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20 June 2022: Articles
A Case of Exacerbation of Haloperidol-Induced Rhabdomyolysis Following the Onset of COVID-19
Unusual clinical course, Challenging differential diagnosis, Adverse events of drug therapyKeisuke Takada1ABDEF*, Yukiyoshi Sada2ABDEF, Masaru Samura 1ABDEF, Masashi Matsuura1BDE, Naoki Hirose1DE, Takenori Kurata1DE, Fumio Nagumo1DE, Junichi Ishii1DE, Sakura Koshioka1DE, Masaki Uchida1DE, Junki Inoue1DE, Koji Tanikawa1DEF, Hiroyuki Kunishima3ADEF
Am J Case Rep 2022; 23:e936589
BACKGROUND: Rhabdomyolysis is a condition in which intracellular components are released into the blood and urine. Rhabdomyolysis can be caused by drug-related complications and COVID-19; however, the underlying mechanism is not clear. In this study, we report a case of rhabdomyolysis complicated by COVID-19, in which we presumed that the cause of rhabdomyolysis was related to prior administration of haloperidol by assessment of the drug history and progression of myopathy.
CASE REPORT: A 52-year-old man with schizophrenia experienced worsening insomnia 10 days before admission. Thus, haloperidol was increased from 1.5 mg to 3 mg once daily, and 2 to 3 days later, he developed hand tremors and weakness. One day prior to admission, the patient suddenly developed severe back pain. Based on the examination, the patient was diagnosed with COVID-19 complicated with rhabdomyolysis. Laboratory findings on admission were as follows: creatine phosphokinase: 41 539 IU/L; urinary myoglobin, 190×10³ ng/mL; and hematuria scale, grade 4. On day 1, he was started on saline infusion; therefore, haloperidol was discontinued. On day 2, the hematuria resolved. On day 5, the tremor, weakness, and back pain had resolved. On day 7, his creatine kinase level was 242 IU/L, and saline was administered.
CONCLUSIONS: It has been suggested that the onset of COVID-19 can exacerbate haloperidol-induced rhabdomyolysis. Therefore, if there is a complication of rhabdomyolysis and COVID-19, it is important to review the drug history, specifically that of haloperidol. We recommend hydration and discontinuation of haloperidol to avoid acute kidney injury, in addition to treating COVID-19.
Keywords: COVID-19, creatine kinase, Haloperidol, rhabdomyolysis, SARS-CoV-2, Acute Kidney Injury, Hematuria, Humans, Male, Middle Aged
Rhabdomyolysis is a condition in which the massive release of intracellular components into the blood and urine by degeneration and necrosis of skeletal muscle cells can be associated with acute renal failure [1]. As it is a life-threatening disease, prompt diagnosis is required to avoid acute complications. Rhabdomyolysis is known to be caused by drug-related complications [2]. It has been suggested that muscle toxicity caused by antipsychotics, including haloperidol, is mediated by serotonin and dopamine blockade [3]. The effect of haloperidol appears to be related to increased blood levels rather than the duration of administration [4].
There have been several case reports of haloperidol-induced rhabdomyolysis without the malignant syndrome [5,6]. There were 309 reports of haloperidol-induced rhabdomyolysis in VigiAccess™ (accessed April 2022) and 164 in the FDA Adverse Event Reporting System (accessed April 2022). In addition, rhabdomyolysis can occur as a complication of viral infections [7]. Furthermore, rhabdomyolysis in COVID-19 has been reported [8], but its mechanism and etiology are not clear.
In cases caused by haloperidol, rhabdomyolysis progresses slowly over several weeks [9]. Hence, there is a report that 78% of rhabdomyolysis cases associated with COVID-19 occurred after the onset of COVID-19 [10]. If the rhabdomyolysis progress did not fit the typical case of haloperidol-only and COVID-19-only involvement, then it may be a combination of these effects. Herein, we report a case of rhabdomyolysis complicated by COVID-19, in which we presumed that the cause of rhabdomyolysis was related to prior administration of haloperidol by assessment of the drug history.
Case Report
A 52-year-old man was diagnosed with schizophrenia several years ago, and pharmacotherapy was continued. One month before admission, his insomnia worsened. The medication was then changed from brexpiprazole 2 mg once daily (QD) to haloperidol 1.5 mg QD. Ten days prior to admission, insomnia persisted. Haloperidol was then increased to 3 mg QD, and 2 to 3 days later, hand tremors and weakness developed. One day prior to admission, he suddenly developed fever and severe back pain with difficulty moving, which prompted a consult at the Emergency Department. As a result of the examination, the patient was diagnosed with COVID-19 complicated by rhabdomyolysis and was admitted to our hospital. His medical history included diabetes mellitus, which was maintained with dapagliflozin 10 mg QD. There was no travel history or history of contact with COVID-19-infected patients. The patient's social history included no history of smoking.
The physical examination findings on admission were as follows: height, 176 cm; body weight, 85 kg; body mass index, 27.4 kg/m2; blood pressure, 120/87 mm Hg; pulse, 85 beats/ min; body temperature, 36.6°C; respiratory rate, 30 breaths/ min; saturation of percutaneous oxygen, 93% (room air); and consciousness, Glasgow Coma Scale E4V5M6. The psychiatric examination and mental status were normal. A chest examination revealed coarse crackles in the lower right lung. The pain was observed extending from the lumbar spine to the sacrum. Cardiac and abdominal examinations were normal, and no excessive sweating was observed. Neurological examination revealed severe tremor and weakness in both upper limbs, but without muscular rigidity, dysphagia, or akinesia.
Laboratory examination findings on admission were as follows: white blood cell count, 3.2×103/μL; lymphocyte, 650/μL; C-reactive protein, 6.11 mg/dL; creatinine, 0.82 mg/dL; lactate dehydrogenase, 1134 IU/L; creatine phosphokinase, 41 539 IU/L; ferritin, 1158 μg/mL; D-dimer, 0.8 μg/mL; urinary myoglobin, 190×103 ng/mL; and hematuria scale, grade 4 (Table 1). Loop-mediated isothermal amplification assays of a nasopharyngeal swab sample indicated SARS-CoV-2 infection. Chest computed tomography (CT) revealed bilateral peripheral ground-glass opacities (Figure 1).
The clinical course after hospitalization is shown in Figure 2. On hospital day 1, he was started on saline 1800 mL/day continuous infusion, remdesivir 100 mg intravenous (i.v.) every 24 h (q24h) (200 mg on the first day), dexamethasone 6.6 mg IV q24h, and oxygenation O2 1 L (nasal cannula). In addition, haloperidol and risperidone were discontinued. On hospital day 2, the tremor, back pain, and weakness reduced, and the hematuria disappeared. Additionally, his oxygen saturation level was maintained at >95%. The oxygen administration was discontinued. On hospital day 3, the tremor and weakness resolved, and on hospital day 5, the back pain resolved along with a decrease in creatine kinase (CK) to 2600 IU/L. On hospital day 6, the oxygen saturation decreased to 94% (room air), and oxygen administration of 2 L (nasal cannula) was restarted. On hospital day 7, his CK level was 242 IU/L; thus, he was administered saline. However, his oxygen saturation decreased to 94% (O2 10 L reservoir mask); therefore, he was administered a single dose of tocilizumab 680 mg i.v. and started on methylprednisolone 1000 mg IV q24h. On hospital day 10, the remdesivir was completed, and the methylprednisolone was changed to dexamethasone 6 mg PO QD. Subsequently, the dexamethasone and oxygen were administered, and the patient was discharged on hospital day 15.
In this study, we report a case of haloperidol-induced rhabdomyolysis followed by the onset of COVID-19 and exacerbation of rhabdomyolysis at the time of the onset of COVID-19. Immediately after starting the examination, the cause of rhabdomyolysis could not be determined. The patient was thought to have developed COVID-19 a few days before visiting the Emergency Department, and that COVID-19 was the cause of the rhabdomyolysis. Therefore, we reviewed his medical and drug history and revealed that the dose of haloperidol was increased owing to schizophrenia 10 days before the onset of COVID-19. Moreover, as for the musculoskeletal symptoms, tremor and weakness developed immediately after haloperidol was increased, and subsequently, severe back pain suddenly occurred on the first day of COVID-19. In contrast, the most common days of rhabdomyolysis onset associated with COVID-19 are within a week of hospitalization [11], whereas cases of rhabdomyolysis associated with haloperidol occur within 2 months of initiation or 3 to 7 days after a dose increase [4]. Moreover, the timing of the tremors and weakness suggest rhabdomyolysis in this patient was more related to haloperidol intake than to COVID-19. These considerations suggest that the cause of this rhabdomyolysis was strongly related to haloperidol, as the musculoskeletal symptoms developed before the onset of COVID-19. In this regard, it is recommended that a careful review of the medical and drug history should be completed to determine the cause of rhabdomyolysis in such patients.
Generally, CK elevation caused by haloperidol is a differential diagnosis of the malignant syndrome and rhabdomyolysis [12]. A previous report suggested that there is a risk of developing malignant syndrome when prior haloperidol decanoate administration complicates COVID-19 [13]. However, in our patient, no physical or neurological examination suggested a malignant syndrome; therefore, CK elevation was strongly suspected to be caused by rhabdomyolysis. Further, the differential diagnoses leading to rhabdomyolysis, other than haloperidol, were trauma, exertion, and other factors such as electrolyte and endocrine system abnormalities; however, these were considered unlikely after examination upon admission. To the best of our knowledge, there is no report of exacerbation of haloperidol-induced rhabdomyolysis at the onset of COVID-19, which is a rare case.
The related mechanisms of rhabdomyolysis, haloperidol, and COVID-19 demonstrate that they have similar effects on the dopaminergic systems. COVID-19 appears to cause disorders of the dopaminergic system [14]. Haloperidol-induced rhabdomyolysis was described as a consequence of dopamine blockade [3]. The common effect of these is depletion of the dopaminergic system. We then hypothesized that the occurrence of comorbidities exacerbates rhabdomyolysis. However, this hypothesis needs to be established in an experimental animal model.
By December 31, 2021, several cases of rhabdomyolysis and COVID-19 had been reported [8,15–20]. However, our patient was not screened for serum phosphorus, which is necessary to assess rhabdomyolysis and its complications. Therefore, the McMahon score [21] can estimate the severity score of rhabdomyolysis without measuring serum phosphorus, and this score ranges from 8.5 to 11.5 points to predict the patient's prognosis. This value indicates that the risk of death and conversion to renal replacement therapy was 30% (phosphorus <4.0 mg/dL) to 65% (phosphorus >5.4 mg/dL). Thus, the risk of prognostic failure in our patient was moderately high. In addition, there are a few reports of death in cases of rhabdomyolysis complicated by COVID-19 [8,19,22]. Most of the cases of death had initiated treatment on days 3 to 5 after the onset of COVID-19 symptoms. The reason for the avoidance of acute kidney injury and the survival of this patient was that he was diagnosed on the second day after the onset of COVID-19 symptoms. Furthermore, it was considered effective to immediately discontinue haloperidol and initiate the hydration and treatment of COVID-19.
The limitations of this study are as follows: First, this case was not analyzed for the SARS-CoV-2 variant; therefore, the results may not be identical for all cases of SARS-CoV-2. Second, this study is based on a single case, and therefore, it may not apply to all rhabdomyolysis complicated by COVID-19.
The association between rhabdomyolysis, haloperidol, and COVID-19 is hypothesized to be caused by a combined disorder of the dopaminergic system. Moreover, the onset of COVID-19 can exacerbate haloperidol-induced rhabdomyolysis. Therefore, if there is a complication of rhabdomyolysis and COVID-19, it is important to review the drug history, including that of haloperidol, before the onset of the disease to determine its etiology.
The recommended management strategies to avoid AKI and save lives are as follows. Early discontinuation of haloperidol and hydration should be achieved in the management of rhabdomyolysis.
FiguresFigure 1.. (A, B) Chest computed tomography showing bilateral peripheral ground-glass opacity. Figure 2.. Clinical course of the patient. RDV – remdesivir; DEX – dexamethasone; mPSL – methylprednisolone; TCZ – tocilizumab; CI – continuous infusion; CK – creatine phosphokinase; SCr – serum creatinine.
1.. Khan FY, Rhabdomyolysis: A review of the literature: Neth J Med, 2009; 67; 272-83
2.. Prendergast BD, George CF, Drug-induced rhabdomyolysis – mechanisms and management: Postgrad Med J, 1993; 69; 333-36
3.. Packard K, Price P, Hanson A, Antipsychotic use and the risk of rhabdomyolysis: J Pharm Pract, 2014; 27; 501-12
4.. Star K, Iessa N, Almandil NB, Rhabdomyolysis reported for children and adolescents treated with antipsychotic medicines: A case series analysis: J Child Adolesc Psychopharmacol, 2012; 22; 440-51
5.. Karre PR, Gujral J, Rodriguez E, Rhabdomyolysis with erratic serum creatinin phosphokinase levels: Intramuscular injection of haloperidol decanoate: BMJ Case Rep, 2009; 2009; bcr0620091931
6.. Marsh SJ, Dolson GM, Rhabdomyolysis and acute renal failure during high-dose haloperidol therapy: Ren Fail, 1995; 17; 475-78
7.. Ayala E, Kagawa FT, Wehner JH, Rhabdomyolysis associated with 2009 influenza A(H1N1): JAMA, 2009; 302; 1863-64
8.. Khosla SG, Nylen ES, Khosla R, Rhabdomyolysis in patients hospitalized with COVID-19 infection: Five case series: J Investig Med High Impact Case Rep, 2020; 8; 2324709620984603
9.. Yoshikawa H, Watanabe T, Abe T, Oda Y, Ozawa K, Haloperidol-induced rhabdomyolysis without neuroleptic malignant syndrome in a handicapped child: Brain Dev, 2000; 22; 256-58
10.. Finsterer J, Scorza F, SARS-CoV-2 associated rhabdomyolysis in 32 patients: Turk J Med Sci, 2021; 51; 1598-601
11.. Haroun MW, Dieiev V, Kang J, Rhabdomyolysis in COVID-19 patients: A retrospective observational study: Cureus, 2021; 13; e12552
12.. Meltzer HY, Cola PA, Parsa M, Marked elevations of serum creatine kinase activity associated with antipsychotic drug treatment: Neuropsychopharmacology, 1996; 15; 395-405
13.. Kajani R, Apramian A, Vega A, Neuroleptic malignant syndrome in a COVID-19 patient: Brain Behav Immun, 2020; 88; 28-29
14.. Rethinavel HS, Ravichandran S, Radhakrishnan RK, Kandasamy M, COVID-19 and Parkinson's disease: Defects in neurogenesis as the potential cause of olfactory system impairments and anosmia: J Chem Neuroanat, 2021; 115; 101965
15.. Byler J, Harrison R, Fell LL, Rhabdomyolysis following recovery from severe COVID-19: A case report: Am J Case Rep, 2021; 22; e931616
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17.. Samies NL, Pinninti S, James SH, Rhabdomyolysis and acute renal failure in an adolescent with coronavirus disease 2019: J Pediatr Infect Dis Soc, 2020; 9; 507-9
18.. Chedid NR, Udit S, Solhjou Z, COVID-19 and rhabdomyolysis: J Gen Intern Med, 2020; 35; 3087-90
19.. Solís JG, Esquivel Pineda A, Alberti Minutti P, Albarrán Sánchez A, Case report: Rhabdomyolysis in a patient with COVID-19: A proposed diagnostic-therapeutic algorithm: Am J Trop Med Hyg, 2020; 103; 1158-61
20.. Taxbro K, Kahlow H, Wulcan H, Fornarve A, Rhabdomyolysis and acute kidney injury in severe COVID-19 infection: BMJ Case Rep, 2020; 13; e237616
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So very little has changed this week, GT5:P is still going strong, there is a suprising lack of PS3 and 360 titles in the charts this week and for the first time on this site we are going to be looking at the DS and PSP sales as well
166,202 (+11%) 25,270,557
125,075 (+8%) 7,595,768
115,712 (-23%) 5,020,174
75,708 (-17%) 6,091,991
52,143 (-4%) 11,542,121
So the DS is easily the winner this week followed by it's big brother the Wii, However the PS3 is closing fast and the 360 is falling behind. The PSP is bringing up the rear.
What is interesting however is that the 360 now only has a 1.02 million lead over the PS3, however at the current rate the PS3 won't overtake the 360 for another 26 weeks.
When we look at the software charts we have a similar looking pattern
614,052 (268k on GT5 alone)
I am pretty sure Microsoft are not happy at all with those software figures….
VGChartz.com | Europe / Others Weekly Chart
Last Updated: April 8, 2008

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The following is a transcript from the Raised Catholic podcast. To listen to the podcast, click here.
Today is episode 33: What About the Kids?
Well, hello friends. Today's episode is kind of a challenging one for me. As some of you know, I write and record this podcast over the span of four or five days in a given week, and the topic is normally inspired during the course of my long run that week or while reading Scripture or some other epiphany time. The theme kind of rises to the surface somehow and then I just kind of start praying, researching, and writing. And this week, the following phrase kept coming to me: what about the kids. Hmmm.
I teach music with small children in preschools, enrichment centers, libraries, that kind of thing, and I've done this work for over eighteen years. I love it and as I return to in-person teaching, sometimes while wearing a mask, I am reminded of the strong connection that you can make with a child with just your eyes. You can see so much in a child's eyes, sometimes I could cry at the vulnerability that's right there on the surface, their emotion, and how much they long to be seen and known. In today's episode we're exploring a few angles on kids and the Church.
Well, we all know the horrific stories of how the Church has victimized children, how priests and religious have covered for each other in the ugliest form of clericalism, prioritizing their fellow priests over the welfare of kids. And we'd like to think that dark chapter is over, but then we hear more stories from the past and the present too, the reckoning that's never fully arrived.
This week ex-cardinal Theodore McCarrick became the highest ranking clergy member to face criminal charges for sexually assaulting a teenager at a wedding reception in the 1970s. By the time that happened, fellow cardinals and the Vatican too were well aware that McCarrick was abusing seminarians, but his status in the Church as a major player and fundraiser kept so many clergy quiet, and this silence allowed more people including children to be victimized over the span of decades. In our Church, they had no voice. No one speaking up for them, no one seeing the pain which is life-long, inescapable, family-wrecking trauma.
Then there was the recent discovery of unmarked graves at Church-run schools in Canada (and likely here in America too) of hundreds of indigenous children who were taken from their families with the goal of assimilating them into the primary culture. The stories have been out there for years in native communities, of the widespread physical, emotional, and sexual abuse, the neglect, of the infants born to the young girls who were housed there. Yet for decades, no one heard them. No one paid any attention. Though the USCCB has expressed support for the investigation here in the US by the Department of the Interior to find and identify similar sites, the reaction from the Church seems to me at least, muted. As a Church, we don't seem to lament well, we don't apologize readily, and our efforts in truth and reconciliation can seem hollow and halfhearted sometimes, don't they? I think of Jesus when He said, "If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea", and then I wonder if the His Church's reaction to the harm done to children quite measures up.
And all of this, plus the politicization of the American Church, has led to a full-blown credibility crisis right now, and this has impact for all of us but most particularly for the generation of kids that is rising into adulthood today. If you're listening to this podcast and you have teenagers, young adults, or even kids in their thirties, it will come as no surprise to you that the distrust of the Church as an institution has made a huge impact on church attendance and membership.
This group, particularly Gen Z, could readily be described as seekers. They're open, but generally speaking, they're not finding faith in the organization of church.
A two-year study by St. Mary's Press and the Center for Applied Research in the Apostolate at Georgetown which was released in 2018 indicated that the disaffiliation from churches among young people is at times associated with intensification rather than diminishment of personal faith. And that means they're finding God, just not in the pews.
And research from Michele Margolis's book: From the Politics to the Pews, which I'll link along with lots of other sources in today's show notes, suggests that the strong association between religion and the Republican party is fueling the divide in the American church.
Further, a poll by Gallup from this past spring has just 47% of American adults claiming membership in a church at all, and if you're listening to this podcast, you likely have stories about the members of Gen Z or millennials in your own family who are driving that statistic. I do. I remember teaching tenth grade confirmation CCD about five years ago to a class who largely identified as atheist, agnostic, or just plain bored. They didn't know why they were there. They didn't know why they were getting confirmed except that their mothers told them to. It was a challenging year for me as a teacher, and at the end of it, to be honest, I felt kind of helpless. I decided to write each student a letter with prayerfully chosen descriptive words just for them, and I told them the Church was not perfect, but that it was their home. This was all I could think of to do, to let these kids know that I saw them, and that God did, too.
Gen Z in particular is more engaged in activism and far more interested in social justice than the generations who came before them. They're idealistic, they value authenticity, they want to belong to something good and positive, they're caring for the people on the margins and the disenfranchised, and they're seeking justice for the oppressed. In my view, this capable and determined generation – if they encountered Jesus and His Gospel in a real and personal way would, as Catherine of Siena said, "be who God meant for them to be and set the world on fire."
So, what do we do with all of this? How do we reach them? What about the kids?
I come back to my experience with my young music students – their longing to be seen. And I remember the children whose Church-inflicted pain has never been fully seen and the kids who grew up in pews hearing more about how to do things 'the right way' from a Church that so often gets it wrong than about the reality that God made them for a purpose and loves them personally and fully.
I think we have to see them and somehow make a way for them to know the way that God sees and loves them too, just as they are, with unlimited possibility.
Jesus said, "Let the children alone, and do not hinder them from coming to Me; for the kingdom of Heaven belongs to such as these."
And friend, I think we have hindered them. It's not the Jesus or the Gospel they're rejecting, but it is the example and the messages they're hearing from the pulpit or Catholic media, or some in leadership that just does not sound like a loving God to them.
This problem is too big for any one person to solve and I don't have a roadmap. I won't recommend a program or a curriculum to you today. I'll just say that my prayer, for my young adult kids and for the kids they grew up with and for the kids I teach is that they feel seen, loved, and encountered by the Risen Christ in every day. I pray that God would send messengers and experiences of Christ's love to them in a way that will lead them forward in loving relationship with God in their life. And maybe you'll be that messenger for someone today. Maybe you'll see and pour into a child or teen or young adult with the faith that was given to you. I hope so.
The statistics do tell a dark story both in our past and for the future of the Church, but the Holy Spirit is bigger, and I do believe this generation will set the world on fire with the goodness and clarity of God but friend, it just may not be in the way we expect. So, let's be open and let's pray for them together.
In the name of the Father and of the Son and of the Holy Spirit, amen.
God, you create each soul to know you, so today we bring you the kids, the ones who are suffering and the ones who have not encountered you yet, the ones who have never felt seen and we ask you to be present to them right where they are and to awaken in them the fullness of your Spirit living within them. And help us to be Your Hands. Help us to see and to care well for the children in our midst, ever aware that their angels are always before You. And God, please let the Church – in its buildings and its clergy, but more importantly in us, the Body of Christ, be a safe place for kids to learn and grow. In the name of Jesus and under the mantle of Mary, we pray, amen.
Well, thanks for listening today friends. Blessings on you, your kids your grandchildren, your students – all of the precious kids in your circle, and I'll see you next time.


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Founder and Chief Executive Officer (CEO) of the Willing Ways Foundation Ghana (WWF), Madam Lydia Abena Manu has charged on the Government and all Ghanaians to adopt a system of making mental health care and addiction as one of their topmost priority from next year.
According to the CNN 2018 heroes award nominee and CEO of WWF, treatment of the mentally ill and addicts needs a united front and joint hands hence the need for everyone to get on board.
Madam Abena Manu made this appeal at Ahinsan old Post office drugs ghetto when she held a party for over 500 drug addicts and prostitutes whose lives have ended them homeless due to drugs and other social vises.
Some ghettos which were visited were Ahinsan old Post office, Kaase ghetto, Bantama ghetto, and popular drugs and prostitutes base B.B.
They were served with food, soft drinks, and pastries as well as second clothes.
Speaking in an interview with Otec News, Madam Abena Manu called on the Government to establish more rehabilitation centers and support the existing ones to make them effective. She said treating such illness needs time and monitoring of patients which can not be done without these rehabs.
She also called on Ghanaians to understand that mental illness and addiction are diseases, therefore, must be treated as such and not to always relate them to satanic disease.
Meanwhile, the former rapper now born again Evangelist Lord Kenya founder and head Pastor and congregation of the Face of Grace church at Adiebeba, who were partners of the charity ghetto party shared with the Word of God from the Bible and prayed for them. He advised them to begin thinking of how they will eliminate drugs and social vises lifestyle from their lives and with that they can change and become respected persons in the society. He recounted the bad times he went through whiles he was on drugs some years ago.
Evangelist Kenya, however, called on Ghanaians not to neglect persons who have landed in the ghettos rather get close to them, know their problems and help them and with that, there will be no or fewer drug addicts in our society.
The willing ways foundation is a Non-Governmental Organization (NGO) well known for the treatment of mental health issues, drug addicts and alcoholism is based at Ejisu Kwamo in the Ashanti region. The center has two rehabilitation centers for both sexes.


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About The Event
The AAPM Annual Meeting 2021 will bring together top experts and thought leaders in the fields of precision medicine, life science, biotech, medtech and pharma. With the theme as "Accelerating Precision Medicine and Transforming Patient Health," AAPM2021 is designed to bring the community together and serve as a leading forum for new medical breakthroughs as well as cutting-edge basic, translational, and clinical research. To fulfill this vision, AAPM2021 is showcasing thought leaders involved in innovative research, developing new capabilities, developing technological interventions to speedup the delivery of personal health. AAPM 2021 will also showcase new solutions to clinical and omics data collection, transfer, storage, analysis, security as well as designing and implementing new Big Data Solutions and artificial intelligence in the industry.
Who We Are?
AAPM is on a mission to accelerate the field of Precision Medicine through research, education, communication, and collaboration to foster new medical breakthroughs.
What We Do?
Through its programs and services, AAPM accelerates dissemination of new research findings among scientists and stake holders.
Register Now
AAPM Annual Meeting is the largest gatherings of thought leaders and stakeholders with a common goal to accelerate precision medicine.


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MEF has announced the first round of sponsors and partners supporting the MEF19 global networking event, held November 18-22, 2019 at the JW Marriott LA LIVE in Los Angeles, California.
MEF19 is the premier event showcasing network services for the digital economy – where transformation leaders converge and innovate. This year's conference is expected to draw more than 1,000 attendees from 270+ companies and 35+ countries.
"We are delighted by the incredible support that MEF19 has received from world-leading service and technology companies who are committed to delivering innovative networking solutions optimized for digital transformation," said Kevin Vachon, COO, MEF. "Expanding upon the MEF 3.0 framework, MEF19 will focus on accelerating the industry transformation to dynamic, assured, and certified services across a global federation of automated networks. Our action-oriented program will help service providers on their journey to transform their businesses, services, and networks; federate on a global basis; and certify that their services perform at the highest levels."
MEF19's current list of 30 sponsors includes leading service providers, technology vendors, and software services, network consulting, and testing companies.
Diamond Sponsors: PCCW Global.
Platinum Sponsors: AT&T, Comcast Business, Spectrum Enterprise, and Verizon.
Gold Sponsors: Orange Business Services, Equinix, Sparkle, Fujitsu, NEC/Netcracker, RAD, and Spirent.
Silver Sponsors: CenturyLink, ADVA Optical, Infinera, and Intraway.
Bronze Sponsors: Colt Technology Services, Tata Communications, Accedian, Amartus, Canoga Perkins, CDG, Champion ONE, Datavision, Iometrix, Inmanta, NoviFlow, and Telco Systems.
Activity Sponsors: Ufinet.
MEF19 will also be supported by dozens of industry research firms, media companies, enterprises, open source projects, standards organizations, and other event partners. Initial partners include:
Media and Analyst Relations:Witz Communications
Participating Industry Analyst Firms: ACG Research, ATLANTIC-ACM, Broadband Success Partners, Dell'Oro Group, Frost & Sullivan, Futuriom, Heavy Reading, Ovum, TeleGeography, and Vertical Systems Group.
Media: Light Reading, Converge! Network Digest, CIO Review, My Security Media, Telecom Reseller, TelecomDrive, Telecompetitor, and TyN Magazine.
MEF19 is the global event showcasing network services for the digital economy, where transformation leaders converge and innovate.
MEF19 focuses on accelerating the industry transition to dynamic, assured, and certified services across a global federation of automated networks. Emerging cloud-centric "MEF 3.0" services provide an on-demand experience with user- and application-directed control over network resources and service capabilities. These services are orchestrated across automated, virtualized, and interconnected networks powered by LSO, SDN, and NFV.
MEF19 has a target audience exceeding 1,000 professionals from 270+ organizations and 35+ countries. MEF19's content, networking, and special activities are designed to appeal to executives and other senior experts from communication and cloud service providers; enterprises; government organizations; network technology suppliers; systems integrators, open source projects, standards organizations; industry and financial analysts; investors; the press; and others.


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'Drug Court Changed My Life.' Counties Turn To Courts As One Way To Battle Opioids
Runners and walkers were cheered across the finish line at a recent charity run in South Williamsport. The goal was not only to win a half-marathon or 10K, but to raise money and awareness to counter addiction.
Among those cheering at the finish line was Dylan. He'll have been sober for two years in November.
"Drug court changed my life. It saved my life," he said.
Dylan, who's in his mid-20s, asked that we only use his first name. He broke his neck when he was 13 and was sent home with prescription painkillers. He says that's where his addiction started. It wasn't until he was 20 that he was introduced to heroin.
"And then one day, someone was like, we'll give you a bag of dope to drive us to Williamsport, and I didn't even know what it was. I was like, 'OK,' " Dylan said. "The rest is history, you know."
He started snorting heroin, then ended up shooting it. After going in and out of jail, he went to rehab, but nine months later relapsed, taking acid. He was in drug court, and turned himself in. He told them to send him to prison, but they didn't.
"They saw something in me that I didn't see in myself," he said.
As communities in Pennsylvania continue to look for ways to address opioid addiction, one option is a drug court. When Centre County was starting its new program it looked to Lycoming County, whose program is more than 20 years old.
Shea Madden is executive director of West Branch Drug & Alcohol Abuse Commission. The commission handles case management for Lycoming and Clinton counties' drug courts, working with people like Dylan.
"These are high risk, high need individuals that need this kind of structure," Madden said.
A participant could be someone who is on probation, but tests positive for drug use, or has new charges brought against them.
If they do go into the Drug Court program, that means working with Madden's office, meeting with the judge every other week, getting treatment, seeing their probation officer, going to self-help meetings. And getting frequent drug or alcohol tests or wearing a patch that can detect use. Participants are in the program for an average of 18 months.
The program is especially intense in the beginning. In exchange, the participant could get a reduced sentence.
"I think most folks would tell you that the program is much harder than sitting in jail and not having the responsibilities and you know the pressure to kind of you know do what they need to do in the program," Madden said.
Madden has been with the drug court since its start. She says she has seen people transformed.
"It gives me hope for everybody, not just people suffering from substance use disorders, but everybody," Madden said. "If there's something about you you want to change, you can do it."
Many Pennsylvania counties have drug courts. And, according to the National Association of Drug Court Professionals, they save money — from $4,000 to $12,000 dollars a person.
Cathy Arbogast, program administrator for Centre County Drug and Alcohol, helped start the county drug court in January. The goal, she said, is to serve those who are most likely to reoffend. That includes offering structure, resources and guidance to build skills to help them in the long-run.
"The behaviors that we're seeing, the charges that we're seeing really stem from an underlying addiction, and coming up with whatever solutions they need to survive and manage the demands of that chronic disease," she said.
Arbogast said there will always be people who think the approach is too soft.
"What we're seeing and what the research has shown is that the success rates for those that come through treatment court programs is much higher than it is for folks on standard supervision," Arbogast said.
Arbogast said they look to celebrate all levels of success.
"We just recognized someone who had clean urine screens for 30 days; she cannot remember the last time she had 30 days clean."
The county has nine participants now, and the program is designed to work with as many as 25.
President Judge Pamela Ruest is the judge for the drug court. Centre County has had a DUI court for several years. She said they decided to have a drug court because of the seriousness of the opioid epidemic.
She went to the DUI court program and the participants gave her advice.
"So some of the advice that I've received is that I should be open, honest and willing to work with the people involved, that I should have patience. Not one of my virtues, but I am working on that," she said. "Recognize that they're all individuals, even though they're all addicts. It was wonderful; I got wonderful advice."
Ruest said her father was an alcoholic who got treatment, and that helps her cut through some of the stories.
"I've heard them. I've grown up with them. I've heard the excuses. And, I've seen the struggles. I've seen how you can go a month without drinking and then relapse, or even longer," Ruest said. "It's a difficult process, but I've also seen that it can be done."
The program has its skeptics.
Rebecca Tiger, associate professor of sociology at Middlebury College, in New York, has studied and written about criminal justice systems and drug policy. She said historically drug problems tend to be made worse by criminal justice responses.
She pointed to approaches other countries are taking, such as decriminalizing drugs or having safe injection centers.
"Those responses don't demand that someone be abstinent," Tiger said. "It's at the moment you demand someone be abstinent and you have the force of the criminal justice system against them if they don't succeed, I think you've given over to criminalization, and you're not helping anyone when you do that."
Tiger said now is a good moment to think about what could work.
"So, the crisis around opiates, I think, is a really great chance to say, 'What we've done in the past hasn't worked," Tiger said. "What could we do differently?'"
Matthew Welickovitch was one of the runners in the 5K. To him, "This is a public health emergency."
Welickovitch is also an assistant public defender in Lycoming County. He's seen both sides of a treatment court.
Welickovitch applied to the Lycoming County treatment court after getting his third DUI in 10 years and facing a one-year prison sentence. He got kicked out of law school, but was able to go back and finish his degree at Penn State Law.
He now works with people — those who have abused drugs or alcohol — who are in a similar situation to what he went through — "getting them involved gives me a passion for my job, for what I do."
He said turning to harsher incarceration doesn't work.
"Every study that we look at screams that we need a different approach," Welickovitch said. "Treatment courts are a beginning for that, but there's still a lot of work to do in our criminal justice system."
Welickovitch and others say focusing on treatment and getting rid of the stigma are important steps.
This story is part of "Battling Opioids," a Pennsylvania public media collaboration focused on the opioid crisis.


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Sunday, March 18, 2018 - Naomi Osaka plays Daria Kasatkina in the Final of the BNP Paribas Open in Stadium 1 at the Indian Wells Tennis Garden in Indian Wells, California. (Michael Cummo/BNP Paribas Open)
Unseeded 20-year-old Naomi Osaka defeated 6-3 6-2 Daria Kasatkina to claim her first WTA Premier Mandatory title — or title of any kind. See the photos.


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CHARLOTTE, N.C. — Charlotte Mayor Vi Lyles says there are no words to describe Tuesday night's incident on 4th Street where protesters appeared to have been trapped between different lines of CMPD officers.
"Most of you are aware there was a video of the protest action that took place last night. And on that video it appeared to be a situation that there are probably not the words to describe the way that it appeared and how it acted and turned out," Lyles said.
Earlier Wednesday Charlotte-Mecklenburg Police announced it will conduct an internal review of its officers' actions after protesters said they were trapped and gassed in uptown.
Protesters say they were acting peacefully during a march when CMPD officers trapped them in a parking garage on 4th Street, using pepper spray and tear gas on the crowd. The department sees it a little different, with CMPD saying rocks and bottles were being thrown at officers during Tuesday night's protest.
"Last night is one of those nights that none of us can be proud of. That we wouldn't want to see happen in our city. But it did. And I hope everyone is aware that that's not the kind of department we want to have for policing. It's not the kind of reputation that we want to have nationally or locally," Lyles said.
Charlotte City Council met in closed session Wednesday and Lyles said the one thing all members agreed upon was hearing from residents.
"We need to make sure that we ask the questions: what is this pain causing you and what can we do about it," Lyles said.
The mayor announced an open forum will be held outside the Charlotte-Mecklenburg Government Center, 600 E 4th Street, Wednesday from 6 p.m. to 8 p.m. and again on Friday from 6 p.m. to 8 p.m.
"The Charlotte City Council, your mayor, all of us feel that we are in a particularly dangerous time right now. We can make a decision whether to actually work towards a better city or we can just sit and let ourselves be found in a place of darkness. I choose light over darkness any day," Lyles said.
At the open forum, city leaders spoke with community members that were angry over the incident. After a heated exchange, community members started chanting "walk with us."
Mayor Lyles did just that, walking off to lead hundreds to the streets of Charlotte.
Some accused Mayor Lyles of not answer many questions from the community at the event.
Later, Members of the Charlotte City Council and Mayor Lyles joined protesters taking a knee on 4th Street where the controversial incident happened Tuesday night. As a tribute to George Floyd, the group kneeled nearly nine minutes.
CMPD Captain Brad Koch took a knee with protesters as well, telling one woman it was "on behalf of the entire department."
Protesters also took a knee in honor of other victims killed by officers.
Once protesters reached the CMPD headquarters in uptown Charlotte, some started chanting "where's the chief."
Shortly after, it was announced that by popular demand the CMPD chief was on his way to talk to protesters — it was not clear if it was referencing CMPD Chief Kerr Putney or the future CMPD Chief, Johnny Jennings.
City Manager Marcus Jones also spoke during the news conference Wednesday saying in order to keep public trust they are bringing in the SBI to investigate what took place.
Jones said the SBI will review policies as they relate to policing and procedures. If the review finds any of that is incorrect, Jones said they will be fixed.
"If those policies and procedures are deemed to be adequate during this review, we're going to address them anyway," Jones said. "Because what occurred last night is a reflection of us and it's important that you continue to have trust in the leadership of the city."
Lyles said Charlotte Mecklenburg Police should release all body camera videos from the incident so that everyone can see what happened. She says the state law hampers that but they are working through it.
"That video is disturbing. No two ways about it," said CMPD Chief Kerr Putney during a news conference Wednesday. "And the other thing I need you to know is there are a lot of other angles and videos and perspectives that you need to see. "
Putney explained approval must come from a judge to release body cam video.
"And that is exactly what we're going to do," he said.
Putney said he reached out to ask the SBI to review the incident to determine whether or not any laws were violated. There will also be an internal investigation.
"I can't get into a lot of the specifics, but I can tell you I didn't like what I saw. I can't wait until I can share more," Putney said.
He went to to say this one incident overshadows all of the positive work the officers have been doing.
This is a developing story. Refresh this page for the latest from WCNC Charlotte.
More news:


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Below is today's College Crosse Scoreboard with all of today's results, box scores, and winning team recaps. Clicking on any Box Score will take you to that game's box score. Clicking on the Recap cell will take you to that team's recap.
College Crosse Scoreboard For March 10, 2018.
Press Row & Highlights
BOSS Desko and his lads talking to the media after the Hop game.
Highlights from the Hop vs. Syracuse game.
Shout out to the all the GOATs on the field for the halftime ceremony celebrating the 1988 & 2008 national champion Orange teams.
Check out the highlights from Towson's overtime win over Ohio State.
Duke took care of Loyola today.
Colgate was too much for BU today.
UMass Lowell vs. Manhattan highlights.
UVA vs. Stony Brook highlights.


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Um, okay, first full, we will start from Bitcoin, bald Bitcoin. Uh, well, I want show you our current, uh, support level. It's 9,000, 200, few floors. Is this slow? Uh, as you can see, price mates, um, at least two fake brick cows, his one and Zeus one. So, uh. And Zen. Bryce made a move up here and here. So what I expect if price will and nozzle one fake brick out in this case, we can open a long position to like a Zeus too.
Strong movements up after fake breakouts after previous fake breakouts of our support level. So I expect long, only after fake breakouts on, uh, after confirmation of, uh, support level. Okay. Next one is a terrarium bouts material, a Tyrian price. Also trades. Uh, Nia support LEL support little East 184 points.
So I did ours as this one. As you can see right now in upward trend. So we can trade a long position and, uh, after fake breakouts of our support level, we can open a long position, uh, for higher targets. As always, uh, also like on Bitcoin, uh, I expect that a terrarium will, will follow. If BTC will grow, a terrarium will also, uh, grow.
Okay. Uh, about a terrarium alone after five breakouts of support level Broadripple let's switch to two hour. Chart the bottle. Um, repo NOL traits also at both key level. Well, both support level. So a SUV size bonds, it have this level. Yeah. So many times too. Tree. So, uh, if price was bill reached our key level and made the fake breakouts in this case, we also can, uh, open a loan position by our trends because as you can see, our trend is uptrend and, uh, open a lot position after foot brick out of our key level.
Zero points, 24, $45. So in this case, it's will be the best, uh, the safe. Placed open long position for, uh, this top to, uh, cryptocurrency, uh, for, for today. Okay, guys, I hope it will be useful for you. Useful. Uh, so don't forget to push like button and subscribe, uh, because as you can see, it's the best Sanks from your side to me.
Okay guys, we should a good day. Uh, see you later. Bye.


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Food distributors US Foods says it will save more than 2 million kWh in 2011 by retrofitting lighting throughout the company. Since 2007, lighting retrofits have reduced overall energy use by eight percent, or 34 million kWh, the company said.
Additional energy usage reduction projects are expected to save another 3 million kWh in 2012, the company said, as part of its ongoing sustainability strategy.
In November the company activated a 905 kilowatt, 3,934 photovoltaic solar panel system at its Phoenix, AZ, division, estimated to generate 15 percent of the division's annual power needs. The system is leased from Del Solar. Two other solar installations operate in California, the company said.
US Foods is a certified EPA SmartWay partner for its management of fuel use and emissions. The company says it improved fleet efficiency by 5 percent by implementing strategies such as reducing idle times and routing deliveries efficiently. Energy-efficient, high-intensity fluorescent lights have also increased distribution centers' energy efficiency by 15 percent. The combined efforts saved more than $22 million, the company said.
US Foods has a line of compostable, biodegradable and petroleum-free disposable products, made with renewable resources such as corn, sugar cane and potato starch, and distributes EPA-certified equipment including fryers, ice makers, refrigerators and freezers.
According to its website, the company helped set up a composting program for one of its food service clients that reduced waste at the facility by 84 percent.


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The 2018 MTV Movie & TV Awards is airing tonight at 9 p.m. ET/PT, and E! News has an exclusive first look at host Tiffany Haddish's hilarious opening monologue. The show, taped Saturday at the Barker Hangar in Santa Monica, Calif., brought out dozens of stars, including Kristen Bell, Chadwick Boseman, Kris Jenner, Nick Jonas, Kim Kardashian, Chris Pratt, Yara Shahidi, Lakeith Stanfield and Lena Waithe—and a few of them made it into Haddish's act.
In the exclusive clip, Haddish says, "I'm always excited to see the Kardashians. That family is basically the Star Wars franchise, OK? They make a ton of money, a new one is always popping up and they're ruled by a bossy overlord who sleeps in a mask and she love black men, so yes!" Kardashian and Jenner, who were beside Olivia Munn, shared a big laugh over Haddish's joke.
"And you know who else I love? Zendaya. She taught me how to model. She told me how to model and I taught her how to grapefruit. What!" Haddish said, referencing her Girls Trip gag. "She 21 now, y'all! She a grown woman. You gotta know how to do that if you want a husband."
To see the rest of Haddish's killer monologue, watch the MTV Movie & TV Awards tonight—and check out Daily Pop and E! News for Sibley Scoles' exclusive red carpet interviews, only on E!.
Going into the show, Black Panther and Stranger Things lead with seven nominations each.


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Newly released emails from the office of Chicago mayor, and former Obama crony, Rahm Emanuel, show a coordinated effort with police and a supposedly independent police review board to "speak with one voice" in order to tamp down public reaction to the death of a black teen at the hands of a police officer.
Thousands of emails regarding the death of 17-year-old Laquan McDonald were made public on Thursday after The Associated Press and other media outlets requested them.
McDonald was shot 16 times in October 2014 and the emails show a concern from city officials that the release of the shooting video would cause massive protests and make Chicago look bad nationally, the Associated Press reported.
In early December 2014, Scott Ando, head of the Independent Police Review Authority — publicly touted by the mayor as uniquely independent in its probes of police shootings — singled out the case. He sent an email to the mayor's deputy chief of staff, Janey Rountree, with a link to a website that raised questions about police accounts of the shooting.
Emanuel spokesman Adam Collins sent a flurry of emails about media inquiries into video of the shooting. His subject line on a Dec. 10, 2014, email to fellow Emanuel staffers included the headline in one Chicago newspaper: "If Chicago police have video of teen shooting, let's see it: advocates."
The risk that a publicly released video could blow up not just locally but also nationally was made by lawyers from McDonald's family, who reached out to the city about a settlement in early 2015, just over a month before Emanuel's re-election.
Although none of the correspondence directly addressed Emanuel, in a letter on March 6 — after the family's lawyers saw the video — attorney Jeffrey J. Neslund told city lawyers that the footage would reflect badly on the city.
While the Independent Police Review Authority is supposed to be, as its name suggests, independent from the mayor and police, some of the emails show coordination between the three.
In one such email Collins warned IPRA spokesman Larry Merritt to "tread lightly" when a reporter asked for an interview about the McDonald case in May, the AP reported.
"I completely agree that we need to engage more, but if their focus is on specifics (sic) investigations we should tread very lightly," Collins wrote. "This is about Laquan McDonald and we should not do interviews about open investigations."
Social media response to the emails was fierce.
.@deray pretty convenient for Rahm that it broke on NYE. Might be hoping it gets lost in the holiday shuffle. Classic Chicago tactic!
— Travis Bird (@BirdTravisBird) January 1, 2016
Can someone who has done a close read of the emails please compiile a list of all ppl Rahm's office considered friendly partners??
— Ida's Disciple (@prisonculture) January 1, 2016
@PuestoLoco @BanTorture @70torinoman amen!!! He's a disgrace and I hope his political career is over
— Thrilling (@burdentruth) January 1, 2016
No one paying attention has ever thought IPRA is actually independent. It needs to go. As does Rahm. #ResignRahm https://t.co/isZrr19Jl9
— EbenezerWilkesSmith (@the_torff) January 2, 2016
Chicago's Independent Police Review Authority is a shame. IPRA communicated w/ Rahm after #LaquanMcDonald shooting pic.twitter.com/GHvior3JJG
— David McGuire (@DavidMcGuireEsq) January 1, 2016
These emails make it clear that Rahm covered up black kids murder & IPRA allowed it. We need Community Police Accountability Council #cpac
— Sarah Chambers (@Sarah4Justice) January 1, 2016
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North Dakota Darkhouse Spearfishing Opens at Ice-Up
North Dakota's darkhouse spearfishing season opens on most state waters whenever ice-up occurs. Legal fish are northern pike and nongame species.
Individuals who are required to possess a valid fishing license (age 16 and older) to darkhouse spearfish must first register online at the North Dakota Game and Fish Department website, gf.nd.gov.
Spearers and anglers are reminded that materials used to mark holes must be in possession as soon as a hole greater than 10 inches in diameter is made in the ice.
All waters open to hook and line fishing are open to darkhouse spearing except:
East Park Lake, West Park Lake, Lake Audubon – McLean County
Heckers Lake – Sheridan County
Lake Ashtabula – Barnes and Griggs counties
Larimore Dam – Grand Forks County
McClusky Canal
New Johns Lake – Burleigh County
Red Willow Lake – Griggs County
Whitman Dam – Nelson County
Wood Lake – Benson County
Anglers and spearers should refer to the North Dakota 2020-22 Fishing Guide for more information.


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This property is available on your dates. Enquire below to book.
This property is not available on your dates. Get in touch and we can help you further.
6 Bedrooms
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Chalet Frosty is located in the center of the station, which is exceptional for Megeve.
It's a 325 sqm chalet that can accommodate up to 12 guests in 6 ensuite bathrooms.
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Second Floor
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HOUSEKEEPER: 3h/day
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Home > Information >Knowledge > Circulating fluidized bed combustion technology
Home > Information >Knowledge > Circulating fluidized bed combustion technology
Circulating fluidized bed combustion technology(CFBC) uses a fluidized bed, an apparatus that mixes solid fuel(coal, biomass, RDF fuel) and air with a sorbent such as limestone during the combustion process, to facilitate more effective chemical reactions and heat transfer. In a fluidized-bed combustor, combustion occurs when the mixture of fuel, a sorbent and fuel ash particles is suspended by using a continuous stream of primary combustion air to create turbulence in the bed. The gas cushion between the solids allows the particles to move freely, giving the bed a liquid-like (fluidized) characteristic.
The features of circulating fluidized-bed boilers:
Conventional boilers for power generation can use only fossil fuels, such as high-grade coal, oil, and gas. The CFBC is also capable of using low-grade coal, biomass, sludge, waste plastics, and waste tires as fuel.
NOx and SOx emissions are significantly decreased without special environmental modifications. In the case of fluidized-bed boilers, desulfurization is carried out in the furnace, using mainly limestone as the fluidizing material. For denitration, PC boilers operate at combustion temperatures from 1,400 °C to 1,500 °C, whereas circulating fluidized-bed boilers operate at lower temperatures, ranging from 850 °C to 900 °C, thereby suppressing thermal NOx emissions as the generation of NOx is dependent upon the combustion temperature. In addition, the operation of circulating fluidized-bed boilers involves a two-stage combustion process: the reducing combustion at the fluidized-bed section, and the oxidizing combustion at the freeboard section. Next, the unburned carbon is collected by a high-temperature cyclone located at the boiler exit to recycle to the boiler, thus increasing the denitration efficiency.
Improved combustion efficiency is attained through the use of a circulating fluidization-mode combustion mechanism.
Space saving is attained because there is no need for separate desulfurization, denitration, and fine-fuel crushing units. Accordingly, trouble-spots are minimized, and maintenance is simplified.


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Upcycled + Recycled
What people are saying about Haiku Designs...
Sustainability is so important!
I look forward to receiving the items I ordered from Haiku Designs as well as ordering more items in the future. I appreciate being able to buy from a company that is devoted to selling good quality as well as healthy products. I hope to be a part of helping to create a healthier more sustainable world for future generations.
Beautiful lamp
Just wanted to let you know how much we liked the shoji hanging lamp. In fact, we liked it so much we ordered an additional one. Thank you also for packing it so beautifully.


text: If you are passionate writer and seek to learn new things, you can opt for research as your profession. These days you get paid research studies but what is it exactly all about? Let us delve deeper into it. Paid research – What is it all about? There are many industries and allied jobs that bank heavily on research. The best part is you can do research online. You can work as an industry researcher or a subject expert, or for that matter just a consultant. Entry-level jobs online If you are a fresher and have no prior experience in this field, you can still start afresh. These jobs, however, will not be very lucrative as you may not have formal qualification in this field. As such, if you have a formal qualifications, let us say a certificate or a degree, the payout is much better. With a formal education in research related field, you stand a better chance of finding relevant paid online studies related job. Experts in a paid research study Subject matter experts have knowledge in technology, healthcare, travel and tourism, movies and theater, fashion and lifestyle, and so on. Once you register yourself with any company that offers such opportunities, you might be assigned to live research projects. You might have to work individually or as a team member for paid research studies. If you are a subject expert and your work is virtual, it is comparatively lucrative than an entry-level online research associate. Research studies online have gained immense popularity over the years. There is a need for authentic and valuable information and that is exactly what readers online or website visitors look for. For paid studies and online research jobs, you get the payment through PayPal mostly. Also, it is bi-weekly in many cases. However, you can always negotiate with the company you are dealing with and arrange for a mode of payment that will suit both.


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Nikki Grimes
Off to See the Sea
Night has fallen and Mom and Dad need to get their little one in the tub. To make it more fun, Mom brings a magical adventure out at sea to life, where the faucet is a waterfall, a rubber ducky is a sea creature, and the splashing water is a raging sea! In their ocean journey, Mom and Dad manage to get their little one clean just in time to dock for bedtime.
From Children's Literature Legacy Award-winning author Nikki Grimes and acclaimed illustrator Elizabeth Zunon comes an adventurous bath time story.


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The best thing we can say about Week 4 of the preseason is that it's over, at least here in the NFC North. The next time one of our teams is on the field, it will be for real. In between, roster cutdowns from 8o to 53 will take place. The deadline is Saturday evening.
A quick rundown of Thursday evening's activity, which featured four fun but meaningless victories:
Chicago Bears 24, Cleveland Browns 14
Final preseason record: 2-2
Of interest: Only a handful of Bears starters played. One of them, defensive tackle Henry Melton, registered an encouraging sack of Browns quarterback Seneca Wallace in the first quarter. ... It was interesting, but probably not newsworthy, that Chris Spencer started at center alongside the rest of the Bears' first-team offensive line. Just a night off for veteran Roberto Garza. ... Backup quarterback Caleb Hanie took a step in the right direction, completing 7 of 10 passes for 83 yards and dropping a perfect pass into the far corner of the end zone for a 19-yard touchdown to receiver Johnny Knox. ... Tailback Chester Taylor started but managed 27 yards on 10 carries in what was presumably a showcase stint. But an injury to tailback Khahlil Bell might change the Bears' plans for Taylor, depending on its severity.
Detroit Lions 16, Buffalo Bills 6
Final preseason record: 4-0
Of interest: Most starters played one series. ... Quarterback Matthew Stafford threw a 39-yard pass to receiver Calvin Johnson on the game's first play, allowing Stafford to finish the preseason with this line: 25 completions, 33 attempts, 395 yards, five touchdowns and a 154.7 passer rating. ... Receiver Maurice Stovall produced a nice final argument for a roster spot, downing a punt at the Bills' 8-yard line and catching a 16-yard touchdown pass from Shaun Hill in the first quarter. ... Running back Jerome Harrison was untouched until the end of his 47-yard run in the first quarter. ... Rookie punter Ryan Donahue got the first punt of the night, for whatever that's worth, and averaged 44.0 yards on four punts. Veteran Nick Harris averaged 51.5 yards on two punts.
Green Bay Packers 20, Kansas City Chiefs 19
Final preseason record: 3-1
Of interest: Some starters, including quarterback Aaron Rodgers, played one series. Rodgers' final pass of the preseason was an 8-yard touchdown to tight end Tom Crabtree. Rodgers finished the preseason with 37 completions in 47 attempts for 395 yards and four touchdowns for a 130.1 passer rating. ... Tailback Ryan Grant's 23-yard run to start the game came after strong blocks from tight end Andrew Quarless and right tackle Bryan Bulaga. ... Linebacker Vic So'Oto has put on a late charge for a roster spot. Thursday night, he had 1.5 sacks, a forced fumble and a 33-yard interception return for a touchdown. ... Not that it's a big concern, but quarterback Matt Flynn had one of the ugliest lines you'll see: two completions in 10 attempts for 12 yards and an interception, good for a 0.0 passer rating.
Minnesota Vikings 28, Houston Texans 0
Final preseason record: 2-2
Of interest: Nearly every starter sat out this game. Rookie quarterback Christian Ponder put on an unexpected display of his scrambling ability, running for 61 yards on eight carries, before leaving midway through the third quarter. Some were nice improvisational plays. A few were necessary when blitzers came free. And a few came after the point when he should have thrown the ball. All in all, however, Ponder left the Vikings with a positive impression after completing 10 of 16 passes for 83 yards, including a 5-yard touchdown to tight end Kyle Rudolph. ... With their top three running backs sidelined, the Vikings gave a workout to rookie Caleb King, whom they signed last month after no one selected him in the supplemental draft. King finished with 62 yards on 19 carries, including two touchdown runs.


text: Home Solutions Flow Measurement Products Variable Area Flow Meters Variable Area Flow Meters The flowrate of gases and liquids can be determined simply, yet relatively accurately with variable area flowmeters. The measuring medium flows upward through a vertical conical tube whose diameter increases in the upward direction. The upward flowing fluidlifts a float located in the tube to a height so that the annulus has an area which resultsin an equilibrium of the forces acting on the float. Comparing the flowmeters with the product and installation cost, simplicity of design, piping requirements, Variable area flowmeters are the most effective solution for almost all applications involving the measurement of industrial process liquids, gases or steam. Another outstanding advantage due to its mechanical design is that it does not require external power supply. First analyzing the flow and its properties and decide what type of variable are flow meter will be, then we choose a float for your variable area flowmeter. Advantages:– Inexpensive– No external power supply required for local indication– Suitable for liquids, gases and steam– No inlet and outlet sections required– Simple meter design, therefore easy to install and maintain– Indication also with opaque liquids– Metal cone meter with transmitter– Metal cone meter can be sterilized, CIP testedLimitations:– Vertical mounting position– Constant pressure drop– Affected by density, temperature and viscosity changes– Solids damage metering edge, otherwise slight contamination allowed– Affected by pulsation and vibration– Expensive when exotic materials are required The metal cone variable area is the first choice for chemical plants and oil and gas rigs. The armoured variable area purgemeter is designed for low gas and liquid flows. Glass tube variable area flowmeter for a high degree of reproductivity. Optimum flexibility with a mininmum number of components. These are also designed specially for marine, lubricant monitoring and seal applications.


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White/Black WS2812 Pixel LED Ring
Newstar's ws2812 Pixel LED rings are chainable - connect the output pin of one to the input pin of another. Use only one microcontroller pin to control as many as you can chain together! Each WS2812 LEDs is addressable as the driver chip is inside the LEDs. Each one has 18mA constant current drive so the color will be very consistent even if the voltage varies, and no external choke resistors are required making the design slim. Power the whole thing with 5VDC.
White/Black WS2812 Pixel LED Ring Spec,
Chip: WS2812B
LED: 5050 package, RGB full color, high light
Voltage: 5V
Interface: VCC,GND,DIN,DOUT
Ports: Digital
Platform: Arduino microcontroller
LED Qty: 1/8/12/16/24/32/40/48/60/93/241LEDs
There is a single data line with a very timing-specific protocol.
Since the protocol is very sensitive to timing, it requires a real-time microconroller such as an AVR, A rduino, PIC, mbed, etc.
It cannot be used with a Linux-based microcomputer or interpreted microcontroller, such as the netduino or Basic Stamp.
Intelligent reverse polarity protection, power supply reverse polarity will not damage the IC.
IC control circuit and a power LED spot light utility.
Control circuit chip with RGB components in a package in 5050, to form a complete external control pixels.
built-in signal shaping circuit, any one pixel after receiving the signal through the waveform shaping and then output to ensure line waveform distortion will not accumulate.
Built-in power-on reset and brown-out reset circuit.
trichromatic color of each pixel can realize 256 highlighted, complete 16777216 colors of all true color display, the scanning frequency is not less than 400Hz / s.
serial cascade interface, through a signal line to complete the receiving and decoding of data.
transfer transmission distance between any two points in less than 5 meters without any additional circuitry.
When the refresh rate of 30 frames / sec, cascading number of not less than 1024 points.
data transmission speeds of up to 800Kbps.
The color of the light highly consistent, cost-effective.
WS2812 Pixel LED ring Applications:
Full-color module, Full color soft lights a lamp strip.
LED decorative lighting, Indoor/outdoor LED video irregular screen.


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Our customer was devastated when her lovely Louis Vuitton bum bag became stained with dye transfer. Having cleaned and restored this it is now back…READ MORE
Louis Vuitton
Louis Vuitton Degreasing And Vachetta Restore
After a disastrous oil spillage from inside the bag, it seemed like there was no hope left for this beautiful vachetta Louis Vuitton. A full…READ MORE
Louis Vuitton Vachetta Restore
The delicate vachetta leather found most commonly on Louis vuitton handbags needs specialist attention to ensure it gets the best type of cleaning without unnecessary…READ MORE
Louis Vuitton Neverfull Monaco Treatment
Louis Vuitton Neverfull Monaco Treatment. Dye transfer staining on the back of this bag was really ruining its appearance. It required an Exterior Clean, Dye…READ MORE
Louis Vuitton Backpack Vachetta Stain Removal
We're all guilty of carrying a drink around inside our bags, but what about if the contents leak? This can lead to some serious staining,…READ MORE
Dark handles are such a common problem we see here at the spa! Handles made from leather can go very dark due to the grease…READ MORE
Louis Vuitton Coated Canvas Full Clean
This Louis Vuitton Damier Azur tote came into The Handbag Spa for a Full Clean. The lighter coloured coated canvas was looking grubby after years…READ MORE
Louis Vuitton Handle Degrease & Vachetta Restoration
This Louis Vuitton handbag had grease present in the handles and had darkened as a result. After a Handle Degreasing treatment and overall Vachetta Restoration…READ MORE
Here's an example of a Louis Vuitton Handle Degrease treatment as undertaken by our expert technicians at The Handbag Spa. The first photo depicts the…READ MORE
Louis Vuitton Interior Lining Stain Removal
Marks in the interior of bags are such a common problem! This Louis Vuitton Neverfull tote came into The Handbag Spa for Full Clean and…READ MORE


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Soft Play Gym Equipment Indoor Playground For Parent-Child Restaurant
Indoor playground equipment also offer a plethora of opportunities for children, which not only support their physical development and motor skills but also help develop cognitive thinking. Different types of equipment are used to stimulate different areas in the brain. So an indoor playground offers your child many benefits that they can't get anywhere else! Keep in mind that brain development is crucial, especially during the first few years of your child's life. Another way indoor playground equipment stimulate the brain is with the use of a variety of colors! Colorful play equipment provides many benefits, from strengthening your kids' visual system and developing vocabulary skills to improving overall cognitive intelligence. Indoor play encourages the development of motor skills. One of the best benefits of an indoor playground is that it promotes development and stimulation for children younger than five years old, providing them with a safe space to explore the environment freely without fear. This helps develop their motor coordination and social skills because kids are so free to interact in this environment! They can crawl, climb, jump and play for hours without fear of injury. They can move their bodies freely in ways they might not be able to do in an outdoor playground. Because an indoor playground is climate controlled (usually), your child will be able to spend more time playing than they would outdoors.
Description of Hanlin Indoor Playground Equipment
|Product Name
|Playground Manufacturer For Kids Indoor Playground Equipment
|Main Material
|Galvanized Steel Pipe+High density Plywood or Plastic+High density EPE Filling + Quality PUcoat + Stainless Hardware
|Themes Available
Mysterious space theme, Candy theme, Dream ocean theme, Macaron theme,
Forest theme, Romantic snow theme, British theme, Trampoline series, etc.
|Zones or Attractions
indoor playground equipment sand pool; pit balls pool; Epp Foam Building Blocks; iron chain bridge; indoor playground electric bicycle; zip line; indoor playground equipment rotating bucket; yoga ball; indoor playground merry go round; ball swing; soft play rotating coconut tree; rope bridge; indoor playground boxing swing; ball blaster; indoor playground space tunnel; crawl tunnel; Inflatable Boxing Ring Bouncer; foam climber; indoor playground light slide; mini carousel; indoor playground octopus; indoor trampoline; indoor playground bed;
hanging punch bag; Inflatable Roller; indoor climbing wall; soft play rainbow bridge; indoor climbing net; soft play electric swing; Cannon Ball Blaster; merry go round chairs; soft play pirate ship; soft play steps/ladder; rainbow climbing net; Inflatable pirate ship; indoor volcano slide; ndoor playground slide; kids role play game; indoor playground globe;
Our Cooperation Process of Indoor Playground Equipment
1, Please send me the layout in CAD of your indoor playground.A, To make sure new design fit perfect, please mark information on floor plan (Clean height, Entrance, Column location and size, Place for play structures and soft play) B, You can customized (color, theme, components) of indoor playground equipment 2, Producing: Our product leading time is 14-20 days depend on design. We will do trial installation before delivery (metal and plastic part), will provide real images and 3D installation diagram. 3, We can take care of delivery (Please advise shipping to which port). We can arrange technician do installation of indoor playground equipment.
Before we design indoor playground equipment for the owner, We learn all details of your place, No only the specification of width, length and height. But also where is the best location for the entrance, how to security the pillar... Make clear understanding of your requirements in terms of theme, function, style and elements. Make ultimate use of your place, has the right mix of play events and activities, has the best visibility, has the best play ability and safety! We will keep revising the design until you completely satisfied and love this indoor playground, your playground will be most attractive to kids. We already have many theme for choice and hundreds existing design for reference, we also make list of components and material to maximize your choice on kids playground. We put ourselves in the shoes of the playground owner.
Hanlin amusement company
Zhengzhou hanlin is located in Shangjie District, Zhengzhou City,Center of China, together with other hundreds big or small companies all working in matured upstream and downstream chain of amusement industry. Our factory specializes in designing, producing and installation amusement equipments. Our products scope mainly covers four main customized categories and thousands of independent or small types of amusement devices, which are sold to shopping centers, schools, commercial parks, residential communities and amusement centers all over the world.
Indoor Playground Equipment Play site


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The Cooley Family will be performing Sunday, October 1st during the 10:00 am service.
About Haskell and JoLee Cooley
I began playing the piano for the Cooley Brothers Quartet when I was 14 and we had a Cooley Brothers singing group off and on for over 40 years. I was pianist for the Weatherfords in 1972 & 1973. I was pianist for the Cathedrals from spring of 1974 to spring of 1979. These were great groups and great people. I enjoyed being with them. When I left the Cathedrals my wife and I started traveling & singing. She sings and plays the bass guitar. When our 2 children came along they also sang with us. They are both married and now it is just JoLee and I, still doing what we love: traveling & singing & playing music. We'd like to come your way and present a gospel concert.


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- Home
- Annuities
- About
- Blog
- Contact
An immediate annuity is purchased with one single premium or a lump sum of money. Its purpose is to provide you with a lifetime stream of income. There are even options that allow you to extend that stream to the lifetime of your spouse if you pass away. A short and simple way to describe immediate annuities is "money for life". There are a few things that can affect the income stream that you receive. Any income is calculated based on the amount invested, the payout rate, and your life expectancy. The higher the amount invested in the contract the more money you will receive. It's almost a mirror image of life insurance except in the reverse. Life insurance requires you to pay up premiums for a lump sum benefit when you pass away. An immediate annuity requires you to produce the lump sum up front in exchange for the payments for life. One of the major benefits that come with an immediate annuity is the tax-deferred status. You will pay taxes on the income as it comes in likely at a lower rate than you would if it was all pulled out at once. The payout rate is often the most important part of an immediate annuity contract. It determines the amount of yearly income you will receive from the annuity. A higher payout rate will result in a larger chance of you outliving the amount in the annuity and turning a positive investment. The best immediate annuities offer great payout rates and low fees that allow a retiree to cover basic living costs for life. Immediate annuities offer great protection from volatility risk that occurs from stock or other risky investments. As the stock market moves up and down the constant guaranteed stream of income from a guaranteed annuity can give retirees peace of mind. The certainty of an immediate annuity can provide comfort for those worried about running out of money during their retirement.
An immediate annuity is purchased with a lump sum of money. In return, the insurance company provides a guaranteed series of payouts over a specified period of time, or for the rest of your (or even your spouse's) life — no matter how long you live. The amount of income you receive depends on a number of factors:
Hence the name, immediate annuities start paying out income immediately. Individuals in or approaching retirement may benefit from the predictable stream of income immediate annuities can provide. Contract holders can prevent outliving retirement income by purchasing an immediate annuity with a lifetime payment option. An immediate annuity allows a policyholder to lock in a predictable income stream that is unaffected by fluctuations in the stock market.
Over time, inflation can erode the value of income received from fixed return investments. Immediate annuities are no exception and may also fall victim to the damaging effects of inflation. For optimal portfolio allocation, immediate annuities can be paired with other investments that offer a hedge to inflation.
If the contract owner chooses a lifetime only payment option, the insurance company is contractually obligated to pay income for the rest of the contract owner's life. However, if the contract owner dies shortly after buying a lifetime only immediate annuity, the insurance company keeps the remaining value of the annuity contract.
Immediate Annuity Rates
If you think an immediate annuity may be right for you, click below to receive a no-obligation annuity quote. Our AnnuityUSA team members are standing by to help you find the perfect annuity to fit your goals!
Get instant access to our complimentary "7 Annuity Basics" report!
We are an independent financial services firm helping individuals create growth and income strategies using a variety of insurance solutions to custom suit their needs and objectives.
Investing involves risk, including the potential loss of principal. No investment strategy can guarantee a profit or protect against loss in periods of declining values. None of the information contained on this website shall constitute an offer to sell or solicit any offer to buy a security or any insurance product.
*Any references to protection benefits or steady and reliable income streams on this website refer only to fixed insurance products. They do not refer, in any way, to securities or investment advisory products. Annuity guarantees are backed by the financial strength and claims-paying ability of the issuing insurance company. Annuities are insurance products that may be subject to fees, surrender charges and holding periods, which vary by insurance company. Annuities are not FDIC insured.
The information and opinions contained in any of the material requested from this website are provided by third parties and have been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed. They are given for informational purposes only and are not a solicitation to buy or sell any of the products mentioned. The information is not intended to be used as the sole basis for financial decisions, nor should it be construed as advice designed to meet the particular needs of an individual's situation.


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FuelCell TC EnergyStreak Neo Flame|Light Aluminum and White | New Balance Womens Running Shoes
New Balance For Sale Online
Made for runners, the FuelCell TC EnergyStreak includes innovative features to help you beat your personal best. These women's racing shoes feature new and improved FuelCell along the entire midsole for a responsive feel, and have a carbon fiber plate to propel you forward. Finished with a sleek, breathable upper, these women's running shoes will keep you light on your feet whether you're running a 5k or a marathon.
Product Details
222 grams (7.8 oz)
- Breathable mesh upper to keep the air flowing when you pick up the pace
- Carbon fiber plate provides forward momentum
- Designed and engineered using data from Team NB elite athletes
- Durable outsole for lasting wear
- FuelCell foam delivers a propulsive feel to help drive you forward
- Inspired by NB Heritage racing


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Let's face it: we live in a credit society. Everywhere we go, we pay with credit, get offers for credit, and wish we had more of it. But it doesn't stop with us personally. Credit is a big issue that businesses face as well, and on a regular basis. Customers want it, and there's a good chance that you don't even know where to begin, or if you should.
First, let's start with the basics. Credit is a sales tool. It's true enough that you don't need to offer credit. There is no law that requires it and nobody is going to force you to offer it to anyone. Quite simply, credit is a method of getting a competitive advantage over your competition. It's just one more way for you to attract more customers.
From a cash flow stand point, cash on delivery (COD) or pre-pay (where the customer pays you prior to you delivering your product or rendering your service) is almost always the better way to go. There is no arguing with that. You can argue when your year-end comes, and you are doing all your last minute tax planning stuff, that you may not want cash right away. But generally speaking, cash on the barrel head is best.
When it comes to customers, it's a different story. They want to delay paying if they can, since that will help their cash flow. This is exactly why you can use credit to attract customers. But it is important to do it the right way so that it doesn't become a burden that leads to losses or you chasing down delinquent accounts.
Keep these three simple rules in mind when it comes to offering credit to your customers. Now mind you, these three rules aren't something I simply picked out of the thin air. These are the methods that credit card companies use to extend credit to millions of customers every year.
1. Start small
Offer the credit in a small amount at first. Starting out with around $500 to $1,000 (or whatever is appropriate for your industry), is ideal. It would be a mistake to offer a big credit line right from the beginning, as you might get taken advantage of. What you want to do is build a credit history with the customer and avoid taking on a huge risk from the get-go.
2. Reward them
After you have been doing business with them successfully, slightly increase their credit line. Be sure to tell them about it once you do. After more successful time together, do it again. Every time you increase their credit line, you create a "feel good" moment for them, encouraging them to do more business.
3. Enforce
Always enforce your extension of credit, just like a credit card company would do. If a client fails to comply with the credit terms they accepted from you, you will need to take action. Start by applying the penalty in fees or interest, and if you need to, use a collection agency.
Another important factor to keep in mind when it comes to extending credit is maintaining a consistent credit policy. Write up your policy, provide it for customers to review, and have them sign it, stating that they have read and agree to the terms.
Offering your customers credit is an act of trust. Your customers will appreciate the trust that you are extending to them and in most cases, they won't abuse it. You may just find that offering credit will put you head and shoulders above the competition!