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Harvard Medical School and Massachusetts General Hospital, Wellman Center for Photomedicine, 55 Fruit Street, Boston, Massachusetts 02114
* Address all correspondence to: Martin Villiger, Harvard Medical School and Massachusetts General Hospital, Wellman Center for Photomedicine, 40 Blossom Street – Bartlett Hall 704, Boston, Massachusetts 02114. Tel: (617) 643-6092; Fax: (617) 643-9208; E-mail: firstname.lastname@example.com
Laser thermal therapy represents a possible method to treat premalignant epithelial lesions of the esophagus. Dynamically conforming the thermal injury profile to a specific lesion boundary is expected to improve the efficacy of such a treatment and avoid complications. In this work, we investigated wavelength tuning as a mechanism to achieve this aimed control over injury depth by using the strong variation of water absorption close to 1900 nm. We developed a numerical model simulating in steps the photon propagation in the tissue, the diffusion of the absorbed heat, and the resulting tissue damage. The model was compared with experimental results on porcine esophageal specimens ex vivo and showed good agreement. Combined with power tuning, the wavelength agility in the range of 1860 to 1895 nm extends the injury range compared to a fixed wavelength source beyond 1 mm, while at the same time improving control over shallow depths and avoiding vaporization at the tissue surface. The combination of two or three discrete wavelengths combined at variable ratios provides similar control, and may provide an improved strategy for the treatment of endothelial lesions.
Esophageal cancer caused 14,500 U.S. deaths in 2010 and its incidence is rising faster than that of all other malignancies in the western world.1 To improve these statistics, new techniques enabling earlier detection are needed in hand with strategies for early-stage intervention. Significant progress has been made toward improving diagnosis through optical imaging, for example, optical frequency domain imaging (OFDI).2 High resolution imaging of the esophagus using OFDI has been shown to provide high-speed, wide-field, and high-resolution (∼10 μm) cross-sectional imaging of the epithelial tissue microstructure using a balloon catheter deployment.3- 4 The balloon acts to center an inner lumen within the tubular organ, and a side-looking imaging beam is rotated and translated within the inner lumen, scanning the imaging beam in a helical pattern, enabling wide-field imaging. Comprehensive in vivo imaging using this paradigm has been demonstrated in clinical studies.5- 7
The past 5 years have additionally seen dramatic changes in the therapy of early-stage esophageal cancers, and in the management of Barrett's esophagus, a precursor lesion of esophageal adenocarcinoma. Radio-frequency (RF) ablation, which uses finely structured electrodes integrated into a balloon catheter to thermally coagulate the tissue at a superficial depth, has achieved unprecedented eradication rates of Barrett's esophagus.8 The ease of operation of RF ablation and the low incidence of complications may transform the standard-of-care treatment strategy for this disease. Instead of surveilling the patient and waiting for Barrett's esophagus to develop into high grade dysplasia, treatment of low grade dysplasia and even nondysplastic epithelium is now envisioned.9 Recent studies established that in the short-term Barrett's esophagus is eradicated for a majority of the patients.10 However, despite repeated treatment sessions within 1 year, up to 23% of patients are left with metaplasia (11% dysplasia).11 A possible explanation is the difficulty of applying the thermal therapy homogeneously over the irregular surface of the esophagus. The superficial application of the ablation without local control on the depth of the treatment also bears the risk of missing buried glands, which could reinitiate metaplasia at a later point in time. Patients are hence enrolled in post-treatment surveillance programs, which, together with the need for repeated treatment sessions, constrain the cost-efficacy of this approach.12
We have thus hypothesized that an image-guided therapy that combines improved imaging with spatially and depth controlled ablation therapy may dramatically improve the efficacy of this treatment and limit adverse complications and long term recurrence. In such an image-guided ablation device, a method for controlling the depth of the ablative injury is needed. In this work, we explore a mechanism to dynamically adjust the injury depth in laser thermal therapy (LTT), applied comprehensively in a beam scanning paradigm similar to that employed by the OFDI imaging system [Figs. 1]. Critical to this approach is the strong variation of the absorption coefficient of most biological tissue in the vicinity of the 1900 nm water absorption peak. Using combined wavelength and power tuning in this spectral region we demonstrate through both simulation and ex vivo studies that high fidelity depth control can be achieved. We further contrast the performance of two strategies of implementing depth controlled laser ablation: a continuous wavelength and power tunable therapy laser, and a combination of a set of individual power tunable fixed wavelength sources.
Principle of wide-field beam scanning in the distal esophagus provided by balloon catheters in (a) longitudinal and (b) lateral cross section. The optical probe is rotated and slowly pulled back to sample large areas in a helical pattern. For OFDI imaging, the beam is focused at the surface to a ∼20 to 30 μm spot, whereas for LTT, a beam of several millimeters could be used. (c) At each scan location on the sample surface, the scanned therapy beam deposits a transient heat profile. Its cumulative effect and diffusion in the tissue determine the resulting injury depth. (d) Absorption coefficient of tissue assuming water content of 70%, varying by nearly an order of magnitude when approaching the absorption peak at 1920 nm.
We performed ex vivo laser ablation studies on porcine esophageal tissue samples harvested immediately after sacrifice and stored at −80ºC. To generate scanned beam injuries, we placed the tissues on a metal fixture heated to 37ºC. The tissue samples were flattened and slightly compressed with a coverslip to ensure physical contact and as a proxy to balloon inflation. The epithelium was oriented against the glass coverslip. The dimensions of each tissue sample were approximately 3 cm × 4 cm along the top face and 3-mm thick after compression. The metal fixture was mounted to a motorized stage to provide fixed velocity translation at v = 2.2 mm s−1.
The collimated beam from a wavelength tunable thulium fiber laser (TFL) (IPG Photonics) was directed at the epithelium through the glass side. The TFL provided single-mode output at powers up to 1.2 W and wavelengths from 1860 to 1895 nm. The collimated beam diameter was 1.3 mm. Four linear injuries approximately 3 cm in length were generated in each tissue sample. The laser power and wavelength were held constant during exposure for each injury. A total of 32 laser settings were used, spanning the combination of four laser wavelengths (1860, 1870, 1882.5, and 1895 nm) and 8 laser powers (150, 300, 450, 600, 750, 900, 1050, and 1200 mW). The thermal therapy was monitored in real time with OFDI by focusing the imaging beam on the tissue surface in the center of the therapy beam.
After laser exposure, the metal fixture containing the compressed tissue was placed in an −80ºC freezer for 30 min to fix the conformation of the tissue. The frozen tissue was then removed and cut into smaller pieces for histological processing. The cuts were oriented perpendicular to the line injuries. Between 8 and 12 pieces were obtained from each tissue sample. Each piece was embedded in optimum cutting temperature compound for frozen processing and 10 μm sections were cut. From each piece, a minimum of 2 slides were prepared using a nitroblue tetrazolium chloride (NBTC) histology stain specific for thermal injury,13- 14 resulting in 16 to 22 histological sections for each generated injury. NBTC stains positive for the thermolabile enzyme lactate dehydrogenase (LDH). Loss of LDH activity ensues rapidly upon heat-induced cell damage and NBTC staining correlates with classical histology.15
For some pieces, additional sections were generated using NBTC staining with an eosin counterstain for enhanced structural visibility. Histology slides were digitized and the depth of each injury was read from the NBTC stained slides using ImageJ software. The injury depth was defined as the deepest point of unambiguous thermal injury.
To explore the impact of laser power and wavelength on injury depth and investigate important design parameters, we modeled the laser-tissue interaction and the coagulation of tissue. This simulation comprised three independent stages. The first stage used Monte Carlo methods to determine the three-dimensional energy absorption in the tissue as a function of the wavelength dependent absorption coefficient (μa), the scattering coefficient (μs), and the anisotropy (g). The second stage used this absorption profile as the heat source in a three-dimensional, time-dependent finite-difference modeling of the heat diffusion in the tissue. Finally, a third stage deduced from the time-dependent temperature profile the resulting tissue damage by modeling the protein denaturation with the Arrhenius equation as a first-order process.16
Monte Carlo modeling of light radiance in the tissue was carried out with the multilayered approach and source code of Wang et al. ,17 where our sample was modeled as a two-layer media. The first (superficial) layer described the ∼180 μm thick coverslip used in the ex vivo studies (μs = 0, n = 1.44, where n is the refractive index). The second layer described a homogeneous tissue (n = 1.38). To calculate the irradiance due to a 1.3 mm Gaussian beam, the result of the Monte Carlo simulation that corresponds to the photon distribution of an infinitely narrow photon beam in cylindrical coordinates and assuming circular symmetry, was interpolated on a three-dimensional grid and convolved with the Gaussian beam profile. The tissue optical properties were assumed to be independent of temperature. The scattering coefficient and anisotropy were modeled as wavelength-independent over the limited spectral range (Δλ = 50 nm) of this study. The scattering coefficient was extrapolated following Collier et al. 18 to μs = 21 cm−1, and an anisotropy of g = 0.9 was assumed. The significant wavelength dependence of the absorption coefficient due to the nearby 1900 nm water absorption peak was included by using the absorption values for water reported by Wieliczka et al. 19 [Fig. 1]. The absorption of the tissue was obtained by multiplying the values for water by the water content of the tissue, which was estimated to be 70%.14
The diffusion of the heat deposited by the laser irradiation is governed by the laws of heat transfer. For the case of an isotropic medium with location dependent material properties the heat conduction is governed by:
Display Formula
Finite difference simulation of the heat transfer equation. (a) Dimensions and layout of the simulation. A control volume approach with centered node-points was used. Instead of scanning the beam, after each time iteration the tissue volume was moved along the x-coordinate. (b) Resulting spatiotemporal heat profile.
The thermal conductivity and specific heat of esophageal tissue were estimated from Refs. 21 and 22 to be k = 0.5 W m−1 K−1 and c = 3.7 J g−1 K−1, with a density ρ = 1.05 g cm−3. The physical properties for the borosilicate coverslip were k = 1.13 W m−1 K−1 and c = 0.753 J g−1 K−1, with a density ρ = 2.17 g cm−3. The top surface (z = 0) was modeled as a convective boundary with a heat transfer coefficient h = 5 W m−2 K−1 and an air temperature of 37ºC. The tissue face preceding the therapy beam (i.e., at x = 0 and not yet exposed to therapy light) was held fixed at 37ºC. Insulating boundary conditions were used on the remaining four faces. The tissue dimensions were chosen to prevent boundary effects from any but the top surface from significantly affecting the temperature solution. The time was iterated forward until the tissue was moved by a distance equivalent to 1.5 times the moving frame length. In this way the initial transient temperature profile was moved outside the reference frame, leaving the steady state solution.
The solution of the heat transfer equation defines the temperature history of the tissue as a function of depth and lateral position (y) as it translates through the therapy beam exposure [Fig. 2]. From this temporal temperature profile, the thermally-induced coagulation injury was computed as a first order rate process, with the reaction rate constant given by the Arrhenius equation. The resulting damage integral in function of lateral position and depth is given as
Display Formula
For the assessment of the injury depth, the temperature profile and damage fraction were analyzed at midline of the therapy beam (y = 4.8 mm). The tissue was assumed to be fully coagulated in regions where D > 0.95.
To establish a baseline performance, the injury depth range achieved by power modulation of a fixed wavelength therapy beam was analyzed. The optical properties of the tissue at a specific wavelength define the effective penetration depth and energy distribution inside the tissue. Changing the laser power results in a linear scaling of this distribution. Because the finite-difference model is at equilibrium in the absence of any irradiation, the solution to the heat transfer equation likewise scales linearly with power around the initial temperature of 37°C. Figure 3 displays the maximum temperature that occurred at each depth during exposure along the middle of the therapy beam for two different power settings and a wavelength of 1875 nm. The shape of these temperature curves is defined by the tissue physical properties and the glass slide at the surface that acts as a heat sink and evacuates heat from regions adjacent to the surface. Whereas the temperature profile scales linearly with power, the damage integral does not. This reflects the tissue's susceptibility to temperatures above ∼64°C, for which the activation energy for protein denaturation is exceeded. Assuming the tissue to be fully coagulated in regions where D > 0.95 results in treatment depths of 0.26 and 0.78 mm for irradiation with 0.29 and 0.61 W, respectively. The transitory region 0.95 > D > 0.05 was interpreted as a region of partial damage, where reversible damage such as edema and perivascular inflammation occur. In the interest of producing a clear treatment boundary, to reduce the risk of excessive collateral damage, and to ensure rapid healing and good tolerability of the treatment the margin, δ, of this region should be minimized.25
Scanned beam thermal therapy. (a) Temperature maximum occurring during the therapy scan in function of depth at the center of the therapy beam, and resulting fractional tissue damage for a fixed wavelength of 1875 nm at two power settings. The 0.95 fractional damage was chosen as criterion for treatment depth, and the width of the transition region between 0.05 and 0.95 to quantify the margin δ of thermal collateral damage. The high power setting is limited by a 100°C threshold, whereas a fractional damage of 0.99 was used to determine the lower bound power setting. (b) The same upper and lower bound criteria, but applied to illumination at two distinct wavelengths increases the available treatment range. (c) Treatment depth in function of both wavelength and power. Only regions between the two thresholds are viable power-wavelength combinations. The contour lines indicate the variation of the margins δ in function of both parameters. (d) Following the upper threshold with a 5°C security margin, indicated by the dashed line in (c) defines the ideal wavelength-power combination for a given treatment depth. To access more shallow depths, the extreme wavelength of 1900 nm is power controlled, before starting the wavelength tuning.
At sufficiently high powers, the peak temperature at a superficial depth in the tissue reaches 100ºC, sufficient to induce vaporization. Although commonly used in the laser ablation of various tissue types, in the present setting vaporization is undesirable for two reasons. First, it results in an unpredictable and unstable injury zone. The removal and vaporization of superficial tissue likewise removes the landmarks necessary for guidance and control of the treatment depth. Second, vaporization induces dynamic modulations in the tissue properties that frustrate high resolution imaging. Thus, the vaporization threshold bounds the applicable power on the upper side and limits the achievable injury depth. Our model predicts a power threshold for vaporization of 0.61 W at a wavelength of 1875 nm. For these parameters, the injury depth is limited to 0.78 mm [Fig. 3].
As the power is reduced to drop the injury depth, several characteristics of the injury response are noteworthy. First, at sufficiently low powers, too little energy is deposited in the tissue to induce damage. This constitutes the most fundamental low-power/shallow-injury bound. The lower power setting of 0.29 W in Fig. 3 just reaches a fractional damage of 0.99, and was used as criterion for the lower bound of the achievable injury depth. Due to the presence of the coverslip, the most superficial tissue is no longer completely coagulated in this configuration, but isolated from the spared tissue by a denatured layer. Also, at such low power, the slope of the temperature profile becomes very moderate and results in a larger margin δ. This reduced temperature slope also has the effect that a slight change in power would induce significant variations in injury depth. Besides variation in power, the variability of tissue parameters that define thermal heating and practical limitations in precise delivery of laser light in clinical settings have a similar effect. A short margin δ is desirable to achieve accurate control over injury depths.
To broaden the treatable depth under the constraints of preventing vaporization and maintaining an acceptable injury margin δ, an additional mechanism besides power tuning is needed to alter the depth-dependent energy deposition in the tissue. Varying the wavelength in order to tune the tissue absorption coefficient offers precisely this possibility. The absorption coefficient dominates the light distribution in the considered wavelength range. The absorption length μa−1 varies from 0.15 mm at 1900 nm to 1.28 mm at 1850 nm, whereas the modeled transport mean free path is μs−1 · (1−γ)−1 ≈ 5 mm. Ignoring scattering, a variation in the absorption coefficient simply results in an altered exponential intensity decay along depth. The impact of this effect on injury depth is highlighted in Fig. 3 which shows the maximum temperature in the function of z and the resulting fractional tissue damage for the previously discussed bounds at the extreme wavelengths of our experimental laser source (1860 nm: μa−1 = 1.00 mm, 1895 nm: μa−1 = 0.176 mm). At vaporization threshold, the injury depth is pushed to 1.07 mm and at the lower bound reduced to 0.13 mm.
Figure 3 indicates the achievable injury depth for all possible wavelength-power combinations in the considered range, together with the contours of the resulting injury margin δ. The vaporization threshold and the settings, which induce no damage to the tissue, define an area of viable wavelength-power combinations. As previously observed, with increasing power the treatment depth is extended. At the same time, the injury margin δ shrinks within the viable region. The eventual rise for power levels above the vaporization threshold has to be regarded as an artifact due to the temperature independence of the physical tissue properties employed by the model. At the least, this hypothesis breaks down by the induced phase change at vaporization. Close to the lower bound, the contour lines of the treatment margin become dense, which indicates again the strong sensitivity of the treatment depth and margin δ to variation of power close to the lower bound.
An isolated change of wavelength at maintained power has only little influence on the achieved treatment depth. If in Fig. 3 contour lines for constant treatment depth were drawn, they would be tangent to the wavelength axis for a specific wavelength. Indeed, this inflection point defines the wavelength with a minimized power requirement for a given treatment depth, which equals the absorption length in this case. For longer wavelengths, the energy is absorbed at more shallow depths, reducing the treatment depth. For shorter wavelengths, on the other hand, the energy is redistributed to larger depths, effectively diminishing the energy deposited at shallow depths, and inducing the observed recline in treatment depth.
However, the change of wavelength has an eminent influence on both the lower and upper power thresholds and in combination with power tuning considerably increases the range of treatment depths. Figure 3 indicates the ideal wavelength-power combination by first using the maximum wavelength of 1900 nm as a single wavelength source and then following the vaporization threshold at a 5°C security margin. The model estimates injury depths from 0.13 mm up to 1.14 mm with powers ranging from 0.19 to 1 W. Together with an increase in treatment depth, an amplification of the margin δ in an approximately linear fashion comes in hand. Opposite to the increase of δ close to the lower bound, in the present case the boundary margin is however very robust as a function of power.
To validate the simulation results, we performed scanned beam therapy on porcine esophageal sections ex vivo at varying power and wavelength. The induced injury depth was assessed in histology using NBTC, which stains the thermolabile LDH and leaves thermally injured regions unstained.
Powers were selected at 150 mW intervals from 150 mW to 1.2 W, and at four discrete wavelengths. Not all combinations induced a recognizable injury. The 150 mW power setting was below injury threshold for all four wavelengths, and at 300 mW, only the high tissue absorption at the 1895 nm wavelength generated sufficient deposition of energy to leave a detectable injury in the NBTC stained sections. On the other hand, for the high power settings, the vaporization threshold reached, resulting at times in audible pops. The parallel monitoring of the exposure with OFDI allowed clear distinction between denaturation below vaporization threshold, which resulted in a continuous variation of the OFDI signal,26 and above threshold, in which case vaporization induced an abrupt disturbance in the signal.
Figures 4 show two examples of histology at the extreme injury depths, irradiating with just enough power to result in a thermal damage [Fig. 4], and just below the vaporization threshold [Fig. 4], respectively. The lower panel of Fig. 4 displays the lateral injury profile obtained from the simulation using matched wavelength-power settings. While the shape of the simulated injury matches well with histology, spatial dimensions are overestimated both laterally and in depth.
Experimental validation of injury depth control by combined power and wavelength tuning. (a) and (b) Comparison of NBTC histology (top row, indicating the measured injury depth) with the fractional tissue damage according to the simulation for (a) 1895 nm and 0.30 W and (b) 1860 nm and 0.9 W. (c) Measured injury depth (mean ±SD, 16 to 22 individual sections for each data point) for different power-wavelength combinations. The spreading of the markers around the central wavelengths is for visualization purpose only.
Figure 4 shows the experimentally measured injury depths for the various wavelength-power combinations. The empty symbols mark the settings, which resulted in vaporization at the surface of the tissue. The vaporization and injury thresholds predicted by the simulation are displayed in the same graph and exhibit a good match with the experimental data. The largest discrepancy is found at 1860 nm, in which case vaporization was induced below the theoretically predicted bound. Also, the variability in the measured injury depths is significant for some points, whereas it remains small for others. This can be attributed to local variations and inhomogeneities in the tissue samples, a situation that is very likely to be encountered in a clinical setting.
Overall, the histological measurements of injury confirm the trend described by simulation, i.e., an extension of the accessible injury depth is achieved when wavelength is included as a control parameter relative to a fixed wavelength response.
Dynamically conforming the thermal injury profile to a specific treatment plan or lesion boundary may best be facilitated by continuous and rapid tuning of both the laser power and wavelength. The implementation of a rapid wavelength tuned source is feasible but rather involved, however, whereas fixed wavelength fiber lasers have a far simpler architecture and are commercially available. As an alternative to continuous wavelength tuning, we investigated multiplexing of a discrete number of power-tunable fixed wavelength sources as a more practicable solution.
From Fig. 3 it is clear that selecting as little as two wavelengths with overlapping treatment bounds would cover nearly the entire depth range available with the wavelength-tunable source. However, the predicted injury margin δ would be severely compromised, and low power settings close to the lower bound would be required. Again, because of the linearity of the heat transfer equation, a simple mixing of wavelengths results in a linear combination of the simulated temperature profiles. Figure 5 displays the injury response to a mixing of the two extreme wavelengths at 1850 and 1900 nm. The assembly of the ideal ratio-power combination following the 95°C threshold is presented in Fig. 5. The drawback of combining only the two extreme wavelengths is an increased injury margin as compared to the same treatment depth with a continuously tuned wavelength.
Combining several discrete wavelengths results in a similar depth control. (a) Combining two wavelengths at 1850 nm and 1900 nm, and controlling their mixing ratio as well as the overall power produces a similar picture as the continuous wavelength scan displayed in Fig. 3 [see legend of Fig. 3 for a detailed description]. (b) Resulting treatment depth and injury margin δ for the ideal mixing of the two wavelengths. The dotted line indicates the injury margin resulting from the continuous wavelength tuning. (c) Two consecutive binary combinations between wavelengths at 1900, 1876, and 1850 nm. (d) Treatment depth and injury margin δ for the ideal parameter pairing. The dotted lines indicate the injury margins from the continuous wavelength tuning and from (b), respectively.
Conceptually, this performance could be significantly improved by adding a third wavelength at an optimized intermediate wavelength of 1876 nm, in a consecutive binary mixing, as indicated in Figs. 5. For shallow treatment depths, the power was gradually transferred from the 1900 nm to the 1876 nm wavelength line. To induce injuries beyond the upper threshold of this discrete wavelength, it was then gradually mixed with the 1850 nm wavelength. In this way, the injury margin penalty compared to the wavelength tunable scenario was minimized to an acceptably low level.
Wavelength tuning of the therapy beam in LTT in addition to power tuning was shown to effectively extend the achievable injury depth range in both simulation and empirical studies, offering a range from about 150 μm to beyond 1 mm. Based on the simulation results, two conceptual approaches for implementation in therapy systems were discussed. In the first, a single therapy source with continuous wavelength tuning was used, and both power and wavelength were modulated along a predefined path in the two-dimensional parameter space to control injury depth. In the second, a set of two or three fixed wavelength sources were multiplexed, and the relative power of each line was controlled, imitating the effect of a tunable wavelength. While far simpler from the point of view of technical implementation, this second approach only slightly compromised injury control compared to a tunable wavelength in terms of the margin of the injury boundary, and hence seems to be a viable concept for depth controlled LTT.
Controlling the injury depth by means of wavelength tuning is possible because of the absorption peak of water located around 1920 nm. In the vicinity of this absorption peak, water is the dominant chromophore in biological tissue. The evaluated wavelength range offers injury depths from about 150 μm to 1 mm. Just beyond this range, the absorption coefficient peaks, and hence tuning beyond 1900 nm offers no benefit. Likewise, reducing the wavelengths below the evaluated range brings barely any gain in penetration depth. The absorption coefficient levels out [see Fig. 1] and the light propagation in tissue becomes dominated by scattering, limiting the deposition of energy deeper inside the tissue.
Although the available treatment range might be sufficient to treat superficial endothelial lesions, a range of about 2 mm would be desirable to treat, for instance, the whole thickness of the squamous esophageal mucosa. Repeated treatment with intermediate removal of the coagulum could be considered to access larger depths. Another strategy to increase the therapy depth without reaching the vaporization threshold at the surface consists in actively cooling the top surface by forced convection. The presence of the coverslip in the simulations had a strong influence on the temperature profile. Acting as a heat sink, it evacuated heat from the topmost layer in the tissue, forcing the temperature profile to bend, and impacted strongly the vaporization threshold. The good match between experimental and simulated vaporization threshold in Fig. 4 was lost when running the simulations without coverslip and instead free convection at the tissue surface. Forced convection could serve to extend the injury depth, even to the point where the top surface no longer experiences thermal injury; this is a mechanism employed to treat only subsurface structures.27 Yet, such a configuration requires an excellent thermal contact between the heat sink and the tissue, which could be problematic in the envisioned clinical setting.
In this current study, a fractional tissue damage of 0.95 was used as the criterion for treatment depth, as used by others.22 Chen et al. ,28 on the other hand, defined the injury depth as the location where the damage integral Ω = 1, which is equivalent to a fractional damage of 0.63. In their illustrative study, Chen et al. evaluate the thermal damage induced to pig skin in vivo, assessed 48 h after irradiation by histology, and match the injury depth predicted by the model with the depth of thrombosis in the dermis. They compare values for the frequency factor and the activation energy of the Arrhenius model from several sources. The best match is obtained for coefficients reported by Gaylor,29 which are similar to those employed by Khan et al. ,14 whereas all other sets of coefficients, including those of Henriques,24 used in our study, overestimated the treatment depth. Interestingly, applying Gaylor's coefficients in combination with Chen's criterion to our simulation aggravates the overestimation of our model. Whereas the cited studies considered a static treatment beam, the present work examines a scanned exposure beam, which introduces a smooth temporal envelope to the temperature profile. The resulting slower transition across the threshold temperature inducing thermal damage explains this seeming contradiction.
Chen et al. also analyzed tissue morphological changes and features beyond the induced thrombosis and necrosis, identifying a large zone of perivascular inflammation and edema. Arguing that this inflammatory response is a complex matter, beyond the purely physical effects of laser irradiation, they omitted a model prediction for the extent of this region. Despite this just argument, we employed the margin δ of the transition region between a fractional damage of 0.05 and 0.95 as a measure for this thermal collateral damage. It seems nevertheless reasonable to assume that an ideal temperature step profile induces a smaller irritation in the spared tissue than a slow gradient. Pulsed laser ablation has become a widely accepted method for this very reason. Short and high intensity laser pulses vaporize tissue very locally and nearly instantaneously, limiting the diffusion of heat to surrounding tissue. Only future studies monitoring tissue response to LTT in vivo will elucidate the influence of reversible thermal damage on the healing process and determine the tolerability of the proposed method. Besides the physiological motivation to reduce the transition region, a short δ with a steep temperature slope also reduces the uncertainty on the treatment depth and improves the accuracy of the depth control.
The aim of this work was to develop a numerical model for thermal tissue damage induced by a scanned therapy beam and to investigate the feasibility of wavelength tuning as a mechanism to control injury depth. Both the simulations and the experiments confirmed this approach. The development of more accurate models is certainly possible, but is questionable in view of the experimental setting, where most of the involved parameters are likely to change locally. Depending on these local tissue properties, the absolute mapping of power and wavelength to treatment depth will vary. The presented tuning mechanism, however, should prevail. In combination with OFDI, which can provide feedback on the progress of therapy in real-time,26 true depth-controlled LTT could be achieved by continuously tuning the laser parameters until the image guided target depth is attained, rendering the therapy independent of tissue properties.
In conclusion, the present study discussed the use of wavelengths close to the water absorption peak at 1920 nm to control the thermally induced injury depth in epithelial tissue. We developed a numerical model in order to gain insight into the underlying physical mechanisms and corroborated the simulations with experimental results of LTT ex vivo. With the numerical model as a design tool at hand, we outlined two configurations for depth controllable LTT: a continuous power and wavelength-tunable laser source or, alternatively, a combination of two or three discrete and independently power controlled wavelength sources. Both approaches are anticipated to provide accurate control over the depth of thermally-induced damage to tissue, and may represent improved strategies for the treatment of endothelial lesions.
This work was supported by the National Institutes of Health (Grant Nos. NIH R33CA125560 and NIH K25CA127465 ).
Martin Villiger ; Andrew Soroka ; Guillermo J. Tearney ; Brett E. Bouma and Benjamin J. Vakoc"Injury depth control from combined wavelength and power tuning in scanned beam laser thermal therapy", J. Biomed. Opt. 16(11), 118001 (October 26, 2011). ; http://dx.doi.org/10.1117/1.3647581
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Charles Trevelyan and the Great Irish Famine
By Robin Haines
Charles Trevelyan, assistant secretary to the Treasury during the Great Irish Famine, has received much of the blame for the British government's parsimonious response to the catastrophe. This study begins by exploring the demonization of Trevelyan since the 1960s. It asks why a senior civil servant has been condemned as the architect of a policy allegedly aimed at depopulating Ireland in order to restructure the Irish economy and acculturate Irish society to English norms. This book challenges the verdict of history by showing how Trevelyan's most severe critics have re-circulated half-truths and misinterpreted evidence to create a picture of an anti-Irish evangelical bent upon preventing food reaching those most in need of it. In tracing the efforts of Trevelyan and his subordinates to implement government policy and deliver relief in the field, the author presents a portrait of a complex, opinionated man working against the odds, to assist a country to which he was attached by ties of affection, sympathy, and ancestry.
606 pages
Publication Date: 8/26/2004
Format: Cloth

subset: commoncrawl


text:
Danielle Davis and Matthew were seven months into their wedding when the unexpected happened. Matthew went into a coma after being involved in a motorcycle accident. The situation was so hopeless that even doctors advised Danielle to pull the plug.
Their advice was somehow justified since 90% of the patients who go through the same circumstances don't make it. Though Matthew had miraculously survived, it seemed impossible for him to wake up from the coma.
As opposed to pulling the plug, she took her husband's lifeless body home and became the caretaker. Then another miracle happened three months later.
Matthew could not talk, walk and had lost his memory. But four years after that, he could talk, walk and even ride a bike. He is really grateful that she stood by him and saved his life.
Kindly SHARE this story if you believe in true love!


text:
Opinion: Nnamdi Kanu's Illegal Detention Is Buhari's Bait To Generate Carnage
by Emeka Ibe
As a schooled human rights canvasser and advocate, I believe in the rights of any distinct set of people to exist on their own as a country or to determine their political future, irrespective of their inherent political reality or entity. This is an internationally recognized right which is essentially enshrined in the opening articles of the UN Charter. This right is otherwise called the right to self-determination of any homogeneous group of people like the Igbo, Idoma, Yoruba, Efik, Urhobo, Hausa, Fulani, Gbagyi, Igala, etc. of Nigeria. This right has been in existence since 1948 and therefore, precedes an independent Nigeria.
I don't believe in violent agitations or any secessionist agenda that is replete with acerbic recriminations against the Nigerian establishment or animosity and hate for other tribes or sections of the country. This is my sole ground for not supporting Nnamdi Kanu's quest and approach towards the realization of Biafra.
It's not a crime to advocate for Biafra through peaceful means. So, the hysteria that engulfs most Nigerians whenever the word 'Biafra' is mentioned is unnecessary and uncalled for, especially because it merely evokes an emotional feeling which borders of sentiments.
Biafra, as mentioned in Nigeria today, does not necessarily translate to geographical dismemberment of Nigeria. It further has a very deep philosophical meaning which is usually lost on the fancy of most Nigerians who view it with contempt. On one hand, it only requires listening to flimsy and inane 'beer palour' tales and gossips or reading viral mongering propaganda to fall victim to the hoax that Biafra literally means the end of Nigeria. On the other hand, it entails a conscious effort at studying Nigeria's chequered political history (which most Nigerians who don't like reading hardly do), to come to terms with the philosophical essence of Biafra.
Permit me to limit this piece to what Biafra is not, as to do otherwise will involve an abstract journey along a tortuous path, with the potential of losing many readers along the political matrix. That's a case for another lens.
The reason for this write-up is to alert Nigerians that Nnamdi Kanu was arrested and charged to a competent court by Buhari's Directorate for State Security (DSS). The court found that the preferred charges are bailable and granted him bail upon the fulfillment of stipulated onerous and stiff conditions.
His lawyers have made a press release where they informed the whole world that the bail conditions were satisfied, but the DSS refused to release him, attributing their refusal to "orders from above". Meanwhile, Nnamdi Kanu, a certified diabetic patient, is kept incommunicado and denied any visitor whatsoever, including his lawyers or doctor.
His lawyers have gone back to court to report this wanton disobedience of the court's order, prompting the court to summon the DSS, with an order that Nnamdi Kanu be produced in court. But on the appointed date, the DSS neglected, failed or refused to re-appear in court.
The unlawful detention of Nnamdi Kanu has precipitated series of protests by his numerous supporters in the South/South and South/East zones of the country who are demanding his unconditional release, with a resultant lockdown of most towns in that region. It is remarkable to note that the protesters are unarmed and have so far conducted themselves peacefully all through, despite provocations to stir violence by security agents who have shot and killed so many of them.
It is also noteworthy to state that the real reason for the protests, viz: unconditional release of Nnamdi Kanu, as sanctioned by the court, has been surreptitiously jettisoned by the Nigerian Government and replaced with another one, viz: protests for the secession of Biafra, which the Nigerian Government considers a better cloak under which to hatch their vile and evil plans to kill and maim the protesters, as has been the norm in Nigeria. This, a lot of thinking Nigerians believe, is the reason behind the continued illegal detention of Nnamdi Kanu – keep him incommunicado to arouse protests by his associates and supporters, then exterminate them when they file out in the open. It was therefore not surprising to see the GOC of the Nigerian Army 82nd Division, Enugu, on national television yesterday, reading a military riot act to unarmed civilian protesters.
One wonders what the military rules of engagement read on air to the protesters by the GOC are meant for in a case of peaceful protests by unarmed citizens of a country. Are we at war? Has any protester been sighted with any weapon of any nature – even a stick? Does engaging in civil protests amount to enmity with Nigeria? Is the right to civil protest no longer applicable in Nigeria? Who is trying to fool who that we're in a democracy? Why is nobody telling President Buhari that a court order must be obeyed by all and sundry in any constitutional democracy that intends to be reckoned with.
Meanwhile, President Buhari was busy in Abuja, inaugurating his ministers that took 6 months to select, without any iota of concern for the fact that the entire former Eastern Region of Nigeria was on lockdown by civil protesters demanding for the unconditional release of Nnamdi Kanu, which release and guaranteed freedom had been ordered by the law of the land. Perhaps, this is another glimpse of the clannishness or multi-ethnic insensitivity often attributed to Buhari.
This is a foreboding solely aimed at putting the records straight, as the callous shedding of further innocent Igbo blood (or any other innocent blood indeed) through state sponsored sinister machinations will no longer be tolerated in the world of today.
Emeka Ibe is a legal practitioner and political commentator. He studied at Ahmadu Bello University, Zaria. Connect with him on Facebook.
The opinions expressed in this article are solely those of the author.


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FitSugar, an online fitness community, posted a great article today about the benefits of resistance bands. It talks about a few of my favorite reasons: you can use them to target specific muscles and to reach some often neglected muscle groups, you can use them to up the intensity of some of your basic moves like push-ups and squats, and bands push you to work on your balance and coordination.
One thing it didn't mention was how easy it is to use your bands everywhere. If your gym is like mine, too often there are not enough bands to go around and even the ones that are available are a bit outdated. My favorite thing about bands is that you really can do them anywhere and fit your workout in anytime.
Have you checked out our first office workout video? If you haven't yet, why don't you grab a band and try the workout while you read FitSugar's article on resistance bands? It has links to few more exercises if you finish the article and are ready to move the workout away from your desk!


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[Marston catches up with West in Ridgewood.]
West: Ah, Mr. Marston. How are you, sir?
Marston: I'm alright. I met up with your friend Seth.
West: Oh, Seth of the dead. Yes, interesting fellow. You don't meet many men these days with the moral fortitude to cut straight to the chase like that, do you?
Marston: Thankfully not, Mr. West Dickens.
West: Yes, contemporary society is remarkably harsh on professional exhumers, but did you know, in Ancient Egypt, it was an art form more highly valued than literature? I believe Seth comes from that school of thought.
Marston: How very interesting. Look, you thought any more about our plan?
West: Ah, your plan, dear boy, your plan. I am merely the help, not mercifully the arbiter of wisdom.
Marston: What you are, dear boy, is a man whose life I've saved twice now. A man who sells lies and deceit to unwitting people. A man who if he doesn't help me, I won't think twice about putting a bullet through his skull, feeding to the vultures myself.
West: You see, Mr. Marston, you have the exterior of a violent man, but the soul of an angel, and that is what I think I cherish most about you.
Marston: That's what I thought.
West: But, before we can attend to your particular problems, we need some extra lubricant to oil the machinery of business, and this being America, that lubricant with which we concern ourselves, is money.
Marston: Money? What are you talking about?
West: We need weapons, armor plate for the wagon, extra hands. And...I need some danger money.
Marston: So, let's sell some more of these cures.
West: Sell cures? Around here? Do you want to see me lynched? No. The sport of kings, racing my friend! The sport of kings. A noble activity, without reproach. Exactly the kind of activity where a lying, cheating degenerate like myself can prosper. But come, let's finish the loading and we'll discuss it as we drive. Now, sir, to Gaptooth Breach!
[They start off.]
West: Seth is an interesting fellow, is he not?
Marston: I wouldn't say interestin'. More deeply disturbed. I can see why you two get along.
West: I see the good in everybody, John. It's a flaw of mine. I have a soft spot for life's flotsam and jetsam.
Marston: A connection with them, more like. You and Seth have a lot in common. You both rob people, for one. Mind you, at least he waits until they're dead.
West: Ah, my dear boy. Nobody is more critical of drinkers than a drunk who's mended his ways.
Marston: What are you talking about?
West: Come on now, John. I've heard about you. You spent your life robbing people. It's a little inappropriate to be taking the moral high ground now.
Marston: I had the courtesy to put a gun in their face.
West: Whatever helps you sleep easily at night.
Marston: We stole from those who had too much. And tried to give to those who had too little.
West: A Robin Hood with spurs. How romantic! You expect me to believe that poppycock? Maybe I'll have the good fortune to be able to leave my nefarious life behind one day and work on the government's dime.
Marston: Don't talk about things you don't understand.
West: Dear, oh dear. Simmer down, my boy. You need to start appreciating your friends more. Folks around here don't see you as any different than Bill Williamson.
Marston: I didn't think I'd have to huckster snake oil and dig up the dead, that's all.
West: Take it from me, John. Collaboration is the key to success.
Marston: I can help you. Seth can help you. It's business. Nothing more, nothing less. There's no need to make it quite so personal.
Marston: Suits me.
West: Anyway, John. We must talk about the race!
Marston: Yes, the race.
West: Oh, come on! Time to purge that negativity and start thinking like a winner! You're going to have a whale of a time! They've been holding these chariot races in New Austin for as long as I can remember. And... we need the money.
Marston: Why are you racing then?
West: Me? Oh no, not my thing at all. You've already proven yourself as more than adept at the reins, my dear boy, and under some stress. These races are Byzantine in their ferocity and the terrain is treacherous. People will do just about anything to win. Men die. It's a marvelous spectator sport.
Marston: Sounds like fun.
West: And you are my wild card, John! They won't be expecting you.
Marston: So what's your role in all this?
West: Think of me as your spiritual guide.
Marston: Do I have to?
West: You are a free man, of course, but I strongly recommend it! Imagine, just for today, you are not an aging bounty hunter and I am not an avant-garde business pioneer. No sir. Today, we are gladiators! Motivation, dear boy.
Marston: I'm definitely feeling motivated to get the hell out of here!
West: Here we are, John! Gaptooth Breach.
[John gets onto the wooden chariot.]
Clay:: Drivers! Y'all know the rules...but for you newcomers this here's a fair race. Keep to your manners and let the faster cart pass. So now that's been said y'all can get to runnin' each other off the road like always! Alright now! Countin' to three! Ready! Set! Go!
West: Fly like the wind, my boy! FLY LIKE THE WIND!
[Marston comes in first.]
Clay: Helluva race, mister. I'll take care of this cart for Mr. West Dickens.
West: Come on, John. I suggest we beat a hasty retreat. Right, best remove ourselves from the stage before somebody decides they want their money back.
Marston: Fine by me.
West: Wasn't that fantastic? The cheers of the crowd! The thunder of the wheels!
Marston: The falling rocks. The homicidal maniacs.
West: Oh come on, John. Even a coldhearted misanthrope like you must have found that the tiniest bit exhilarating?
Marston: Not the friendliest bunch are they?
West: They take their racing very seriously in these parts. And your participation was not entirely pre-approved.
Marston: That was clear.
West: Ah...sport, war and heartache! The guilty pleasures of mankind since the dawn of time!
Marston: I'd get away from the men we just swindled before you start waxin' too lyrical.
West: Yes, yes. Uh, of course.
[They come to a stop near Benedict Point.]
West: Well done, sir, well done! Having you as a ringer has netted us a fine profit.
Marston: We seem to be wasting time, old man.
West: Oh, patience, my friend. The Trojan horse cannot run before it can walk, if you'll forgive the metaphor. Next, we need to procure some grand and overwhelming firepower. And for that, you need to contact an old friend of mine, goes by the name of Irish.
Marston: Irish?
West: Yes, he's an interesting kind of fellow. He usually can be found in Armadillo or some other town around here, on some bacchanalian revel or such.
Marston: Great, an alcoholic arms dealer.
West: What could be better?


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Snack Food
Crazy Corn
Como Gopo delivers wacky popcorn flavors right to your door. more
May 18, 2016 2:06 PM Made in MO
Greek Popcorn
This easy recipe to spice up your popcorn makes the perfect companion snack for a night of drinking beer, wine, or cocktails. more
Mar 15, 2016 4:50 PM Recipes


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Free Phone 08000 556 331From Cologne +44 (0) 1922-450-040
Moving To Germany
Telephone number
Collection town (uk)
Delivery country
Delivery city
Brief description of goods to be moved
Click here for a FREE Cologne Germany Removals Quote
Germany removals Services offered:
Bonn Germany: 2-3 days Berlin Germany: 4-5 days Munich Germany : 4-6 days
The times stated above are estimates for house removals to Germany and Europe, our move managers will be happy to advise on delivery times to Germany but as a general rule we would estimate 14-21 days for part load deliveries depending on the area in the Germany that delivery is to. However deliveries to rural or distant destinations in Germany may take longer.
We base all part loads to Germany on a delivery time of between 7-21 days, however depending on the day of collection or your requirements these can sometimes be reduced.
Cologne is Germany's 4th largest city, after Belin, Munich and Hamburg. It is one of the oldest cities in Germany and was founded by the Romans. The city is situated on the River Rhine and is known in Germany as "Koln". It is a beautiful place and as one of Germany's most historic, it has endless sightseeing opportunities.
Many of the popular sights are close to the breathtaking Cathedral (Kolner Dom), this Cathederal took around 600 years to build and is truly spectacular. There are also numerous monuments from over the past 2000 years, such as the Roman Dionysus Mosaic, The Gurzenich Hall and the Overstolzenhaus. There are also modern attractions such as the Opera House and Media Park. Another popular sight is the house of 4711 (the origional Eau de Cologne), the origional scent was called Aqua Mirabilis on the basis of its refreshing and stimulating effect.
Carnival season runs from 11th November each year, along with a main event aptly named "three mad days" that takes place around Easter time, this attracts over a million revelers. Cologne is a beer city, and their own beer is named Kolcsh. the city has a mild climate, with the summers typically wet and humid, often with a cool breeze. Ask for a quote to Cologne.
Bamberg | Berlin | Cologne | Dresden | Frankfurt am Main | Freiburg im Breisgau | Hamburg | Heidelberg | Munich | Münster | Leipzig | Regensburg | Stuttgart
Removals to Germany Bamberg – Moving to Dresden | European Moving Dusseldorf | Removal StuttgartInternational Moving Frankfurt | Overseas Removal to Germany Cologne | Moving Quotes Munich House Removal Costs to Germany Berlin | UK Germany Removals | House Removal Germany
European Germany Moving */]]>
Type Of MoveJust Boxes1 Bed House2 Bed House3 Bed House4+ Bed HouseOffice MoveCommercial ShippingOther


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Check out the NBA's top 10 plays of the 2013 calendar year! So sit back, relax and enjoy the best plays from the NBA from 2013.
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NBA2K4LIFE is dedicated to the NBA 2K series game.
nba2k4life.com is not affiliated with 2K Sports. NBA 2K is a basketball video game developed by Visual Concepts and published by 2K Sports.


text:
- Home >
- Health, Safety & Workwear (PPE) >
- Tool Belts, Pouches & Braces >
- Tool Pouches >
- Bahco Two Pocket Fixings Pouch
Two pocket fixings pouch manufactured from extra strong 600D polyester with a leather knife sleeve and a handy extra pocket.
Own it? Review it! Be the first to tell everyone what you think about this product...


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William Gordon Lennox
William Gordon Lennox (1884–1960) was an American neurologist who was a pioneer in the use of electroencephalography (EEG) for the diagnosis and treatment of epilepsy.
Lennox first became interested in epilepsy when working as medical missionary in China.[1] At the Harvard Medical School, he worked alongside and published many papers with Stanley Cobb and Erna and Frederic Gibbs. Lennox was president of the International League Against Epilepsy from 1935 to 1946. After a period as co-editor, he became the editor-in-chief of the journal Epilepsia from 1945 to 1950.[2] He was jointly awarded (with Frederic Gibbs) the Albert Lasker Award for Clinical Medical Research in 1951. He wrote, with his daughter Margaret, "Epilepsy and Related Disorders" (Vols. 1 and 2, Little Brown & Co, Boston, 1960), which contains his description of Lennox-Gastaut syndrome.
In 1937, Lennox described the situation regarding the medical treatment of epilepsy at the time:
- "In the US there are some 500,000 persons subject to epilepsy. This is approximately the same number as have diabetes or active tuberculosis. In Roman days a seizure in the forum caused its dissolution; now a seizure in a classroom means dismissal of the offending student. In the US we have only the extremes of care in the home, or in largely publicly supported institutions into which the dregs of patients have settled. From the practical point of view, patients with epilepsy are an unusually valuable group for human experimentation. They are numerous, and are available to the research staff of the general hospital; they can usually give intelligent co-operation; they are pathetically anxious to be experimented upon; they have abrupt and unmistakable changes from normal to abnormal states. Epilepsy comparatively speaking has been a neglected field. To the epileptic writhing on the road of medicine, the investigator has perhaps given a cup of cold water, but then has passed by to succour those with illnesses which seemed more likely to reward his efforts. From the humanitarian point of view, epileptics are peculiarly in need of help."[3]
Lennox was also involved with the eugenics movement. He gave a speech in 1938 to Harvard's Phi Beta Kappa, recommending euthanasia for "the congenitally mindless and for the incurable sick who wish to die".[4] In the same year, he wrote "The principle of limiting certain races through limitation of off-spring might be applied internationally as well as intranationally."[5] In 1943, Lennox joined the advisory council of the Euthanasia Society of America (later known as Partnership for Caring). In 1950, he wrote an article entitled "The Moral Issue", calling for the mercy killing of "children with undeveloped or misformed brains" as a way of opening up space in "our hopelessly clogged institutions."[6]
He continued working into his 70s, only retiring from Harvard in 1958. He died two years later.
Partial bibliography[edit]
- The Health and Turnover of Missionaries (1933)
- Science and Seizures: New Light on Epilepsy and Migraine (1941)
- Epilepsy and Related Disorders (1960)
- ^ "William Lennox Obituary". New York Times. 1960-07-23. Archived from the original on January 12, 2005. Retrieved 2006-02-22.
- ^ Harry Meinardi. "Appendix IV, EPILEPSIA ISSUES". ILAE History. International League Against Epilepsy. Retrieved 2006-02-22.
- ^ Lennox, William G. (February 1937). "Title unknown". Epilepsia. 2nd Series, Vol.1. doi:10.1111/j.1528-1157.1937.tb05579.x.
- ^ Jennifer Terry; Jacqueline Urla, eds. (1995). Deviant Bodies: Critical Perspectives on Difference in Science and Popular Culture (Race, Gender, and Science). Indiana University Press. ISBN 0-253-20975-7.
- ^ Lennox, W. G. (1938). "Should they live? Certain economic aspects of medicine". American Scholar. 7: 454–66.
- ^ Dowbiggin, Ian (2003). A Merciful End : The Euthanasia Movement in Modern America. USA: Oxford University Press. p. 198. ISBN 0-19-515443-6.


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I was on Wikipedia earlier today, and I saw something horribly untrue about this wiki:
Call of duty wiki
- I know a more reliable, call of duty-based encyclopedia, it's called the Call of Duty wiki, it's much better and each article on wikipedia is more detailed on cod wiki, and there's even articles on characters and levels.--184.108.40.206 (talk) 15:10, 22 August 2009 (UTC)
- Yeah, I've checked it out. Most of the stuff isn't sourced and certainly not up to wikipidea's rules. Why, what about it? Noneofyour (talk) 06:20, 23 August 2009 (UTC)
- It's just you could get more info on cod if you looked on there--188.8.131.52 (talk) 07:01, 23 August 2009 (UTC)
- I wouldn't consider it a reliable source. I don't know about anyone else though. Noneofyour (talk) 15:20, 23 August 2009 (UTC)
- Hey (talk) i need your help with some jerks. Darkman 4, WouldYouKindly and their pals are being soo mean to me and i want payback!!! please can you help me. williamstrother September 4, 12:02
- What are they doing? Anyways, this is not the right place to post this.Noneofyour (talk) 17:17, 4 September 2009 (UTC)
- @Noneofyour- do you really think people would come here for CoD info when there are more detailed pages on CoD wiki? and who cares how many sources there are? most of the info is from testing and playing missions over and over, not from other websites. User:IamBeastly20 02:44, 23 August 2010 (UTC)
as you can see, Noneofyour thinks Wikipedia is a better source for Call of Duty info than us because they have more sources than us.
and yes, IamBeastly20 is me.


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Call us: +1-415-738-4000
Learn how customers use BigMemory to go big and go fast.
We wanted to improve the stability of our web servers and our capacity to handle more partner activity as it was severely constrained. I needed the problem to go away. With Terracotta's Enterprise Suite, it did.Andre Zardini, CIO, Rewards Network
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R&R -- So Long, Summer
Article's first summer is officially coming to an end, and it's hard to believe we're nearing our first birthday next month. We've been extremely busy this summer and loving every second of it. We just completed our first collaboration with our friends at Noble Denim, several amazing new brands are headed your way for Fall, the press on Article has been nothing short of extraordinary, we're cherishing more than a few new friendships, and many new projects are coming soon. The things we have learned are incredible, but with the hustle and bustle of it all, sometimes you have to take a step back and enjoy a little R&R. It's fun to celebrate a hundred things at once - so that's exactly what we did.
(photos: Aaron Conway)


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WHEN: Weds., Feb. 8, 2017 — 5:30 pm – Food / 6-8 – Program
WHERE: Local 60 – Plumbers Hall, 3515 N. I-10 Service Rd W (at Severn Ave.), Metairie
Please note: Advance registration on-line is $20 (plus a $1.49 processing fee) until midnight the day before the event. Students and Code Officials can register for $10 (plus a $1.24 processing fee).
Payment will only be taken at the door on the day of the event. The price is $30 on the day of the event — by cash, check, or credit card.
If you would prefer to register in advance by mail, please send a check for $20 to SELACACI, P.O. Box 791722, New Orleans, LA 70179.
Code Officials & Home Inspectors can use CEU credits from SELACACI programs as applicable for their professional purposes. Builders, architects, insulation contractors & others are always welcome. Please help us spread the word so that these volunteer-organized programs can have maximum educational impact.
Report on Nov. 15 Training in the December LA-MS HVAC Insider:
SELACACI Holds Monthly Heatload Workshops
Tues., Feb. 7, 2017 — In order to provide a way for HVAC contractors to learn skills using heatload software and to improve sizing calculations, SELACACI has been hosting monthly gatherings on this subject.
Tentatively scheduled for Delgado Community College's Jefferson Campus, 5200 Blair Dr., Metairie (off Airline Hwy. west of Transcontinental), Building B, Room 2.
Personalized orientation, skill-development, and problem-solving involving Computerized Heatload Analysis. This is a regular event held on the First Tuesday of every month. Free help & advice — Take advantage of this while it's available!
The next Heatload Workshop will be on Tuesday, Feb. 7 at 5 p.m.
If you're new to computerized heatload analysis, the workshop will offer orientation. If you want to develop your skills further, you'll be in good company.
Each month, these networking sessions have grown more popular. Given the competitive nature of the industry and the investment of time necessary for contractors to properly go through all the steps of Manual J (A/C Sizing) & D (Duct Sizing) & S (Equipment Selection), it's critical for technicians to understand the various steps in the process and to know to what degree shortcuts may or may not be acceptable — to avoid problems with the actual installation.
This effort is not meant to take the place of heatload software training courses, but rather to provide an ongoing forum for the exchange of information, promoting maximum productivity. Come & Bring Your Hard Questions!
There is no charge for these informal meetings; they are not a "class" per se (but you might learn as much as in a class). To receive monthly email confirmations of SELACACI's Heatload Workshops, join SELACACI's listserv if you're not already on it.
SELACACI's Board invites your input & ideas as it develops its programs for 2017.
Stay tuned to this website's Resources page for updates as more Parishes announce their implementation of the 2009 Energy Code provisions on duct testing, etc.


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The Centre for Global Health
The Centre for Global Health (CGH) is an interdisciplinary platform dedicated to improving health and achieving health equity for people worldwide, through research, education and training. The centre consists of researches from several departments at Karolinska Institutet.
Global Health Night
Global Health Night is a yearly event dedicated to Global Health for university students, employees, researchers and teachers at Karolinska Institutet.
Save the date for Global Health Night 2016, on October 24! Find more information about the night 2016 at the website for this years Global Health Night
CGH News and events
1 Dec 2016
World AIDS Day: Film Screening and Panel DiscussionDecember 1st is World AIDS Day. This year the library is teaming up with S.O.G.H and Queerolinska to observe this day. Everyone interested in the subject is welcome! We will be serving sandwiches and coffee. Programme 16:30-16:40 Presentation of the Face of AIDS Film Archive with examples from the...
24 Oct 2016


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Anger Management
Nancy Davis, LMFT, SAP
Licensed Marriage and Family Therapist
201B Commerce Way, Clovis, NM
Working with clients who are experiencing issues with anger management, it is imperative that each case be taken individually, as I have found there are no "cookie cutter" answers in working with anger. Anger is a secondary emotion and there are often multiple layers of emotions beneath the anger. Working with the client to understand what is beneath the anger and finding coping skills, as well as behavioral changes to alleviate the pattern that has often been set from the past, is important in finding relief from the anger that plagues the client's life.


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Touch of Klaas sinks Sunderland
Sunderland lost their unbeaten pre-season record after going 1-0 to Ajax at the Stadium of Light.
Last Updated: 03/08/08 6:50pm
Sunderland lost their unbeaten pre-season record after going 1-0 to Ajax at the Stadium of Light.
Ajax hit-man Klaas Jan Huntelaar's second-half strike proved the difference between the sides as the Dutch outfit took the spoils.
The Holland forward, linked with a move to England over the summer, lashed home the game's only goal nine minutes into the second period after two good saves from Scotland goalkeeper Craig Gordon.
Roy Keane's side will consider themselves unlucky to have lost after bossing possession, particularly in the latter stages, but the closest they came to a goal was a first half Daryl Murphy effort which struck the outside of the post.
Ajax, making their second trip to the Stadium of Light, had the first real chance in the seventh minute when Gordon instinctively threw out a right hand to block Huntelaar's close-range attempt after good work down the left by Luis Suarez.
The Black Cats' first sight of goal came in the 16th minute when former Bolton striker El-Hadji Diouf slid a neat ball through for Dean Whitehead whose low shot skidded wide of Maarten Stekelenburg's post.
Ten minutes later Whitehead again tried his luck after cutting in from the left, but curled his right-footed shot just wide.
Three minutes before the interval the hosts came within a whisker of taking the lead when Murphy, again supplied by the influential Diouf, curled a left-footed strike which just skimmed the outside of the left-hand upright.
DebutSteed Malbranque, the third Tottenham player to move to Wearside this summer, was handed his Sunderland debut as a half-time replacement for Murphy.
The Frenchman was powerless to prevent his side going behind in the 54th minute, however.
Rasmus Lindgren's initial effort from the left was saved by Gordon, as was Huntelaar's follow-up, but the rebound fell at the feet of the Holland frontman a second time and he lashed high into the net.
Diouf drew a fine save from Stekelenburg with a free-kick from the edge of the area, and Teemu Tainio had a long-range effort blocked by Gabri before Michael Chopra slotted home in vain late on after being flagged offside.


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LUPINE Headlamp Wilma RX14 3200 Lumen 26° Optics Bluetooth
Article details
LUPINE headlamp Wilma RX 14 3200 lumen 26 ° optics Bluetooth
There are situations in which you would like to take you to the head - but do not need you!
With the newly integrated Bluetooth module, you control the Wilma R no longer exclusively via the button directly on the lamp head, but now also by remote control or a free mobile app. The new Wilma changed everything. With 3200 lumens you really recognize every stone on your way even in the fastest movements and difficult circumstances. No matter how extreme your activity also is - the Wilma headlamp makes it possible.
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Illumination range: 325 m
Dimensions: 50 x 50 mm (diameter x length)
Protection class: IP 68 (waterproofing), IK 09 (impact strength)
Color temperature: 6000K (5% tolerance)
Battery: 13.2 Ah Li-Ion Smart Core with capacity display, and rear light function
Color: Black
Weight (incl. Battery): 630g
- 10 lighting levels
- SOS signal, alpine distress signal, RVLR
- rear light function (Smart Core battery)
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- Reservetank
- voltage display
- capacity indicator LEDs (10% accurate)
- battery warning in the lamp head
- Deep
- Operation via Bluetooth remote control or smartphone app
Light output - Operating time:
2800 lumens / 28W - 3:20
2360 lumens / 23W - 4:10
2050 lumens / 19W - 5:00
1630 lumens / 14W - 6:45
1200 lumens / 10W - 9:30
900 lumens / 7W - 13:30
650 lumen / 5W - 19:00
400 lumen / 3W - 31:30 h
210 lumen / 1.5W - 63:00 h
45 lumens / 0.3W - 310: 00 h
- Wilma 14 lamphead 26 ° (28W)
- Smart Core battery 13.2 Ah
- Charger Micro Charger (available Other) with EU power supply
- 12V car - Cable
- 120cm extension cable
- Transportation bag L
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- instructions
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Note: Not permitted on public roads! Note the instructions for battery regulation
Manufacturers battery (secondary battery): BMZ / VRI GmbH
If a US or UK power supply needed please see the Note box on the right at the end of the order.
|Product weight:


text:
I am Ace! I love reading and writing. I am a sophmore in college. I live in the Bat Cave. I am a very busy person so I apologize for the span of time between posts.
I have never read Surviving the McLane Boys or My Life With the Walter Brothers, All Twelve of Them, though I do plan to once I finish my story.
Pretending to Be Andersen is the sequel to Surviving the Andersen Brothers. I will try my best to update the story every two wweeks. Please be patient as I am in college and I work two jobs. Thank you for your understanding!
If you are rude, your comment will get deleted. Do not ask me to read or advertise your story in any of my comment sections, it will get deleted. I apologize if I sound harsh.
There is a facebook fan page for Surviving the Andersen Brothers/Pretending to Be Andersen, be sure to fan! If you would like to be friends with me on facebook, look for Ace Heart! Be sure to check it out! I will be posting estimated posting times and other fun things! Show your support! (I WILL BE USING THE FAN PAGE A LOT MORE SO BE SURE TO CHECK IT OUT FOR UP TO DATE INFORMATION)
If you have any questions, feel free to ask me :)
Read. Vote. Comment. Enjoy!
God bless!
- District 12, Panem
- JoinedJanuary 14, 2011
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Ace-Of-Hearts Jan 16, 2016 08:34PM
Dearest Fans,The next chapter of Pretending to Be Andersen has just been posted! As always, I am so sorry for how long it took me to come up with a chapter but I've had such a strong case of writer'...View all Conversations
Stories by Ace Heart
- 4 Published Stories
Pretending to Be Andersen Romance
Jasmine Clark, here! My life with the Andersen family continues to keep me on my toes. Almost one year with the unusually large family and you'd think I'd get some kind of normalcy at this point. Not here. Not when...
Surviving the Andersen Brothers Romance
My name is Jasmine Clark and my life is set for a drastic change when Social Services learn of the neglect my mother inflicted on me after my father's untimely demise. I am taken away from my home and sent to live...
All's Fair in Love & Magic Fantasy
Millennia after the Great War of Ages, almost all magic has faded away. Weak strains of magic remain, with the three Immortals as the guardians. In the modern age, one of the Immortals, Kaius Ka'l Kalantha, introdu...
1 Reading List


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Italian Chicken and Sausage Rolls
Recipe by Geema
The flavors in this dish are not subtle, but zesty and hearty. It's simple to make, and great to serve family or dinner guests.
Top Review by Latchy
This was an excellent recipe so full of flavour. I do think a lot depends on the italian sausage that you use as to the final flavour you will get. My Italian sausage was sort of hot and sweet from my favourite butcher. I also used my favourite wine that I am drinking now a nice Australian Merlot. I must say I tried this on a couple of guests and they were impressed and asked for the recipe. Well done Geema.
See Discussion:1 Review
Ingredients Nutrition
- 4 boneless chicken breast halves
- 1 onion, chopped
- 1⁄2 lb hot Italian sausage or 1⁄2 lb mild Italian sausage
- 3 tablespoons olive oil
- 1 green bell pepper, chopped
- 1 red bell pepper, chopped
- 4 ounces mozzarella cheese, cut in 4 sticks
- 1⁄4 lb mushroom, sliced
- 2 tomatoes, chopped
- 1⁄4 cup flour
- 1⁄2 cup red wine or 1⁄2 cup chicken broth
- 1⁄2 teaspoon salt
- 1 teaspoon basil
- 1⁄2 teaspoon dried oregano leaves
- red pepper flakes
- fresh ground black pepper
Directions See How It's Made
- Pound chicken flat until very thin.
- I place my chicken in a zip lock bag while pounding to keep the mallet from sticking to the chicken.
- Remove skins from sausage, unless you have bulk sausage.
- In large skillet, cook sausage until done.
- Pour off most of the fat, leaving drippings in pan.
- Spread 1/4 of the sausage on each chicken breast and place a cheese stick at one end of the flattened chicken.
- Roll up the chicken over the cheese, then fold in the sides continuing to roll the chicken breasts like an egg roll,encasing sausage and cheese.
- In a bowl, mix flour, salt and oregano.
- Dredge chicken rolls in mixture.
- In pan drippings, brown chicken on all sides over medium heat.
- You do not have to cook completely, just brown.
- Remove chicken from pan.
- Add olive oil to skillet; then saute onion, peppers, and mushrooms for 1-2 minutes.
- Add chicken rolls to skillet, then tomatoes, red pepper flakes wine, basil and pepper.
- Cover and simmer 25 to 30 minutes.


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3 Tips To Avoid Getting Robbed Like Kim Kardashian In Paris
Recently, celebrity Kim Kardashian made headlines again.
This time it wasn't for "breaking the internet" with nude photos …
It was because she was the victim of a home invasion where she was robbed at gun point in Paris, France.
Since everyone is already talking about it (even Hillary Clinton) let's quickly see what we can learn from this incident.
Kim K Got Robbed At Gun Point In Paris, France During A Home Invasion …
Kim Kardashian was in Paris for fashion week and staying at an apartment when she became the victim of a home invasion/armed robbery late at night.
Multiple armed men — according to some reports dressed as policemen — broke into her apartment at the Hôtel de Pourtalès, restrained her with zip ties and duct tape, and robbed her of anywhere from $4 to $10 million worth of jewelry.
While the internet goes crazy talking about it, let's learn something from it.
1. Gun Control Does NOT Stop Criminals From Using Guns
I am putting this first, because I must be honest I was actually with the NRA when I first heard about this robbery who posted immediately about how the VERY strict gun control laws in Paris did nothing to protect Kim K from getting robbed at gun point:
This is because Kim Kardashian has been VERY outspoken … and I would hasten to point out … VERY wrong on supporting gun control.
From spreading the myth of the "terror watch list" propaganda to thinking that more gun control will stop criminals.
To outright misinformation — because she's ignorant of the facts (I said ignorant, not stupid, calm down) — saying things like you can just buy guns online like an Amazon.com order with no background checks:
It's a fact that Paris, France has some of the most restrictive gun control laws in the world.
In fact, guns are practically impossible to get for the average civilian there. Actually carrying a gun legally (concealed or open carry) is truly impossible as I understand it.
Despite all this we've seen at least three major terrorist attacks in France in 2015-2016. In all cases, the terrorists were heavily armed with guns like AK-47's (definitely illegal to own in France). Because Terrorists always get around gun control laws. And gun control simply won't prevent mass shootings or terrorist attacks.
And then Kim K gets robbed at gun point recently
In short, gun control does not work to keep guns out of the hands of criminals. The ONLY thing gun control does is keep guns out of the hands of law-abiding citizens who need those guns for self-defense.
As the GOA re-tweeted: "Its terrible that Kim Kardashian was held at gunpoint. Its worse that she couldn't shoot back." Amen to that.
2. Don't Flash Your Valuables And Location All Over Social Media
Kim K posted to various social media accounts days before the robbery both where she was and pictures of the valuables she had. Like this post from a few days earlier of a new ring worth more than $4 million according to some sources.
Obviously this let the robbers know 1. Where she was and 2. What valuable items she had that they could steal. The robbers specifically demanded to know where the ring was according to one source I read. They came looking for it because she advertised it.
Don't do this!
We all have stuff that robbers might want to steal.
Almost all of us also have Social Media accounts like Facebook, Instagram, Snapchat, whatever else is in fashion when you read this.
It's probably not a good idea to flash all the stuff you have that robbers might want to steal all over social media — along with — posting your location (or where you are going to be).
Be careful, because many of these social media accounts will automatically "tag" photos with GPS-derived locations — automatically putting you at risk. Find a way to turn off that setting and/or don't use it if at all possible.
And be careful what you post on social media that might display your wealth. This is a judgement call you'll have to make at where you draw the line. I know lots of gun guys that post all their guns on instagram … on the one hand they're advertising all the guns that they have that someone could steal … on the other hand they're advertising they're well armed.
Again, think it through — whatever you post on social media the entire world (including all the "bad guys") are going to see it.
3. You Should Learn How To Escape Common Restraints Because Home Invaders Like To Use These
TMZ posted a blow-by-blow of the home invasion robbery like this …
"Our sources say … Kim was lying in bed with only her robe on when she heard boots pounding up the stairs of her 2 story apartment.
We're told Kim saw at least one masked man and another wearing a police hat through a sliding glass door. She knew something was amiss, so she rolled off the bed and tried dialing her bodyguard on her cell phone.
Before she could finish dialing one of the men yanked the phone out of her hands. They zip tied her hands with plastic handcuffs and duct taped her to make it more secure. We're told one of the men grabbed her by the ankles … Kim told cops at that point she believed she was about to be raped.
The robbers duct taped her ankles, picked her up and put her in the bathtub. She then started screaming … begging them not to kill her because she had babies. She went on to say she had money and they could take whatever they wanted."
This is reality people.
In a lot of home invasions, the victims are restrained.
The criminals favor zip ties, rope and duct tape.
According to the U.S. Department of Justice, 1 out of every 5 homes will be the victim of a break-in or home invasion. And get this: 38% of violent assaults and 60% of rapes occur during a home invasion.
Kim K may only be alive and/or not raped because she is a celebrity. It's a sad truth that the police investigation and response would have been much more severe if a celebrity was killed/raped than if this was a "normal" Paris civilian who was not famous. The robbers may have left her alone because they feared the retaliation.
Either way, it would be good if you learned how to escape common restraints such as rope, zip ties and duct tape that home invaders like to use. It's not that hard and will go a long way towards keeping you calm in a situation like this.
My good friend and former CIA officer Jason Hanson teaches this in his Spy Escape & Evasion Course. This method #1 works well with zip ties and duct tape:
When you are getting ziptied, make sure you keep your elbows together and bend forward.
Next, you need to have the lock in the middle of your hands. This allows you to pop the lock, later. If the lock is not in the middle of your hands, you need to maneuver it, or use your teeth to reposition the lock.
Put your hands over the head, come down past your hips out to the side. The lock will pop right off.
The video below shows how this is done as well to get out of duct tape:
You can see method #2 here or check out his full live training course.
The Bottom Line Is That — No Matter Who You Are — Your Self-Protection Is Your Responsibility
Learn from Kim K's experience and these three tips.
Remember, even a celebrity with bodyguards and people paid to protect her can be vulnerable.
The cops can't help you in a situation like this.
I'm just very thankful that Kim's child wasn't with her that night.
Your self-protection and the protection of your family is YOUR responsibility.
and # 4. Put you nasty cans away.
HAHAHAHA wow – take it easy!
Yup, that gun control really works well, doesn't it?
#4 Don't travel with more displayed wealth than you can lose to thieves, even if your first name is "Kim". "You can't fix stupid". Sounds like an insurance scam ! No posted guards ? Thieves just happened to be driving by in police uniforms and randomly chose her rented apartment ? RIGHT !
I'm sure if you read the article, you'd realize they didn't just "randomly choose" her apt. They obviously monitored her social media accounts to see where she was staying and what jewelry she had. They specifically demanded the ring she displayed on instagram for example …
Hasn't she heard of fake jewelry when traveling?
YES! Since Victim Disarmament is the effect of gun control, it worked really well; AND she will end up with "a hitlery charge" for Insurance Fraud.
She never changed her routine and she let her body guard go to her sisters for her protection…..she is either using this for a insurance scam or her security people are just plain stupid….
Given she truly believes gun control keeps guns away from criminals — I'm willing to believe it is just naivete — that nobody would do this to her.
We already have gun control. If you don't think so, try to buy a gun. What we need is criminal control.
use common sense and don't carry all that stuff around. when your ego is as big as her butt is than you are looking for trouble. i still say this was all just a stunt to keep her show ratings from sagging as low as her bust and butt are.
what does (11mil$$) worth of jewelry even look like,maybe her
honey Ky, put a hit out on her stuff.,you know insurance, and all,
no matter you don't have a gun,you're a sitting duck.
Princess Fah-Tass lived through the ordeal. Too bad.


text:
Selling health insurance is a highly competitive way to earn a living. However, you can set yourself apart from the rest of the health insurance salespeople out there by incorporating an organized contact plan, strategic sales letters and an aggressive referral plan into your daily health insurance marketing plan.
Contact Plan
An effective contact plan ensures that you have a detailed record of each of your contacts, so you can quickly and efficiently work on every contact until a clear outcome is achieved--either you sell the contact a health insurance policy or the contact is no longer in the market for your services.
You can construct your own contact plan by first making a list of all of your current prospects. Then, write down how you can leverage yourself to get noticed by that contact, such as through networking functions, emails or in-person presentations. Then, write down how you can specifically help that person get the most coverage for their money. Finally, you will want to contact that person in a timely and professional manner until you have gained a definitive yes or no answer.
Well-written health insurance marketing letters can save you a lot of time prospecting new clients. The trick to writing attention-grabbing marketing letters is to send a series of letters that entices the recipient to want to hear about what you have to offer.
The first letter that you send to your prospects should be a light-hearted introduction letter that briefly explains your benefits and services and offers a free personalized consultation. Your second letter should pack a heavier punch by directly asking the prospect to give you at least 20 minutes of their time to take advantage of your personalized consultation. Your third prospecting letter should resemble the second letter, but offer a "last chance" appeal to present your services. You should use humor in your last-chance letter, such as enclosing a band aid with the words, "I got you covered" written on it to further entice your prospect.
Follow up with your prospects one to two days after your third letter to set an appointment.
Every sale you make is an opportunity to make new sales through a personal referral process. People are more likely to purchase your health insurance coverage if someone they know and trust has recommended you, so make it a point to ask your clients for referrals on a regular basis.
Adapt referral generation into your health insurance sales habits by asking for referrals in your initial agreements. Ask your prospects questions like, "If I do a great job handling your health insurance, will you give me a certain number of referrals per year?" You can also answer client compliments with, "I'm pleased that you are satisfied with my work. Who else do you know who can benefit from my health insurance services?"
Related Searches
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Ways to Sell Group Health Insurance
Being a group health insurance broker can be a very rewarding and lucrative specialization. Health insurance is a major area of concern...


text: To get from Termini Imerese a Vimercate by train you can catch one of the 7 trains that everyday travel between Termini Imerese and Arcore, the closest station to the city. The first train to Arcore leaves from Termini Imerese at 07:32 and the last train departs at 21:39. If you choose a local train the trip lasts on average 14:12 hours. On Wanderio you can compare all schedules, fares and railway companies to Arcore and book the best itinerary starting from Termini Imerese.


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|Message view
|« Date » · « Thread »
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|Vy Ho <st946...@drexel.edu>
|newbie - Getting mod_jk2.so to work
|Thu, 29 Apr 2004 19:40:17 GMT
I am running Mandrake 10 linux. Trying to use mod_jk2, but cannot get it to work. The apache version is 2.0.48, and tomcat version is 5.0.19. Both servers run fine on their own. I did not build the mod_jk2 binary, but tried both the Fedora and Suse version without success. I got no error in the error_log. The apache front page said it load things such as mod_perl, but does not mention the mod_jk2, is that an indication of something go wrong? I also check http://localhost/jkstatus but it says file not found. Basically, when I try to access: http://localhost/examples/..., it says page not found (apache), while http://localhost:8080/examples/... would work. How do I diagnos this? I use socket chanel for the communication. I search tutorial all over places, but I could not see where the problem is. I also searched the tomcat-user, but the archive does not have a good search engine, and it's so hard to find a good answer. Thanks you for your attention, VD. --------------------------------------------------------------------- To unsubscribe, e-mail: email@example.com For additional commands, e-mail: email@example.com
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text:
Holidays House Apartaments is a holiday home is situated in Rome is 600 metres from Piazza Bologna. The holiday home is 1.1 km from Villa Torlonia. Free WiFi is offered throughout the property.
There is a dining area and a kitchen. Towels and bed linen are featured in this holiday home.
Via Salaria is 1.5 km from Holidays House Apartaments, while Sapienza University of Rome is 1.6 km away. The nearest airport is Rome Ciampino Airport, 14 km from the property....
|via lorenzo il magnifico 35


text:
Beautiful Mattel 22" Mrs Beasley with glasses "Talks
- Sold for: Start Free Trial or Sign In to see what it's worth.
- Item Category: -
- Source: eBay
- Sold Date: Jan 16, 2012
- Channel: Auction House Sell similar item on eBay
22" Mrs Beasley is clean and in nice condition . Her hair has not been cut and She is missing no hair plugs but she does have some bedhead. She has her original apron, collar, and glasses. No chews on her hands or rubs on her face. She is from a smoke free home. Her voice box has been professionally repaired to talk and she talks excellent and will say all of her original phrases in her granny voice. A Couple of the phrases she will say when you pull her string are "You may call me Mrs Beasley. Would you like to play" "Do you want to hear a secret? I know one". This is the original doll from the 60's. it is not the newer reproduction. Buyer pays actual shipping. Fast shipping is available if wanted for Christmas.


text:
These North Face shoppers are true survivors. Did you ever think a shopping trip could make you feel like a superhero?
Watch as this North Face retail outlet puts its shoppers to the test.
Unsuspecting customers are completely oblivious to what is about to strike them. But to their credit, they fared pretty well.
Of course, it only makes sense if you are shopping for gear, you might as well be tested on your ability to use it.


text:
It's looking like if we can win our last three games against Crystal Palace, Aston Villa and Tottenham Newcastle could be safe this season but a let-down in any one of the games could also be fatal.
Rafa believes three wins will see Newcastle safe and the players seem o be ready to fight for their lives (so to speak) in the last three games – two of which are at St. James' Park – which we expect to be sell-outs for two of our most games in recent memory.
It also brings former manager Alan Pardew back to St. James' Park since he left early last year.
Rafa Benitez on the touchline at Newcastle


text:
Balancing Growth, Environment: Sweden Is Best
According to a report, Sweden does the best job of balancing growth and environment. European nations hold the first five positions.
"Germany was 13th, Japan 24th, and the United States 27th.Six developing countries -- the Dominican Republic, Belize, Guyana, Uruguay, Surinam, and Peru -- made it into the top 20 in the complex points system adopted by the report titled 'The Well-being of Nations,' which grades 180 countries."
Thanks to Abhijeet Chavan
Full Story:
Published on Wednesday, October 17, 2001 in


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Journal of Biomedical OpticsSpectral imaging technique for retinal perfusion detection using confocal scanning laser ophthalmoscopy
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Paper Abstract
To evaluate retinal perfusion in the human eye, a dual-wavelength confocal scanning laser ophthalmoscope (cSLO) was developed that provides spectral imaging of the fundus using a combination of red (670 nm) and near-infrared (810 nm) wavelengths. The image of the ocular fundus was analyzed to find out if quantitative measurements of the reflectivity of tissue permit assessment of the oxygen perfusion of tissue. We explored problems that affect the reproducibility of patient measurements such as non-uniformity errors on the image. For the first time, an image processing technique was designed and used to minimize the errors of oxygen saturation measurements by illumination correction in retina wide field by increasing SNR. Retinal images were taken from healthy and diabetic retinopathy eyes using the cSLO with a confocal aperture of 100 μm. The ratio image (RI) of red/IR, as oxygen saturation (SO2) index, was calculated for normal eyes. The image correction technique improved the reproducibility of the measurements. Average RI intensity variation of healthy retina tissue was determined within a range of about 5.5%. The capability of the new technique to discriminate oxygenation levels of retinal artery and vein was successfully demonstrated and showed good promise in the diagnosis of the perfused retina.
Paper Details
Date Published: 1 November 2012
PDF: 10 pages
J. Biomed. Opt. 17(11) 116005 doi: 10.1117/1.JBO.17.11.116005
Published in: Journal of Biomedical Optics Volume 17, Issue 11
PDF: 10 pages
J. Biomed. Opt. 17(11) 116005 doi: 10.1117/1.JBO.17.11.116005
Published in: Journal of Biomedical Optics Volume 17, Issue 11
Show Author Affiliations
Seyed Hossein Rasta, Univ. of Aberdeen (United Kingdom)
Ayyakkannu Manivannan, NHS Grampian (United Kingdom)
Ayyakkannu Manivannan, NHS Grampian (United Kingdom)
Peter F. Sharp, Univ. of Aberdeen (United Kingdom)
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PIP Bolle' Boss Safety Eyewear
High impact 2mm polycarbonate lens with anti-fog/anti-scratch coated on both sides
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