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Click here for Personalised search for Laser Skin Rejuvenation near Me
Laser skin resurfacing or Laser skin rejuvenation can help treat sagging, wrinkles, uneven skin tone, age spots, and scars and other signs of aging.
Similarly to peels it removes the outer layer of skin but with the added benefit of treating the deeper layers of the skin stimulating it to increase the production of collagen which is essential ingredient for skin health.
The only side effect can be redness and sensitivity to sunlight for several months with results lasting several years.
These treatments can also help boost collagen levels in your skin in other parts of the body to improve the overall tone and texture including the hands and neck.
Parent: Laser Treatments


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"The key to selling your house for top dollar—even in a dismal market—is simple: Implement a broad-based advertising campaign to generate spirited buyer competition for your property."
– House Selling for Dummies
Components of the Comprehensive Paragon Marketing Plan
- Determine buyer profile for property
- Price and position to maximize buyer and broker response
- Prepare property to maximize number of showings and quality of offers
- Professional real estate photography
- Gorgeous promotional materials
- Traditional media advertising
- Direct mail and email campaign
- Targeted community marketing
- Extensive Internet marketing
- Marketing to the broker community
- Orchestrated schedule of open houses, broker tours and individual showings
First Steps
- Pricing walk-through by selected Paragon agents, as applicable
- Staging consultant review
- Landscaping review
- Prepare property-preparation punch list
- Professional photo-shoot
- Order architectural and floor-plan renderings, as appropriate
- Order pre-sale inspections
- Complete Seller and agent disclosures
- Order Natural Hazard Disclosure Report
- Order County Bldg Dept. report
- Order transferable Home Warranty, as appropriate
- Prepare newspaper advertisements
- Prepare magazine advertisements
- Develop color property statement and brochure
- Create Property-Tour Slideshow and Virtual Tour (if appropriate)
- Develop Property-Showcase website with description, multiple photos, slideshow, showing dates, neighborhood information, loan calculator, etc.
Prior to First Showing
- Update comparative market analysis: check for new competitive listings, recent comparable sales or changes in market conditions
- Pre-sale inspection reports received and reviewed
- Post property on the San Francisco Multiple Listing Service and affiliated website with multiple photos, detailed description and initial showing dates
- Post enhanced-showcase listing on Realtor.com
- Post property on over 90 of the most important local and national real-estate listing web sites—including those of Paragon, the San Francisco Chronicle, The NY Times, Trulia, Zillow, YouTube, Luxury Real Estate ($1.5m+) and Google Base
- Property is posted on hundreds of Bay Area broker and agent websites for maximum exposure to prospective buyers working with other local agents
- Post listing and showing information on Craig's List
- Mail "Just Listed" postcards to 250+ households within the neighborhood
- Mail (or hand-deliver) neighbor invitations to first Open House
- Distribute property flyers to major brokerages announcing first Brokers' Tour and Sunday Open House
- Outreach to neighborhood businesses and organizations: invitations to open houses, posting of property brochure
- Email listing announcement, website address and slideshow to selected agents
- Install "For Sale" sign with website rider, and brochure box, if appropriate
- Order loan scenario handouts for open houses
- Finalize comprehensive disclosure package for interested agents and buyers
- Arrange catering for first Brokers' Tour and Preview Open House
- Complete final preparations of property to show in best possible light
On Market: Week One
- Consider preview Open House or Twilight Tour for neighbors, friends and selected brokers invited by personal invitation
- First Brokers' Tour
- First Saturday Open House, if appropriate
- First Sunday Open House
- Individual showings to interested agents and prospective buyers
- Follow-up with attendees of Brokers' Tours, Sunday Open Houses and private showings
- Review market response and re-strategize as necessary
- Prepare new advertisements; mailings; MLS, Craig's List and website updates
On Market: Week Two
- Revise ads and website postings to reflect new showing information
- Second Brokers' Tour
- Second Sunday Open House
- Individual showings to interested agents and prospective buyers
- Follow-up with attendees of Brokers' Tours, Sunday Open Houses and private showings
- Distribution of comprehensive disclosure packages to interested parties
On Market: Week Three
- Review market response and feedback, Internet website traffic reports, changes in market conditions, and new data on competitive properties and comparable sales
- Review and revise marketing plan & pricing strategy, as needed
Subsequent to offer acceptance, marketing campaign shall continue until all contingencies of sale have been removed.

subset: commoncrawl


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Just as the creations of the world's great fashion designers rely on the perfect mix of fabric and cut, the Tissot Couturier timepieces blend elegant lines with materials to match. These watches express their made-to-measure character through their uncompromising attention to detail. These promise to outlive any fashion whim and stand the test of time.
* ct = carat; kt = karat; tcw = total carat weight
Last update : 2019-11-15
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New International Version
1 You, however, must teach what is appropriate to sound doctrine.
2 Teach the older men to be temperate, worthy of respect, self-controlled, and sound in faith, in love and in endurance.
3 Likewise, teach the older women to be reverent in the way they live, not to be slanderers or addicted to much wine, but to teach what is good.
4 Then they can urge the younger women to love their husbands and children
5 To be self-controlled and pure, to be busy at home, to be kind, and to be subject to their husbands, so that no one will malign the word of God.
6 Similarly, encourage the young men to be self-controlled.
7 In everything set them an example by doing what is good. In your teaching show integrity, seriousness
8 And soundness of speech that cannot be condemned, so that those who oppose you may be ashamed because they have nothing bad to say about us.
9 Teach slaves to be subject to their masters in everything, to try to please them, not to talk back to them
10 And not to steal from them, but to show that they can be fully trusted, so that in every way they will make the teaching about God our Savior attractive.
11 For the grace of God has appeared that offers salvation to all people.
12 It teaches us to say "No" to ungodliness and worldly passions, and to live self-controlled, upright and godly lives in this present age,
13 While we wait for the blessed hope – the appearing of the glory of our great God and Savior, Jesus Christ
14 Who gave himself for us to redeem us from all wickedness and to purify for himself a people that are his very own, eager to do what is good.
15 These, then, are the things you should teach. Encourage and rebuke with all authority. Do not let anyone despise you.
Amplified Bible
1 BUT [as for] you, teach what is fitting and becoming to sound (wholesome) doctrine [the character and right living that identify true Christians].
2 Urge the older men to be temperate, venerable (serious), sensible, self-controlled, and sound in the faith, in the love, and in the steadfastness and patience [of Christ].
3 Bid the older women similarly to be reverent and devout in their deportment as becomes those engaged in sacred service, not slanderers or slaves to drink. They are to give good counsel and be teachers of what is right and noble
4 So that they will wisely train the young women to be sane and sober of mind (temperate, disciplined) and to love their husbands and their children
5 To be self-controlled, chaste, homemakers, good-natured (kindhearted), adapting and subordinating themselves to their husbands, that the word of God may not be exposed to reproach (blasphemed or discredited).
6 In a similar way, urge the younger men to be self-restrained and to behave prudently [taking life seriously].
7 And show your own self in all respects to be a pattern and a model of good deeds and works, teaching what is unadulterated, showing gravity [having the strictest regard for truth and purity of motive], with dignity and seriousness.
8 And let your instruction be sound and fit and wise and wholesome, vigorous and irrefutable and above censure, so that the opponent may be put to shame, finding nothing discrediting or evil to say about us.
9 [Tell] bond servants to be submissive to their masters, to be pleasing and give satisfaction in every way. [Warn them] not to talk back or contradict
10 Nor to steal by taking things of small value, but to prove themselves truly loyal and entirely reliable and faithful throughout, so that in everything they may be an ornament and do credit to the teaching [which is] from and about God our Savior.
11 For the grace of God (His unmerited favor and blessing) has come forward (appeared) for the deliverance from sin and the eternal salvation for all mankind.
12 It has trained us to reject and renounce all ungodliness (irreligion) and worldly (passionate) desires, to live discreet (temperate, self-controlled), upright, devout (spiritually whole) lives in this present world
13 Awaiting and looking for the [fulfillment, the realization of our] blessed hope, even the glorious appearing of our great God and Savior Christ Jesus (the Messiah, the Anointed One)
14 Who gave Himself on our behalf that He might redeem us (purchase our freedom) from all iniquity and purify for Himself a people [to be peculiarly His own, people who are] eager and enthusiastic about [living a life that is good and filled with] beneficial deeds. [Deut. 14:2; Ps. 130:8; Ezek. 37:23.]
15 Tell [them all] these things. Urge (advise, encourage, warn) and rebuke with full authority. Let no one despise or disregard or think little of you [conduct yourself and your teaching so as to command respect].
King James Version
1 But speak thou the things which become sound doctrine:
2 That the aged men be sober, grave, temperate, sound in faith, in charity, in patience.
3 The aged women likewise, that they be in behaviour as becometh holiness, not false accusers, not given to much wine, teachers of good things;
4 That they may teach the young women to be sober, to love their husbands, to love their children,
5 To be discreet, chaste, keepers at home, good, obedient to their own husbands, that the word of God be not blasphemed.
6 Young men likewise exhort to be sober minded.
7 In all things shewing thyself a pattern of good works: in doctrine shewing uncorruptness, gravity, sincerity,
8 Sound speech, that cannot be condemned; that he that is of the contrary part may be ashamed, having no evil thing to say of you.
9 Exhort servants to be obedient unto their own masters, and to please them well in all things; not answering again;
10 Not purloining, but shewing all good fidelity; that they may adorn the doctrine of God our Saviour in all things.
11 For the grace of God that bringeth salvation hath appeared to all men,
12 Teaching us that, denying ungodliness and worldly lusts, we should live soberly, righteously, and godly, in this present world;
13 Looking for that blessed hope, and the glorious appearing of the great God and our Saviour Jesus Christ;
14 Who gave himself for us, that he might redeem us from all iniquity, and purify unto himself a peculiar people, zealous of good works.
15 These things speak, and exhort, and rebuke with all authority. Let no man despise thee.
Becoming a Christian
Would you like to experience forgiveness and new life from the God of the Bible, who calls every person to believe that he sent his son Jesus Christ to make this possible?
The Bible explains why everyone needs to receive forgiveness and is called to serve Jesus Christ. The consistency of the Bible story, which was authored by people living thousands of years apart from diverse cultures and even different languages, is often cited as evidence of divine inspiration. Wikipedia has a list of many Biblical prophesies which have come true.
The story of God's plan to restore his relationship with us can be summarised in eight famous Bible verses below.
- In the beginning God created the heavens and the earth.
Genesis 1:1
- All have sinned and fall short of the glory of God.
Romans 3:23
- God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.
John 3:16
- Jesus said, "I am the way and the truth and the life. No one comes to the Father except through me."
John 14:6
- If you declare with your mouth, "Jesus is Lord," and believe in your heart that God raised him from the dead, you will be saved.
Romans 10:9
- For it is by grace you have been saved, through faith – and this is not from yourselves, it is the gift of God.
Ephesians 2:8
- But you will receive power when the Holy Spirit comes on you; and you will be my witnesses in Jerusalem, and in all Judea and Samaria, and to the ends of the earth.
Acts 1:8
- Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit.
Matthew 28:19
The truth in these verses is simple, yet to embrace it means letting go of all our personal hopes and dreams and embracing God's greater purpose for our lives instead, a purpose far above anything we could dream or imagine.
This is the most important decision you will ever make, because it affects not just the rest of your life here on earth, but what comes after as well. Don't put it off until too late. If you died tonight make the decision to spend eternity with your loving Father in Heaven.
If you're wondering what to do next as a new Christian, check out these helpful suggestions from Mary Fairchild on About.com:


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Southview lnternal Medicine
Clinton Crossings, Building E
Monday–Friday 7 a.m.−5 p.m.
We provide 24-hour telephone coverage for emergencies and urgent problems. Please call your doctor's number and the answering service will have the doctor call you back.
Welcome to Southview Internal Medicine. We are an Internal Medicine Practice providing medical care for adult patients over the age of 18. Our doctors are board certified in Internal Medicine and are faculty members of the University of Rochester School of Medicine and Dentistry.
Since we are part of UR Medicine Primary Care, we work closely with the region's top specialists at UR Medicine.
- Routine physical exams and health screenings
- Sick visits
- Treatment and management of chronic diseases (such as diabetes and high blood pressure)
- Same-day appointments
- Prescribing medication and refills
- Immunizations and flu shots
Appointment Information
We feel that it is important for you to be seen by a doctor who knows you and understands your concerns. That's why we'll do our best to make sure that you can see a doctor when it's convenient for you. If your doctor is not available when you call for an appointment, you may be offered an appointment with a different physician in our office. We offer same day appointments for patients with urgent problems.
Your cooperation in arriving on time for your appointment helps us stay on schedule. We strive to provide each patient with the highest quality care. In the event that our schedule is delayed, please rest assured that you will also get personalized attention during your appointment.
If you must cancel your appointment for any reason, please call at least 24 hours in advance. That will allow us to offer the appointment to another patient.
First Time Patients
- Please arrive 15 minutes early from your scheduled appointment to allow for registration and paperwork.
- To save time, fill out our new patient form and bring it with you.
- Before your first appointment, call your previous doctor's office and have your records forwarded to our office.
- If your insurance company requires you to notify them when you change doctors, please call them with the name of your new primary care doctor.
What to Bring
- Your medical and drug insurance cards.
- A list of your current medications (with dosages), including any over-the-counter medications or supplements you have taken in the past six months.
- Check to see which prescription refills you may need so we can provide them for you at the time of your visit.
Additional Information
Prescription Refills
Please allow 48-72 hours for all prescription refills. Call your pharmacy and ask them to transmit the refill request to us electronically or fax the refill request to your doctor's fax number. The pharmacy will provide us with all the information needed to refill your prescription.
If you are experiencing a life-threatening emergency, call 911 or go to the nearest emergency room and have the hospital notify our office or the physician on call.
Most insurance plans require prior approval of all emergency room visits. Please call our office before obtaining these services.
If you require hospitalization, Dr. Judith Allen admits patients to Strong Memorial Hospital.
Southview Internal Medicine is part of Strong Memorial Hospital. Because of that, you may receive two separate bills for your care–one from Strong Memorial Hospital and one from your provider.
That is so because Medicare requires us to file two claims with them each time we see a patient. Medicare Part A covers your visit to this hospital facility, and Medicare Part B covers the professional services of the physician/provider who provides your treatment. Therefore, you may receive two separate bills to satisfy your coinsurance payment and deductible responsibilities.
Co-payments should be made at the time of your visit. You can pay with cash, personal check or credit card and you now have the ability to pay your hospital or physician bill online at Pay a Bill.
You will be billed for any services not covered by your insurance company.
If you have questions regarding your bill, please call the number listed on the bill and the staff will be happy to answer your questions.
We accept most types of insurance including Excellus Blue Cross-Blue Shield, Preferred Care, Aetna, Medicare, Medicaid as well as others.
Please notify our office if your insurance coverage changes. Bring your insurance card with you to your appointment; we will need the new information printed on your insurance card.
We are committed to providing excellent health care for everyone. Financial hardships should never stop you from getting the medical care you need. We offer financial assistance to individuals who are unable to pay medical bills. If you feel you need help, please call our customer service staff at (585) 758-7650 or out of area toll free 1-888-925-4301.


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Here Comes Your Mani
Come in to Bliss Salon Day Spa and let us treat you. Whether you want the full luxurious spa experience or a quick manicure on the go, we're here to serve the people of Warren. Don't stress yourself out trying to apply nail polish with your non-dominant hand when you can just unwind while we give you perfect nails. Our services range from a simple polish change, to nail shaping and light cuticle care, to a more thorough and relaxing experience including hydrating hand massages or a full hot stone massage to make sure that you are as comfortable and rejuvenated as possible.
Going to a salon to get our nails done is part of a tradition that women have been enjoying for 5,000 years. Women were painting their nails in India in 4000 BC, and a thousand years later women in Mesopotamia started manicuring their nails. The experience is just as important today in Warren as it was back then. Here at Bliss Salon Day Spa, we feel like we are part of a tradition that stretches back to the dawn of civilization, and we believe you deserve to enjoy the same kind of luxury as any ancient queen.
Types of manicures available
- European Manicure – We moisturize your hands, shape the nails, and polish with your choice of colors
- Paraffin Manicure – Heated wax infuses your skin with moisture and makes your hands feel great, followed by a hand massage and a basic manicure.
- Classic French Manicure – A clear, pale pink, or beige polish accented by white polish along the tip.
- Reverse French Manicure – The same style as the French Manicure, but with darker base colors, or reversed so that the nail is white with a colored accent at the tip.
- Hot Stone Manicure – The most indulgent and pampering option. Add the delight of hot stone massage to any of the other manicures. Your hands will feel fantastic!
We think we give the best manicures the people of Warren can find. Why don't you come in and judge for yourself?


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Matching T-Shirt for Nike Air Flight Huarache Varsity Purple and Royal Blue
Matching T-Shirt for Nike Air Flight Huarache Varsity Purple and Royal Blue
Get it between -
Introducing the perfect addition to your sneaker collection: our stylish and comfortable crew neck t-shirt designed to match the iconic Nike Air Flight Huarache Varsity Purple and Royal Blue sneakers. Made with high-quality materials, our t-shirt features a classic crew neck and short sleeves, making it perfect for any occasion.
Crafted with a soft and breathable cotton blend, this t-shirt will keep you comfortable all day long. The varsity purple and royal blue color of the shirt perfectly matches the sneakers, while the minimalistic design allows the sneakers to be the star of the show.
Whether you're running errands or out for a night on the town, our Retro Huarache matching t-shirt is the perfect choice. Order now and take your sneaker game to the the next level.
• Style: Adult Short Sleeve Crew Neck Shirt - Shoes not included
• Materials: 100% cotton. Dark Heather is 65% polyester, 35% cotton
• Shirt Size: S, M, L, XL, 2XL, 3XL
• Custom Made: Not Jordan Brand or Nike
Where do you offer shipping?
Shipping available to United States only. We are currently offering free priority shipping which takes one to three business days on average, during the holiday seasons shipping can take longer due to increase in shipping. We do not offer expedited shipping at this time.
When will I receive my order?
Please note, due to fulfillment and shipping orders can take up to 5 business days (M-Sa) before they are shipped. Your tracking information will be sent by email to the email address used to place your order once your order has been shipped. Due to the holidays your order might experience processing and carrier delays.
What is your Refund/Returns policy?
SNKADX products are made to order meaning when orders are paid the production begins on that item. Refunds or Returns are only accepted for defective products. We are unable to offer refunds/returns for incorrect sizes or buyers remorse since our products are made to order. Please contact us directly if any issues with your order. Our return policy lasts 14 days. If 14 days have gone by since your purchase, unfortunately we can't offer you a refund or exchange. To be eligible for a return, your item must be unused and in the same condition that you received it. Since items are made to order we cannot offer refunds for buyers remorse. Refund would be made to the original source of payment after your return is reviewed. To complete your return, we require a receipt or proof of purchase. To request for refund send us a detailed email at email@example.com. We will review and provide a resolution on your request.
It is the responsibility of the customer to review their shipping address and information for accuracy before completing the purchase. Refunds or exchanges will not be issued on the basis of an incorrect address. If a package is shipped back to SNKADX due to an incorrect/undeliverable address, shipping charges will not be refunded.


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After the Orthopedic Center in South Dakota, and it WAS my birthday, and that cortizone shot had perked up my spirits, we decided to head east for a 2-day road trip, about 70 miles, to Badlands National Park, in SD in the southwestern part of the state, near/in/through Pine Ridge Indian Reservation. I was shocked to learn it was there all this time, and I'd never heard of it - MY loss.
The drive north to the Ortho Center included this view of Crazy Horse, taken from the moving car.
Crazy Horse, a work in progress, taken from the car. |
View from our Lodge porch |
South Unit |
I would definitely recommend this trip, although it's NOT plush. Climate is semi-arid, not much snow, but a lot of wind, and I presume very HOT in summer. Fill up your gas tank before you get in the Park.


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BERLIN- Stephen Decatur's boys' varsity basketball team, along with several other teams from the Bayside Conference, will compete next week in the 3rd Annual Governor's Cup Holiday Basketball Tournament featuring the top teams from Maryland against some of Delaware's best.
For years, the Wicomico Youth and Civic Center in Salisbury has played host to holiday basketball tournament featuring some of the best prep teams from around the region between Christmas and New Year's. Two years ago, for the first time, the tournament was renamed the Governor's Cup after Maryland Gov. Martin O'Malley issued a challenge to Delaware Gov. Jack Markel with a Maryland Smith Island cake on the line against a Delaware peach pie for the winner.
Next week, the second annual Governor's Challeng Cup will be held, although it has been renamed the M&T Bank Cup, and will once again feature some of the top teams from Maryland's Eastern Shore against a strong field of teams from Delaware. Decatur will be among the Bayside South Conference teams represented along with Parkside, Crisfield, Washington, Pocomoke, Snow Hill, Bennett and Wicomico.
Delaware teams in the field include Cape Henlopen, Indian River, Sussex Central, Sussex Tech, Woodbridge, Laurel, Milford, Seaford, Delmar, Delmarva Christian, Arcadia and Campus Community. Decatur will face Arcadia next Wednesday, December 26 at 4 p.m. and Sussex Central on December 29 at 2 p.m.
The tournament expanded last year to include two new cups including the Dr. Pepper 10 Cup featuring ten of the top teams in Maryland from both sides of the Chesapeake. Finally, the tournament will feature an elite division called the East Coast Challenge with four of the region's top high school teams. The tournament is set for next week, December 26-29, at the Wicomico Youth and Civic Center. Last year, the teams from Delaware took the Governor's Cup, amassing 13 wins to Maryland's 10 in the competitions between schools from the two states.


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Lovely Long Hot Peppers
There now Winter is here. We had our first Snow this Saturday. I am not too fond of winter. The thing I hate about winter is bundling up the kids in layers to even go to the grocery store. A simple task takes hours in just preparation. Coats waiting to be zipped, leggings to be worn, the cap messing the hair, the car seat now gets uncomfortable, the two young things shout out protests, the thought itself drives me nuts.
I like winter as long as I am allowed to stay inside. Inside the home it is warm and cozy and you truly start appreciating what "warm and cozy" means. Such was this Saturday, snowing in white fluffs outside while we sat in the warm glow of the fireplace, eating hot hot Mirchi Curry.
This curry is inspired by Nupur's alu dum which again was inspired by Trupti's alu dum recipe. Instead of potatoes I decided to use long hot peppers in the creamy curry. Some heat to warm up the palate.
Ok truth be told I wanted to make a Mirchi ka salan like this or this. But then except for the long hot peppers I had no other ingredients. But I still desperately wanted to have Mirchi in a Curry and so in a fit of inspiration used Nupur's curry as a base for the beautiful hot peppers.
The Mirchi Curry or Long Hot Peppers in a creamy gravy was truly delicious and enjoyed by all barring the kids. The dish does have a fair amount of heat (though long hots are not too hot) and so be careful while cooking and eating. Though I have used long hot peppers for this dish you can use other type of hot peppers. For other kinds you may need to de-seed to reduce the heat
Read more...
Mirchi Curry -- Long Hot Peppers in a gravy
Serves: 5-6 people
Cut 8-10 long hot peppers in 4ths each(i.e. each cut in 4 ). Sprinkle salt and pepper, drizzle with olive oil and roast in one single layer at 375 for 30-40 mins.Note: These are my toaster oven settings and time may vary in a regular one. Take care not to burn but just brown the peppers. More on roasting long hot peppers.
Soak 1/4 cup of cashew or slivered blanched almonds in water. Yes, what can I say, I have too many almonds in my pantry :-)
Heat oil in a frying pan. Saute 1 medium onion diced + 2 cloves of garlic + 1" ginger peeled and chopped till onion is soft and lightly browned. Add 1 medium tomato chopped in large chunks and fry till tomato softens
Cool the above and grind to a fine paste along with the cashew(or blanched almonds) and very little water
Heat Oil now for cooking
Temper with 1/4 tsp of Nigella seeds and 1/2 tsp of Cumin seeds
Add the masala(onion + cashew etc.) paste that you have prepared and fry till you see oil seeping out of the masala
Add 1 tsp Kasoori Methi, Turmeric, salt and a little Paprika for the color. Mix well.
Add about 1 cup of 2% Milk. Add water if required for the gravy. Let the gravy simmer to a boil
Add the roasted long hot peppers and cook until the gravy thickens to a creamy consistency. Add a little sugar to taste, a little garam masala and very little chopped corriander.
Serve with Roti or Rice. It is fiery hot but in a pleasant way.
Trivia: There is debate whether or not men and women sense capsaicinoids(the substance that gives chilli peppers their intensity) similarly. Research carried out by the University of Reading shows that the effect of Capsicum chinense is elevated in the conjunction with testosterone. Thus men are more affected than women. Now you know why a pepper spray is effective


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Data-Driven Manufacturing Moves Ahead at Mazak
Modern Machine Shop – March 11, 1014 – Written by Mark Albert.
"We thought we knew what our utilization was, but now we know for sure. And we have a clear picture of how to make it even better, too," Ben Schawe says. Mr. Schawe is vice president of manufacturing at Mazak's North American Headquarters and Technology Center in Florence, Ky. He oversees production at this campus, located about 10 miles southwest of downtown Cincinnati, just across the Ohio River. What is giving Mr. Schawe and other shopfloor personnel greater certainty and insight into operational efficiency is a newly installed machine monitoring system. This system may well prove to be the prototype for similar systems implemented at other Mazak plants around the world.
Mazak is part of Yamazaki Mazak, a global manufacturer of CNC machine tools and automation systems headquartered in Oguchi, Japan. Yamazaki Mazak began establishing manufacturing plants in major markets around the world in the early 1970s to be closer to its customers and to understand their specific manufacturing requirements. The Florence, Ky., facility began operation in 1974. Since then, Mazak has undergone numerous expansions, the latest of which is a 100,000-square-foot addition to its manufacturing plant to be completed this spring. At that point, the company will be able to produce as many as 200 units per month, depending on product mix.
More important, Mazak has assumed a role as a designer, as well as a builder, of machine tools. Kentucky-designed and built machines are exported around the world as part of Yamazaki Mazak's global offering of advanced manufacturing technology. In addition, the Florence plant plays a role in exploring manufacturing processes and methodologies that can be implemented in other Mazak manufacturing plants to improve productivity and efficiency.
The machine monitoring system appears to be a good example of this sort of technology. In operation since November, the system has yielded significant benefits, initially by uncovering some easily fixed inefficiencies and practices. Mr. Schawe says that these fixes have increased uptime by 6.2 percent across the 15 machines that are fully integrated into the system. "This was that low-hanging fruit, so to speak," he says. "We've also recognized some opportunities to make additional gains from efforts such as putting greater emphasis on having replacements for worn tools ready to go." Taken together, these efforts have yielded a 17 percent improvement in utilization for the monitored machines so far.
But over and above these benefits is the advantage of having a system that takes the guesswork out of tracking machine utilization. "We can tell at a glance how we are doing, and the basis is in real-time data," Mr. Schawe explains.
Making The Connection
What is distinctive about the machine monitoring system running in several locations in the Florence facility is that it uses MTConnect as the common data format for capturing and analyzing data about machine performance. MTConnect is an open, royalty-free standard intended to foster greater interoperability between manufacturing devices and software applications. This communication standard is facilitated by XML and HTTP technology (the basic "language" of the Internet) to provide real-time data sharing throughout a factory.
MTConnect was introduced at the International Manufacturing Technology Show (IMTS) in 2008. Not long after this introduction, executives at Mazak recognized the potential of this standard to facilitate plant-wide integration and enhance automation. Brian Papke, president of Mazak, recalls the initial excitement about the announcement of MTConnect as a communication standard. "We could see how MTConnect would make it possible for the data generated by our machine tools to be shared across the network for processing by various software applications. This capability would be a boost not only in our own manufacturing operations, but it would be equally valuable to our customer base."
With so much at stake, Mazak resolved to play a leadership role in promoting the adoption of MTConnect across the U.S. manufacturing landscape. On one hand, this meant a commitment to supporting the continued advancement of the standard by involvement in the MTConnect Institute, the body that oversees its development. On the other hand, it meant implementing MTConnect-enabled technology not only on its machine-tool products, but also in its own manufacturing equipment in the factory.
"This total embrace of MTConnect was intended to make a statement," Mr. Papke says. "We wanted to be a leader in both promoting and implementing MTConnect. We wanted our example to show the country the importance of moving toward data-driven manufacturing. MTConnect is an essential part of what makes data-driven manufacturing possible."
As eager as Mazak is to adopt MTConnect-enabled technology, the company has planned its implementation carefully. Although these plans call for virtually all manufacturing equipment to be integrated using the MTConnect protocol, the company has focused on a full installation of a machine monitoring system involving six FH8800 HMCs in a Palletech flexible manufacturing system, three FH6800 HMCs in a similar Palletech system and six large V100 bridge mills.
Since November, all of these machines have been connected to the machine monitoring system, which uses MERLIN MES monitoring software developed by Memex Automation (Burlington, Ontario). MERLIN (Manufacturing Execution Real-time Lean Information Network) is a manufacturing execution system and machine-to-machine communications platform. Memex has been providing network connectivity, DNC software and machine monitoring systems since 1992 and has offered MTConnect-compatible versions of its MERLIN machine monitoring and manufacturing execution systems since 2010.
"Rather than offering an expensive, custom installation for every client, we've produced a packaged, machine-to-machine toolkit adaptable by all manufacturers. The technological breakthrough here is that MERLIN is an MTConnect-based hardware and software module that does not require programming or setting up of PLCs. The MES leverages a company's existing investment in plant, equipment and enterprise software," says David McPhail, president and CEO of Memex Automation.
This supplier was selected after a task force headed by Neil Desrosiers, Mazak's developer of digital solutions, evaluated numerous commercial monitoring systems. This task force included IT personnel, machine operators, shopfloor supervisors and managers from the machining department. Two factors tipped the choice to MERLIN. The most important of these was the apparent ease with which reports could be configured for various users within the company. The other was the ability to store collected data and archived reports locally on a dedicated network server rather than on remote storage accessible on the Internet (the "cloud"), a concession to security concerns raised by the IT team.
The importance of report configurability is a point that Mr. Desrosiers is quick to comment on: "Machine tools generate a lot of data. This data has to be organized properly to be understood and acted upon." Whether machine-generated data is translated into MTConnect vocabulary by a software or a hardware adapter, it isn't very usable until it is organized in meaningful ways for an intended user, he says. Because not all users have the same needs, different styles of reporting help more users find the data valuable.
For example, presenting data in an easily interpreted, visual format is useful for operators on the shop floor who can tell at a glance how machine tool conditions are influencing efficiency. Likewise, bar graphs that summarize activity across a number of machines can inform supervisors and managers of trends useful for decision-making and long-term planning such as scheduling refresher training that might be needed.
Mazak opted to install 60-inch flat-screen displays at two shopfloor locations near the machines being monitored. These flat screens scroll through a series of displays that are viewable for about 30 seconds at a time using MERLIN's built-in slideshow feature. Most of the screens represent a report about a specific machine with the top portion showing machine performance as a dashboard, so-called because the needle gages and readouts resemble the speedometer or tachometer gages on the dashboard of a car. Another display presents graphs that compare all of the machines according to a variety of critical metrics such as uptime, stoppages by category and an overall equipment effectiveness (OEE) rating, a critical manufacturing metric.
With this system in place and fully functional, the configuration of various reports could be finalized, users could be trained on their use, and monitoring software could be installed on management computers as required. This paves the way to expand the system more rapidly in the months ahead by adding the ability to tie Mazak's ERP system to MERLIN bi-directionally. When the current facility expansion is completed, it is expected that all machines will be monitored, including metalcutting machines of all types, fabricating equipment such as laser cutters, and a powder paint line.
Fruitful Findings
Because tracking and improving machine utilization is a main objective of Mazak's monitoring system, gathering data related to why a machine was stopped is a key function. Among other sorts of data, MTConnect provides a set of defined terminology for the signals, alarms and alerts that indicate the reason for a machine's stoppage. Having this "dictionary" ensures that the data from machines or devices sourced from different suppliers will have the same meaning. This approach enables software applications such as MERLIN to make sense of incoming data, regardless of the device sending it.
For example, every time any machine on the network stops, the system records the type of stoppage and the reason for it. Then it immediately updates the reports and displays accordingly. Thus, the software can show program stops, feed holds, spindle overrides, tool changes and other reasons why a machine is not running. Analyzing this data can suggest ways to reduce or eliminate many of these stoppages, and thereby improve overall utilization.
Some of the results of Mazak's analysis of this data were surprising, Mr. Schawe reports. For example, a number of part programs included optional stops originally added so that operators could check tool wear periodically or measure a critical part feature, during the prove-out of the process. When the part went into production, however, these optional stops were never removed from the part program, or operators simply got in the habit of restarting the machine at these points in the program. The high occurrence of stoppages linked to these programmed stops showed up in the reports and they could be traced to the cause. Systematically editing the part programs to remove these unnecessary optional stops was an easy way to recover the lost production time.
A similar pattern was detected in stoppages for tool changes. Some operators were stopping the machine every time the access to the tool magazine was opened to replace or check a cutting tool. Instead of using the feed-hold button, which stops the machine, they should have been using the magazine manual interrupt switch, which enables the machine to continue running safely while they perform tool maintenance. Training that addressed this issue took care of the problem.
Analyzing stoppages also revealed more subtle situations. For example, an unusual number of machine stops were reported with a certain run of part castings. Checking with the operators revealed that castings of the same part sourced from two different foundries were not identical. Dissimilarities in the foundry patterns created excess stock conditions that required the operator to interrupt the part program to manually add a second tool pass on the affected castings.
In other cases, the operators could point to data as evidence that a persistent shortage of a certain cutter type was holding back productivity. Because adequate spare tools were not available, the machine had to be stopped to index inserts on the spot instead. Acquiring additional tool cutter bodies help resolve these delays. In fact, a more general pattern of not having sufficient replacement tools ready to restock tool magazines in a timely fashion was also detected. An initiative to correct this situation is now underway.
Open-Ended Possibilities
Connecting a group of turning centers to the monitoring system is slated for the next phase of expanded integration. Mr. Schawe reports that the turning supervisors already have proposed process changes in mind that data analysis can help point in the right direction. For example, it has been suggested that standardizing on one size of barstock will reduce setup time significantly, even though parts now produced from smaller- diameter barstock will require additional tool passes. Data will prove if the increased cycle time for these parts is not outweighed by savings from the reduced setup time resulting from using standardized barstock.
Connecting the machine tools in one of the plant's grinding departments is also imminent. Unlike the machining centers already integrated, which all have Mazatrol CNCs that natively generate MTConnect-compliant data, the array of grinders in this department represent control systems from a variety of suppliers, including FANUC, Toyoda and Cincinnati Milacron. Memex has provided a universal and configurable hardware adapter solution to connect these disparate legacy machines to MERLIN via MTConnect.
Essentially, these adapters intercept the data generated by the controls and translate it into the equivalent MTConnect terminology. When this translated data is conveyed to the MERLIN software (or any other MTConnect-compliant software, for that matter) it is ready for processing.
The adapters for the grinding machines were installed in a variety of ways, showing the potential for interoperability in an MTConnect environment. On the grinders with newer, PC-based interfaces, the adapters could be installed as a software utility using the PC's application program interface (API). On other, older controls, the adapter resides on a separate printed circuit board integrated to the control's existing I/O structure. In this case, an Ethernet port on the board provides the network connection. Generally, the older controls are limited in the kind of data that is available for monitoring.
Of course, retrofitting additional sensors to any type of machine tool opens up all kinds of monitoring possibilities. For example, sensors that detect the temperature of the spindle and vibrations from its bearings are on the list for future enhancements to the machine monitoring system in Florence. Mazak is already using MTConnect-compliant sensors that report these measurements on its spindle headstock test stands. The same technology can be transferred to production equipment and the data results incorporated into the MERLIN software.
"Although Mazak's history with MTConnect is longstanding, we think we've only scratched the surface as far as its transformative possibilities go," Mr. Schawe observes. Creating a comprehensive machine monitoring system is a big step forward, but only one of many that are feasible with having a "universal language for shopfloor and plant-wide communication," he believes.
The Big Picture
Mr. Papke takes an especially wide-angle view of developments such as MTConnect, which he sees in the context of advanced manufacturing technology that encompasses lean manufacturing practices, multitasking and five-axis machine tools, manufacturing cells, flexible systems, and all kinds of automation. "I firmly believe that manufacturing has more potential to grow and flourish in the United States than it has in many years. If there is truly a Renaissance in manufacturing, it will happen because companies invest in state-of-the-art facilities that are woven together with digital technology," he says. He adds that "implementing MTConnect [as a communication protocol] is one of the simplest and fastest ways to improve productivity and boost utilization of equipment."
In addition, implementing MTConnect "at home" has given Mazak experience with the same issues that its customers are likely to encounter with their own implementation. As a result, the company has better advice to give, sounder recommendations to share, more expertise in problem-solving and troubleshooting to tap and other insightful assistance to offer. Likewise, it has also helped Mazak refine and prove out its growing library of MTConnect adapters so customers have smoother, error-free installations.
Being able to showcase proven results from this technology is one of the most compelling reasons that Mazak has invested heavily in MTConnect-enabled applications for its own manufacturing operations. "We want companies who visit our plant to see how this has benefited us so that they have more confidence in what it can do for them in their own facilities," Mr. Papke says. "Likewise, incorporating MTConnect within our own machine tool products gives our customers an advantage. It is a significant move forward for them."
He concludes with this assertion: "We have to set the example. That's our responsibility as believers in this technology. It's what a leader has to do."
To see the full article, please click here.


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Konstantin Pavlovich Buteyko was born on the 27th January 1923, into the small farming community of Ivanitsa (about 150km from Kiev). Inheriting his fathers enthusiasm for machines, Konstantin was enrolled into the Kiev Polytechnic Institute until his studies were interrupted by World War II when Buteyko joined his country's armed forces. After his experiences during the War, Buteyko felt compelled to study what he called "the most complicated piece of machinery of all" – the human organism.
In 1946, he enrolled into the First Medical Institute in Moscow. During his third year he started working in the clinical therapy group under the departmental head, academician Evgeniy Mikhailovitch Tareiev.
During this third year at the Institute, Buteyko was given a practical assignment which involved monitoring diseased patients breathing. He spent hundreds of hours sitting by patient's bedsides, recording their breathing patterns prior to death. He noticed a considerable and uniformed deepening in patients breathing with the approaching of death. By recording these increases, Buteyko found that he was soon able to form a prognoses on how many days or hours were left before the patient's death occurred. This event determined the area of Buteyko's future interest.
In 1952, having graduated from the Institute with Honours, Buteyko continued his experiments independently along similar lines. He asked healthy subjects to breathe deeply for a period of time, and found that they became dizzy and nauseous, developed asphyxiating symptoms such as wheeziness and coughing, and eventually fainted. This (he had been told) was due to oxygen over-saturation of the brain.
During the second month of this independent work it occurred to Buteyko that certain diseases may develop as a result of deep breathing. He himself had suffered form hypertension for some time, and had often pondered its causes. By measuring his carbon dioxide levels, Buteyko discovered that his body's carbon dioxide level was lower than recommended. It was known that over breathing lowered carbon dioxide levels in the body. He theorised that if his low levels were caused by over-breathing, then by correcting his breathing he may able to cure his disorder.
He immediately began experimenting on himself. Soon he had trained himself to breathe in a more shallow fashion. He found that by reducing his breathing, some symptoms such as headache and rapid heart beat also reduced. When he increases the depth of his breathing, the symptoms returned. Buteyko concluded that he had discovered the reason for his disease. He immediately set out to devise a programme by which a patient's breathing could be quickly and effectively measured and then, if need be, reconditioned. He had shortly healed himself completely.
Buteyko checked and rechecked his theory on patients. He measured the breathing patterns of sufferers of asthma, stenocardia and other diseases. Discovering, without surprise, that they too were hyperventilating. Once again by correcting these patients' breathing to an acceptable level Buteyko was able to normalise their carbon dioxide shortfall and their attacks stopped immediately. When they were asked them to return to their previous breathing patterns, their attacks resumed. It was clear, that Buteyko had stumbled across a very important discovery, a global discovery, and that current medical thinking was upside down.
Through further research, Buteyko was able to lay down the theoretical foundation for this idea – hyperventilation causes a depletion of carbon dioxide; low levels of carbon dioxide in the organism cause blood vessels to spasm and also cause oxygen starvation of the tissues. This results in a whole range of "defence mechanisms" that have been previously misunderstood and labelled as diseases. It was not difficult to surmise that vessel spasming occurring in hypertension could occur also with other types of diseases, for example: stenocardia (angina pectoris) with the resultant myocardial infarction (heart attack): end arteritis (inflammation of the innermost coat of an artery, usually occurring in legs) or ulcerative stomach disease. Scientific data associated with the physiological role of carbon dioxide is discussed in more detail in the "Buteyko Theoretical Manual".
Buteyko worked very intensively at the Central and Lenin Medical Libraries researching his theory. Was it really possible that for the entire existence of the medical science such a simple thought had never occurred to anyone else? He learnt very quickly that the answer to this question was yes. For centuries, the majority of the human race had taught their children to breath deeply, and no-one, even for a moment, tried to reduce breathing. During his research, Buteyko was lucky to learn of a few experiments supporting the viability of his thinking. (See- Bohr, Holden, Priestly, Henderson, De Kosta). This then led to Buteyko sharing his thoughts with his teachers, but he found no support from any of them.
He knew well, through his studies, that many medical discoveries had initially been dismissed and suppressed officially only to become accepted practice years later. He recalled the story of sepsis on 1846. A doctor friend of Zemelweise had cut his finger while performing an autopsy on a woman who had perished of sepsis (or "puerperal fever" as it was then known). Three days later, the doctor also contracted the "puerperal fever". Zemelweise concluded that "something" had been passed from the corpse and into the doctors cut, via the blood. At the time microbes were not yet known of, they were discovered by Pastor 20 years later.
With the desire to confirm his supposition, Zemelweise began washing his hands prior to operations, disinfecting them with a chloride of lime solution. He suggested his assistants also follow this routine. In those times, about one third of all new mothers and surgical patients died of sepsis. A three month experiment confirmed Zemelweise's hypothesis, and he lost no patients thereafter. He informed his societ of surgeons and suggested they follow his example. He was declared to be mentally disturbed.
Similar destiny befell Professor Lister, an Englishman, who ten years later also called for disinfection of hands prior to operations. Only after this discovery had reached the ears of the public, and hordes of patients' relatives started to turn up at the operations demanding to know if the surgeons had washed their hands before operating, did this procedure become accepted by the surgeons. This happened half a century after the initial discovery by Zemelweise.
Historical knowledge of this nature made it clear to Buteyko that voicing his convictions was not likely to bring any positive results at that stage. He knew he must organise an experimental laboratory . He had to gather evidence, develop it, and only then, announce the fundamentals of his ideas.
Later that year Buteyko became a clinical therapy intern under Academic Tareiev again. Here he was given his chance to establish a functional diagnostics laboratory, This project failed due to lack of funds, personnel and equipment. An attempt to establish the laboratory under the auspices of the Ministry of Health in Moscow was also unsuccessful – the necessary equipment was made available, but not the scientific personnel. In 1958 Buteyko was invited by Professor Meshalkin to join the Institute of Experimental Biology and Medicine at the Siberian Branch of the USSR Academy of Science (where Meshalkin was the director). Once again he set about the task of establishing a laboratory of functional diagnostics. This project was completed in 1960.
In 1958 – 1959 Buteyko conducted clinical studies on nearly 200 people, both healthy and sick. When the first data, various measurements, association, deductions, correlations, regulations, etc., were obtained. All of these confirmed the correctness of Buteyko's discovery. On 11th January 1960, he presented his work to the Scientific Forum at the Institute and tried to explain the concepts of his thinking. He told those present of the experiments, which showed the objective linear relationship between the depth of breathing, the content of carbon dioxide in the body and vessel spasming and degrees of illness.
Buteyko's colleagues were stunned. Surgeons took the studies as some dirty trick, because Buteyko offered to treat such diseases as asthma, hypertension, stenocardia, without a knife. Invasive surgery never cured these disease anyway, everybody knew that, and mortality was high. But the Buteyko method gave a quick, almost 100% recovery. Quite naturally, Buteyko had expected the surgeons to be delighted but unfortunately their reaction was quite the opposite. Never the less, he did receive temporary approval from Professor Meshalkin who chaired the Forum. He said he understood the perspective and wanted the research continued.
Over the next ten years of the laboratory's existence, Buteyko and his team were able to obtain extensive information on the basic functions of the human organism – whether healthy or diseased. The laboratory was equipped at the highest level. There was a compendium of over forty various instruments capable of registering almost all basic functions of the human organism, and producing approximately 100,000 pieces of data per hour. Analysis of this information was done on computers, mathematically deriving physiological measurements and the various conformities of the body's processes.
Two hundred medical specialists were trained in the laboratory, most of whom, by the way, had suffered from one condition or another and successfully treated themselves with the method. Soon they were all treating other patients utilising- Buteyko's method. Official statistics showed that as at 1 January 1967 more than 1000 patients suffering from asthma, hypertension or stenocardia had been successfully treated and had totally recovered from their illnesses.
Despite this, Meshalkin categorically refused Buteyko's request for an approbation to be conducted at the Institute's clinic. Shortly thereafter Meshalkin mysteriously implemented brutal repression, up to the forcible confiscation of the laboratory equipment. There were to be no publications, and strong reprimands were made for any public appearances or speeches on the subject. This attitude was exhibited not only by Professor Meshalkin but by all of his student-surgeons. In 1963 Professor Meshalkin had also subjected a few new ideas which challenged current opinions of surgery, to a similar treatment. As a result of these unseemly management practices, the Institute was disbanded and closed.
This disbandment may have saved Buteyko's laboratory. He was able to keep one third of all the instruments, personnel and the original laboratory premises. From 1963 to 1968 the laboratory was attached to the Institute of Cytology and Genetics of the Siberian Branch of the USSR Academy of Science. Professor Meshalkin's clinic was reassigned into the system of the Russian Ministry of Health. Buteyko's repeated requests to accredit his method had not met any support what so ever.
Only In January 1968, after representations made by the local and foreign press in defence of his discoveries was the approbation carried out in Leningrad, at the Institute of Pulmonology under Academician Uglov. Shortly before this, a visit was paid to Buteyko's clinic by the Minister of Health, Academician Petrovsky. The Minister informed Buteyko that if he successfully treated at least 80% of the patients given to him, Petrovsky would make recommendations for an immediate entrenchment of the method into standard medical practices. He promised also to make available a 50 bed clinic for the continuation of Buteyko's clinical work. The Minister had one condition – that the patients used on the approbation were the most serious and difficult cases, not otherwise treatable by conventional methods of medicine.
Of the 46 patients who underwent Buteyko's treatment 44 (95%) were officially recognised as cured. Only 2 from the 46 had a smaller positive effect. Some of the patients had up to twenty different conditions each. One of the female patients had been recommended to undergo a mastectomy, as she was diagnosed to have a malignant tumour in the initial stages. She had refused the operation. She was included on the list of patients because of her asthma. She recovered not only from her asthma but from the rest of her complaints, including the tumour.
It should be added that the two patients not included in the success rate were also relieved of their diseases after further treatment and had informed the Minister responsible. Consequently, in effect, Buteyko could describe the results of his method as having had a 100% success rate.
The official conclusions of the approbation, which was monitored by the health ministry, were sent to the Health Minister, academician Petrovsky. These conclusions were never seen by either Buteyko or the Siberian Branch of the Academy of Science. The Ministry later, in a phone call to the chairman of the Siberian Branch, academician Lavrentiev, advised that the approbation had failed, with only two out of the 46 patients having been cured. This unexplained falsification served as a foundation for closing the Buteyko laboratory. On 14 August 1968, all of the scientists were dismissed without any offers of alternative employment, and all of the equipment was confiscated or pilfered.
However, even against such great odds, the method survived. The originally trained team of medical practitioners continued to treat patients. Although not one official medical establishment in Moscow was using the method, it was being used in Harkov, Chernigov, Kdhovka, Leningrad, Krasnoyarsk, Khabarovsk, Sverdlovsk, etc…
Success after success forced the government to once again look into the method. The second official approbation was conducted at the First Moscow Institute of Paediatric Diseases in April 1980 at the direction of the Government Committee for Science and Technology of the Soviet Ministry of USSR. The study confirmed the findings of the earlier approbation, conducted in Leningrad: 100% success rate. This time the results were officially recognised.
Whilst the Russian approbations tended to focus on treatment of Asthma, it should be understood that this method is also extremely effective for a whole range of related disorders such as allergies, rhinitis, bronchitis, sleeping disorders (such as sleep apnea), breathing problems, etc.


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A California appeals court has upheld a lower court ruling that Johnson & Johnson must pay penalties to the state for deceptively marketing pelvic mesh implants for women, but reduced the amount by $42 million to $302 million.
Johnson & Johnson had appealed in 2020 after Superior Court Judge Eddie Sturgeon assessed the $344 million in penalties against Johnson & Johnson subsidiary Ethicon.
Sturgeon found after a non-jury trial that the company made misleading and potentially harmful statements in hundreds of thousands of advertisements and instructional brochures for nearly two decades.
California's Fourth District Court of Appeal issued a ruling Monday that $42 million in penalties assessed for the company's sales pitches to doctors were unjustified because there was no evidence of what the sales representatives actually said.
But the appeals court said Sturgeon received ample evidence that Ethicon knowingly deceived both physicians and patients about the risks posed by its products, the San Francisco Chronicle reported.
Ryan Carbain, a Johnson & Johnson spokesperson, told the Chronicle that the company would appeal the appeals court ruling to the state Supreme Court.
The instructions for use in all of the company's pelvic mesh implant packages "falsified or omitted the full range, severity, duration, and cause of complications associated with Ethicon's pelvic mesh products, as well as the potential irreversibility and catastrophic consequences," Presiding Justice Judith McConnell of the appeals court said in a 3-0 ruling upholding the $302 million in penalties.
She rejected the company's claim that the fine was excessive, saying it amounted to less than 1% of Johnson & Johnson's net worth of $70.4 billion.
The products, also called transvaginal mesh, are synthetic and surgically implanted through the vagina of women whose pelvic organs have sagged or who suffered from stress urinary incontinence when they cough, sneeze or lift heavy objects.
Many women have sued the New Jersey-based company alleging that the mesh caused severe pain, bleeding, infections, discomfort during intercourse, and the need for removal surgery.
The condition is estimated to affect 3% to 17% of women and it sometimes becomes severe after age 70.
Johnson & Johnson, the world's biggest maker of health care products, is contesting other lawsuits over drug side effects, its role in the U.S. opioid epidemic, and allegations its baby powder caused cancer in some users.
Newsy is the nation's only free 24/7 national news network. You can find Newsy using your TV's digital antenna or stream for free. See all the ways you can watch Newsy here.


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'Empire' May Not Get a Series Finale Due to Coronavirus
Fox's hip-hop family drama Empire is receiving an untimely end. According to Deadline, next week's Season 6 Episode 18 will serve as the season finale for now. There's even a possibility the episode will become the show's series finale. Originally, Season 6 of Lee Daniels and Danny Strong's show was intended to unfold over the course of 20 episodes, but that plan was derailed because of filming complications due to coronavirus.
Both Daniels and Strong expressed their sadness over not being able to film the finale episode they had originally planned, but hope to give the series a proper conclusion in the future. "I'm heartbroken we aren't getting to shoot the finale we wanted — at least not yet," said Daniels. Strong added, "We had an ending for the series planned that we all loved, and hopefully someday we'll be able to film it and give the series its proper conclusion."
Starring Terrence Howard and Taraji P. Henson, Empire first debuted on Fox in 2015. The show follows the fictional hip-hop company Empire Entertainment. Season 6 was intended to be Empire's last season. Its events were supposed to wrap the series up entirely, including an ongoing mystery that wouldn't get resolved until Episode 20. But now, the creative team will have to conclude the series a different way, at least for now.
Empire's Season 6 finale will air on April 21 at 9PM ET/PT on Fox.
Gallery — Fox Franchises That Could Have New Life at Disney:


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Spoiler warning: DON'T.
You have got to be kidding me.
…For those who can't see the photo: Fox News is reporting an email where Obama for America asked for volunteers to man the Annapolis, MD phone banks, starting at 5:30 PM this afternoon. At that point, Hurricane Sandy will be descending upon the Chesapeake Bay area and will make landfall some time between 8 PM this evening and 8 AM tomorrow. Annapolis is in the possible storm track. It WILL get hammered by winds, rain, and flooding.
So NO. DO NOT GO INTO ANNAPOLIS TO PHONE BANK TODAY. IT CAN WAIT.
Sheesh. Are there no adults in Obama for America? …Sorry, rhetorical question.
Moe Lane (crosspost)


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- This event has passed.
Sharing Our Fertility Journeys: A Group for Women in the Jewish Community
January 19, 2023 @ 7:00 pm - 8:00 pm
7:00 – 8:00 pm via Zoom
Facilitated by Lillian Soloweszyk, MSW, LMSW
Join us for meaningful conversations as we support each other through fertility and family building challenges.
This weekly group will focus on identifying and practicing ways to cope as you navigate your personal journey and offer a safe space to share experiences and resources. The group is welcoming and sensitive to Jewish women of all backgrounds, denominations, and levels of observance.
Seeds of Hope offers another opportunity to connect with women on their fertility journeys by joining our women-only, private Facebook group, Baltimore Jewish Women Sharing Fertility and Family Building Journeys.
For questions or more information, contact Michelle Goldberg at email@example.com
Seeds of Hope, a program of Jewish Community Services, is made possible by grants from Michelle & Ira Malis and the Jewish Women's Giving Foundation, a program of The Associated: Jewish Federation of Baltimore.


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Add an artful touch to your seats with this beautiful pillow, try tossing it on a clean-lined white sofa in your living room to effortlessly elevate your space. Invisible zipper for a clean look and easy care.
Cover Only - Cushion Not Included
17 x 17 inches (45 x 45 cm)
100% Polyester
Processing Time
1-3 Business days
Estimated Shipping Time
Canada/US: Express Shipping 3-8 Business days
Other countries: Standard Shipping 12-14 Business days
Spot clean with mild soap


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How does this medication work? What will it do for me?
This medication is most often used as an eye drop to treat glaucoma, but is sometimes used to treat some other conditions of the eye.
Pilocarpine causes constriction of the pupil of the eye. This enlarges the outflow canal, allowing drainage of excess fluid (aqueous humor) from the eye and causing the pressure inside the eye to drop.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Odan-Pilocarpine is no longer being manufactured for sale in Canada. For brands that may still be available, search under pilocarpine eye drops. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.
How should I use this medication?
The recommended dose of pilocarpine solution drops is 2 drops instilled into the affected eye(s) 3 or 4 times daily.
Your doctor will choose the strength of pilocarpine that is best for you based on the pressure inside your eye.
The following procedure is recommended when using eye drops:
- Wash your hands.
- Tilt your head back and gently pull your lower eyelid away from your eye to make a pouch.
- Drop the medicine into this pouch, then let go of the eyelid and gently close your eyes.
- Do not blink.
- Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for one or two minutes to prevent excessive absorption into the body.
- Wash your hands to remove any medicine that may have gotten on them.
- Do not touch the dropper or the applicator tip to any surface (including the eye).
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you:
- are sensitive or allergic to pilocarpine or any ingredients of this medication
- have inflammation of the coloured part of the eye (iris or uvea)
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- blurred vision or change in near or far vision
- decrease in night vision
- eye irritation
- headache
- dizziness
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- diarrhea
- dizziness
- eye pain
- eyelid swelling
- increased sweating
- floaters or flashes in your field of vision
- eye swelling
- increased eye pressure
- nausea
- vomiting
- watering of mouth
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a severe allergic reaction (hives, difficulty breathing, swelling of the mouth or throat, skin blisters, sores or pain in the mouth or eyes)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Contact lenses: This medication contains a preservative that can cause eye irritation and discoloration of soft contact lenses. People who wear contact lenses should remove the lenses before using the eye drops and wait at least 15 minutes before reinserting them.
Reduced vision: This medication may cause reduced vision especially at night or with reduced lighting. Do not drive or operate machinery until you are familiar with this medication's effects.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if pilocarpine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
What other drugs could interact with this medication?
There may be an interaction between pilocarpine and any of the following:
- other eye drops
Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. In many cases, interactions are intended or are managed by close monitoring. Speak to your doctor about how any drug interactions are being managed or should be managed.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Odan-Pilocarpine


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Joann K. Carpenter, Ph.D
Clinical Psychologist
Gentle Care:
Psychotherapy for Couples, Families, and Individuals
To schedule an appointment or for more information contact us
at 301-907-8821 or email email@example.com.
If You Need Help, We're Here for You.
Bethesda Marriage Counseling is conveniently located in downtown Bethesda, Md. We serve the online community as well as communities in Suburban Maryland, Washington, D.C. and Northern Virginia including: Bethesda, North Bethesda, Boyds, Cabin John, Chevy Chase, Colesville, Cabin John, Garrett Park, Gaithersburg, Glen Echo, Kensington, North Potomac, Olney, Poolesville, Potomac, Montgomery Village, Rockville, Silver Spring, Takoma Park, Wheaton, Woodley Park, Georgetown, McLean American University Park, Tenleytown, Friendship Heights, Montgomery County 20008 20814 20016 20815 20817 20904 20812 20855 20877 20878 20879 20896 20895 20886 20830 20832 20854 20859 20850 20852 22106 22101 22102 20853 20903 20905 20906 20910 20912 20902
Services at Bethesda Marriage Counseling include: marriage counseling, relationship therapy, couples counseling, premarital counseling, counseling, and psychotherapy for couples and individuals dealing with relationship issues, infidelity, cheating, marriage, communication, conflict resolution, eldercare issues, sexual problems, divorce recovery, infertility, medical illnesses, stress management, life transitions and positive psychology coaching.


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While getting some vitamin D may be good for you, being outdoors without adequate sun protection can cause your body more harm than good. Exposure to ultraviolet (UV) light from the sun can lead to the onset of wrinkles, dark spots, and sagging skin.
Read on to find out how a visit to your dermatologist can help rejuvenate your sun-damaged skin.
What is Sun Damage?
Sun damage to your skin occurs after too much exposure to UV light rays. This results in changes to your skin cells, disrupting their growth and appearance.
According to the National Institutes for Health, sun damage can cause your skin to lose its suppleness and elasticity, making it wrinkled, thin, and leather-like. In addition, sun exposure at a young age will cause your skin to age faster.
What are the Symptoms of Sun Damage?
Sun damage results in significant changes to your skin. Not only does it put you at a higher risk for developing skin cancer, but it includes physical changes that can make your age faster.
Studies show that 80% of visible facial signs of aging can be linked directly back to a person's exposure to UV rays.
Common symptoms of sun damage include:
- Loss of your skin's natural oils
- Leathery skin
- Wrinkles
- Sunspots
- Dry, coarse skin
- Sunburns
- Peeling skin
How is Sun Damage Diagnosed?
Your board-certified dermatologist can help diagnose the symptoms of skin damage and offer an individualized treatment plan to rejuvenate sun-damaged skin.
Seeing a dermatologist is also recommended if you have a family history of skin cancer or if you notice a difference in the size, color, or shape of your moles or sudden growths or spots on your skin.
Treatment for Sun Damage to Your Skin is Safe When Performed by a Board-Certified Dermatologist
While the best way to prevent sun damage to your skin is to limit your exposure to the sun, your dermatologist can perform cosmetic treatments to reduce the appearance of fine lines, wrinkles, and other commonly occurring symptoms of sun damage.
Typical forms of treatment for the rejuvenation of sun-damaged skin include:
- Botox
Commonly used to treat wrinkles in your forehead and around your eyes, botox injections are a popular cosmetic procedure to prevent the formation of wrinkles. - Chemical peels
Your dermatologist may prescribe a series of chemical peels if you have sun spots, wrinkles, and dry skin. Chemical peels work by removing the top layer of your skin, resulting in a more youthful appearance and an overall improvement in your skin. - Dermal fillers
This type of cosmetic procedure is used to replace the collagen lost by your skin due to sun damage. Your dermatologist may also recommend dermal fillers if you have fine lines and wrinkles. - Laser skin resurfacing
Light from a laser is used to lighten sun spots, target redness caused by sun damage, and decrease the appearance of fine lines and wrinkles.
Prescription creams
For some patients, a prescription tretinoin cream may be sufficient in treating wrinkles, fine lines, and discoloration. It works by helping your skin shed dead skin cells and regenerate new ones, improving your skin's overall texture.


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2017 DHHL Legislative Package – Proposed Legislative Action Request
Posted on Jul 20, 2016 in Department of Hawaiian Home Lands, Media ReleasesEvery year, the Department of Hawaiian Home Lands prepares and submits legislative proposals for inclusion in the Governor's Administrative Package for the next session of the Hawaii State Legislature. For the 2017 package, the department is soliciting recommendations from beneficiaries and the general public for consideration in our legislative package. The deadline for proposals is August 10, 2016.
Proposal Guidelines
Proposals must be good public policy for the department; must address the department's operations, programs, regulations, processes, budget and/or resources; and must create a benefit or an advantage for the department, the trust, or trust beneficiaries, or otherwise correct a deficiency. Authors of proposals should keep in mind that amendments to the Hawaiian Homes Commission Act, 1920, require review by the U.S. Department of the Interior and may require the consent of the U.S. Congress prior to implementation.
Review and Consideration
Staff will review and evaluate all proposals and will determine which will be submitted for consideration for the Governor's Administrative Package. The proposals to be submitted to the Governor will be approved by the Hawaiian Homes Commission. Proposals not submitted to the Governor may be introduced independent of the administrative package. Please note that the Governor may also choose not to include proposals submitted by the Commission.
Proposals can be submitted by filling out the online form below, or by downloading a PDF form here and emailing the completed form to:
Lehua Kinilau-Cano
DHHL Legislative Analyst
[email protected]
Additional information can also be submitted by email. If you already have a bill drafted, please send that as well. Completed proposal forms must be submitted by August 10, 2017.
[si-contact-form form='8′]


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U2NhbGluZyBTZWNyZXQgIzI6IERlbm9ybWFsaXppbmcgWW91ciBXYXkgdG8gU3BlZWQgYW5kIFBy b2ZpdA==
Alan Watts once observed how after we accepted Descartes' separation of the mind and body we've been trying to smash them back together again ever since when really they were never separate to begin with.
The database normalization-denormalization dualism has the same mobius shaped reverberations as Descartes' error. We separate data into a million jagged little pieces and then spend all our time stooping over, picking them and up, and joining them back together again.
Normalization has been standard practice now for decades. But times are changing. Many mega-website architects are concluding Watts was right: the data was never separate to begin with. And even more radical, we may even need to store multiple copies of data.
Information Sources
We normalize data to prevent anomalies. Anomalies are bad things like forgetting to update someone's address in an all the places its been stored when they move. This anomaly happens because the address has been duplicated. So to prevent the anomaly we don't duplicate data. We split everything up so it is stored once and exactly once. Bad things are far less likely to happen if we follow this strategy. And that's a good thing.
The process of getting rid of all potential bad things is called normalization and we have a bunch of rules to follow to normalize our data. The price of normalization is that when we want a person's address we have to go find the person and their address in separate operations and bring the data together again. This is called a join.
The problem is joins are relatively slow, especially over very large data sets, and if they are slow your website is slow. It takes a long time to get all those separate bits of information off disk and put them all together again. Flickr decided to denormalize because it took 13 Selects to each Insert, Delete or Update.
If you say your database is the bottleneck then the finger is pointed back and you and you are asked what you are doing wrong. Have you created proper indexes? Is your schema design good? Is your database efficient? Are you tuning your queries? Have you cached in the database? Have you used views? Have you cached complicated queries in memcached? Can you get more parallel IO out of your database?
And all these are valid and good questions. For your typical transactional database these would be your normal paths of attack. But we aren't talking about your normal database. We are talking about web scale services that have to process loads higher than any database can scale to. At some point you need a different approach.
Many mega-scale websites with billions of records, petabytes of data, many thousands of simultaneous users, and millions of queries a day are doing is using a sharding scheme and some are even advocating denormalization as the best strategy for architecting the data tier.
We sees this with Ebay who moved all significant functionality out of the database and into applications. Flickr shards and replicates their data to reach high performance levels. For Flickr this moves transaction logic back into their application layer, but the win is higher scalability.
Joe Gregorio has identified some common themes across these new mega-data systems:
It's the web model pushed to the data tier. Ironically, it may take a web model on the back-end to support a web model on the front-end.
The Great Data Ownership Wars: The Database vs. The Application
A not so subtle clue as to who won the data wars is to look at the words used. Data that are split up are considered "normal." Those who keep their data whole are considered "de-normal." All right, that's not what those words mean, but it was to good to pass up. :-)
Traditionally the database owns the data. Referential integrity, triggers, stored procedures, and everything else that keeps the data safe and whole is in the database. Applications are prevented from screwing up the data.
And this makes sense until you scale. Centralizing all behavior in the database won't mega-scale as the web does, which is why Ebay went completely the other way.
Ebay maintains data integrity through a service layer that encapsulates all data access. The service layer handles referential integrity, managing replicated copies, doing joins, and so on. It's more error prone than having the database do all this work, but you are able to do scale past what even the highest end databases can handle.
All this sharding and denormalization and duplicating at one levels feels so wrong because it's so different than we were all taught. And unless you are a really large website you probably don't need to worry about this level of complexity. But it's a really fascinating and unexpected evolution in design. Scaling to handle the world wide web requires techniques and strategies that are often at odds with our years of experience. It will be fun to see where it all leads.