without delay.
Plus, just like Sodium, it lets you run your favourite shader packs - although do not count on that to extend your FPS. Principally, it gives an FPS increase which naturally decreases lag spikes and smooths gameplay. There's little doubt that mods can completely change the gameplay expertise in Minecraft. If a title has unbelievable gameplay at its core, I am willing to overlook lots (but then, perhaps not all). The flowers added to your world has a variety of performance. After all, using this mod utterly adjustments world generation, so you won't be able to make use of our list of finest Minecraft seeds, however who wants it when you've received so many new biomes to explore? Enter. It will open up your Minecraft installation directory. GasCubby - Your automobile may be certainly one of the biggest drains in your budget, however GasCubby will assist you keep it in test. I would like that pet and the bee swimsuit so dangerous, so regardless that I do not see any method on the planet I can get sufficient tokens, I'm nonetheless going to attempt!
Even if tomorrow isn't a assure, all the time look ahead to it and always act like you are going to completely sort out that day. However both of them may act as a complement to each other. Ensure that you've permission from the proprietor of the server being penetration tested. Be certain that to obtain the recommended installer. Hunt down cows, pigs and chickens to breed them for foods and get some wool from a herd of sheep to make a bed and to established your new spawn place. You'll must do some slight configurations to get began, but it's all straightforward to do and laid out of their mod install house page. It's not straightforward navigating by way of thousands of items in a whole lot of chests. It's a bit of disappointing that the game only runs at 720p whereas docked, nonetheless because of the blocky, low-res artwork-fashion of the sport, this is well forgiven.


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In this insightful and comforting episode of Swedenborg and Life, host Curtis Childs and featured guests review Swedenborg's beautifully detailed vision of children in heaven. While it may not answer every question you have, it may bring some much-needed clarity and peace to your soul.Continue Reading
Archives for January 2016
A Peek inside Swedenborg's Garden
January 29 is Emanuel Swedenborg's birthday and we thought we'd celebrate by taking a closer look at one of his favorite places: his garden.Continue Reading
Scholars on Swedenborg: Swedenborg and the Present-Day Apocalypse in Blake's "The Everlasting Gospel"
Scholars have debated energetically the nature and extent of Swedenborg's influence on Blake for a century. Rebecca Esterson argues that the most apt metaphor for Blake's relationship to that other seer is sparring partner.Continue Reading
Swedenborg and Life Recap: The Four Kinds of Love 1/18/16
In this episode of Swedenborg and Life, host Curtis Childs and featured guests review the four kinds of love, the role each type plays in our lives, and how we can rearrange them if they fall out of order so that we can get back on the path of happiness and spiritual fulfillment.Continue Reading
What Do Your Cravings Say About You?
It's human nature to crave things: ice cream, donuts, money, fame. But Emanuel Swedenborg says that what we crave might reveal more about us than we think.Continue Reading
Swedenborg and Life Recap: Why Bad Things Happen 1/11/16
In this episode of Swedenborg and Life, host Curtis Childs and featured guests review Swedenborg's written philosophies on the importance and consequences of free will and God's role in the good and bad things that happen in our lives.Continue Reading
More Money, More Members: Thanks to Our Supporters!
We got a tremendous response to our 2015 annual fundraising appeal, receiving a total of $106,962 from all sources—a 26 percent increase over 2014! We were blown away by the generosity of all of our contributors, and we're planning to use that money to create even more great content in 2016.Continue Reading
Scholars on Swedenborg: Crosscurrents of Swedenborgianism and Zen Buddhism
Famed Zen Buddhist author and teacher D. T. Suzuki saw Emanuel Swedenborg as the key to mutual understanding between East and West.Continue Reading
Foundation Welcomes New Editor
We are very pleased to announce that after an intensive search, we have a new editor at the Swedenborg Foundation. John Connolly started at the beginning of January and will work out of the Foundation's main office in West Chester, Pennsylvania.Continue Reading
Achieving Work and (Spiritual) Life Balance
How do you balance a mundane but financially sustainable working life with a desire for spiritual fulfillment? Does choosing one mean sacrificing the other?Continue Reading


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This paper presents a micro Fourier transform infrared spectrometer (μFTIR), enabled by an H-shaped electrothermal microelectromechanical systems (MEMS) mirror. A special driving method was developed for obtaining a linear, uniform-speed motion of 186 μm, and the tilting angle of the MEMS mirror was as small as 0.06°, so there was no need of complex closed-loop control. A telecentric lens was employed in the interferometer of the μFTIR to reduce the influence of the MEMS mirror tilting effect. Also, a new phase interpolation algorithm, instead of the traditional fringe interval method, was applied in the process of the spectral reconstruction to improve the spectral stability. Finally, the new μFTIR was applied in the composition prediction of soybeans, and the experimental results show that it can accurately measure grain moisture, protein, and fat contents.
© 2018 Optical Society of AmericaFull Article | PDF Article
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Today we will take you for Half Day North / South Goa (As opted by you) to familiarize you with the place. Evening will be at leisure on the beaches.
Afterfast breakfast we will drive to dudhsagar fall. Dudhsagar is one of the India's tallest waterfalls having the height of 310 m (1017 feet) the fall of water from that height creates the illusion of a literally sea of milk falling from the top. Return Back to the Hotel in the evening.
Today after breakfast, full day will be at leisure on the beaches of goa.
We don't like to say good bye but you have to depart to meet again! Transfer to the airport 2.5 hours before the flight time!
27600Per Person
9700Per Person
54000Per Person
4500Per Person
Assam and Meghalaya
17250Per Person
33000Per Person
Kerala Honeymoon
14467Per Person


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The outcome of Dobbs v. Jackson Women's Health Organization at the Supreme Court will define when an unborn child becomes human, according to a Democrat senator.
Sen. Richard Blumenthal (D-CT) was asked by CNS News if a 15-week-old unborn baby is a human being.
"The Supreme Court this fall will review a Mississippi law that bans most abortions after 15 weeks of pregnancy. Is an unborn baby at 15 weeks a human being?" the reporter asked on Tuesday.
Continue reading story at: toddstarnes.com


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Beard Oil – 2 oz
Beard Oil – 2 oz
$19.99 — or / month
Native Ceuticals CBD Beard Oil deeply nourishes dry beards while helping to seal the hair shaft and protect it from breakage.
This 2 oz Beard Oil is infused with rich oils & hemp extract, the oil boasts restorative properties that help enhance the hair's moisture retention. Ingredients: Almond Oil, Grape Seed Oil, Argan Oil, Jojoba Oil, Rosemary, Clove Bud, Tea Tree, Sweet Orange, Cedarwood, Cypress, Hemp Extract (CBD)


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EMR for pain management is built for the common complaints and procedures dealt with by pain management practitioners.
EMRs are, therefore, designed to meet the unique requirements of practitioners.
A software solution that increases customer satisfaction on a whole new level by:
- Cutting down manual tasks
- Reducing hardware maintenance costs
- Minimizing human errors
- Providing effective practice and health management
- Providing meaningful use objectives
When it comes to EMRs, an essential part of a healthcare system, there are endless options of companies and vendors offering specialized support pain management needs in the market. Finding quality-care software is no doubt an exhausting task.
Implementing pain management-specific EHR software will make your life a hundred times easier. And to get you started, this article has chosen three best EMR for pain management. Designed to not only simplify your workflow but also increase productivity and financial revenue.
Let us go through the best pain management EMRs in 2021.
PrognoCIS pain management EMR software provides ample templates and content for:
- patient evaluation
- interventional treatments
- medication management
The meaningful use and HIPAA compliant EHR can be customized according to your specific workflow to deliver quality care with proper monitoring and tracking results.
Features of pain management EHR
- Comprehensive diagrams depicting pain, procedures, and injection sites.
- In-built customizable templates for procedures including CESI and LESI.
- Ability to copy forward prior HPI, ROS, & physical into the current encounter.
- In-built eRX for controlled substamces.
- Patient portal.
- Analytic tools
The pain management templates that PrognoCis offer include:
- trigger point injections
- epidural steroid injection cervical
- back pain thoracic region
- selective nerve root blocks
- peripheral nerve blocks
- radiofrequency treatments
- discography
- spinal cord stimulation
- joint injections
- epidural scar tissue lysis
- medial nerve block and facet joint injections
- minimally invasive lumbar decompression
A free demo can be requested by filling out the form on the company's website. Training is provided in person, live, through documentation, webinars and videos.
Pricing: PrognoCis starts at $250 per month per feature.
Deployment and supported devices
- On-Premise – Windows
- On-Premise – Linux
- Android, iPhone and iPad
- Desktop: Windows
- Cloud, SaaS, Web-Based
The company is ranked in the top 10 cloud-based EHR by KLAS.
Revenuexl provides a suite of services such as pain management software, telemedicine, and patient engagement with free medical billing. Revenuexl is an award-winning company with MACRA certification built specifically for pain management healthcare clinics and providers. Offering templates and features for quality care, document management, and all the billing functions. Revenuexl software platform will streamline your clinical and financial processes, amplify staff productivity as well as optimize your workflow.
If you opt for Revenuexl, it will offer free data migration from your existing EHR software system.
A free demo can be availed upon requesting the vendor.
- Customizable EHR to increase revenue and communication.
- Comprehensive medical billing system.
- Reporting under MIPS and APM.
- Integrated telehealth software.
- e-Prescription integrated with EPCS and medication management adherence facility.
- Patient portal and referring physician portal to improve your practice's performance.
- User-friendly patient scheduler
- Appointment management with text reminder to decrease no-shows.
- Free 'White Glove' EHR implementation.
Price quotes can be availed by providing relevant information about your practice to the vendor.
Deployment Method:
Cloud, SaaS and Web-Based
Revenuexl Alternatives:
eRecord, AllegianceMD, and SOAPware.
The 2015 edition HIPAA compliant paint management EMR offers one-shot electronic patient charting to reduce paper cost and staff time. The charts include entire patient demographics such as:
- insurance
- appointment management
- pharmacy and visits information
- updated vital signs
- medical history
- surgical and family history
- current medications
- allergies
- lab tests
- health maintenance and tracking
The EHR includes templates for
- Rheumatoid Arthritis
- Sarcoidosis
- Gout
- Fibromyalgia
- Pseudogout
- Rheumatic heart disease etc
Pain Management EHR billing lets you submit accurate bills in minimal clicks.
Features of PracticeEHR pain management
- Visit Indicators: A feature that lets providers categorize between the office and diagnostic visits.
- Patient portal
- Documentation
- Financial reporting and analytics
- Easy to use dashboard
- Lab integration and pharmacy integration
- Patients' scheduler
- Billing system
- Appointment reminders
- Integrated Fax system
- Electronic Messaging
- Referral Management
- Clinical and financial alerts
- Body Charts: for annotation pains, strains, sprains, and myalgia.
- Percent Loss of Range of Motion: auto-calculation of percent loss of range of motion depending on the user input for each body.
How to boost pain management practice with the following tips
- Upgrading to E-prescription to help you make informed clinical decisions about controlled substances.
- Engaging your patients at all times via online or providing remote care. Patients must have immediate online service to enhance your patient care experience.
- Use the mobile app facility by your EMR software to pull up patients' information and medical records anywhere, anytime.
- Utilise the pain care templates to eliminate the process of filling endless and redundant form every time a patient visits.
- Handle and manage all your documentation electronically to spend more time with your patients and reduce labor-extensive work.
To optimize clinical and administrative processes, you need to equip your practice with the right tools. Get rid of the hassle of manual work by implementing an EMR that is designed for your pain management practice's specific needs.
If you are interested in finding out more or looking for any other information, reach out to us for a FREE consultation, or shoot an email to [email protected] to get in touch with our consultant. Our consultant will help you determine your priorities and compile a list of pain management EMR vendors to compare your clinical needs. Find the right EMR with FindEMR.


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of method Null safety
- BuildContext context
The state from the closest instance of this class that encloses the given context.
Typical usage is as follows:
ScrollableState scrollable = Scrollable.of(context);
Calling this method will create a dependency on the closest Scrollable
in the
context, if there is one.
static ScrollableState? of(BuildContext context) {
final _ScrollableScope? widget = context.dependOnInheritedWidgetOfExactType<_ScrollableScope>();
return widget?.scrollable;


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Another woman has filed a lawsuit against Cleveland Browns quarterback Deshaun Watson, becoming the 23rd civil case to accuse him of sexual misconduct during massage sessions in 2020.
It is the first lawsuit filed against him since the 22 others were filed in March and April of 2021 and potentially could complicate any plan for the NFL to resolve questions about Watson's playing status before the season.
In this case, the lawsuit filed Tuesday states the woman had three encounters with Watson in Houston that got progressively worse. During the third encounter in the summer of 2020, the lawsuit states Watson exposed himself to her, touched the woman between her legs and repeatedly requested that the woman have sex with him.
After first deciding not to file a lawsuit against Watson, the woman changed her mind after watching a segment about the lawsuits last week on HBO's "Real Sports with Bryant Gumbel."
"In that piece, plaintiff was struck by the courage of the victims willing to step forward and speak and was extremely displeased by Watson and his legal team's mistreatment and revictimizations of the plaintiffs," the new lawsuit states. "But it was Watson himself claiming that even now he has 'no regrets' and has done nothing wrong that solidified her resolve. She brings this case seeking minimum compensation, but to obtain a court finding that Watson's conduct was wrong."
Watson, 26, has denied wrongdoing and has not been arrested or charged. His attorney, Rusty Hardin, said the women are lying, out for money and said three of the cases involved consensual sex initiated by the plaintiffs. He didn't immediately return a message seeking comment.
"Today we filed suit for the 23rd plaintiff in this litigation," plaintiffs attorney Tony Buzbee said in a statement. "Other cases may come. The Watson defense team has vilified these women and this cause. Shame on them! We look forward to trying this case in court."
The NFL also has been investigating these cases and could suspend Watson if he is found to have violated the league's personal conduct policy. In March, two grand juries in Texas considered a combined 10 criminal complaints made against Watson to police but declined to indict him on criminal charges.
Watson previously played for the Houston Texans but recently was traded to the Browns, who gave him a record guaranteed contract of $230 million over five years.
Follow reporter Brent Schrotenboer @Schrotenboer. E-mail: email@example.com


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Once I was on the junior varsity basketball workforce in highschool, I wasn't shocked after I developed a case of itchy, flaky athlete's foot. In any case, I used to be an "athlete," so I assumed it was an indication of dedication and exhausting work.
I used to be shocked when my mom informed me the reality: it was attributable to poor foot hygiene, not my dribbling expertise.
Quick-forward nearly 4 a long time, and I'm rather more diligent about skincare. Nonetheless, some pores and skin points plague me at occasions, like they do many males. Here's a take a look at two frequent issues and options.
Dry pores and skin
Signs of dry pores and skin embody scaly patches (with or with out redness), itching, and total dryness. You will get dry pores and skin year-round — from the heavy warmth of summer time to the bitter chilly of winter. Solar publicity damages pores and skin, leaving it thinner and fewer more likely to maintain in moisture over time. Additionally, getting older pores and skin produces much less of the pure oils that hold pores and skin lubricated.
Remedy. The primary line of protection is a moisturizer that softens and smooths pores and skin with water and lipids (fat). Some moisturizers appeal to water to the pores and skin and seal it in. Others stop moisture loss by coating pores and skin with a thick, impermeable layer.
- Petroleum jelly. This waxy, greasy substance stops water loss with out clogging pores. It may be utilized by itself however can also be an ingredient in lots of moisturizers and ointments. As a result of petroleum jelly doesn't include water, it's greatest used whereas the pores and skin continues to be damp after bathing to seal in moisture.
- Mineral oil. Mineral oil has the identical impact however and not using a greasy feeling. It additionally must be used whereas pores and skin is damp.
- Moisturizing lotions and lotions. These merchandise include each water and oils. They're much less greasy and extra cosmetically interesting than petroleum jelly or oils. Search for moisturizers with not less than one of many following elements: glycerin, urea, pyroglutamic acid, sorbitol, lactic acid, lactate salts, or alpha hydroxy acids.
Prevention. Attempt just a few modifications to assist stop dry pores and skin:
- Add moisture to the air with a humidifier or a pan of water set atop the radiator.
- Within the bathe or bathtub, use lukewarm water (sizzling water can dry the pores and skin by stripping it of pure oils).
- Select nondrying soaps with no abrasives or irritants. Tremendous-fatted soaps or cleaning bars are much less drying than common, liquid, or antibacterial soaps.
- To retain the water your pores and skin absorbs whereas showering or bathing, apply jelly, oil, or moisturizer instantly afterward.
Athlete's foot
Athlete's foot is brought on by dermatophytes, a gaggle of fungi on the floor of the pores and skin. Inform-tale indicators embody intense itching; cracked, blistered, or peeling areas of pores and skin, particularly between the toes; and redness and scaling on the soles. Dermatophytes thrive in heat, moist environments like swimming pools, showers, and locker rooms the place individuals stroll with naked toes. The nice and cozy, moist setting of sweaty socks and footwear encourages them to develop.
Remedy. First, attempt an over-the-counter antifungal ointment, cream, or powder, equivalent to clotrimazole (Lotrimin AF, Mycelex, generic), terbinafine (Lamisil AT, Silka,), or miconazole (Lotrimin AF spray, Micatin). It could take weeks for an an infection to enhance, and recurrences are frequent. If signs do not enhance after a number of weeks, seek the advice of a health care provider, who might prescribe antifungal tablets.
Prevention. Retaining toes clear and dry is one of the best ways to chase away athlete's foot. Additionally, do the next:
- Wash your toes nicely on daily basis, and put on a clear pair of socks after your bathtub or bathe.
- Take time to dry your toes totally (together with every toe and particularly the net area between the toes) after you bathe, bathe, or swim.
- Put on flip-flops or sandals round public swimming pools and in gymnasium locker rooms and showers.
- Put on moisture-wicking socks that take up sweat.
- Don't put on the identical footwear two days in a row. Give footwear a 24-hour break between wearings to air out and dry.
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James Earl Jones Confirmed for Rogue One
Ever since Star Wars spinoff, Rogue One was confirmed by Disney, the question of whether the galaxy's ultimate villain would return has been circling the interwebs. Being set between Episode's III and IV, Rogue One certainly has a chance of Darth Vader appearing in a bigger form than the half melted helmet we saw in The Force Awakens. Now, it seems that the rumours have been confirmed.
James Earl Jones will be making a triumphant return as the voice of Darth Vader in Rogue One. How exactly Vader will be integrated into the story remains to be seen but since the plot revolves around the Rebellions mission to steal the plans of the iconic Death Star, it won't be too hard to slip him in.
Don't go expecting for Vader to run the show however. Producer Kathleen Kennedy told Entertainment Weekly 'He will be in the movie sparingly.' with the main villain seemingly Ben Mendelsohn's Director Orson Krennic. Mads Mikkelsen meanwhile, is playing a character named Galen Erso, a designer of the Death Star. On the Rebellion side we have Felicity Jones and Forest Whitaker playing Jyn Erso and Saw Gerrara respectively. Rogue One is due out December 16. More news as we get it of course.


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Vladimir Radmanović
Vladimir Radmanović (born November 19, 1980) is a Serbian former professional basketball player who played for the Seattle SuperSonics, Los Angeles Clippers, Los Angeles Lakers, Charlotte Bobcats, Golden State Warriors, Atlanta Hawks, and Chicago Bulls from 2001-2013.
Radmanović was born on November 19, 1980 in Trebinje, Bosnia and Herzegovina, Yugoslavia.[1]
References[change | change source]
Other websites[change | change source]
|Wikimedia Commons has media related to Vladimir Radmanović.
- Career statistics and player information from NBA.com, or


text: First Security Islami Bank launched 4 investment products on the first day of New Year-2022 with a view to providing shariah based banking services in a greater extent to its clients. The products are- FSIBL Prochesta for start-up entrepreneurs, FSIBL Shabolambi for women entrepreneurs, FSIBL Udyami for cottage, micro and small entrepreneurs, FSIBL Sonali Swapno for agriculture and rural development projects. Syed Waseque Md Ali, Managing Director of the Bank inaugurated the new products. Among others, Abdul Aziz and Md. Mustafa Khair, Additional Managing Director(s), Md. Zahurul Haque and Md. Masudur Rahman Shah, Deputy Managing Director(s), Principal of Training Institute, Zonal Heads of Dhaka, Divisional Heads of Head Office along with other officials present in the occasion. A Doa Mahfil was organized in this regard.