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J Cancer 2019; 10(1):205-210. doi:10.7150/jca.26298 This issue Cite
Research Paper
1. Department of Dentistry, Miyagi Cancer Center
2. Department of Head and Neck Surgery, Miyagi Cancer Center
3. Department of Plastic and Reconstructive Surgery, Miyagi Cancer Center
4. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine
Background: Extensive resection and free-flap reconstruction surgery has become the standard treatment for locally advanced head and neck cancer. Surgical site infection (SSI) is one of the serious complications of this treatment. This study aimed to investigate the risk factor for onset of SSI, particularly focusing on whether preoperative professional oral health care in cooperation with general dental clinics is effective in reducing the occurrence of SSI.
Methods: From March 2003 to August 2011, 183 patients who underwent head and neck free-flap reconstructive surgery by the same plastic surgeon at Miyagi Cancer Center for Head and Neck Surgery were investigated retrospectively.
Results: Of the 183 patients, 135 and 48 were men and women, respectively, with a mean age of 62 (range, 29-82) years. The tumor was located in the oral cavity (n = 76), hypopharynx (n = 55), oropharynx (n = 28), and others (n = 24). Clinical stages were stage I/II in 18, stage III/IV in 164 patients, and benign tumor in one patient, based on UICC classification. SSI occurred in 66 patients (36.1%). Based on multivariate analysis, professional oral health care [P = 0.0076, odds ratio (OR) = 0.39] and radiation therapy history (P = 0.0214, OR = 2.820) were shown as factors that are significantly related to SSI.
Conclusion: This study identified history of radiation therapy as a significant risk factor for SSI from univariate and multivariate analysis and revealed that patients receiving preoperative professional oral health care at general dental clinics reduce the risk of SSI. Preoperative professional oral health care in cooperation with general dental clinics has been shown to reduce SSI of head and neck free-flap reconstructive surgery.
Keywords: Head and neck tumor, free-flap reconstructive surgery, Surgical site infection, Professional oral health care, Medical collaboration, general dental clinic
Since the 1980s, extensive resection and free-flap reconstruction surgery has become one of the main treatments of locally advanced head and neck tumor, and treatment outcomes have improved [1,2]. However, surgical site infection (SSI) is one of the serious complications after head and neck tumor free-flap reconstructive surgery, accounting for >40% of all complications [3,4,5], which may be because the surgery is performed at a surgical site where oropharyngeal bacteria are readily exposed to the skin, mouth, and pharynx, classified as class II (clean-contaminated wound area) in the surgical wound classification of the CDC guidelines [6]. SSI causes discomfort and psychological stress, resulting in longer hospital stay and increasing medical expenses. In addition, deterioration of the general condition of the patient, such as nutritional status, not only significantly impairs the patient's quality of life but also delays the start of additional treatment and affects the survival rate [7].
Many risk factors for SSI during head and neck tumor surgery have been reported. Based on the CDC guidelines, risk factors include American Society of Anesthesiologists' Association (ASA) scores, age, nutritional status, smoking, and diabetes [6]. Based on previous multiparameter studies, many risk factors for SSI, such as cervical metastasis, albumin level, hemoglobin level, and oral hygiene status, have been found determined [8,9,10,11,12]. However, comparing these definitions for SSI is difficult because are in these studies, and the characteristics of patients (e.g., proportion of cases of free-flap reconstructive surgery) are different.
The oral bacterial count has also been reported to be suppressed by oral health care performed by dental practitioners preoperatively, and it is effective in reducing the incidence of SSI in patients undergoing head and neck cancer reconstructive surgery [13]. During the study period, there was no dental department in our hospital; the head and neck surgery department provided preoperative oral care in cooperation with the general dental clinics in the area for patients undergoing head and neck tumor free-flap reconstruction surgeries from March 2005 onward.
The purpose of this study was to clarify the most important risk factor for SSI after head and neck reconstruction and to identify effective strategy for preventing SSI. In particular, we focused on whether preoperative professional oral care in cooperation with the general dental clinics in the area is effective in reducing the occurrence of SSI.
From March 2003 to August 2011, 183 patients with head and neck tumor who underwent free-flap reconstructive surgery by the same plastic surgeon at Miyagi Cancer Center Head and Neck Surgery (Natori City, Miyagi Prefecture) were retrospectively investigated. This survey was conducted in accordance with the Declaration of Helsinki with the approval of the Miyagi Cancer Center Ethics Review Committee.
For all patients, the following methods were used:
SSI was judged based on the CDC guidelines [6]. SSI is defined as the presence of at least one of the following symptoms within 30 days postoperatively:
Clinical data were recorded; SSI, patient age, sex, tumor location, clinical stage, life history, medical history, and general condition were recorded. Preoperative intervention included preoperative tracheotomy, head and neck surgery, radiotherapy (defined as a dose of >40 Gy in the surgical field), and chemotherapy. Pre- and postoperative factors included mandibular resection, reconstruction, duration of surgery, bleeding volume, and blood transfusion.
The presence of diabetes mellitus was defined as a preoperative diagnosis of borderline or more severe diabetes mellitus. The general conditions were as follows: anemia was defined as a hemoglobin concentration of <8.5 g/dl; hypoalbuminemia was defined as a serum albumin level of <4.0 mg/dl; diabetes mellitus was defined as a fasting blood glucose level of ≥200 mg/dl; and poor performance status was defined as an American Society of Anesthesiologists Physical Status score ≥3.
All patients received an explanation about the necessity of professional oral care from doctors and nurses at the visit to the hospital head and neck surgical outpatient and recommended dental examination within a week from the day of surgery. Based on self-determination, patients who visited a general dental clinic underwent oral examination, dental plaque and dental calculus removal, and professional mechanical tooth cleaning, and severe periodontitis and severe caries were extracted. Furthermore, it was guided by dentists and dental hygienists regarding the necessity of oral cleaning and self-care method.
Patients in both groups brushed their teeth and performed self-oral cleaning preoperatively; the oral cavity was cleaned thrice a day by a nurse using a sponge brush immediately postoperatively until oral feeding was resumed. We gradually increased self-care after starting oral feeding.
Statistical analysis was performed using SAS version 9.3 (Cary, NC, USA). We examined the relationship between each variable and SSI using univariate analysis. Categorical data and continuous variables were tested using Fisher exact test and Wilcoxon signed rank test, respectively. Variables with P < 0.05 in the univariate analysis were subjected to multivariate logistic regression analysis for identifying variables that are independent of SSI. P < 0.05 was considered to be statistically significant.
Table 1 shows the characteristics of patients. The mean age of patients was 62 (range, 29-82) years. Of the 183 patients, 135 and 48 were men and women, respectively. In total, 66 patients received professional oral health care at the general dental clinic, whereas 117 patients did not. Tumor locations include the oral cavity (n = 76), hypopharynx (n = 55), oropharynx (n = 28), cervical esophagus (n = 7), and others (n = 24). Clinical stages were stage I/II in 18 patients, stage III/IV in 164 patients, and benign tumor in one patient, according to the UICC classification. The tumor recurred in 10 patients. Free abdominal femoral (n = 23), free fibular (n = 6), free forearm (n = 9), free abdominal (n = 80), free jejunal (n = 63), Latissimus Myocutaneous (n = 1), and Scapular (n = 1) flaps were constructed.
Patient characteristics
Characteristic | Patients | (%) | |
Age | <65 years | 103 | 56.3 |
≥65 years | 80 | 43.7 | |
Sex | |||
Male | 135 | 73.8 | |
Female | 48 | 26.2 | |
Location | |||
Oral cavity | 76 | 41.5 | |
Hypopharynx | 55 | 30.1 | |
Mesopharynx | 28 | 15.3 | |
Cervical esophagus | 7 | 3.8 | |
Maxilla | 6 | 3.3 | |
Salivary gland | 6 | 3.3 | |
Larynx | 4 | 2.2 | |
Thyroid | 1 | 0.5 | |
Performance status | |||
1 | 56 | 30.6 | |
2 | 102 | 55.7 | |
3 | 24 | 13.1 | |
4 | 1 | 0.5 | |
Clinical stage | 0/x/benign | 4 | 2.2 |
SSI occurred in 66 patients (36.1%). The incidence of SSI in the group receiving professional oral health care was 24.2% (16/66), whereas that in the non-receiving group was 43.6% (51/117). Univariate analysis showed significant differences in terms of professional oral health care (P = 0.011) and radiotherapy history (P = 0.042) (Table 2). Multivariate analysis revealed that radiotherapy history increased the risk factor [P = 0.0214, OR = 2.820], and professional oral health care reduced the risk factor [P = 0.0076, odds ratio (OR) = 0.39] (Table 3).
The median duration of surgery and blood loss were 596 (range, 284-1094) min and 390 (range, 50-1900) mL. Surgical time and blood loss were not significantly associated with SSI (Table 4).
Head and neck surgery, particularly head and neck tumor surgery with microvascular free-flap reconstruction, is the most invasive surgery, and the incidence of SSI is high (range, 36.4%-50%) [5,9,10]. In our study, the incidence of SSI was 36.1%. Majority of our patients have T3 and T4 disease (89.6%, 164/183) and have more advanced cancer than that reported in other studies. However, the incidence of SSI was similar to that reported in other recent research [3-5,9,10]. In our study, univariate analysis and multivariate analysis revealed that a history of radiation therapy increased the risk of SSI, and it was identified that professional oral health care at general dental clinics is a factor that reduces the risk of SSI.
Univariate analysis of preoperative and perioperative risk factors
Variable | Cases (%) | Surgical site infection (%) | P value |
Sex Male | 73.8 | 35.6 | 0.8617 |
Age ≥ 65 years | 43.7 | 38.8 | 0.5372 |
Poor ASA-PS (>2) | 13.7 | 44.0 | 0.3791 |
BMI(kg/m2) ≥ 25 | 15.9 | 31.0 | 0.6743 |
Albumin < 4.0mg/dl | 30.6 | 35.7 | 1.0000 |
Diabetes mellitus | 11.5 | 33.3 | 1.0000 |
Smoking | 68.3 | 36.0 | 1.0000 |
Alcohol | 36.1 | 68.2 | 0.2225 |
T-stage (T3+T4) | 73.2 | 38.8 | 0.2270 |
Clinical stages III + IV | 89.1 | 37.4 | 0.3311 |
Previous cervical operation | 10.4 | 42.1 | 0.6172 |
Previous chemotherapy | 16.9 | 45.2 | 0.3052 |
Previous radiotherapy | 13.7 | 56.0 | 0.0417* |
Professional oral health care | 36.6 | 23.9 | 0.0106* |
Reconstructive procedure | |||
Mandibulotomy | 31.7 | 39.7 | 0.5116 |
Maxillectomy | 7.1 | 53.8 | 0.2300 |
Bone reconstruction | 4.9 | 33.3 | 1.0000 |
Bone surgery | 36.1 | 39.4 | 0.5231 |
Surgery time (>10h) | 51.9 | 33.7 | 0.5390 |
Blood loss (>600ml) | 10.4 | 42.1 | 0.6172 |
Blood transfer | 4.9 | 55.6 | 0.2872 |
Tracheotomy | 93.4 | 36.8 | 0.5414 |
Results of multiple logistic regression analysis of wound infection
Variables | Odds ratio | 95% confidence interval | P value |
Professional oral health care | 0.39 | 0.20-0.78 | 0.0076* |
Previous radiotherapy | 2.82 | 1.17-6.82 | 0.0214* |
Relationship between patient characteristics and risk of surgical site infection (continuous data)
Factor | Overall Average | Average with SSI | Average without SSI | P value |
Body mass index (kg/m2) | 21.57 ± 3.49 | 22.04 ± 3.46 | 21.26 ± 3.44 | 0.1502 |
Duration of surgery (min) | 600± 108 | 615 ± 107 | 592 ± 108 | 0.166 |
Blood loss (ml) | 332.9 ± 292.7 | 371.2 ± 338.9 | 311.2± 262.3 | 0.184 |
±Standard deviation.
Microorganisms in the oral cavity are sources of SSI pathogens [14]. Preoperative professional oral health program significantly reduces wound infection after oral cancer surgery [15]. The results of this study were supported by these reports. There are two features of this research. First, the effectiveness of professional oral health care was proven to be applicable to oral cancer surgery as well as to head and neck tumor free-flap reconstruction surgeries. Second, professional oral health care is not performed only by dentists in the general hospital, but by medical collaboration with the community dental clinic. This is a beneficial result for a hospital with head and neck surgery without dentistry. It is also beneficial for patients to access a local dental office for consultation for treatment to be effective.
The reason why SSI is alleviated by professional oral health care administered preoperatively at the dental clinic is considered to be due to the following features of the oral cavity and pharyngeal region. The oropharynx has complicated structures and organs that are not anatomically uniform. Particularly, the oral cavity has a surface area of approximately 220 cm2 with many niches (tooth, buccal mucosa, tongue, mouth cavity, gums, etc.), and the surface is covered by a biofilm. More than 700 kinds of bacteria inhabit the oral cavity, but only 54% can be cultured [16]. Bacterial harvesting in the oropharynx requires testing sticks of the surface of the tongue (dorsal tongue), accounting for 12% of the intraoral area [17]. Therefore, only species of bacterial flora in the oral cavity can be evaluated. This may be one reason for the deviation between the result of bacterial culture of the SSI Wound Department and the result of the oral bacteria test. Saliva covering the oral mucosa contains 109 bacteria per mL [18]. The tooth covers 20% of the oral area, and the biofilm (dental plaque) attached to the surface contains 1 billion bacteria/mg [19]. Generally, pathogenic bacteria are detected at clinically low levels [20, 21]. However, the number and proportion of pathogenic bacteria increases in pathological conditions [18]. Oral diseases are speculated to occur because of harmful changes in the natural balance of microorganisms [22, 23]. A biofilm is formed several minutes after tooth surface cleaning, and bacterial flora changes as time passes. Oral streptococcus is the main facultative anaerobic bacteria present in the oral cavity. However, without self-care and professional oral health care, it becomes a complex biofilm containing many anaerobic bacteria after 7 days, such as gram-negative bacillus spirochete [24]. They are diffused into the saliva and are speculated to be reservoirs for oropharyngeal region/upper respiratory tract infection. Pathologically increasing oral streptococci will also break down salivary pellicles on the mucosal surface and thereby produce enzymes that expose adhesion receptors to pathogenic bacteria [25, 26].
Oral biofilm (dental plaque/dental calculus) removal is impossible with antibiotics [27]. Mechanical destruction and elimination by removal of dental calculus and professional mechanical tooth surface cleaning are the only methods to remove these diseased biofilms [28]. Immediately after 1 or 2 weeks of treatment with this method, the total number of subgingival organisms decreased 10- to 100-fold and the proportions of culturable gram-negative organisms and anaerobic organisms decreased 3- to 4-fold or more. [29]. These previous findings support the rationality of the present study, which demonstrated significantly reduced occurrence of SSI by performing self-care daily and professional oral health care at general dental clinics once every 1 to 7 days before surgery [15].
In this study, radiation therapy history was identified as a risk factor for SSI in univariate and multivariate analyses. In multivariate analysis by Lee et al., radiation therapy history [10] was a risk factor for SSI after head and neck surgeries (OR, 2.85). Radiation has been shown to have pathophysiological effect, poor wound healing, and delayed infection [30], which are consistent with our results.
Hypoalbuminemia is the evaluation item that determines whether the nutritional state is a risk factor. Nutritional status is believed to be related to poor healing of tissues, decreased collagen synthesis, and granuloma formation on surgical wounds. In this study, no significant relationship was found between albumin and hemoglobin levels. Accurately determining the nutritional status was impossible because the examination was performed 1-14 days preoperatively, with the half-life of blood albumin at 14-20 days, and dehydration due to difficulty in oral ingestion.
This research has limitations. First, it is an observational research conducted at a single facility. In addition, the preoperative dental condition is not included in the evaluation items. This is because information on the dental condition from the requested dental medical institution could not be obtained. The presence of tooth defects, such as dentures [15], has been reported to be a risk factor for SSI in univariate analysis, but the preoperative dental condition of patients with head and neck tumor is not a serious risk factor for SSI [31]. Therefore, we speculate that quantitatively evaluating and analyzing the condition of the patient's teeth are difficult because each patient may show various dental conditions. Currently, there are methods for quantitatively evaluating various oral hygiene/dental conditions (e.g., OAG [32] and OHAT [33], serum levels of blood-related periodontal disease bacteria [34], and antibody titer). Considering cost effectiveness, prospectively considering whether these are effective as evaluation items is necessary.
In conclusion, this study indicated that preoperative professional oral health care in cooperation with general dental clinics reduces the SSI of head and neck free-flap reconstructive surgery.
The authors have declared that no competing interest exists.
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27. Costerton JW, Lewandowski Z, Caldwell DE. et al. Microbial biofilms. Ann Rev Microbiol. 1995;49:711-45
28. Arweiler NB, Netuschil L. The Oral Microbiota. Adv Exp Med Biol. 2016;902:45-60
29. Slots J, Mashimo P, Levine MJ. et al. Microbiological and clinical effects of a single course of periodontal scaling and root planing, and of adjunctive tetracycline therapy. J Periodontol. 1979;50:495-509
30. Dormand EL, Banwell PE, Goodacre TE. Radiotherapy and wound healing. Int Wound J. 2005;2:112-27
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34. Dye BA, Herrera-Abreu M, Lerche-Sehm J. et al. Serum antibodies to periodontal bacteria as diagnostic markers of periodontitis. J Periodontol. 2009;80:634-47
Corresponding author: Masatoshi Usubuchi: Department of Dentistry, Miyagi Cancer Center, 47-1, Nodayama, Medeshima-Shiote, Natori, Miyagi Prefecture, 981-1293, Japan. Tel: +81-22-384-3151 extension 8847; Fax: +81-22-381-1174; E-mail: masatoshi-usubuchijp
Received 2018-3-26
Accepted 2018-10-23
Published 2019-1-1


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On the Coming Deluge of Non-Tenders
I'd like to specifically talk about how I think the COVID-19 financial ripples will impact the way teams approach non-tendering players this offseason. It's logical to assume that teams will be apt to non-tender players more often this year than ever before because of financial fallout from the pandemic, but based on recent trends, the game was perhaps likely to see a record number of non-tenders anyway. Here are the past 12 years of league-wide non-tender totals:
Year | Number of Non-Tenders |
2008 | 35 |
2009 | 39 |
2010 | 52 |
2011 | 29 |
2012 | 37 |
2013 | 43 |
2014 | 33 |
2015 | 36 |
2016 | 35 |
2017 | 25 |
2018 | 41 |
2019 | 53 |
Note that the two years with the fewest non-tenders are the years in which new Collective Bargaining Agreements were ratified, but largely the number of annual non-tenders has lived in the mid-thirties (with occasional spikes above that) until the last two seasons, when the number has climbed.
Why is the number of non-tendered players rising? The number of front offices who view the bottom of their rosters as fungible is growing. This type of thinking is also why teams more often shuttle several relievers back and forth between Triple-A and the big leagues during their option years. They'd rather a) slow down the rate at which those players accrue service time so they can be controlled for longer and b) have fresh, low-leverage relievers at the ready rather than keep their fifth-, sixth-, and seventh-best relievers on the active roster all the time, and you could argue it's fraught to assess your last few relievers (and beyond) with that level of granularity. They see relievers 6-10 (or so) as very similar to one another, especially if they're an org that has intentionally built depth in that area.
Often these types of relievers are accruing service time while their option years are simultaneously withering away. Once those happen in concert with one another, they need to be good enough to stick on the roster or else they are at risk of being non-tendered (that is, if they're not traded "downstream" to a worse team without as much pitching depth). Because teams have intentionally built this kind of depth, they often have comparable talents in the upper minors who can still be optioned.
Are there other types of players who are regularly non-tendered? Let's take a look at some notable names from the last several years to get an idea. These were included either because of the player's pre- or post-non-tendering performance, or their name/prospect recognition. I've abbreviated some names to keep the table from looking too hideous and also included links to source materials with a complete list of the players cut loose in each year. A hearty thanks to Jason Martinez as well as the people at MLB Trade Rumors who have been excellent stewards of this information for such a long time.
It's common for injured pitching, especially if those injuries are chronic and/or the pitcher has accumulated the kind of stats that influence arb salaries, to be non-tendered, as we see with Kris Medlen, Brandon Beachy, Domingo German, Drew Smyly, and several others.
For hitters, the players most often non-tendered are, again, the ones teams see as imminently replaceable: 1B/DH types who might post impressive stats in a vacuum, but because they're part of a deep, mashing position group, they're typically 1-ish WAR types who are getting deep into their arbitration years. There are lots of these. Jesus Aguilar, C.J. Cron, Mark Reynolds, Chris Carter, and on and on.
You also occasionally see volatile, ultra-aggressive hitters — who often have a very strong statistical season or two on their resume — non-tendered because teams don't trust them to repeat that peak level of production, like Avisail Garcia, Tim Beckham, and Jonathan Schoop.
There's also the "Infielders Without Power" bucket, home to Cesar Hernandez, Tyler Saladino , Yolmer Sanchez, etc. This demographic has been cut loose more frequently in recent years as heavier-hitting, shift-dependent infielders like Asdrubal Cabrera have become more prevalent.
Then we have catchers. There are several backstops non-tendered every year, and most of them were third or fourth on the depth chart and pressed into duty by injuries to 40-man occupants ahead of them, but then the team didn't want the backup to take a 40-man spot next year. Every once in a while one of them pans out in a pretty big way, with Tyler Flowers, Russell Martin, and James McCann representing the most significant of these.
Now that a universal DH seems to be on the horizon and electronic strike zones are just beyond it, sizeable changes are coming to the catching position. Without pitchers hitting, catchers will become the most desirable position for which to pinch hit, and roster expansion will enable teams to carry an extra catcher to facilitate this. An automated zone will eliminate the importance of framing and place emphasis on other catching traits (arm strength, ball-blocking), but it will likely take time for players who have been acquired and developed in this context to occupy the position across the league. Because there are so many, teams most frequently tell you what kind of players/traits they like via lesser, unsexy transactions, and I think it's now time to look for anticipatory patterns as it pertains to the future of catching.
Can the Mets, and Other Spenders, Gain Ground?
A market flush with more above-replacement talent could be a boon for teams willing to spend, as it presents them a unique opportunity to swiftly patch several holes in their roster and/or add depth to it. Under new ultra-rich ownership which wasn't subject to the MLB-specific financial cramps of 2020, the Mets are an obvious candidate for this, and they've already signed several players to minor league deals. The Phillies have deep pockets and obviously need to Frankenstein together a better bullpen for next season, but the fact that they did not leap at Brad Hand perhaps indicates they'll be less likely to throw money at their problems this offseason. The Blue Jays and Angels have similarly obvious needs.
Anaheim's proclivity for spending in free agency and their obvious needs on the pitching side are strong signals, but we don't yet know how new GM Perry Minasian will approach anything, and the way the club treated scouts during the summer is an indication, Arte Moreno may be more frugal for a while. The same caveat applies to John Henry's Red Sox, who could obviously accelerate their rebuild by adding high-priority non-tenders, even if they're just used as trade pieces later. The rebuilding, well-funded Giants are a logical fit, but their 40-man is quite full and they have several prospects worth adding before the Rule 5 deadline, so perhaps they lack the roster space to improve their team via non-tenders.
Will There Be A Non-tendered Player Diaspora?
I think it's fair to assume that not all of the non-tendered players will easily find a new job, so where will all the extra players go? The KBO and NPB should both loosen roster restrictions on foreign players to take advantage of this. Currently, KBO teams are only allowed to roster three foreign-born players — two pitchers and one hitter — who are allowed to make an annual maximum of $1 million. There are some ways that a signing bonus and incentives can override that limit, but not by a lot, and that capped amount creates a very narrow, circumstantial band of major leaguer who has financial incentive to play in Korea. There are similar rules in the NPB and CPBL, which limit teams to four foreign-born players on the active roster. Many of the players who are non-tendered in a given offseason would not only be upgrades for most pro teams in Asia, but many could become stars over there.
This, combined with the growing ease of global media access (you can VPN a Korean IP address and watch practically all the KBO games on Twitch) and the uncertainty surrounding 2021 sports in the United States due to our poor collective handling of the COVID-19 pandemic, makes for an interesting global viewership opportunity for the KBO and NPB if we have a gap in American sports at some point next year like we did in 2020. It's not as if they're going to pull stars overseas right away, but I submit that more ex-MLB player name recognition would increase the likelihood of baseball fans in the Western Hemisphere watching and engaging with Asian baseball, and it could also buoy the level of play, closing the gap between those leagues and the majors.
Later this week I'll examine the individual players who are candidates to be non-tendered.

subset: commoncrawl


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Double Up on Game Day Snacks!
Watching football games with our family is a great way to spend time together and share some tasty snacks! We love a classic veggie tray, but if you're looking for something heartier, we pulled together a few recipes that are delicious, easy to make, and perfect for enjoying on the couch (no silverware required).
The best part? You can use Double Up to buy the fruits and veggies you need in these recipes. Double the fruits and veggies = Double the delicious snacks!
Keep an eye out for Michigan-grown and -raised fruits and veggies the next time you Double Up at a participating store or market.
Chicken Pesto Flatbread
(Source: Michigan Farmers Market Association)
Start cooking chicken in the crockpot Sunday morning, assemble the other ingredients (like 2 cups of seasonal veggies) between the first and second quarter, and enjoy this delicious flatbread by halftime. Score!
Double Up on your favorite veggie toppings, pick up some cheese, tomato sauce, and whole-grain English muffins, and pop them in the oven for a healthy twist on a game day favorite. Want to add pepperoni or Italian sausage? Go for it!
Potato Nachos
They're like regular nachos, but even MORE satisfying. Plus, like the mini-pizzas, the topping opportunities are endless. Roasted cauliflower? Sure! Ground beef or turkey? Sounds good to us. Swapping out Greek yogurt instead of sour cream? Great call, coach!
PB&J Smoothie
Looking for a post-game dessert? This smoothie is a must-try with fresh strawberries and raspberries!
For more delicious ideas, check out our other Recipes!


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7 Dec – Three of Pixar's animated features finally will get the treatment they deserve - a chance on the big screen, that is.
According to an announcement by Disney, "Soul", "Luca", and "Turning Red" are the three Pixar movies which will finally have their day in cinemas, after going straight to Disney+ due to the pandemic prior.
"Soul", released in December 2020 and has Jamie Foxx and Tina Fey among the stars voicing the characters, revolves around a middle-school band teacher and aspiring musician who falls into a coma following an accident and seeks to reunite his separated soul and body in time for his big break as a jazz musician. The film will be released in cinemas on 12 January. "Luca", a coming-of-age fantasy film about a young sea monster boy with the ability to change into a human form while on land, receives a lot of good words but still landed on Disney+ instead when it was released in June 2021. It will be released on 22 March.
Meanwhile, "Turning Red", an entry from Canadian Domee Shi about a girl who transforms into a giant red panda when she experiences strong emotions, was somehow sent straight to Disney+ despite cinemas beginning to actively open in 2022. The movie will be on the big screen beginning 9 February.
It is said that the three movies were selected to be released in cinemas due to the slowdown in family movies in 2024 as a result of the previous WGA and SAG-AFTRA strikes.


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is an urban bag, working to improve conditions for the street minorities!!
Buy MINORITY BAG - improvement of environment and the street minorities
Minority BAG is not just a spacious city bag, you always can carry on shopping - it will create better environment by saving plastic bags.
The bag also makes a difference to the drug users and homeless people of Copenhagen who sell it on the street. The bag is designed to fit the street when you are living 24/7 whitout a home – when all you have is in a bag.
On the street from the street minorities 40 Dkr.
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That's why MINORITY cph is here.


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Cute cat with a "Rare USSR Analog Noisebox" as described in this auction and seen on matrixsynth.
"Two LFO waveforms
Two LFO frequency bands
Filter, echo block with LFO delay time modulation
Audio input, CV inAn interesting device using the sound from a gloomy drone to the sounds of dolphins. The device is filled with various sound effects and sounds.
Toggle switches of the Soviet military acceptance, will last a long time!
Also USSR transistors and microcircuits are a powerful base for a unique sound.
Another photo of this instrument.
Strangely, the auction appears to have been canceled. But I am intrigued by the idea of new instruments based on Soviet components, so we will see if it ever returns.


text: Publication date August 20, 2020 Publisher Delta Center for a Thriving Safety Net The Delta Center for a Thriving Safety Net funded the New Mexico Primary Care Association (NMPCA) and Behavioral Health Providers Association of New Mexico (NMBHPA) as part of the 2018–2020 State Learning & Action Collaborative. The two associations collaborated on several policy initiatives, including implementation of reimbursement parity for behavioral health services and funding the workforce, and also supported their members in moving towards value-based payment and care through joint training and conferences. The NMPCA also established a state-authorized clinically integrated network to support contracting for value-based, integrated medical and behavioral health services. The NMPCA and NMBHPA's work to advance value-based policy and payment has strengthened the financial sustainability of provider organizations, and effected a more unified and accessible safety-net health system. Download Resource


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The body mass index (BMI) provides an indication of how much fat mass a person has developed over time. If you have been told your BMI number is in an unhealthy range, you might be eager to shift the excess pounds to improve your health.
Thankfully, there are many actions you can take to lose unwanted weight and prevent the development of various health conditions, such as heart disease and diabetes. Read the below advice on how to reduce your BMI.
Set Yourself A Realistic Goal
Many people make the mistake of aiming to lose a substantial amount of weight when they first start dieting and exercising. However, you are more likely to stick to a healthier lifestyle by setting more realistic goals.
For example, you should start by aiming to lose 5% of your weight. So, if you weigh 200lbs, you'll need to lose 10lbs. By doing so, you could significantly reduce your risk of developing diabetes by 50%.
Once you have lost 5% of your weight, you should then review your goals to tackle the next challenge, which could be shedding another 5% or maintaining your weight loss.
Start Exercising
Exercise could be the key to preventing additional weight gain and shedding excess pounds. To lose weight and keep it off, you should embark on at least 150 minutes of moderate exercise every week or 75 minutes of intense exercise.
Also, you should cut yourself some slack when you first hit the gym, as you should start slowly and work your way up to a greater intensity, speed, and duration. You also should find a gym that will allow you to shake up your routine to ensure you're never bored. For example, you could sign-up to use The Club Fitness Facilities to step onto their various exercise machines and attend many fitness classes.
Learn About Nutrition
It can be difficult to choose from the many diets available. Instead, it might be helpful to talk to a dietitian to ensure you consume the right foods for your body and goals. Plus, they could provide advice for meal planning and how to eliminate unhealthy habits.
Make it your mission to learn more about nutrition, as you'll think twice about reaching for a candy bar or a bag of chips. It could change your viewpoint on food and help you to adopt healthier habits.
Be Consistent With Your New Routine
It is easy to feel disheartened when you don't lose weight at a fast rate. While you might be tempted to throw in the towel, you must continue with your new routine and be consistent with your efforts. You also must look for ways to help the pounds fall off, such as:
- Drinking more water
- Getting enough sleep
- Moving your body more
If you continue to diet and exercise and are consistent with your efforts, it will be a matter of time until you achieve your set goals and lower your BMI.


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Ignoring Central Banking policy decisions in formulating the best wealth preservation strategies is now essential. On 17 August at 2PM, New York time, the Federal Reserve bankers will release minutes from their last meeting and traders may move some markets sharply in a knee-jerk reaction to what is contained in these minutes. However, don't let any irrational responses to Federal Reserve bankers steer your focus away from reality and from the best wealth preservation strategies. I've been discussing the absurdity of planning the best wealth preservation strategies around Federal Reserve banker policy statements for a long time now. Just check out my entry here from nearly a year ago, in which I discussed how Central Bankers absurdly rehashed the same statement for six straight years without ever stating anything new. Then, in 2015, Central Bankers placed interest rate hikes on the table again, but again, absurdly have since issued identical statements with slightly different language that virtually never state anything enlightening or new. Just visit their website and pull any of the archived statements from the past two years and you will encounter, in every statement, language that discusses "possible" interest rate hikes if sufficient progress has been demonstrated in the US economy towards their realized and expected objectives of "full employment and 2% inflation".
If US Central Bankers really desired (1) fundamental growth in the economy, (2) sustainable stock market growth instead of artificial bubbles comprised of grossly distorted stock prices, (3) inflation that was really 2% or lower, and (4) anything close to full employment (none of which exist by the way), they would have voluntarily dissolved themselves in 1913 and let free markets set interest rates instead of artificially manipulating interest rates for Machiavellian purposes ever since. Those steps alone would have represented some of the best wealth preservation strategies ever for those planning for their golden years of retirement. In fact, I also posted commentary a year ago about how one can insulate oneself against falling victim to the lies of Central Bankers in their production of absurd "official" inflation and unemployment rates. In any event, in the absence of the liberating dissolution of Central Banks worldwide and allowing free market interest rates to exist, if Central Bankers were sincere about any of their proclaimed objectives of low inflation, full employment, sustainable economic growth, etc., they would have needed to start raising interest rates many moons ago. But they haven't.
In terms of silver and gold assets, we were consistent last year in stating that prices would continue to fall all year after a January spike to $1,308 an ounce gold and $18.50 an ounce silver, and because of our year-long negative outlook on gold and silver in 2015, we entered and quickly exited after short runs higher, and we were still able to return a positive, healthy 31.6% yield on our junior gold and silver mining stocks in our Platinum portfolio despite huge losses in the HUI gold bugs index of more than 50% from January 2015 to January 2016. In fact, you can follow this link to see how I warned back then, after the January gold and silver spike in 2015, that "even though gold [was] above $1211 an ounce now and silver ha[d] risen 1.96%…don't get too excited, because Western bankers [were] waiting nearby to hammer gold back below $1,200 again later [that] month." However, unlike last year, we have been likewise consistent in our belief that this year would produce a year-long rising gold and silver price trend, and instead of selling all gold and silver price spikes, as I advocated in 2015, I believe that all dips in PM asset prices should be bought this year, even those dips that may be created by absurd Central Banker policy statements. Buying physical gold and physical silver on significant price dips caused by Central Banker press releases will undoubtedly prove to be among the best wealth preservation strategies executed this year for a long-term plan.
For example, this past June, I explicitly stated that "much higher gold and silver prices [were] still ahead" and immediately after I wrote that article, in less than two weeks, gold surged 8.4% and and silver rocketed higher by 23.5%. Since then, both PMs have been consolidating in price, but whereas it was my belief in 2015 that all price spikes in gold and silver stocks should be sold, it is my belief that in 2016, all dips in gold and silver stocks should be bought. In fact, I reiterated this belief in this 26 July article I released after gold had fallen $67 an ounce in and silver had fallen $1.87 an ounce that month, by stating that the fall in gold and silver prices back then would "prove to be just a temporary lull in a strong continuing uptrend" that started at the end of last year, and discussed, how gold and silver stocks were still in a state of undervaluation last month.
In conclusion, even if Central Bankers raise interest rates again at some point in the future, as the title of my article states, we have traveled well beyond the point of no return for a long time now regarding interest rate policy solutions, and any knee-jerk reactions of immediate falling gold and silver prices in response to more hollow "hawkish" Central Banker minutes or even too-little, too-late, actual small interest-rate increases should be completely disregarded, with all eyes kept firmly on the big picture of the inevitable continuing fiat currency purchasing power destruction. No matter if Central Bankers raise interest rates or not in the future, they have firmly set the course for further and inevitable fiat currency purchasing power destruction, and this should be the unwavering focus of anyone's best wealth preservation strategies.
To learn when to buy the dips that develop during this continuing gold and silver price uptrend for all gold and silver assets, including gold and silver stocks, consider our Crisis Investment Opportunities newsletter and our Platinum Membership.
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•• Featured in issue 65 ••
In the next few instalments of my column based upon rhythm playing I am going to be taking a look into the world of utilising suspended chords and add chords over various bass notes that create ethereal textures within our rhythm part writing and playing. In this issues column, I have
created a track that demonstrates various usages of these type of chords mixed with wide interval 'modal' voicings that can be moved around to create different chordal extensions, some of which are outside of our traditional '7th' chord extensions. Be sure to check out the video section of this column to hear the example itself and hear what I have to say about the piece of music I have prepared for this column. I have also made a TAB available as PDF or Guitar Pro so you can see some of the voicings on paper. This can be helpful for really 'seeing' how these modal voicings move around and how they look on a traditional music stave.
BARS 1 – 8 The first section of this column, I started with a simple bass line. Eb, F to A. Over the top of the first two root notes, I used a specific voicing that when played over the bass note of the Eb and F would give us a 6/9 chord. A 6/9 chord is built from the following intervals:
1 – 3 – 5 – 6 – 9
These chord voicings may appear a wide stretch if you find them challenging to get to then try and voice only the top G, B and E strings of the chord voicings in order to highlight the 5th, 6th and 9th intervals. The Minor Second relationship between the 5th and 6th intervals creates a nice crunch, which makes these particular voicings of the 6/9 chord sound particularly beautiful. It's close to how maybe a piano player would voice these chords. When the bass line in this first section moves to the note A, I play a small shell voicing which implies the notes C, D and F#. These intervals over the note A spell out 1 – m3 – 11th – 13th. This is a very Dorian sound. Within the riff I swap between the high F# note and the open E string. When played with the open E string we are simply voicing the 5th over our Tonic A root note.
BARS 9 – 16 This is where the harmony gets very interesting. It's also where I stress that chords can be named a numerous amount of different technical names. For guitarists its best to simply these voicings, so they are understandable for musicians. As the guitar is often playing over instruments that can play a lower register, I feel it's best to notate these as slash chords for simplicity. As far as the voicings I am using here; they were chosen based on the top note melody of each chord. The basic melody here moves between E, D back to E then to G over the descending root notes C#, G, F# and F. In the video I analyse each of these voicings over the root note. Over the first voicing, we have an Asus2 over C# followed by a Gadd9. This is then followed by an Asus2 over F#, then what could be seen as Am7 (no 5th) over F (giving a Fadd9 tonality) This sequence is repeated, but on the G note, I play what could be seen as a CMaj7th over the G note, making it a first inversion CMaj7. The piece is finished off with an arpeggiated chord moving down an Fadd9#11 arpeggio with the final note on the 14th fret A tapped with the right hand in order to keep a legato flowing feel to the cascading slow arpeggio.
In Summary:
Hopefully, at the very least you've picked up some tasty new voicings for some very cool, abstract modal style voicings that you can use over fairly straight diatonic harmony. Be sure to check out the video section of this column for some interesting pointers on choosing voicings in different areas of the guitar for different harmonic situations. It's important to break some of these fingerings down into smaller chunks, especially if you're finding some of the stretches tricky. Either try them in different registers or using your new found knowledge, take some of the less important intervals out over the bass note. Until then, have fun and I'll see you in the next instalment of my look at rhythm guitar concepts, enjoy!


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CPC Newsletter 05/06/2018
Issue #174
Updated Guidance from Cabinet Office on GDPR and Procurement
Enhanced GDPR guidance issued on how the regulation affects contracts with suppliers.
Read article
Latest News Posts
Encouraging SMEs into our Supply Chains
The Cabinet Office have published Policy Notes, Consultations and Legislation to support SMEs…
Find out more
The Little Known Veloss Legal Case
CPC had a tender go to standstill and it created a very interesting conundrum…
Find out more
Framework Updates
Banner Pricing Changes
A price review has been completed across the Office Supplies agreement...
Find out more
Novation of Supplier on Grounds Maintenance Framework
Wright Landscapes are the new supplier on this framework...
Find out more
Framework Extension - Sports, Fitness and Gym Equipment Framework update
The majority of suppliers have agreed to extend the framework until 12th April 2019…
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Re-Tender of Outsourced Catering Services Framework
The re-tender is now live on CPC Sourcing Cloud for suppliers to bid for…
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New framework for Paint and Decorating Supplies
The new Paint and Decorating Supplies framework is designed to act as a one-stop-shop for all paint products and supplies…
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Latest from the Blog
12 months of CPC and Tenet Services
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Crescent Purchasing Consortium
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Unit 23, Leslie Hough Way
Salford, Lancashire M6 6AJ
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Copyright © 2018 Crescent Purchasing Consortium, All rights reserved.


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Today's environment is your disrupted world, and also ours. Advancing technology and changing business models have transformed the rules and risks of the game.
Businesses are demanding a broad mix of consulting services as they seek to address the myriad of challenges and opportunities presented by a persistently volatile and complex economic environment. Our Consulting experts work across the corporate health spectrum covering areas as diverse as profitability, transformation, technology, risk, growth, structure and operations.
No matter where you are in the business cycle, and whether it's advice on improving the performance of your business, deploying new technology, operationalizing a deal, or advice on how to handle risk and regulation – we can help.
How can we help?
- IT Advisory
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I know a Kolmogorov-Smirnov test will tell me if a sample distribution belongs to a normal distribution or not, with a certain probability (correct me if I am wrong?).
I performed a KS test on my data and got a p < 2.2e-16, which seems to indicate my distribution is normal?
Below is a histogram of my data with a normal curve overlayed.
If I am to make predictions with this data, can I use normally distributed confidence intervals? My main concern are the columns either side of the mean, that dont seem to fit the distribution.


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portland's best breakfast burrito?
5August 19th, 2009more restaurants (not LA), portlandon my recent trip to PDX, i used food fight grocery's vegan guide to portland to help find my way around town. on their list of places to hit up was laurelthirst public house. they even went as far as to call it,
"Portland's best breakfast, or so we think right now… The vegan breakfast burrito with their homemade sausage and salsa, can't be beat. Not even with the stick that is stuck up your uptight vegan butt."
naturally i had to check this place out.
we hit up laurelthirst on the last day of our trip, and as promised, their breakfast didn't disappoint. while it wasn't the best breakfast i had in portland, and laurelthirst only had a few a vegan options, what they did have was pretty damn good. i got the breakfast burrito, pictured above, which came with a large serving of home fried potatoes. inside the burrito was a hearty amount of tofu, whole beans, vegan sausage and super spicy salsa. it was all topped off with several cool slices of avocado, which added a perfect creamy texture. overall the burrito had a pretty smoky taste, and was packed with tons of heat. if you are a fan of breakfast burritos, this is definitely one to try.
my husband got the veggie hash with added tofu, which we confirmed was vegan. the overflowing plate came stacked with home fries, grilled vegetables such as broccoli, carrots & cauliflower, as well as thick chunks of scrambled tofu. a very simple breakfast, but super filling and tasty at a reasonable price.
inside, laurelthirst is a comfortable traditional pub with a long bar, several beers on tap, and ample seating. unfortunately, we were there too early to drink. it's sad because i don't think i've ever been in such a nice pub and not enjoyed a beer or two. oh well, there's always next time.
laurelthirst is just one more reason i can say portland is the best town i've ever visited. here we have a good pub, one that would make most LA bars ashamed of themselves, that just happens to offer up a damn good vegan breakfast with homemade veggie sausage and everything. i'm really looking forward to my next visit to pdx. if any of you guys have ideas about what the best vegan breakfast is up there, let me know.
Tags: breakfast, burrito, oregon, portland
2958 NE Glisan St
Portland, OR 97232-3271
(503) 232-1504
5 responses to "portland's best breakfast burrito?"
jennifer August 19th, 2009 at 09:22
i must go eat my way around portland using quarry-reviews as my guide 🙂
I love Portland! My best friend lives there so I am always asking "you need me to come visit again. right?" We have always had good breakfasts at Blue Moose Cafe (http://www.yelp.com/biz/blue-moose-cafe-portland).
I love the oatmeal blueberry chai vegan pancakes at Jam on Hawthorne. Love.


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Well, since cell phones are part of networks as well I am posting this in the Network security section.
Anyway, I promised some of you the Powerpoint presentation from Job de Haas about the Nokia mobile phone dos vulnerability.
This whas his presentation during HAL 2001, interesting for those of you who couldn't make HAL last year


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Aaron Rodgers' Girlfriend Danica Patrick Addresses Pregnancy Rumors
Former race car driver Danica Patrick lit up the Internet this week with an Instagram post that had fans speculating about if she was subtly announcing that she and her beau, NFL star Aaron Rodgers, are expecting. The ex-NASCAR star then had no choice after that but to address pregnancy rumors.
Here's how she responded to those rumors about having a baby with the Green Bay Packers quarterback.
What Patrick said about the rumors
The rumor mill started turning after Patrick shared on social media that she and her sibling had a great discussion about children and she got advice from her.
"My sister Brooke and I sat down for a chat, and it was really good! We covered a lot of topics, especially pertaining to kids, and — I got some good advice!
Realizing how many people interpreted her caption she added a note to the post a few hours later to clarify that she is not pregnant with Rodgers' child.
"NOT expecting!!!…. although I can see how the above text reads like that. *I must proof read better, perhaps – out loud."
Does she want kids?
Although she's not expecting now, Patrick has talked about wanting kids in the past and even had her eggs frozen.
"Full disclosure … I did IVF treatments, I froze my eggs, hormones, I gained four pounds, and I'm five foot one, so four pounds make a difference," she revealed during an interview on CNBC's Power Lunch. "I just decided I needed to try something new."
Patrick elaborated more on her decision at the time saying, "I was like, 'Look, I'm gonna take control of my life here, and I don't know where it's going, and I'm not married, and I don't know what the plan is. I just feel like it's one less concern. It's like one less thing to think about. And there's a lot of s**t to think about. Especially nowadays, when I have, like, five businesses."
How long Patrick and Rodgers have been together
In January 2018, Patrick confirmed that she and the NFL player were dating and explained that they started out as friends first.
"We've just been sort of friends the whole time, kept in vague touch and seen each other at the ESPYs almost every year, and other places," she said. "So one thing led to another, and we realized how similar we were, and yeah, that got the ball rolling."
The two have been going strong ever since so perhaps they will have a family someday but for now, it appears that they just enjoy being with each other and something they love to do together is travel. In April 2018, the pair embarked on a trip to India and met the Dalai Lama. Then in March 2019, the athlete whisked his lady away to Paris for her birthday.
Read more: Aaron Rodgers' Love Life: A Look Back At the Other Famous Women He Dated Before Danica Patrick
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Use at your own risk! Your data can not be retrieved once erased!


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- The Iron Post | Urbana, Illinois
The reconfigured 2-piece Triple Whip was kind enough to invinte us to play again in Champaign/Urbana. Click the thumbnail of the flyer for a closer view.
There was video taken of this entire show. I will post it as soon as I get full band approval. -Robert
And here, one year later, is that video:


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Tips for an AWESOME Stay at LEGOLAND Florida Resort
- Thursday April 8th 2021
- Banks Lee
- Hotel
Are you heading to LEGOLAND Florida Resort? I've got to tell you that the fun doesn't stop when the brick-tastic Theme Park and Water Park close each day.
LEGOLAND Hotel and Pirate Island Hotel have so much fun packed into them, you could spend a whole day there without leaving!
Here are some tips to OWN your stay. This vacation is going to rock. I bet my bricks on it!
Both LEGOLAND Hotel and Pirate Island Hotel have their own pools that are both heated and full of giant, floating LEGO bricks that you could totally use to dump water on your parents (you didn't hear that from us).
But did you know that the pools are open to guests staying at both hotels? It's true!
Even if you are searching for treasure in Pirate Island, you can still head over to the LEGOLAND Hotel's pool and take a ride on that awesome waterslide OVER AND OVER again!
One of our best-kept secrets is right behind the LEGOLAND Hotel: Florida's Wild Side Mini Golf! It's a total hole in one! See what I did there?!
This 9-hole mini golf course is on Lake Eloise and JUST for hotel guests! Be sure to keep an eye out for some LEGO wildlife during your game – you never know what sort of critters you may see.
Your parents can register for a round at the hotel front desk.
There are plenty of options to keep your tummy full during your stay, including FREE breakfast EVERY MORNING of your stay. Parents will agree that's a pretty sweet deal. Plus, it's UNLIMITED.
I know right? My brain exploded too. So don't be afraid to ask for some extra LEGO Brick waffles and stack them up to make a tower! Yes – playing with your food is totally acceptable.
Enjoying a family-style dinner at Shipwreck Restaurant? It's also all-you-can-eat, so feel free to ask for seconds AND thirds! That mac and cheese, #vacationgoals
Nothing says vacation like a super-fun-and-fancy drink, right? I mean the fancy drinks made just for kids! Say CHEERS with your parents with a kid-friendly "mocktail" at any of our bars.
I recommend the Birthday Cake Mocktail—it's a special one that's only available this year since we're turning the big 1-0 this year! It even comes with a candle to make your own birthday wish!
This is personally my favorite part of a hotel stay at LEGOLAND Florida Resort. If you are staying at LEGOLAND Hotel or Pirate Island Hotel, sign up for a FREE Master Model Building Session!
During these workshops, you will meet real LEGOLAND Master Model Builders as they give you some LEGO bricks and show you how to build an exclusive model that you can take home with you.
What's more epic than building your own LEGO model at surrounded by millions of LEGO at LEGOLAND Hotel with a LEGO Master Model Builder?
I don't know, really. I'm asking you, because this is #vacationgold
Best part is that the model changes daily, so if you are staying more than one night, you can sign up each day and get a new model! But heads up, space is VERY limited for these, so be sure to have your parents sign up each day at the front desk.
And this isn't even everything!
All of our hotels have games, play zones, surprise visits from LEGO characters, and more. I'm telling you, you'll have FULL VACATION BRAGGING rights and some really cool, fun stories to share with your friends after this vacation!
Kids, the newsletter information below this is for your parents. Please do not complete or provide any personal information unless you are at least 13.
Related blogs
Why 'THE LEGO MOVIE Masters of Flight' is my FAVORITE ride at LEGOLAND Florida
Wondering what adventure awaits you in THE LEGO Movie World? Learn what's waiting inside the Dog Theater for you!
Related blog posts4 Must Do's in the Water Park
Enjoy some fun in the sun at LEGOLAND® Florida Waterpark with these must-do attractions!
Related blog postsNew Burgers? Who This?
LEGO City Burger Kitchen Restaurant is cooking up some NEW meals you need to try!
Related blog postsCan't Miss Thrills at LEGOLAND Florida Resort
If you're looking for some wild rides that will even make your parents scream, we have just the thrills for you!
Related blog posts


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Their theoretical study focuses on the modulation of the optical properties of Spiro-Indo-diPhenylethene as a function of the environment.
Claire Houmard was recently awarded the Junior Professorship and reinforces the Societies and Environment of the Past theme in the Chrono-environment…
The Chrono-environment laboratory wishes you all the best for 2023
An article by Jonathan Lesven et al. published in the journal Quaternary Science Reviews
An article on innovation in water treatment, the result of a collaboration between Gregorio Crini and researchers from the Catholic University of Murcia…
People > Jobs & Careers
3 March 2018
CHARGE DU SYSTEME D'INFORMATIONS ARCHEOLOGIQUES (BDD) (Poste de catégorie A de la filière culturelle, Attaché de conservation du Patrimoine)
Date limite de réception des candidatures : 3 mars 2018
published on 12 February 2018


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Welcome to the outdoors where life is so much better…
MISSION – Over the next several weeks, let's take a better look between growing up as a kid in my generation as opposed to today's kids. While we're looking at this, let's explore some really simple things you can do to improve your child's chance of future health and success while making sure that he spends plenty of time playing outside >> after all, "Life is Better Outside"!
If you were to stop and think about it; you will probably be able to come up with a variety of ways why today's generation is different from that of yesteryear's.
One of the most drastic contrasts is the amount of time spent indoors! One might consider the lack of safe places to play outdoors; but when you stop to think about it, you might seriously consider the increase in time spent interacting with electronic games, the emphasis on scheduled activities and achievements and of course, we can't forget about concerns of sun exposure. Is this found only in our kids? When you stop and think about it; adults are just as guilty of spending less time outdoors as well!
This week, let's explore our first way playing outside can help our children:
• Sunshine! Mother Nature's Radiance! Yes, exposure to our sun – – especially sun burns can in fact increase the chance of skin cancer. But!!! As it turns out, our bodies need sun! Vitamin D, hmmmm…. Exposure to the sun is essential in the creation of Vitamin D which plays a crucial role in our immune system. Research shows that sun shine aids in attaining a healthy sleep as well as our mood. You might be surprised to find out that our bodies will generally work best when they get some sunshine every day.
Join us next week as we explore other ways how playing outside can help our children. In the meantime, visit us for some free air as you enjoy a walk on our .46 mile walking trail at Hollis Rutledge Sr. Park located at 3404 North Inspiration Road.


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I love options! Why? Because it gives me the power of choosing what suits me. There are lots of universities in Nigeria, but if you are looking to further your education in an institution run on Christian morals, then The Covenant University (CU) is your top option. Once you get admitted into this institution, you will conduct most of your processes on the CU student portal.
It is very important to learn about Covenant University portal because, CU uses portal to manage all the student information and details. Another reason is, students can access the CU portal from anywhere with a device connected to the internet.
How To Use The Student Portal
The first thing to visit the covenant university student portal via http://portal.covenantuniversity.edu.ng, you will land on the university's portal with a login prompt.
The web portal page has a login form for entering of username and password. And also, you can use the Forgot password option if you cannot remember your correct login details. Once logged in, students can do all their online clearance and access hostel allocation without having to visit the institution.
READ ALSO- How To Get Open University Abuja Form, The Registration Requirements And All You Must Know
All suitable qualified candidates interested in pursuing their higher education at CU will start the process by applying through the admission portal, which is different from what current students use. You should note that this application page requires your personal information such as name, age, and phone number. Once you have successfully registered, the next step is to log into your account to apply for your course you intend to study. Please note that when waiting for feedback, you can track the status of your application from the same account you created. And also, using the above process ensures getting admitted to CU will be easy and less stressful. Please during the application process, make sure you comply with all the requirements as stated below:
- All copies of your credentials should be in .pdf format.
- Your passport photograph should be in jpeg format and should be less than 100KB in size.
- All the originals of the uploaded documents should be present for sighting during the screening exercise.
The Covenant University School Fees
I know you have been wondering how much fees it takes to pursue an undergraduate program in this institution, right? The Covenant University school fees vary from one course to another. However, the range is between N817,500 and N882,500. And also, you need to be aware that the school fees keep changing, so there will be need to confirm with the institution by contacting their help desk or you can confirm via the covenant university official portal at http://covenantuniversity.edu.ng.
The CU official website also have all the other necessary details that all interested candidates might want to know. Finally, at least you now probably have a clear understanding of how you can use the covenant university web portal. You should also know that one good thing about this platform is that it provides convenience since you do not have to visit the institution to do some certain processes, which means it will save you the stress of going to the campus.


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So, I'm poking through the g-list wingnut sites (even added a coupla new ones to my blogroll) when I come across this little doozy from one of my favorites:
Sen. Judd Gregg gave a scary-yet-accurate picture of what America's fiscal outlook will look like blah blah blah scary black negro president blah blah blah socialist teleprompters fart (snip) Folks, this is from the guy Obama first nominated to be our Treasury Secretary.
Uhm....that's not quite right, sweetie.
But, c'mon, seriously - Treasury, Commerce...who cares? It's still all about money and shit, right?
Meanwhile, the usual half-wits have been too busy with such
I think Sparkie's lil' buddy, Dewey, said it best: Smartest thing he's EVER did was to turn that job down.
Hanx to LOLFed for teh awesome graphic


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Entries for the seventh annual Ōra King Awards are now open, with the 2019 program set to shine a light on sustainability in the hospitality industry.
Run by New Zealand King Salmon's premium foodservice brand Ōra King, the award's the innovation, imagination and technique of chefs around the world working with Ōra King Salmon. This year's theme challenges chefs from around Australia to draw on their own sustainability story and communicate this creatively in their Ōra King dish.
"We believe that the food industry has the potential to be a positive force for change," says New Zealand King Salmon Marketing Manager Foodservice Anne-Marie Friis. "Sustainability is pivotal to Ōra King. This year's theme lets chefs creatively demonstrate their personal sustainability journey.
"All our Ōra King chefs will be at a different stage of their sustainability journey. We are firm believers this is a journey the world is on together and we can't wait to see how the chefs communicate their different sustainability story in their dishes," she says.
This year's Australian semi-finalists will be judged by Jason Roberts, executive chef at The Bistro at Manly Pavilion, and Ian Curley, co-owner and chef at French Saloon and Kirk's Wine Bar, Melbourne.
"I'm really thrilled with this year's awards theme, sustain," says Roberts. "What drives me now is the sustainability of our ever-growing and changing food industry.
"It's imperative that we sustain ethical values by replenishing and reinvesting in the planet, and important that this ethos extends to our kitchens. I'm excited to see how Australian chefs show their own sustainability journey through the dishes they put forward in this year's awards season."
Chefs from Australia, New Zealand, North America and Japan compete for one of four titles for the Best Ōra King Dish in their respective region.
Entries for the Best Ōra King Dish Australia award are open now until July 31.
Six Australian semi-finalists will be announced on 12 August, with the three finalists announced on 16 September. All local and international finalists will be flown to the Nelson and Marlborough region for a four day all-expenses paid celebration from 13 to 17 October, with the Ōra King Awards ceremony taking place on 15 October.


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We strive to be a hospitable church, where everyone is welcome + feels like they're part of the family whether it's your first time or fiftieth time.
We have Hills Kids for kids age 6 months - 5th grade at all of our services. You can check them in at the Hills Kids Check In area to the left when you walk in the lobby.
We also have a middle school group for grades 6th-8th.
Our guests are invited to park up front - we understand how crazy it can be going to a church for the first time & hope that you feel welcome from the moment you drive onto our parking lot.
You're free to wear what you choose! Many people dress casually, while others dress up a bit more. You're welcome to come in jeans and a t-shirt, your work scrubs or even a suit + tie! We love diversity in all areas - even down to clothes!
Email email@example.com to join the team of incredible volunteers that make church happen each week! You can also check out our Hills Community Groups as they become available each semester!


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Neptune Energy awards technical services contract to TechnipFMC
Neptune Energy announced the award of a new contract to TechnipFMC for the performance of technical services in Norway.
The Technical Service Agreement (TSA) builds on an existing contract which has been optimized to fit Neptune's future requirements.
TechnipFMC will continue to provide a wide range of engineering, studies and technical services to Neptune Energy. This includes installation work and operational support for Neptune's development projects and producing fields.
Neptune Energy's Director of Projects & Engineering in Norway, Erik Oppedal, said: "The extended contract will build on the experiences from recent years' close collaboration between Neptune and TechnipFMC, above all their contribution to the successful development of the Neptune operated Fenja, Duva and Gjøa P1 fields."
Neptune Energy is the operator of the Gjøa platform in the North Sea, which currently acts as a hub for three subsea fields - Gjøa, Vega and Duva. A fourth field, WintershallDea's operated Nova, is due to be tied back for production later this summer. Neptune Energy also operates the Fenja development project in the Norwegian Sea.
Jonathan Landes, President, Subsea at TechnipFMC, added: "We are delighted to have this opportunity to build on the success of our integrated approach, and further strengthen our long-term partnership with Neptune Energy."
The new contract took effect July 1, 2022 with a potential length of 5+ years.


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The Board of the ICAS World group is committed to high standards of health and safety across the group. It is the policy of ICAS to look after the health and safety of its employees and visitors by:
The provisions in this policy apply to all legal entities in the ICAS group. An ICAS legal entity may additionally adopt more detailed policies and procedures to suit its particular business, legal and regulatory environment, provided they are consistent with this overall policy.
The group Chief Executive Officer (CEO) has overall accountability for health and safety.
The group Board is responsible for providing sufficient resources to meet the company's health and safety obligations.
The Director of Group Corporate Services is responsible for coordinating the implementation of this policy and reporting significant outcomes to the CEO.
In countries where the law requires a designated Health and Safety Officer, the Director of Group Corporate Services takes that role. Every ICAS office where more than 20 people work has a safety representative nominated by, or elected by, employees at that office. If there are two or more safety representatives at an office, a health and safety committee is established.
The CEO of each legal entity within the group is responsible for ensuring that relevant national health and safety laws are identified and complied with. As a UK company, ICAS International Holdings Limited must comply with the Health and Safety at Work Act 1974. The South Africa subsidiary must comply with the Occupational Health and Safety Act 1993.
Employees are responsible for taking reasonable care for the health and safety of themselves and of other persons who may be affected by their acts or omissions at work.
A health and safety risk assessment is carried out to identify what could harm people in the workplace. The assessment examines not only risks of physical injury but also risks of work-related stress. Any measures identified as necessary in the assessment are implemented. The risk assessment is reviewed annually and when there is a significant change in working conditions.
Some employees work at ICAS premises or in serviced offices arranged by ICAS. The company ensures that the working environment at these sites complies with national safety legislation, such as taking measures to protect people against fire and other environmental hazards.
Working at home is the normal arrangement for many employees. For employees who normally work in offices, working at home my occur temporarily for various reasons, if authorised by the employer. Employees who work at home are supported to meet standards of health and safety in their homes comparable to that provided in offices, ranging from the availability of ergonomic equipment and a first-aid kit to compliance with applicable working time regulations. Employees are encouraged to have frequent remote contact with their managers and other team members, to prevent problems potentially associated with isolation.
Employees must report all workplace injuries, accidents, near accidents and safety breaches to the Group HR Partner as soon as possible. The Group HR Partner must store all such reports and notify any serious accidents to senior management within 24 hours. Any lessons learned from accidents or incidents are used to prevent recurrence.
Employees receive information about health and safety as part of the induction process. Contracts of employment will state that working safely is a condition of employment. Disciplinary action will be taken if an employee has compromised their own or another person's health and safety.
Senior managers demonstrate leadership in health and safety.
ICAS takes reasonable steps to protect employees and others from transmission of the Covid-19 virus, in particular:


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School shootings. Market massacres. You've heard the tired debates – both sides saying the same things, repeatedly. And does either side ever get to the root of the problem?
I started a podcast: Gracearchy with Jim Babka
What's with the name?
Grace is the extra favor that empathetically reaches beyond tolerance and forgiveness, to understand and help those around us who need it.
The suffix -archy means ruler or government. You've heard of monarchy, rule by a king, or anarchy, no ruler. This is gracearchy — government by grace.
My first episode is about the gun debate.
Bill Protzmann is my show host. He and I were determined to go deeper, to drive towards the root of the problem.
The early reviews are in, and they say we did just that!
"Off to a fine start. The pacing just right. Not too short or too long. Your voice and message come through loud and clear."
"It was a thing of perfection. I thought I was going to have quibbles, but you fixed one of them toward the end, bringing the gracearchy concept back in a strong way. Great content, great delivery, perfect length."
Right now, the show is only on YouTube – on the AHO Radio Network.
And YouTube is a great place to start. You can see us when you screencast or use the app on your television. You can listen in the car or on a walk on your phone.
But we intend to put it on more podcasting platforms, soon like… Apple, Google, Podbean, and Stitcher.
To do that, the Zero Aggression Project needs merely $30 per month in new or increased monthly pledges.
One-time donations help, as well. They're tax-deductible if you itemize. We issue receipts in January for all donations totaling $5 or more.
Please check out my new show Gracearchy, and share it with potentially interested friends.
ZAP the State and have a nice day,
Jim Babka
Zero Aggression Project