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Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)
A Retrospective Analysis
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Background— We examined whether the antiinflammatory action of statins may be of benefit in heart failure, a state characterized by inflammation in which low cholesterol is associated with worse outcomes.
Methods and Results— We compared 10 mg rosuvastatin daily with placebo in patients with ischemic systolic heart failure according to baseline high sensitivity-C reactive protein (hs-CRP) <2.0 mg/L (placebo, n=779; rosuvastatin, n=777) or ≥2.0 mg/L (placebo, n=1694; rosuvastatin, n=1711). The primary outcome was cardiovascular death, myocardial infarction, or stroke. Baseline low-density lipoprotein was the same, and rosuvastatin reduced low-density lipoprotein by 47% in both hs-CRP groups. Median hs-CRP was 1.10 mg/L in the lower and 5.60 mg/L in the higher hs-CRP group, with higher hs-CRP associated with worse outcomes. The change in hs-CRP with rosuvastatin from baseline to 3 months was −6% in the low hs-CRP group (27% with placebo) and −33.3% in the high hs-CRP group (−11.1% with placebo). In the high hs-CRP group, 548 placebo-treated (14.0 per 100 patient-years of follow-up) and 498 rosuvastatin-treated (12.2 per 100 patient-years of follow-up) patients had a primary end point (hazard ratio of rosuvastatin to placebo, 0.87; 95% confidence interval, 0.77 to 0.98; P=0.024). In the low hs-CRP group, 175 placebo-treated (8.9 per 100 patient-years of follow-up) and 188 rosuvastatin-treated (9.8 per 100 patient-years of follow-up) patients experienced this outcome (hazard ratio, 1.09; 95% confidence interval, 0.89 to 1.34; P>0.2; P for interaction=0.062). The numbers of deaths were as follows: 581 placebo-treated (14.1 per 100 patient-years of follow-up) and 532 rosuvastatin-treated (12.6 per 100 patient-years) patients in the high hs-CRP group (hazard ratio, 0.89; 95% confidence interval, 0.79 to 1.00; P=0.050) and 170 placebo-treated (8.3 per 100 patient-years) and 192 rosuvastatin-treated (9.7 per 100 patient-years) patients in the low hs-CRP group (hazard ratio, 1.17; 95% confidence interval, 0.95 to 1.43; P=0.14; P for interaction=0.026).
Conclusion— In this retrospective hypothesis-generating study, we found a significant interaction between hs-CRP and the effect of rosuvastatin for most end points whereby rosuvastatin treatment was associated with better outcomes in patients with hs-CRP ≥2.0 mg/L.
Clinical Trial Registration Information— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00206310.
Received January 7, 2009; accepted August 24, 2009.
In addition to reducing low-density lipoprotein (LDL) cholesterol, statins have an antiinflammatory action.1–3 How much of the benefit of statins, if any, is due to this antiinflammatory action is uncertain.1–6
Clinical Perspective on p 2196
Inflammation is thought to play a role in the pathophysiology of heart failure.7–10 Inflammatory cytokines and other biomarkers such as high-sensitivity C-reactive protein (hs-CRP) are elevated in patients with heart failure and are predictive of worse clinical outcomes.11–14 Conversely, low cholesterol is an independent predictor of a poor prognosis in heart failure.15,16 Heart failure is therefore an inflammatory state in which the usual epidemiological relationship between cholesterol and cardiovascular outcomes is reversed and thus represents an excellent disease model in which to test the statin antiinflammatory hypothesis.17,18 Consequently, we examined outcomes in patients with heart failure in relation to baseline LDL cholesterol and hs-CRP concentrations and the effect of statin therapy according to these baseline measurements in patients in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).19,20
The design and principal findings of CORONA have been reported in detail.19,20 Patients ≥60 years of age with chronic New York Heart Association (NYHA) class II to IV heart failure of investigator-reported ischemic origin and an ejection fraction of ≤40% (≤0.35 if NYHA class II) were eligible, provided that the investigator thought that they did not need treatment with a cholesterol-lowering drug. Exclusion criteria included recent cardiovascular events, procedures, or operations (or planned procedures or operations); acute or chronic liver disease or alanine aminotransferase >2.0 the upper limit of normal; serum creatinine >220 μmol/L (>2.49 mg/dL); chronic muscle disease or unexplained creatine kinase >2.5 the upper limit of normal; thyroid-stimulating hormone >2 the upper limit of normal; and any other condition substantially reducing life expectancy.
Study Procedures
The trial was approved by the ethics committees of participating hospitals, and patients provided written informed consent. Eligible patients were treated with single-blind placebo for 2 to 4 weeks before randomization to demonstrate compliance. Randomization was based on an optimal assignment procedure, with a random element included. An optimally balanced allocation was achieved with the use of a score that included age; ejection fraction; NYHA class; the presence or absence of diabetes mellitus, myocardial infarction, or hypertension; the use of β-blockers; and total cholesterol. Patients were randomly assigned to receive 10 mg rosuvastatin or matching placebo once daily with the use of a centralized interactive Web-based response system (ClinPhone).
We measured serum creatinine, creatine kinase, thyroid-stimulating hormone, alanine aminotransferase, hs-CRP, and lipid/lipoproteins (total, LDL, and high-density lipoprotein [HDL] cholesterol; triglycerides; and apolipoprotein A-1 and B) at baseline in all patients. An immunonephelometric method was used to measure hs-CRP (Dade Behring BNII instrument using the CardioPhase hs-CRP reagent from Dade Behring, Deerfield, Ill; assay sensitivity, 0.040 mg/L; reference range, 0.0 to 8.4 mg/L).
After the study started, the protocol was amended to include measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), which therefore was available in only 3664 patients (73%). All measurements except thyroid-stimulating hormone were repeated at 3 months.
All blood samples were nonfasting and analyzed at a central laboratory (Medical Research Laboratories, Zaventem, Belgium). LDL was measured directly.
Study Outcomes and Definitions
The primary outcome was the composite of cardiovascular mortality, nonfatal myocardial infarction, or nonfatal stroke, analyzed as time to the first event. The secondary outcomes were (in listed order) all-cause mortality, any coronary event (defined as sudden death, fatal or nonfatal myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft surgery, ventricular defibrillation by an implantable cardioverter-defibrillator, resuscitation from cardiac arrest, or hospitalization for unstable angina), cardiovascular mortality (cause-specific cardiovascular death was also analyzed), and total number (episodes) of hospitalizations (for cardiovascular causes, unstable angina, and worsening heart failure). We also included 1 additional posthoc composite outcome: death resulting from any cause or hospitalization for worsening heart failure, which is commonly reported in heart failure trials. The definition and adjudication of all outcomes have been described in detail previously.19,20
Analysis of Outcomes According to Baseline hs-CRP
All study outcomes described above were analyzed according to whether baseline hs-CRP concentration was elevated (≥2.0 mg/L) or not (ie, <2.0 mg/L). An hs-CRP threshold of 2.0 mg/L was chosen retrospectively on the basis of prior studies, was the entry criterion for the Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER), and was consistent with Centers for Disease Control/American Heart Association–recommended hs-CRP cut points.6,21–23
Statistical Analysis
For continuous variables, differences in baseline variables between the 2 hs-CRP subgroups were tested with the Student t test (for NT-proBNP, with the Wilcoxon test); for categorical variables, the Fisher exact test was used. Changes in median values over time were analyzed with the Wilcoxon test. Cox proportional-hazard models (unadjusted and adjusted) were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs; SAS version 8.2, SAS Institute, Inc, Cary, NC) in each hs-CRP group separately. The adjusted Cox regression model incorporated randomized treatment, baseline age (≥75/<75 years), sex (female/male), ejection fraction (≥0.25/<0.25). NYHA class (III to IV/II), total cholesterol (≥6.0/<6.0 mmol/L), and history of diabetes mellitus (yes/no), myocardial infarction (yes/no), hypertension (yes/no), and β-blocker treatment at randomization (yes/no).
Tests for interaction between treatment and hs-CRP category for each outcome were carried out with Cox regression analysis with the following covariates: treatment as 0/1, hs-CRP subgroup (hs-CRP <2.0 versus ≥2.0 mg/L) as 0/1, and treatment-by–hs-CRP subgroup (interaction) as 0/1. Numbers of hospital admissions were analyzed with a permutation test.
The authors had full access to and take full responsibility for the integrity of the data. All authors have read and agree to the manuscript as written.
Of the 5011 patients randomized between September 15, 2003, and April 21, 2005, 4961 (99%) had a baseline measurement of hs-CRP. Of these, 1556 (779 placebo and 777 rosuvastatin; 31%) had a concentration <2.0 mg/L and 3405 (1694 placebo and 1711 rosuvastatin; 69%) had a concentration ≥2.0 mg/L.
The median follow-up time was 32.8 months. Vital status was determined in all patients.
Patients with an hs-CRP ≥2.0 mg/L had more advanced heart failure as evidenced by worse NYHA class, more atrial fibrillation/flutter, higher NT-proBNP concentration, and worse renal function (Table 1). More patients with an elevated hs-CRP had diabetes mellitus and were current smokers (11.6% versus 8.2%). More patients with a high hs-CRP were treated with a diuretic and with digitalis at baseline. The characteristics of patients randomized to placebo and rosuvastatin within the 2 hs-CRP subgroups were very similar.
Baseline Lipids and hs-CRP
Baseline LDL cholesterol, HDL cholesterol, and triglycerides were similar in the 2 hs-CRP subgroups (Table 2). Baseline median hs-CRP was 1.10 mg/L in the lower hs-CRP group and 5.60 mg/L in the higher hs-CRP group.
Change in LDL Cholesterol and hs-CRP With Randomized Therapy
LDL cholesterol was reduced to a similar extent by rosuvastatin in both hs-CRP subgroups (placebo-corrected percent median change from baseline to 3 months, −47%; Table 2). Rosuvastatin-induced changes in HDL and triglycerides were also similar in the 2 hs-CRP subgroups.
Baseline hs-CRP was similar in the placebo- and rosuvastatin-treated patients in the lower hs-CRP subgroup (median, 1.10 mg/L in both treatment arms). The baseline hs-CRP was also similar in both treatment arms in the higher hs-CRP subgroup (5.70 mg/L in placebo group, 5.50 mg/L in the rosuvastatin group). Data at the 3-month follow-up visit are given in Table 2. In placebo-treated patients, hs-CRP tended to rise in the low hs-CRP subgroup and fall in the high hs-CRP subgroup, suggesting regression to the mean. At 3 months, the median reduction in hs-CRP from baseline with rosuvastatin was −6% in the low hs-CRP group (compared with a 27% rise in the placebo group) and −33.3% in the high hs-CRP group (compared with an 11.1% reduction in the placebo group); ie, the net placebo-rosuvastatin difference in hs-CRP was similar in the high and low hs-CRP subgroups.
Primary Outcome
Patients with an hs-CRP concentration ≥2.0 mg/L had a higher rate of the primary composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke (14.0 events per 100 patient-years of follow-up in the placebo group) compared with patients with an hs-CRP concentration <2.0 mg/L (8.9 per 100 patient-years). Compared with placebo, treatment with rosuvastatin was associated with a reduced incidence of the primary outcome in the higher hs-CRP group (unadjusted HR, 0.87; 95% CI, 0.77 to 0.98; P=0.024) but not in the lower hs-CRP group (HR, 1.09; 95% CI, 0.89 to 1.34; P>0.2; test for interaction by treatment, P=0.062; Figure 1). The HR for rosuvastatin to placebo was not altered significantly after adjustment for important prognostic variables (see Methods; Cox-adjusted HR is shown in Figure 2 and the online-only Data Supplement).
Total Mortality
All-cause mortality was also higher in patients with an hs-CRP ≥2.0 mg/L (14.1 per 100 patient-years) compared with those with a lower hs-CRP (8.3 per 100 patient-years). Compared with placebo, rosuvastatin treatment was associated with a lower incidence of death in the elevated hs-CRP subgroup (HR, 0.89; 95% CI, 0.79 to 1.00; P=0.050) compared with those with an hs-CRP <2.0 mg/L (HR, 1.17; 95% CI, 0.95 to 1.43; P=0.14; test for interaction by treatment, P=0.026; Cox-adjusted HR is shown in Figure 2 and the online-only Data Supplement).
Coronary Outcome
The rate of coronary events was higher in the group with an hs-CRP ≥2.0 mg/L (11.3 per 100 patient-years) than in patients with an hs-CRP <2.0 mg/L (7.5 per 100 patient-years). Compared with placebo, rosuvastatin treatment was associated with a lower incidence of coronary events in the elevated hs-CRP subgroup (HR, 0.85; 95% CI, 0.74 to 0.97; P=0.017) compared with patients with an hs-CRP <2.0 mg/L (HR, 1.15; 95% CI, 0.92 to 1.43; P>0.2; test for interaction by treatment, P=0.023; Cox-adjusted HR is shown in Figure 2 and the online-only Data Supplement).
All-Cause Mortality or Hospitalization for Worsening Heart Failure
The incidence of the composite outcome of death from any cause or hospitalization for worsening heart failure was higher in patients with an hs-CRP ≥2.0 mg/L than in patients with a lower hs-CRP. Compared with placebo, rosuvastatin treatment was associated with fewer events in patients with a higher hs-CRP (HR, 0.87; 95% CI, 0.79 to 0.96; P=0.0049) compared with those with a lower hs-CRP (HR, 1.12; 95% CI, 0.95 to 1.33; P>0.2; P for interaction=0.011; Cox-adjusted HR is shown in Figure 2 and the online-only Data Supplement).
Table 3 presents cause-specific data for the total number of patients hospitalized (time to first event) and for the prespecified secondary end points of total number (episodes) of hospitalizations for cardiovascular reasons and for worsening heart failure. Regardless of cause, rates were higher in patients with a higher hs-CRP. Compared with placebo, rosuvastatin treatment was associated with fewer total hospitalizations for a cardiovascular reason (P<0.001) and for worsening heart failure (P=0.004) in the subgroup with an hs-CRP ≥2.0 mg/L but not in the lower hs-CRP group (Table 3).
Discontinuation of Study Medicine
In those with hs-CRP ≥2.0 mg/L, 400 patients on placebo and 346 patients on rosuvastatin stopped randomized therapy (HR, 0.83; 95% CI, 0.72 to 0.96; P=0.011). In 220 and 168 patients, respectively, this was due to an adverse event (HR, 0.73; 95% CI, 0.60 to 0.90; P=0.0023). The corresponding numbers in those with hs-CRP <2.0 mg/L were 144 and 139 patients (HR, 0.98; 95% CI, 0.77 to 1.23; P>0.2) and 82 and 69 patients (HR, 0.85; 95% CI, 0.62 to 1.17; P>0.2). No category of adverse effects was found to be more common in the rosuvastatin group in either hs-CRP subgroup. Muscle symptoms, sought by active questioning or reported as adverse event, and elevations in creatinine kinase were not more common in any rosuvastatin hs-CRP subgroup (data not shown).
We found that the effect of rosuvastatin in patients with advanced, ischemic, systolic heart failure was modified by baseline hs-CRP concentration. Specifically, we found a statistically significant interaction between the effect of rosuvastatin on most of the clinical outcomes and hs-CRP dichotomized at 2.0 mg/L. We chose an hs-CRP cut point of 2.0 mg/L because it was used in prior studies, was an entry criterion in JUPITER, and is consistent with the Centers for Disease Control/AHA recommendations.6,21–23
In patients with an hs-CRP ≥2.0 mg/L, compared with placebo, treatment with rosuvastatin was associated with a lower risk of patients experiencing a number of cardiovascular composite outcomes. Importantly, our findings could not be explained by LDL cholesterol (or any other lipid) levels. LDL cholesterol concentration was identical in both hs-CRP subgroups at baseline and was reduced by an identical amount compared with placebo in both hs-CRP subgroups (net placebo-corrected percent median difference, −47%).
What did differ between the hs-CRP subgroups was hs-CRP, which, by definition, was higher in the subgroup ≥2.0 mg/L at baseline. Consequently, any difference in the effect of rosuvastatin on clinical outcomes in these 2 subgroups was more likely to have been related to hs-CRP (or factors associated with hs-CRP) than lipids.
The number of deaths from any cause and the number of hospitalizations from any cause were also lower in rosuvastatin-treated compared with placebo-treated patients in the hs-CPR ≥2.0 mg/L subgroup. These differences were accounted for entirely by cardiovascular events, with no difference in noncardiovascular deaths or hospitalizations. Inflammation has been postulated to play a key pathophysiological role in atherothrombotic events such as acute coronary syndromes and stroke.1,2,5,6,21,22 These events, however, were relatively uncommon in our patient population. Despite this, rosuvastatin treatment was still associated with a reduction in cardiovascular hospitalizations, including hospitalizations for worsening heart failure. This finding suggests that inflammation may play a role in the progression of pump failure and in other types of cardiovascular events.7–14
Although the findings of retrospective subgroup analyses must always be treated with caution, our observations are in keeping with prior posthoc analyses of other trials and the results of the prospective JUPITER.5,6,21,23 In both a primary prevention5 and a secondary prevention4 coronary heart disease trial, statin treatment was associated with greater event reduction in patients with a higher hs-CRP than in those with a lower hs-CRP. Notably, and in keeping with our findings, a retrospective subgroup analysis of the Air Force/Texas Coronary Atherosclerosis Prevention study showed that lovastatin had no impact on vascular events in patients with an LDL cholesterol <150 mg/dL and hs-CRP <2.0 mg/L but did appear to reduce events in those with an LDL <150 mg/dL but hs-CRP >2.0 mg/L (with similar LDL reductions in each hs-CRP subgroup).5 In an acute coronary syndrome trial, patients with an hs-CRP <2.0 mg/L after statin treatment had a better outcome than those with an hs-CRP concentration ≥2.0 mg/L.6 Recently, JUPITER, which studied the effect of rosuvastatin 20 mg/d compared with placebo in healthy individuals with low LDL cholesterol levels (<3.36 mmol/L [130 mg/dL]) but an hs-CRP ≥2.0 mg/L, was stopped prematurely because of benefit.23 A further analysis of outcomes by on-treatment concentrations of hs-CRP (split, <2.0 versus ≥2.0 mg/L) in JUPITER showed that achievement of an hs-CRP concentration of <2.0 mg/L was associated with improved event-free survival compared with achievement of a low LDL cholesterol alone.24 Although these external data support the validity of our findings, our results must be regarded as hypothesis generating only, especially because there was no effect of rosuvastatin overall on either the primary outcome or all-cause mortality.
Although treatment with rosuvastatin appeared to be associated with better cardiovascular outcomes in the subgroup with an hs-CRP ≥2.0 mg/L at baseline, there were weak trends to worse cardiovascular outcomes in the subgroup with an hs-CRP <2.0 mg/L at baseline. Whether these observations reflect the play of chance or whether statins could be harmful in patients with heart failure and a low hs-CRP is uncertain. The slight excess of deaths in rosuvastatin-treated patients in the low hs-CRP subset (170 on placebo, 192 on rosuvastatin) was wholly accounted for by numerically more cardiovascular deaths (with more of each of the 2 main types of cardiovascular death [ie, sudden death and death caused by pump failure]). However, examination of hospitalizations did not reveal any clear pattern of harm. Although the number of patients admitted with worsening heart failure was increased somewhat in the rosuvastatin group, there was no excess in the total number (episodes) of heart failure hospitalization in the rosuvastatin group or in the number of patients hospitalized for a cardiovascular reason. Consequently, there was no strong evidence of increased risk of any particular type of cardiovascular event with rosuvastatin in the low hs-CRP subgroup. Rosuvastatin also appeared to be well tolerated in the low hs-CRP subgroup, as assessed by discontinuation of study drug. Nevertheless, the possibility that statins could be harmful in certain subsets of patients with heart failure remains, particularly in light of the association of poorer outcomes with lower cholesterol in this syndrome.15–18
Although we have interpreted the apparently beneficial effect of rosuvastatin in patients with a raised hs-CRP to reflect an antiinflammatory action, alternative explanations are possible. An elevated hs-CRP could represent an alternative pathophysiological process (eg, a prothrombotic state) or could be a marker of other patient factors that could be associated with a greater benefit from a statin. Conversely, an elevated hs-CRP may indicate a pathophysiological state in which LDL cholesterol is modified to become more toxic to the arteries (eg, where there is enhanced oxidative stress). Consequently, even though LDL concentration and LDL reduction with treatment are similar, arterial toxicity may be reduced more with a statin in patients with an elevated hs-CRP.
Our findings are consistent with prior data in healthy individuals that statin therapy may be more beneficial among those with increased hs-CRP and are novel in that they extend this concept to patients with congestive heart failure. However, this apparent therapeutic effect in patients with heart failure needs to be confirmed in a prospective randomized trial.
Members of the CORONA Study Group and their affiliations have been previously published.19,20
Source of Funding
CORONA was funded by AstraZeneca.
Drs Kjekshus, Dunselman, Grande, Gullestad, Hjalmarson, Hradec, Kamensky, Korewicki, McMurray, Waagstein, and Wedel report receiving consulting or advisory board fees from AstraZeneca. Drs Kjekshus, Grande, Gullestad, Hjalmarson, Korewicki, McMurray, and Ranjith report receiving lecture fees from AstraZeneca. Drs Hjalmarson, McMurray, and Wikstrand report receiving research grants from AstraZeneca. M. Lindberg is a current employee of AstraZeneca. Dr Wikstrand was formerly a senior medical advisor at AstraZeneca. The other authors report no conflicts.
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There is evidence from retrospective analyses and a prospective trial that a high-sensitivity C reactive protein concentration ≥2.0 mg/L identifies patients who benefit from statin treatment independently of low-density lipoprotein cholesterol reduction. To determine whether similar observations are present in patients with ischemic systolic heart failure, we carried out a retrospective analysis of a large statin trial. Although this trial showed no benefit overall of rosuvastatin on the primary end point or all-cause mortality, the present analysis showed that statin treatment was associated with better outcomes than placebo treatment in patients with a high-sensitivity C reactive protein ≥2.0 mg/L than in those with a high-sensitivity C reactive protein <2.0 mg/L, eg, a hazard ratio for death in the former of 0.89 (95% confidence interval, 0.79 to 1.00) and in the latter of 1.17 (95% confidence interval, 0.95 to 1.43; P for interaction=0.026). The possibility that statins might be beneficial in heart failure patients with a high-sensitivity C reactive protein ≥2.0 mg/L needs to be tested prospectively.
The online-only Data Supplement is available with this article at http://circ.ahajournals.org/cgi/content/full/CIRCULATIONAHA.109.849117/DC1.
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- Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)John J.V. McMurray, John Kjekshus, Lars Gullestad, Peter Dunselman, Åke Hjalmarson, Hans Wedel, Magnus Lindberg, Finn Waagstein, Peer Grande, Jaromir Hradec, Gabriel Kamenský, Jerzy Korewicki, Timo Kuusi, François Mach, Naresh Ranjith and John Wikstrand for the CORONA Study GroupCirculation. 2009;120:2188-2196, originally published November 30, 2009https://doi.org/10.1161/CIRCULATIONAHA.109.849117
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- Effects of Statin Therapy According to Plasma High-Sensitivity C-Reactive Protein Concentration in the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)John J.V. McMurray, John Kjekshus, Lars Gullestad, Peter Dunselman, Åke Hjalmarson, Hans Wedel, Magnus Lindberg, Finn Waagstein, Peer Grande, Jaromir Hradec, Gabriel Kamenský, Jerzy Korewicki, Timo Kuusi, François Mach, Naresh Ranjith and John Wikstrand for the CORONA Study GroupCirculation. 2009;120:2188-2196, originally published November 30, 2009https://doi.org/10.1161/CIRCULATIONAHA.109.849117Permalink:


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Menopause seems to be a time when you have to face life straight-on and deal with the realization that your life is changing and some things that you hold dear are fading. As I've mentioned before, some of these changes are related to the menopausal transition (such as the end of the menstrual period). But other changes are related to aging. And one of those is type 2 diabetes. This disease can sneak up on middle-age women if you're not paying attention. And a new report out of the Centers for Disease Control and Prevention quantifies the increasing threat of this disease as we age.
The report, Diabetes Report Card 2012: National and State Profile of Diabetes and Its Complications, points out that the chance of getting type 2 diabetes increases sharply with age for all adults in the United States today. Interestingly, the number of new cases didn't change much between 1980-1990, but began to increase in 1992; in fact, the number of new cases almost tripled between 1990-2010. The CDC believes that this increase in the number of type 2 diabetes is associated with increased obesity, a decline in physical activity and aging. The CDC projects that if current trends continue, as many as one in three adults in the U.S. could have this disease by 2050. The study also found that most minority populations in the United States are more likely to develop diabetes than white, non-Hispanic populations.
The states with the highest percentage of adults diagnosed with diabetes in 2010 were Mississippi (11.3 percent), Alabama (11.1 percent), West Virginia (10.7 percent), Louisiana (10.3 percent), Tennessee (10.2 percent), Oklahoma (10.1 percent), and Kentucky (10.1 percent). The states with the lowest percentage are Vermont (5.8 percent), Colorado (6.0 percent), Minnesota (6.2 percent), Montana (6.2 percent), Alaska (6.3 percent), Connecticut (6.4 percent), South Dakota (6.4 percent), Wyoming (6.6 percent), Rhode Island (6.8 percent) and Iowa (6.9 percent).
So let's clarify again what diabetes is. First, there are several types of diabetes. Type 1 diabetes accounts for approximately 5 percent of all diabetes cases and is usually diagnosed in children and young adults. However, this type of diabetes can occur at any time. People with this type of diabetes use insulin from an injection or pump. There is no known way to prevent this type of diabetes. However, Type 2 diabetes – which accounts for approximately 95 percent of cases diagnosed in adults – can be controlled or even delayed through healthy eating, regular physical exercise and, if prescribed, medications. There's also gestational diabetes, which develops when a woman is pregnant and can cause health problems during pregnancy for both the mother and child. Furthermore, women who have had gestational diabetes are at higher risk for developing type 2 diabetes. The CDC notes that women who had gestational diabetes have a 35-60 percent chance of developing type 2 diabetes within 10-20 years.
The CDC report also looks at prediabetes. The study's authors found that although approximately one-third of U.S. adults have prediabetes, awareness of this condition is low since fewer than one in 10 U.S. adults with prediabetes reported that they had ever been told that they have this condition. This is important information because the progression to type 2 diabetes is not inevitable for this group. In fact, studies have shown that by losing between 5-7 percent of body weight and getting at least 150 minutes per week of moderate physical activity can help prevent or delay the onset of type 2 diabetes. -
The CDC breaks down the percentage of U.S. adults who have been told they have prediabetes by state. The states with the highest percentage are Tennessee (10.2 percent), California (8.0 percent), Hawaii (7.5 percent), Kentucky 7.2 percent), Idaho (7.3 percent), Alabama (7.0 percent) and Alaska (7.0 percent). The states with the lowest percentage of adults being warned of prediabetes include Montana (4.7 percent), Massachusetts (4.8 percent), Wyoming (4.8 percent), Utah (5.1 percent), South Dakota (5.2 percent), Ohio (5.3 percent), Connecticut (5.3 percent), and Iowa (5.4 percent). Data was not available from Arkansas, Maryland, Missouri, Nevada, New Jersey, North Dakota, Rhode Island and Washington.
Don't think that this last breakdown is good news because there are low levels of prediabetes. Instead, it may mean that doctors are not having this conversation with patients or that some of these adults are not seeing doctors at all.
This report provides fodder for you to have a good and honest conversation with your doctor about your risk of type 2 diabetes. And it also provides a good incentive to continue eating a healthy diet and exercising as you move into the next phase of your life.
Primary Source for This Sharepost:
Centers for Disease Control and Prevention. (2012). Diabetes report card 2012: National and state profile of diabetes and its complications.
Published On:
August 24, 2012
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Immunizations Important for Middle-Aged Women
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subset: commoncrawl


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Position: Business analystLocation: New York city, NY.Duration: 6-12 months.Local's preferred
Job description:
Business Analyst position open in the group for someone who has a strong process and operational background. We have an enterprise Market and Credit Risk platform with a fairly extensive batch and AutoSys processes at the backend that source feeds from multiple systems and regions. We are upgrading this system to take advantage of newer technologies and making the processes more scalable. This is not a market or credit risk BA position per se but any exposure working in risk area would be a plus.


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Mercedes Benz CR1 IMMO Emulator
Item No. SO167
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In Stock
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Estimated delivery time: 7-15 working days.See details» - Weight:
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Mercedes Benz CR1 IMMO Emulator
Mercedes Benz CR1 IMMO Emulator
Vito 2, 2 Cdi 5 plugs
A-Class 1, 7 Cdi 5 plugs
EDC/MSA15.1 2,5 Td 2,9 TD 3,0 Yd 1 plug with mechanical and electronic ignition switch
ECM Bosch with HC11E9 in vehicles with engines of 320-6 cylinders, 430-8 cylinders ML 320
Lucas 4 plugs E-class, 2,0 diesel with mechanical ignition switch
A-class ECM VDO MSM 1,4-1,6-1,9 gasoline
Emulator immo to Mercedes replaces damaged immobilizer or the car key for the group of Mercedes cars.
Its functions after made changes in memory content of Engine Control Module ECM.
In case of losing the car keys or a car burglary, it enable to drive off from the road to the car sevice.
Due to a low cost, you can leave it in the car instead of buying a new immo or making car keys duplicate.
There is a possibility of using it as the additional security!!
Red LED indicating about transmission: will blink and turn off after properly working.
Package including:
1pc x Mercedes Benz CR1 IMMO Emulator
Contact Information
Live Support
What'sapp: +86-1372-015-9182
carTool.co.uk QRcode:
http://www.carTool.co.uk & http://m.carTool.co.uk
Scan the QRcode, feel free to contact us on your smartphone.
International Buyers – Please Note
a) Import duties, taxes and charges are not included in the item price or shipping charges.
Our website don't undertake tax for all customer. These charges are the buyer's responsibility.
If you very care about TAX,please contact us before you buy,we advise you choose airmail/yanwen.
b) Please check with your country's customs office to determine what these additional costs will be prior to bidding/buying.
d) Seller ships within 1 day after receiving cleared payment. Please allow additional time if international delivery is subject to customs processing.
Delivery | European countries | Other countries |
Airmail |
7-15 working days,almost all countries no tax For remote area or holiday, need more time. |
7-25 working days,almost all countries no tax |
DHL/UPS | 2-5 working days,almost all countries pay some tax |
2-7 days, almost all countries pay some tax |
Yanwen | 7-12 working days, no tax for for most european counties Austria, Belgium, Bulgaria, England, Estonia, Finland, France, Germany, Greece, Holland, Ireland, Italy, Luxembourg, Ireland, Portugal, Scotland, Slovakia, Slovenia, Spain, UK, Wales, Denmark, Sweden, Lithuania, Latvia Hungary, Romania, the Czech Republic, Poland | No service |
7-15 working days To Russian only send by EMS. For some remote area, if you do not want to pay remote fee, we can send it to you by EMS too. |
7-20 working days |
Aramex | If you do not like this shipping method, please leave message on your order. |
4-6 working days To most middle east counries. |
If you needs YANWEN express shipping or other shipping method.
Or you have special needs for your order, such as declared name and so on, please leave message on the order to notify us.
Otherwise we will send the order as our usual practice.
Or you have special needs for your order, such as declared name and so on, please leave message on the order to notify us.
Otherwise we will send the order as our usual practice.
As different country has different import policy, sometimes we will change the shipping method based on the counties and goods.
About Warranty
If, after receipt completed, any feedback problems case for compensation, it will not be handled.
Broken items: Almost all item has one year warranty.
We also offer free fix to almost item we sold within one year,free repair.Man-made damage need pay.
We not offer warranty on
keys,cables,adapter,online sent software,please notice it.
keys,cables,adapter,online sent software,please notice it.
About technical support online by teamviwer,we only offer free help to our customer ,who order within one year.
Over one year,all need pay depends on what problem it is.
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Browsing School of Political Science and Sociology by Subject "Political Science & Sociology"
Now showing items 1-9 of 9
Conflict, territory and new technologies: Online interaction at a Belfast interface
(Elsevier, 2007)This article examines the relationship between new information and communication technologies and territorial boundaries through an analysis of online interaction oriented around a sectarian interface in north Belfast. It ... -
Echanges épistolaires Echanges épistolaires en anthropologie : l'enquête Harvard-Irlande/ Letters in anthropological research: the Harvard-Irish Survey (1930-1936)
(2011)This article examines a selection of the professional and private letters associated with the social anthropology strand of the Harvard-Irish Survey (1930-1936). These research letters contribute to the historiography of ... -
Family and Community: (Re)Telling Our Own Story
(2011)The contribution of family, kin and community relations to sustaining a rural way of life was the primary focus of Arensberg and Kimball's anthropological study of Irish families in the 1930s, published as Family and ... -
Forgetting and Remembering: Place and Space in the work of Yvonne Cullivan
(Department of the Environment, Community and Local Government, IRELAND, 2011) -
Reframing Online: Ulster Loyalists Imagine an American Audience
(Taylor & Francis, 2009)This article examines one initiative aimed at taking advantage of new technologies to build new transnational connections between a political movement in the ¿homeland¿ and a diaspora population in the United States. It ... -
The role of an intermediary in back-channel negotiation: Evidence from the Brendan Duddy Papers
(Taylor & Francis, 2011-12)This article draws on the newly available private papers of Brendan Duddy, the key intermediary in contacts between the British government and the IRA between the early 1970s and the early 1990s when the IRA moved towards ... -
Singular Identities Managing Stigma, Resisting Voices
(2000)This paper argues that single women are stigmatised in contemporary Irish society and that this is particularly evident in people's everyday interactions with single women. Stigmatising interactions are apparent in relation ... -
Territoriality and Order in the North of Ireland
(Taylor & Francis, 2011-08)This article draws on the recent academic literature on territoriality and power to analyse territorial strategies for the maintenance of public order in the north of Ireland. It argues that these strategies were shaped ... -
Together in the middle: Back-Channel Negotiation in the Irish Peace Process
(Sage, 2011)This article examines the development of cooperative relationships in back-channel communication and their impact on intraparty negotiation. It draws on extensive newly available evidence on back-channel communication in ...


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The book shows you how architecting a modern security visibility infrastructure can help your business adapt to new threats, lengthen the usefulness of your current security investments, and optimize uptime and availability. See the entire threat landscape, understand security visibility basics, support both inline and out-of-band security systems, explore security visibility use cases and ask the right questions about visibility.
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Cellocity LInux Operating System Cellocity Linux is Based on Fedora Core 6 Source Code. With only basic core elements needed to operate Compatipal and a completley Graphic Interface as well as Text. Version 2.0 will include more applications 32,64 bit and 80 Core Intel CPU


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Dehumidifiers For the Chicagoland Area
"It's Not The Heat, It's The Humidity"
Inside almost every home that phrase rings true. If it's humid and muggy outside, it's humid and muggy inside. Things you do every day like cooking, cleaning and showering can add as much as 25 pounds of additional moisture to your home.
On hot, muggy summer days you count on your air conditioner for cool comfort. But your cooling system only controls the temperature, not the humidity. And that's where ABC can help. We can design and install a system that will control the humidity and maintain comfortable, healthy conditions inside your home.
Our experts will install the right dehumidifier to perfectly match your needs, lifestyle and home. The healthier and more efficient choice is to have a whole-home dehumidifier installed as part of your heating and cooling system.
We'll professionally install a whole-home dehumidifier that works with your air conditioner to remove the ideal amount of moisture from the air throughout your entire home, not just a small area like a portable dehumidifier.
Neighbors Are Saying About ABC


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from the M3…
Head south towards Southampton, and follow signs for the M27 eastbound, (Southampton & Portsmouth) then continue as below.
from the M27…
Leave the M27 at junction 5, take exit from the motorway roundabout signposted A335 Southampton. The road is called 'Thomas Lewis Way', and head towards Southampton City Centre. Go through the first lights, fork left at the second lights, signposted City Centre & Portswood (staying on the A335 Thomas Lewis Way). You pass a Shell petrol station on your right–hand side, then turn right at the next lights (3rd from Motorway) just before Machine Mart, then turn immediate left at the next lights (4th from Motorway) opposite B&Q. You are now on Portswood Road, The Brook is about 200 yards down this road on the left hand side.
We would advise that you park to the rear of the venue on the Belgrave Industrial Estate making sure not to block any part of the road, as lorries come and go at any time of day or night. DO NOT PARK ON THE CORNER!!! If you block the lorries, the show may be interrupted, and you will feel embarrassed!
As with all town parking, make sure that you conceal any valuables. There should be more street parking on Portswood Road, or on the side roads.
by rail…
From Southampton Central or Southampton Parkway stations: Either get a connection to the local stations below or exit the station, jump in a taxi and say "The Brook, Portswood Road please!"
from swaythling station…
Exit the station and cross over Thomas Lewis Way using the footbridge and head on to Burgess Road, Bear left at Macdonalds on to High Road, this turns into Portswood Road, The Brook is about 200 yards past B&Q on the opposite (left hand) side of the road.
from st. denys station…
Exit the station on to Osbourne Road South by crossing the footbridge, turn right, past The Dolphin Pub until you reach the main road, St. Denys Road. Turn left and head up the hill until you get to the 2nd traffic lights, by The Mitre pub and Sainsbury's. Turn right on to Portswood Road, and The Brook will be on the right after a 10 minute walk. If tired on the way you could stop at Talking Heads for a swift drink.
by bus…
First Group bus number 5 stops outside The Brook, The stop is called "Mayfield Road". Solent Blue Line bus number Bluestar 2 also stops outside The Brook and the university bus service Uni-Link U6 also stops here.
The Brook 023 8055 5366.
466 Portswood Road


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Daniel Sturridge returns to Liverpool training ahead of Merseyside derby
Pochettino rejects possibility of joining Barcelona due to his Espanyol past
Gareth McAuley signs new one-year deal at West Brom
Everton's Ramiro Funes Mori likely to miss rest of the season through injury
Jose Mourinho sees signing Neymar as an impossible task
Bastian Schweinsteiger: I didn't get chance of proper goodbye at Old Trafford
Jermain Defoe 'could leave Sunderland for nothing following relegation'
Spurs set for extended deadline over whether to play at Wembley next season
Gerrard: Liverpool lucky to have world-class Klopp
#GoalsRecreated: Sadio Mane (and Emre Can) v Papiss Cisse
Schweinsteiger baffled as reporter asks if Chicago Fire can win the World Cup
Arsenal striker Alexis Sanchez 'happy' in London
Is this Arsenal and Manchester City's best combined XI?
Carlton Cole joins Michael Essien at Indonesian team Persib Bandung
Barcelona defend Lionel Messi against 'unjust' ban
Bundesliga Special: Best of March
Vanarama National League H'lights: Matchday 40
Vanarama National League: Lincoln City v Forest Green Rovers
Bundesliga: Werder Bremen v RB Leipzig
International Friendly: Germany U21 v England U21
International Friendly: Denmark U21 v England U21
Hyundai A-League Highlights: Episode 25
Classic Premier League: Southampton v Middlesbrough 1998/99


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Hugo Cornellier took a selfie everyday, for 8 years, from 12 to 20 years old.
About 3 p.m., the caller said his foe had killed his brother and mother, but cops arriving at the Long Beach address found his 17-year-old video game opponent playing "Call of Duty" in his own home, CBS 2 reported.
The perpetrator placed his emergency call using the Internet and could be anywhere across the globe. Investigators are trying to track down the call's origin.


text:
About Us
Our Story
My name is Venesa Sypniewski, mother and founder of Wunderbox. Like all moms, I strive to encourage my child's growth and development. When I discovered the benefits of sensory play and introduced the first sensory bin to my toddler, her vocabulary exploded as she learned the new words for the textures she was experiencing. She became totally immersed in the small world that I created for her; digging, scooping, counting, pouring, asking questions and making connections. I was in awe.
I spent hours researching, shopping, and assembling more sensory bins for my daughter. Running around town going from store to store for all the different components wasn't an efficient use of time. Let's face it, moms are busy these days and we don't always have the time to craft and curate these learning enriched and developmental activities, so the idea for Wunderbox was born.
Our mission is to provide innovative products that inspire growing young imaginations and celebrate the parenting journey one moment at a time.
Inspiring Imaginative Play
Wunderbox table-top sensory bins offer your child the chance to touch and interact with a variety of shapes, sizes, textures and colors. From bright, cheery seascapes, to animal themed play lands, our self-contained bins are filled with sensory mediums, toys and tools designed to encourage fine motor skills, cognitive ability, language development and a wide range of practical skills through imaginative play.
Wunderbox creates thoughtfully curated themed sensory bins designed to optimize sensory play and motor skill development for your child.
Everything's included in our kits. They're closable, stackable, portable and leak resistant – all your child needs to do is play.


text:
If you are the owner/manager of this business and would like to improve your listing, please submit a request.
If you would like to improve this listing, please contact us.
- Location:
- 22 miles southwest of Leadville
- Setting:
- Mountainous
- Length:
- 10 mile roundtrip
- Difficulty:
- Intermediate
- Time:
- 5.5 to 6.5 hours
- Trailhead Elevation:
- 9300 feet
- Elevation Change:
- -3200 feet
Hope Pass is also the Colorado Trial that passes over to the Clear Creek Road. There is about 3,200 feet elevation gain up to 12,500 feet, so it offers extraordinary views. Visitors should plan on a full day of hiking. This is a popular trail run, as it is the "crux" of the infamous Leadville Trail 100 foot race!
Trailhead Elevation:
Elevation Change:
Basic Directions
This trailhead is shared with Big Willis Gulch, two miles west of Twin Lakes Village on Hwy 82.


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Each year, the members of the Elkin Police Department vote on their peer who they feel is deserving of the title of Employee of the Year. For 2016, Cpl. Kevin Hall, the department's School Resource Officer, earned that honor.
"If you ask Kevin, he just says he is doing his job, but it takes a special person to do that job," said Chief Monroe Wagoner this week. "As officers, we've got to be able to change our attitude and mindset when dealing with different people, and he's good at that and we're proud of him. He deserves the recognition."
Hall received a plaque noting his recognition during the department's Christmas dinner and then was recognized during last week's Elkin Board of Commissioners meeting.
At the meeting, Mayor Sam Bishop emphasized what an honor it is for Hall to be recognized for his service by his peers. "I want to further thank you for servicing as the town's School Resource Officer and for all that you do in that position to instill positive values for the youth of our community," he said.
"I know first-hand how you interact with the students and are always there to assist and counsel them when needed. You are an asset not only to the town but to Elkin City Schools as well," Bishop noted. "You also serve your home community as a captain with the Ronda Fire Department. This, too, shows your willingness to serve and protect your home community as well as Elkin.
"Your service to both Elkin and Ronda is commendable," he said.
Hall recently finalized his state SRO certification through the North Carolina Justice Academy and is a certified general instructor through the North Carolina Law Enforcement Training and Standards Commission.
In July 2005, Hall joined the Elkin Police Department as a patrol officer, and in 2009, was promoted to SRO. He is a mentor for the Students Against Destructive Decisions (SADD) Club, teaches Drug Abuse Resistance Education (DARE) and coordinates security for the school home ball games. Wagoner said Hall "works closely with teachers and administrators to ensure the safety of the students."
First and foremost, Hall is a law enforcement officer, Wagoner said. But he also serves as a law-related counselor and law-related educator. "He provides law enforcement and police services to the schools, school grounds and areas adjacent to the school. He investigates allegations of criminal incidents per police department policies and procedures. He enforces state and local laws and ordinances and appropriate referrals to juvenile authorities or other governmental agencies when necessary," noted the chief.
"He works to prevent juvenile delinquency through close contact and positive relationships with students," Wagoner said. "He maintains a close partnership with school staff and administrators in order to provide for a safe school environment. He assists school officials with their efforts to enforce board of education policies and procedures, ensures school administrator safety by being present during school searches, assists school administrators in emergency crisis planning and building security matters and provides a course of training for school personnel in handling crises situations, which may arise at the school.
"He is highly visible within the school community, attending and participating in school functions while building working relationships with the school's staff as well as with students and parent groups," he continued.
Hall's supportive roles in the school also include developing and implementing law-related education to support the academic efforts of the teachers, which incorporates designing and presenting law-related topics and the role of police in society.
Wagoner said Hall works with school counselors and other school staff to aid students and provide services to students who may have been involved in situations where referrals to service agencies are necessary. He also assists in conflict resolution efforts.
"His presence in the schools increases the visibility and accessibility of police to the entire school community," Wagoner said.
In addition to his other certifications, Hall holds an intermediate law enforcement certification.
Wendy Byerly Wood may be reached at 336-258-4035 or on Twitter @wendywoodeditor.


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text:
(44 Posts)I heard this name a little while ago ( Jade Jaggers dd, I think) and think it is lovely. What do you think? I like the St. Francis of Assisi associations!
Yup, I really like it too but I think both you and the child jaw to be bold to carry it off. It's quite unsual, I don't think it would fit into every kind of social circle and could embarrass your child at times. Also, there's the 'Ass' at the beginning of 'Assisi' ...
'would have to be' not 'jaw' This autocorrect has a mind of it's own!
I know someone who has just called their daughter this and I think it's lovely (also see the connotations that could happen though)
Between the 'ass' and 'a sissy' I would say NO.
I would be slightly worried about the possibility for teasing with Ass. Though not enough to out me off the name. FerrisBueller what reactions has your friend received about her dd name!
It's a 'no' from me.
It's foul. Sorry.
I can see it working on a really hip, trendy teenager, but only if she's with the 'right' group of friends i.e. nothing like the kids who attended my somewhat rough comprehensive.
So what I'm saying is there's nothing wrong with the name, rather the potential for teasing. It depends if she's in the company of people inclined to tease.
Also remember the new pope is Francis after St. Francis of Assisi. Could this be an issue?
Just as tallaluh has mentioned above. However the mum is pretty cool, slightly rock hippy and an incredibly strong woman so no doubt her daughter will be raised the same and be more than capable of dealing with school playground piss takers
I'm pretty sassy and strong and would deal with this ok. My dd2, raised by me, encouraged to be sassy, just isn't. She'd die with a name like this. sometimes children aren't like their parents!
Bad name for lispers.
Awful. Why not Claire if you're Catholic?
It's a bit Madonna/Lourdes esque.
What Tallulah said.
Siena is nicer, or Florence. Or Frances or Clara/Claire..
It's a 'look at me and how cool I am' choice.
Or indeed, if you want a Catholic place name, how about Fatima?
Or the minor saint, Tallulah?
Emilia Romagna ....
.... oooh there's loads
And her brother could be Medjugorje
Apparently the new pope is named after Franacis Xaviour who was a real hard-liner...not the cuddly animal lover.
I am with the A Sissy team.
It's a top name but not fair on a child.
All the official announcements have said he chose the name for Assisi. Though he is a Jesuit.
It's completely ludicrous.
Put the pregnancy hormones down.
Francis Xavier is probably a better attempt at spelling.
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Lucha and Jamson exchange information in the aftermath of their accident.
Lucha remembers the day she left her childhood behind.
Jameson contemplates the multifaceted nature of his personality.
Lucha and Jameson connect at Lucha's performance of Orpheus and Eurydice.
Romance blooms on Lucha and Jameson's first date.
Lucha and Jameson share a passionate physical experience.
The metaphysical peak in Lucha and Jameson's love.
On their wedding day, Lucha gives Jameson a fateful gift.
Lucha receives a mysterious phone call from a voice she seems to recognize.
Before leaving Los Angeles, Orlando pays his last respects to his wife.
Reflect on the impact of a location's geography on a person's psyche.
In a state of darkness, Lucha is haunted by Jameson's red notebook.
Still submerged in darkness, Lucha dreams of Jameson's infidelity.
Lucha descends to the underworld in search of Jameson.
After years apart, Lucha and Orlando reunite in Los Angeles.
Lucha makes peace with Jameson's disappearance.
Hopscotch was divided into three distinct geographic routes: the Red, Yellow and Green route. Each route featured eight of the 36 total chapters, a mixture of car rides and visits to undisclosed sites. Each chapter lasted ten minutes.
The artists bringing each chapter to life were assigned to one chapter; the audience continually changed cars. It took eight rotations for the audience to experience a full route, with each audience group (four people) beginning at a different stage in the cycle and proceeding in either a clockwise or counterclockwise order.
Ten of the 36 chapters, marked in blue, served as narrative milestones accessible at any time: short, animated chapters which weave the story together.
Boyle Height, East Los Angeles, Arts District
Nostalgic, introspective, lonely
Downtown Los Angeles, The Arts District
Frenetic, spatial, surreal
Chinatown, Elysian Park, Los Angeles River
Wild, metaphysical, transcendent
The 24 live chapters of Hopscotch converged at the Central Hub, the focal point of the entire production. The intimate performance inside the car streamed live to the Hub, where 24 screens gave audiences a dazzling panorama of simultaneous life in Los Angeles. The Central Hub was also the site of the spectacular Finale, occurring at the end of each performance day.


text:
Walther - Brand Shop
Innovation based on tradition!
Today, the long-established German firm also produces high-quality, robust outdoor equipment. Its knives, multitools and flashlights are highly developed and extremely reliable tools – equally valuable for camping holidays and trekking expeditions. In addition to the versatile multitool and the small but powerful flashlights, another useful item for bikers is the Rescue Knife, which you can open and use without taking your gloves off when you are rushed for time.


text: From social media platforms like Twitter and LinkedIn to new technologies that leverage them, the tools available to today's meetings and events professionals are multiplying by leaps and bounds. Join Justin Ramers as he presents real-life examples and ideas garnered from the growing use of social media and technology that you can use to kick-start audience engagement at your next event. Learn how to create a social media strategy targeted to your audience and deliver an event that attendees will never forget. Audience members can expect to come away with a blueprint for creating their next multi-level engagement event that includes social, mobile, live chat and more.


text:
United States of Mind[CD]~ Absolute ProofProduct Notes
Static AKA D-One and El*A*Kwents are Absolute Proof, and we kick the facts with a twist of flavor. We started out about two years back and have kept it movin' since. Absolute Proof strives to push the envelope and bring creativity and positivity to the currently weakening state of hip hop today. We bring actual substance to the table instead of braggin' or talkin' some nonsense about a lifestyle we don't even live or about the whips, gats, and ice we don't have. I mean if that's how you livin' then that's real, but if not then you just a poser. This ain't no pipe dream...it's reality...now that's real. AP is infuenced by artists like Nas, Eminem, and Gangstarr, which you can hear in our music, but words can't really describe the vibe. Listen to the music and take it in for yourself. Our debut album brings together a variety of ideas and concepts all into one positively transcending vibe, showing versatility. From hype, battle raps to laid back tracks to a bounce track to melancholy vibes, we keep it well balanced and appealing. Absolute Proof is blunt and straight to the point. We ain't tryin' to hop in and hop outta this game quick for the loot or the fame. We in it to make a difference, and we bring it to you with heart, smarts, and darts aimed at any hater's temple...You've been given fair warning...
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About connecting things together...
On Friday, a whole gang of us went over to the Woodhead facility in Northbrook, IL. Last week was clearly about connectivity, with visiting Turck and Woodhead in the same week.
Woodhead makes connectors and cable sets, as do their parent, Molex. So they compete with Turck, with ifm efector, with Lumberg, and a host of others who make connectors and cord sets.
They make them for power, too. They have a demonstration "machine cell" that has all of its AC power connections "connectorized," as well as its sensor and digital network connections.
Woodhead makes some nice stuff.
But what I really want to talk about is that there is no reason why more connectorized stuff and more cable sets aren't being used in process automation. I think we're going to see lots more of it. I know that Turck, et al., have taken dead aim at the process automation part of the manufacturing industries.
Why is this important?
This is a mindset change in the process area. In the past, hardwiring of the "wire it and forget it" school has been the norm. However, what we have now is plants where the plant personnel do not know where the wires go. If you think I'm kidding, ask around. "Reliable 'as-builts'?" asked one plant engineer of my acquaintance, "You wish!"
What this means is that electricians have to go out with plant maintenance folks to troubleshoot wiring issues, or re-wire things.
If you use a Turck or Woodhead or Lumberg or efector or whothedickenseverelse connectorized cordset, you can send any useful idiot (and we're hiring more of them every day, because we have to) to replace a busted wire.
Not to mention the savings in FAT time, and error correction; after install troubleshooting and maintenance, especially of industrial networks and sensor and final control element connections.
Now that process industries are becoming more interested in agility and mobility and are moving to skid mounted process components, like pharma and food have done already, you'll start to see more connectivity using connectors and cordsets.
It makes sense.


text:
Learn about this topic in these articles:
Worpswede school
...19th-century Barbizon school in France. Fritz Mackensen and Otto Modersohn were the first to arrive; during the 1890s they were joined by Paula Becker (who later married Modersohn), Hans am Ende,
Fritz Overbeck, and Heinrich Vogeler. Clara Westoff, a talented sculptor, also worked at Worpswede, where she met the German poet Rainer Maria Rilke, whom she married in 1901. Two years later Rilke...


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0800 280 2440
Contact Us2013 Ariddu, Grillo, Valdibella, Camporeale, Sicily
White | Ready, but will keep | Valdibella, Sicily | Code: 29078 | 2013 | Italy > Sicily | Grillo | Light Bodied, Dry | 13.0 % alcohol
The small cooperative of Valdibella have followed up their debut 2012 vintage with this equally moreish 2013 Grillo (Ariddu in the local dialect) from the hills close to Palermo. Made without oak and using organic fruit, this light, bright, nutty, white-peach and acacia-honeyed wine brings Sicily's sun and the salty sea-breezes to life. There's something hazlenutty, chardonnay-on-toast about it. On the palate it has more of a roasted-almond flavour, so clearly expressed through the clean fruit. It's deliciously fresh, as well as being distinctly soft and fleshy. A real 'anytime white' to be enjoyed as an alternative aperitivo or with light antipasti.
David Berry Green
The Producer
Valdibella started in 1998 with the setting up a Salesian community to support the local youth of Camporeale in Sicily, and eventually it grew into a farming cooperative in 2000. Today, the cooperative offers a new way for local landowners: a real alternative to that of selling fruit (but also almonds and olives) to huge cooperatives, whose activities are closely tied to those of the big brands. In a spirit of solidarity, the Valdibella cooperative refuses to pay the mafia protection money (as per the logo 'AddioPizzo'), while sharing its values with the local community.
They farm their 220ha (of which 70 are vineyards) organically (certified), vinified in a new cantina, under the direction of both Belgian winemaker Benoit de Coster and their consultant Vincenzo Drago. The first bottled and labelled vintage was in 2009. They also make two wines, a white and a red, without the addition of sulphur dioxide at bottling. Viticulturally the focus of Valdibella is on autochthonous (grape) varieties, notably Catarratto (Lucido, Extra-Lucido and Comune), Grillo, red Nero d'Avola, and Perricone. But they also grow Cabernet Sauvignon, Chardonnay, and Muller-Thurgau.
The 220ha are located around the town of Camporeale, with the vineyards at between 300 – 500 msl, on leached red 'regosuolo', a lime and clay mix, over sedimentary soils. The vineyards are well ventilated, facilitating organic agriculture, and extending the date of harvest until late in the season. They are working on a system of reducing the amount of copper and sulphur used in the vineyard. No chemicals are used.
The Region
Sicily's total vineyard area has actually shrunk from 322,000 hectares in 1880 to 113,000ha today (2014). 85% is planted with indigenous grapes (a growing trend), of which 70% is white grapes. Up until the 1990s much of the white wine production was mainly Trebbiano for distillation; then the switch was made to international/French varieties to be used as blending material in Northern Europe. Now the authorities are beginning to study indigenous grapes more seriously, of which 15 have been identified, along with a further 50 ancient varietals. 80% of the vines are located in the western Val di Mazara part of the island, on the wide open plains. Yet 65% of the island is hilly, especially the mountainous northern and north-eastern Val di Demonte.
The island is responsible for circa 12.5% (2012 harvest) of Italy's wine output, being the fourth most productive region (after Veneto, Emilia Romagna and Puglia). The percentage of DOC/DOCG wines here remains in the minority, with Cerasuolo di Vittoria being the only DOCG. There are 22 DOCs, notably those of: Marsala, Moscato di Pantelleria, Faro, Etna and Eloro. In 2012, the authorities introduced an all-embracing DOC Sicilia, but one that continued to allow international grapes to be included in historic DOCs, such as Etna.
The terroir is much more diverse than expected. Topgraphically, the western end of the island is essentially flat with sedimentary, calcareous clay. The centre northern eastern areas are essentially mountainous with peaks at 2000 msl., made up of ignaceous rocks with sedimentary coastal strips. The east around Catania lies on the lava flows from Monte Etna, while the high Hyblaean plateau that dominates the south-east is underpinned by limestone bedrock, over which lies a tilth of volcanic dust. The area around Vittoria is more red loam over limestone.
The climate is essentially Mediterranean. That said, the south, south west is influenced by north African warm humid scirocco winds; the north battered by northern winds spinning off the Tyrrhenian sea, making the centre almost continental; the east and south east fanned gently by Mediterranean air currents off the Ionian sea; offset by high altitudes.
The key autochthonous grapes, their zones and producers that are leading the (re) emergence of Sicilian fine wine are: white Grillo and Zibibbo around Marsala (producer Marco de Bartoli); white Catarratto and red Perricone in the centre/north (Valdibella and Porta del Vento); red Nerello Mascalese and Cappuccio, and Nocera grapes of Faro (Bonavita); Nerello Mascalese and white Carricante of Etna (Graci); red Nero d'Avola of Noto (Rigoria); and the red Frappato of Cerasuolo di Vittoria fame (Arianna Occhipinti and COS)
The good name of Marsala was created by the British during the18th century, but ruined by the Italians when they took over the industry in the late 19th century, turning it into merely a cooking ingredient. Now the likes of Marco De Bartoli are reviving the quality and reputation; turning the clocks back.
Recommended producers: Alberto Aiello Graci, Marco de Bartoli, Porta del Vento, Valdibella, Bonavita, Rigoria, Arianna Occhipinti


text:
The Saab Viggen was named after a Swedish fighter-jet made by the same company. It was released in 1999 as Saab's 9-3 flagship model. It came with a 2.3-litre turbocharged engine that made 230 brake horsepower.
The Viggen was marketed to driving enthusiasts but the Trionic 7 engine management system was designed with the layman in mind. With a simple guide, the right tools and an aftermarket Engine Control Unit (ECU) tuner the driving enthusiast can unlock up to 40 horsepower just by reprogramming the factory software.
- Skill level:
- Easy
Other People Are Reading
Things you need
- BSR aftermarket ECU tuner
- Socket wrench
- 10mm socket tip
- Adjustable wrench
Show More
- 1
Set the emergency hand brake, remove the key from the ignition switch and open the bonnet.
- 2
Disconnect the negative battery lead from the battery terminal with an adjustable wrench to prevent any possibility of shock. This lead is usually black.
- 3
Open the passenger's side door and remove the floor mat.
- 1
Open the passenger's side door.
- 2
Locate the screw holding the lower portion of the dashboard and carpeting in place. The screw is located across from where the speaker would be if the door were closed. Remove the screw with the 10mm socket wrench.
- 3
Pull back the carpeting 10 to 12 inches. Do not crease the carpeting. The ECU, a silver box with a black and red plastic handle mounted under the dash, will now be exposed.
- 4
Release the wiring harness coupler by pulling down the black plastic handle. Disconnect the wiring harness from the ECU.
- 5
Plug in the BSR tuning computer and follow the instructions on the computer's screen. When instructed, disconnect the turning computer.
- 1
Plug the wiring harness back into the ECU. Fasten the wiring harness coupler by sliding the black plastic handle back into its closed position.
- 2
Fold the carpeting back into its original position. Replace the screw that holds the lower dash and carpet in place.
- 3
Reconnect the battery and close the bonnet.
- 4
Turn on the car and check to see everything is working properly. The car will not start if the reprogramming was unsuccessful.
- 5
Take the car for a test drive. Start at slow speeds and gradually work up to higher speeds.
Tips and warnings
- BSR recommends replacing the factory exhaust system from the catalytic converter to the muffler with an exhaust system that is 2 1/2 inch in diameter before tuning the Viggen software.
- Most tuning companies recommend using fuel rated at or above an 89-octane content level and synthetic motor oil after upgrading the ECU in a Saab.
- Installing aftermarket software will usually void any existing warranty on your vehicle.
- New ECU software needs time to "learn" the most effective way to mix fuel and air in your car. The vehicle may jerk slightly under heavy acceleration. This is normal and should correct itself after a few days of driving.


text: The mod adds KAMAZ 55102 for Farming Simulator 2015 – a three-axis truck. Body Capacity – 20,000 liters. Tote can be a standard culture and sunflowers. The engine capacity of 240 horsepower accelerates it to 72 kilometers per hour. The truck work lights and the traces it leaves. Press 7 and 9 on the numeric keypad, you can open the door to the cockpit.


text: Just /b/ Click to block a category:GamingPoliticsNewsComicsAnimeOther NaldoAndStuff next random Comment Top NextComment We wanna hear what you did. next Tags: do | something | with | Your Life How do: I become interesting? get cuff ml samething with " life I Anonymous (ID: ) ( Wed) Hauling: ; but then Mme hack and tell us what mu did. ... +2888 Views: 65510 Submitted: 10/27/2012 Facebook Twitter Google+ Tumblr Pinterest


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Donaji & the Magical Poncho
This is the story of a fearless girl and her encounter with the wicked cold wind god
4.31 / 5.00 5,567 ViewsGeh, delayed very much but finally done.I hope the next episodes will turn up faster, especially since episode has to appear on christmas day.
why can link talk in this movie and not in my legend of zelda and the other one
Otherwise the joke didn't work?
To be honoust, at the time i made this movie i wasn't obsessed yet with hating characters that couldn't talk, so i probably never even noticed yet
one of the funniest IMP episodes
Although its a little shorter than the other ones, the funniest part for sure is at the end when winnie the poo tried to throw a fireball saying AHHHHH! That is so ironic and funny when he turned to pooh. another favorite line was when bustin said sarcastically "great plan, standing in front of that huge animal calling it a bitch"
ok, glad you liked it :)
You killed Link!
OMG u killed my favorite hero ever! But your shows are worth seeing him get killed! Your the best!^_^


text:
General Question
How do I deal with this problem with my router?
Asked by Mtl_zack (6751)
March 10th, 2009
I use a Linksys router, and the signal just dies all of a sudden. We always have to go downstairs and unplug the router from the wall and re-plug it, and then it works again, but running up and down the stairs sucks. This has been happening for at least one and a half years. I've had enough. How do I fix the problem? I know it's not a software problem because we've contacted linksys a bunch of times, and the problem continues. Linksys support is useless.
Observing members:
Composing members:
11 Answers
Answer this question
This question is in the General Section. Responses must be helpful and on-topic.
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Wednesday, June 30, 2010
24 Hours and Counting
I was going to write a "What I'd Like to See in Free Agency" post, but come on, I think we all know I'm only concerned about one thing when it comes to free agency. I don't really care about anything else.
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Home | Forums | Rules | Articles | diyAudio Store | Gallery | Wiki | Blogs | Register | Donations | FAQ | Calendar | Search | Today's Posts | Mark Forums Read | Search |
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Thread Tools | Search this Thread |
18th March 2012, 12:10 AM | #31 |
diyAudio Member
Join Date: Aug 2008
Grin - How come you're doing the work for your son - He's the engineer?
18th March 2012, 05:30 AM | #32 | |
diyAudio Member
Join Date: Mar 2011
An audio engineer, also called audio technician, audio technologist or sound technician, is a specialist in a skilled trade that deals with the use of machinery and equipment for the recording, mixing and reproduction of sounds. Audio engineering - Wikipedia, the free encyclopedia His field is sound, not electronic design.
Transistor junction temperature is not transistor case temperature. Last edited by mchambin; 18th March 2012 at 05:59 AM. |
18th March 2012, 05:38 AM | #33 |
diyAudio Member
Join Date: Aug 2008
Sorry, I was being smart, implying your son as an engineer, has design skills.
3rd April 2012, 03:19 AM | #34 |
diyAudio Member
Join Date: Aug 2008
Well I've recieved a couple of these little VU's and the driver PC board ... and had a play.
1. They are rather cute; 12V 45ma festoon globe buried inside look nice on 10v 2. I checked them out with the supplied driver PCB. Quite meaningful displays. 3. I like whats displayed though it is certainly not "VU" of old. They show whats happening to below -40dB as you would expect using the TA7318 driver. 4. With this driver they certainly dont overshoot like some so called VU meters do. A good little product and with a simple LED display as demonstrated in sjh327's product would be an excellent measure of true audio levels. I'd like to redesign the driver for a bit more sensitivity and + - 15v sullpies. |
13th September 2012, 11:43 PM | #35 |
Join Date: Jan 2005
Location: tieling
16th September 2012, 09:11 AM | #36 |
diyAudio Member
Join Date: Aug 2008
Very Nice!
Have you described the LED barograph part you are using anywhere? |
15th February 2013, 05:49 AM | #37 |
diyAudio Member
Join Date: Feb 2013
Hey there!
Greatly appreciate any hint on where to find a replacement for a Shure m67's original VU meter. I'd replace the meter's entire buffer/driver part, as well, if only the dimensions are met. The original parts list suggests a 190uA meter and the dimensions are 35x35mm. There's also a calibrating rheostat within the circuit; should i get it replaced, as well? (And if yes, how'd I find the right bang-for-a-buck balance with this one?) The specification also mentions that the original buffer is not completely isolated from the headphones output (low resistance phones are going to affect the metering by a couple of dB). Is there a remedy for this issue? I pursue this as a part of my current project: to upgrade the original m67's design with today's high-end components (with some re-vamping, for it to expose four isolated mic outputs), and i am only stuck with getting a solution for precise metering. I appreciate any help! (Provided that after the unit is ready, i promise to publish a guide for those interested in upgrading this beast). |
15th February 2013, 06:34 PM | #38 |
diyAudio Member
Join Date: Aug 2012
Location: Ontario
Elektor had a article recently, making a VU meter, using a Russian linear nixie tube and a programable analog chip, looked really neat. Easy to assemble, have a look.
Rick |
18th February 2013, 01:30 PM | #39 |
diyAudio Member
Join Date: Feb 2013
I have found some info on jlmaudio.com. They also sell some VU meters, as well as buffering PCB's for them. Thanks for your reply! |
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Digby Eye Associates
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The first-class natural treatment for improving libido is to do regular exercising du...
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Already Registered Voters Are Encouraged To Make Sure Their Current Registration Is Accurate
Tennessee Secretary of State Tre Hargett joins the Cheatham County Election Commission in reminding citizens that September is National Voter Registration Month. Secretary Hargett is working with county election officials to make eligible voters aware of registration deadlines and requirements, as well as encouraging already registered voters to update their current registration if they have recently changed their address.
"It is important for individuals to register to vote, but it is equally important for voters to verify that their registrations are up to date," added Cheatham Administrator of Elections Sandy Cherry. "If you have moved, now is a great time to update your address."
In a concerted effort to remind eligible voters to register or update their voting information before deadlines pass, the National Association of Secretaries of State (NASS) has also declared September 24 as National Voter Registration Day. The goal is to encourage voter participation and increase awareness of state requirements and deadlines for voting.
"The right to vote should never be taken for granted," said Secretary Hargett, who is also president of NASS. "I encourage all eligible U.S. citizens to register if they haven't already."
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Added to Shopping Bag
Kenneth Cole Male Casual Watch KC2709 Brown color
Listed by David Biton
Sale: $116.38
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Male Casual Watch KC2709 Brown color
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Upgrade to style and sophistication with this elegant kenneth Cole watch. Boasting a stunning 47mm stainless steel case matched with a secure calfskin band, this timepiece makes an ideal accessory for any affair. The brown dial sits under a mineral crystal, which combines a stylish look and an easy-to-read display. The sleek, subtle design instills this watch with an unmistakable sense of luxury that cannot be matched. Additional features include water resistance up to 50 meters, date and measures seconds.
Product Details
BrandKenneth Cole
Dial ColorBrown
Strap ColorBrown
Display TypeMulti Function
Strap TypeLeather
Item NameKenneth Cole Male Casual Watch KC2709 Brown Multi Function
Case Diameter160 mm
Strap Length160 mm
Water Resistant30 meters
WarrantyLifetime Warranty
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Please use this identifier to cite or link to this item:
Title: | Observation of a High Burnup Rim-Type Structure in an Advanced Plutonium-Uranium Carbide Fuel. |
Authors: | RAY Ian leslie; MATZKE Hj. |
Citation: | Journal of Nuclear Materials vol. 250 p. 242-243 |
Publication Year: | 1997 |
URI: | http://publications.jrc.ec.europa.eu/repository/handle/JRC15196 |
Type: | Articles in periodicals and books |
Abstract: | The observation is reported of a "rim-type" structure with small sub-grains in an advanced plutonium-uranium carbide fuel pin, which had been irradiated in the Dounreay Fast Reactor to a burn up of 8.3% FIMA. This type of structure has previously been reported in high burn-up LWR UO2 and MOX fuels. |
JRC Institute: | Nuclear Safety and Security |
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Lot 555: M.E.F 1943-47 set & 1942 Postage Due set, fine M, SG.M11/M21, MD1
Postage Stamps & Postal History of the World
by Corbitt Stamps Ltd
November 10, 2016
Newcastle upon Tyne, United Kingdom
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Description: M.E.F 1943-47 set & 1942 Postage Due set, fine M, SG.M11/M21, MD1/MD5. ERITREA 1948-49 set & 1950 Postage Due set, SG.E1/E12 & ED6/ED10. SOMALIA 1943-46 set in pairs, SG.51/59 & 1950 set, SG.S21/S31. (63) Cat. £381
Notes: Philatelic
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As the only watchmaking company that was set up and still remains in Saint-Imier, Longines has stayed true to its historical values: tradition, elegance and sport. Today, with The Longines Saint-Imier Collection, the brand is launching a series of exceptional timepieces that constitutes the watchmaking heritage of its home territory. Longines Saint-Imier Chronograph L2.718.104.22.168 Men's watch features 41mm round stainless steel case, silver color dial with silver polished hands & date display, scratch-resistant sapphire crystal with several layers of anti-reflective coating on the underside, brown alligator strap with With triple safety folding clasp, and Water-resistant to 30 meters. This watch L688, self winding mechanical column wheel chronograph movement beating at 28'800 vibrations per hours and providing 54 hours of power reserve. The chronograph mechanism includes; central 60 seconds hand, 30 minutes counter at 3 o'clock, 12 hours counter at 6 o'clock.
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