text:
Aisha Hamid, Surjit K Golar, Helen M Wharton, Margaret Clarke, Alex Wright
Birmingham, Solihull and Black Country Diabetic Eye Screening Programme, Birmingham Heartlands Hospital, Birmingham, UK
Address for correspondence: Dr Aisha Hamid
Diabetes & Endocrinology Centre, Birmingham Heartlands Hospital,
Bordesley Green East, Birmingham, B9 5SS, UK
Tel: +44 (0)121 424 2039
E-mail: firstname.lastname@example.com
New onset of diabetes is a well-recognised complication of whole organ transplantation. Screening for diabetes-related complications is recommended once diabetes is diagnosed, but little is known about the microvascular complications in this group of patients. Of the 57 patients who were screened within two years of kidney and liver transplantation, 53 had assessable images and these showed background changes in ten patients (19%) and background with maculopathy in two patients (3.7%). The prevalence of retinopathy was similar to that reported in newly diagnosed type 2 diabetes. One of 35 patients developed maculopathy on limited follow-up. Further follow-up beyond two years will be required to document the natural history of diabetic retinopathy in this group of patients.
Br J Diabetes 2017;17:17-18
Key words: diabetic retinopathy, whole organ transplantation, post-transplant diabetes, screening.
Post-transplant diabetes (PTD) is a well-recognised complication of whole organ transplants, first noted in 1964,1 and immunosuppressive therapies are likely to play a part in the development of diabetes. There is variation in reported rates of PTD due to differences in immunosuppressive regimens, diagnostic criteria and ethnicity. For example, rates of PTD vary from 2% to 53% after kidney transplantation, 40% after liver transplantation, 29% after heart and 42% after lung transplantation,2 depending to some extent on the amount of preoperative screening as 8.1% of a pre-transplant population were found to have undiagnosed diabetes.3 Higher rates have been found in some ethnic groups.4 Some but not all studies suggest that new-onset diabetes after transplantation has an adverse effect on graft survival and may increase cardiovascular morbidity and mortality, but little is known about the microvascular complications of this group of patients.5 Screening for complications is recommended once diabetes has been diagnosed after transplantation.6 Diabetes occurring after transplantation could provide a more precise date of onset of type 2 diabetes than is usually determined in ordinary clinical practice. Diabetic retinopathy may be found in 10–20% of patients with newly diagnosed type 2 diabetes,7,8 and we surmised that the prevalence would be lower in new-onset diabetes after transplantation. This study aimed to assess retinopathy in a cohort of patients with PTD.
Records of 552 organ transplantations (343 kidney and 209 liver) at the Queen Elizabeth Hospital Birmingham between 2007 and 2014 were examined for evidence of PTD. Drugs used for immunosuppression were prednisolone together with tacrolimus or mycophenolate. Patients with pre-existing diabetes, temporary post-transplant hyperglycaemia, and those living outside the Birmingham, Solihull and Black Country Diabetic Eye Screening Programme area were excluded. The timing and results of retinal screening, using digital photography with mydriasis, were analysed in all patients with PTD. The UK national diabetic retinopathy grades were used.
Diabetes was diagnosed in 49 patients (14.3%) after kidney transplants and eight patients (3.8%) after liver transplants. Mean age at screening was 56 years (range 19–80 years); 27 were male and 31 female. The reasons for kidney transplant were forms of nephritis (n= 12), IgA nephropathy (n= 8), hypertension (n=7), end-stage renal failure of uncertain cause (n=8), small kidney (n=6), neurogenic reflux (n=2), ischaemia (n=2), drugs (n=2), cystinosis (n=1) and polyarteritis (n=1). The reasons for liver transplant were forms of hepatitis A/B/C (n=5), alcohol (n=1) and liver failure of uncertain cause (n=2).
Retinal screening photographs were taken within two years of diagnosis of PTD in 53 (92.9%) patients (Figure 1). In those photographs that were assessable, no retinopathy was found in 40 patients (76.9%), 10 patients (19%) had background changes but no maculopathy (R1/M0) and two patients (3.7%) had background retinopathy with maculopathy (R1/M1). In one patient the photographs could not be assessed (Table 1). Maculopathy was confirmed by an ophthalmologist in two patients. No patient developed features of pre-proliferative or proliferative retinopathy and laser/anti-VEGF therapy was not required for maculopathy.
The prevalence of retinopathy will to some extent depend on access to healthcare, on whether the diagnosis of diabetes arose from screening or from the investigation of symptomatic patients, and on the prevalence of other risk factors for retinopathy such as hypertension. Currently in the UK, diabetic retinopathy has been reported in 19% of newly diagnosed patients with diabetes.8 The rate of detection of referable diabetic retinopathy may also be affected by the promptness or otherwise of screening.9
PTD could provide evidence of the minimum rate of retinopathy to be expected at the diagnosis of type 2 diabetes, depending on the care of ascertainment of diabetes pre-transplant. In our study, diabetes was excluded before transplantation by random blood glucose measurements but not by systematic glucose tolerance testing. The diagnosis of PTD was delayed for at least six weeks after surgery. The prevalence of retinopathy in our group of patients was not different from reports in type 2 diabetes in general. Whether the retinopathy was due to diabetes, hypertension or other factors cannot be determined from this study. The incomplete follow-up of this group of patients suggests that the natural history of the retinopathy is similar to other patients with type 2 diabetes.
Our results suggest that careful screening for diabetes with both blood glucose and HbA1c measurements should be undertaken before transplantation.
The study showed that screening was undertaken in only 60% of patients within one year of diagnosis, which did not meet the national screening guidelines which recommend that screening should be completed within three months of diagnosis. However, 93.0% of patients were screened within two years. Further efforts are required to improve the screening uptake, although it is appreciated that this group of patients have significant medical issues and retinal screening may get overlooked due to other priorities.
Conflict of interest Previously presented at BARS and EASDec conferences.
Funding None.
1. Starzl TE, Marchioro TL, Rifkind D, et al. Factors in successful renal transplantation. Surgery 1964;56:296-318.
2. Sharif A, Cohney S. Post-transplant diabetes – state of the art. Lancet Diabetes Endocrinol 2016;4:337-49. http://dx.doi.org/10.1016/S2213-8587(15)00387-3
3. Bergrem HA, Valderhaug TG, Hartmann A, et al. Undiagnosed diabetes in kidney transplant candidates: a case-finding strategy. Clin J Am Soc Nephrol 2010;5:616-22. http://dx.doi.org/10.2215/CJN.07501009
4. Montori VM, Basu A, Erwin PJ, Velosa JA, Gabriel SE, Kudva YC. Post-transplant diabetes: a systematic review of the literature. Diabetes Care 2002;25:583-92. https://doi.org/10.2337/diacare.25.3.583
5. Tufton N, Ahmed S, Rolfe C, Rajkariar R, Byrne C, Chowdhury TA. New-onset diabetes after renal transplantation. Diabet Med 2014;31:1284-92. http://dx.doi.org/10.1111/dme.12534
6. Wilkinson A, Davidson J, Dotta F, et al. Guidelines for the treatment and management of new-onset diabetes after transplantation. Clin Transplant 2005;19:291–8. https://doi.org/10.1111/j.1399-0012.2005. 00359.x
7. Kostev K, Rathmann W. Diabetic retinopathy at diagnosis of type 2 diabetes in the UK: a database analysis. Diabetologia 2013;56:109-11. http://dx.doi.org/10.1007/s00125-012-2742-7
8. Looker HC, Nyangoma SO, Cromie D, et al. Diabetic retinopathy at diagnosis of type 2 diabetes in Scotland. Diabetologia 2012;55:2335-42. http://dx.doi.org/10.1007/s00125-012-2596-z
9. Scanlon PH, Aldington SJ, Stratton IM. Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy. Diabet Med 2014;31:439–42. http://dx.doi.org/10.1111/dme.12313


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In the mid-1980s I was a senior at New York University, burning with ambition and happily anticipating the launch of my career. Wall Street was bullish setting new S&P records and I wanted my piece of the pie — or, so I thought.
I took full advantage of the university's on-campus recruiting program. I must have interviewed at 15 different investment firms hoping to secure a spot in one of their rigorous training programs and learn the secret sauce to accumulating real wealth.
Without a legacy, an Ivy League education or a wealthy familys, I found it challenging to get an offer and finally accepted one in the Surety Bond training program at Chubb Insurance Company. Clearly, not my first choice.
After suffering through two and a half years of performing financial analysis on construction companies, I was done. I realized that making gobs of money wasn't inspiring me. But, what would I do instead?
As I was feeling overwhelmed and confused about my next career move, I bumped into my best friend's sister near my apartment at the Hoboken train station. I told her about my situation and she suggested grabbing a cup of coffee nearby.
After listening to my tale of woe, her eyes widened and a smile dipped across her face, "I have the perfect solution." And then she said two words I never heard put together before. Advertising Sales. In my mind, you either pursued a career in Advertising or one in Sales. I didn't know about Ad Sales from any of my fellow students, mentors, professors and I had done a ton of research.
She explained that Ad Sales is a career in which you sell advertising inventory such as pages in a magazine to companies who want to reach their particular audience with their products.
She gave me an example; "lets say you work at Vogue magazine and Chanel was one of your accounts. Your goal was to get them to take an ad. But, Chanel was considering going into In Style instead. My job would be to create and deliver a presentation to the advertiser underscoring how Vogue made more sense for reaching Chanel's potential customers than In Style. I would compare and contrast each magazine's editorial product and levy a promotional campaign on top."
After she finished her explanation, she asked, how does that sound? I thought, "let's see a well-paying career that drew on my interests in sales, advertising, publishing, beauty and fashion?" I said I was sold and wanted to get started at once finding a job. So, I disposed of my Brooks Brothers suits and floppy bow ties, bought chic clothes and accessories and off I went.
I soon learned that Ad Sales is a competitive career choice and without prior ad sales experience, the publishing companies weren't interested in interviewing me. I was totally frustrated, but I love a good challenge and formed a plan of attack. I sent out resumes with creative cover letters personalized to each magazine and literally knocked on doors. The door-knocking got me my first job at a small magazine titled TWA Ambassador (the free magazine placed in seat pockets on airlines).
After working hard for two years developing relationships with media buyers at ad agencies, I was now known in the industry and had the necessary experience the big companies required. I got a call for an interview with Conde Nast – the esteemed publisher of such prestigious titles as Vogue, Vanity Fair, The New Yorker, Glamour and Mademoiselle. It took 6 rounds of interviews including delivering a presentation to win them over. And this is where my story of pinching myself for the first time begins.
I got a position with Mademoiselle — a fashion magazine targeted to young women age 18-34. Being a 26 year old at the time, it meant I was in their demographic and could easily relate to the editorial product, making it an easy sell.
Working in a glossy office tower, with smart and gorgeous men and women, my work life was "Sex in the City" meets "The Devil Wears Prada." Soon I was having lunch at the Four Seasons in the Grill Room with my publisher and presidents of global cosmetic companies. Pinch me again.
We had no limits on our expense accounts and could do whatever it took to get the business. We wined and dined our clients, took them for spa dates, created promotional programs and, attended black-tie industry galas. Once a year we went on extravagant sales meetings in luxurious destinations. We skied the Alps in Austria and sunbathed in the Bahamas and on Turks and Caicos. Pinch me a third time.
I excelled at sales and soared through the ranks of the magazine. I loved everything about my job so much it didn't feel like work. My mentor was a charming power broker that could sell ice to Eskimos. He was such a big personality he became the inspiration for the character Mr. Big in the series "Sex and the City."
I spent eight years at Conde Nast between Mademoiselle and Conde Nast Traveler and loved every minute of it. I was offered more money and eventually left and worked for a competing mega-media company – but they didn't compare. So I returned to Conde Nast for another ten years.
Toward the end of the 1990s, the web was ramping up and by the mid-2000s magazines were closing left and right, budgets were cut, staffs reduced and the glamorous lifestyle of an ad sales exec was replaced with tons of pressure and tension.
We never imagined it would end with such a crash. When my colleagues and I get together now we laugh at the way we were doing business back then. It sounds irresponsible, but we were making money hand over fist. It was part of an era in a certain industry, at a particular time when magazine publishing was the "It" business. I imagine it's what it's like in Silicon Valley now.
About 4 career changes later I am so happy to have experienced those years. Nothing I have done since even slightly compares. My memories of those high times make me laugh and yes pinch myself that it actually happened

subset: commoncrawl


text:
CES 2021 took place in my dining room last month. Well, on my laptop anyway. And though the physical abuse of running around all the halls at the Las Vegas Convention Center was missing, there was still quite a bit familiar about it, including a series of keynotes and education sessions, and a whole lot of new products.
On the keynote front, Verizon chair and CEO Hans Vestberg discussed how the company's 5G ultra-wideband technology was going to inspire advances well beyond communications. "It's an innovation platform that makes other innovations possible," he said.
Automaker GM's chairman and CEO Mary Barra said the company has the bold goal of offering 30 all-electric models by 2025. Oh, and they also showed a video of an all-electric flying car. No timeline was given for the oversized quad-copter drone, but it did have a cute name — the Cadillac Vertile.
Related: Live Edition of CES 2021 Official Daily Now Available
Once again, there were a host of products that had "smart" added to their names, including a smart mop, a smart crib, and, in a reflection of current times, a smart mask. Samsung had some robot assistants, including a robo-vac that emptied itself.
Still, for all the smart products being introduced, there was nothing really game-changing coming into the home space. AV is moving along with better image quality on televisions and projectors and more versatile sound systems, but that is evolutionary, not revolutionary.
I think the main reason why there hasn't been a colossal leap forward is because current home control is pretty darn close to what's been promised. Control is easier than ever, with touch, voice, or even being recognized by the cellphone you are carrying. The scenes integrators create for customers take care of anything they could need — set the lights and shades, lock the doors, start their favorite entertainment…. Even the Jetsons didn't have it so good!
All right, so we don't have a Rosie robot maid yet, but those robo-vacuums are getting pretty close. And, sure, you can't press a button and have a meal pop up from behind a panel in your kitchen, but with a few button presses you can use DoorDash, and that's pretty much the same. Plus, I am sure your local restaurant produces far better food than what could be stored behind some automated panel in your house.
That's not to say that there isn't room for growth. Last June, when discussing AI with Alex Capecelatro, co-founder and CEO of Josh.ai, he described "a true smart home that knows who you are, sets everything up automatically, and reminds you that it's going to rain. And here's an umbrella. That is far from the customer reality today."
So we have some work to do before we have a WALL-E existence where machines take care of everything for us, but, for now, we can take pride in the fact that we have placed our clients in the home of the future, today.
At least until we have program the rooftop helipad to do a welcome scene once they step out of their flying car…


text:
Usually an SKU contains only one product. If you're in doubt, please contact store customer service to confirm.
Due to the quick turnover of product inventory, please consult store customer service to confirm inventory for large purchases. Thank you for your interest in ACME.
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Health Services
A student's health is integral to a child's success in school. Healthy students have better attendance, are more attentive, and perform better than a child who is struggling with health issues. That is why the Cincinnati Public School District works hard to keep students healthy and in school.


text:
Anderson, Craig (2015) Identifying clusters in Bayesian disease mapping. PhD thesis, University of Glasgow.Full text available as:
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This thesis develops statistical methodology for disease mapping, an increasingly important field of spatial epidemiology. Disease mapping has applications in public health by allowing for identification of areas which are at high risk of particular health problems. Such approaches are generally based on areal data, which involves partitioning the study region into a set of non-overlapping areal units and recording counts of disease cases within each areal unit. The majority of approaches assume a spatially smooth risk surface, but this may not be realistic, and there has been recent interest in developing methodology which allows for discontinuities in this structure. This can be done by identifying clusters of areal units with similar disease risks, and allowing for discontinuities between these clusters. The work presented in this thesis develops models to identify such clusters and also estimate disease risk. Three Bayesian hierarchical models are proposed; the first two are based on spatial data at a single time point, while the third extends into the spatio-temporal domain by modelling across multiple time points. Each model is applied to respiratory hospital admission data from the Greater Glasgow and Clyde Health Board area in order to identify clusters which have high disease risk.
|Item Type:
|Thesis (PhD)
|Qualification Level:
|Bayesian, spatial statistics, epidemiology, spatio-temporal modelling
|H Social Sciences > HA Statistics
R Medicine > RA Public aspects of medicine
|College of Science and Engineering > School of Mathematics and Statistics > Statistics
|Supervisor's Name:
|Lee, Dr. Duncan and Dean, Dr. Nema
|Date of Award:
|Depositing User:
|Mr Craig Anderson
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|Copyright of this thesis is held by the author.
|Date Deposited:
|13 Feb 2015 11:47
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text:
Teenaged Indian weightlifter Jeremy Lalrinnunga will look to secure an Olympic Games berth in 67kg category when the 2021 junior World Championships, the last qualification event, is held in Tashkent from May 21 to 31.
Weightlifting qualification for the Tokyo Olympics is based on world rankings, and Lalrinnunga is placed 26th in his weight class. To qualify for the Olympics, he needs to do better than South Korea's Myeongmok Han, who is placed 20th.
Even though doctors have advised the 18-year-old to not stress his injured knee too much, the young weightlifter is pushing hard to better his personal best of 306kgs (140kg in snatch and 166kg in clean and jerk).
The Mizoram lifter, who became India's first Youth Olympics gold medallist in 2018, needs to lift at least 310kgs at the Tashkent tournament to have any chance of usurping the South Korean lifter in the 'Gold Level' ranking event.
Another major hurdle for the lifter is a knee injury he suffered during the Asian Championships in Tashkent last month. Due to the injury, Lalrinnunga's performance suffered and he finished eighth.
Lalrinnunga has undergone an MRI scan and doctors have advised him not to put pressure on his knees. But Lalrinnunga, who is training at National Institute of Sport (NIS), Patiala, is hopeful of full recovery.
"I am focusing more on strengthening right now. I have started doing light training with the world event around the corner. I still have more than a fortnight to recover. I hope to compete in the Uzbekistan event and earn requisite ranking points," the Olympic channel quoted Lalrinnunga as saying.
India's woman weightlifter Mirabai Chanu, who won bronze at the Asian Championships last month, has all but secured her Olympic spot in the 49kg category.


text:
Randexp - Generating test data with Ruby regexs
While paging through reddit programming recently (seems only fair since they linked to me ;)) I stumbled on to the very nifty Randexp gem, a library that uses regular expression patterns to generate data that would satisfy the pattern. Or in less tech terms - a really good test data generator.
# install randexp
$ irb
require "rubygems"
require "randexp"
# simple fake phone number -
/020(7|8) \d{3} \d{4}/.gen
# build a reusable class.
class Randgen
def self.version()
# and use it.
I especially like the ability to make your own character classes. I'm not a ruby guy but I can see this being very useful in lots of little data generation scripts and test harnesses.


text:
Kevin Burkhardt to host stat-friendly NLCS Game 1 broadcast
Fans will be able to watch an alternate telecast of Game 1 of the NL Championship Series focused on sabermetrics.
The main broadcast of Saturday's opener between the San Francisco Giants and St. Louis Cardinals will be on Fox. Cable channel Fox Sports 1 will also show it, with extended replays and statistical analysis of batter-pitcher matchups, umpiring tendencies and defensive shifts.
Kevin Burkhardt will call the game from the studio alongside Gabe Kapler, CJ Nitkowski, Rob Neyer and San Diego Padres manager Bud Black. The broadcast will sometimes use a "double box" to show the commentators and live action at the same time.
FS1 will air the main coverage of five of the last six NLCS games, with Fox showing only a possible Game 6.
Alternate telecasts have recently become more popular for major sports events, such as ESPN's multiple offerings during January's BCS title game and Turner Sports' "home team" announcers during the Final Four.


text:
Trump announces Sen. Mark Green as Army Secretary
President Donald Trump formally announced his intention to nominate state Sen. Mark Green as U.S. Secretary of the Army on Friday in a White House news release that also covered nominations to five other federal government positions.
Green is expected to resign from the Senate when the nomination is confirmed and the new job will also end his planned run for the Republican gubernatorial nomination, announced in January. The pending presidential nomination had been widely but unofficially reported earlier.
Here's the portion of the White House release dealing with Green:
Mark E. Green of Tennessee to be Secretary of the Army.
Dr. Mark Green currently serves as Tennessee State Senator for District 22. He is the Chaplain of the Senate GOP Caucus and was selected as the Tennessee Journal's Rookie of the year in 2013. Dr. Green is the CEO of Align MD, an emergency department staffing company, which provides leadership and staffing to emergency departments and hospitalist services in forty-seven hospitals in nine states. In 1986, Second Lieutenant Green graduated from West Point with a degree in economics and began his military career as an infantry officer. Dr. Green served as a rifle platoon leader, scout platoon leader, battalion personnel officer, a supply officer, an airborne rifle company commander in the famed 82nd Airborne Division, and commanded a recruiting company in U.S. Army Recruiting Command. As an Army physician, Mark served in the 160th Special Operations Aviation Regiment where he made three combat tours to the Middle East. His military awards include the Bronze Star, the Air Medal, the Air Medal with "V" device for valor under heavy enemy fire, and numerous other medals for service.
Lt. Gov. Randy McNally and U.S. Sens. Lamar Alexander and Bob Corker promptly issued statements to media praising Green's nomination. Here they are:
Lt. Gov. Randy McNally: "I would like to congratulate my friend and colleague Senator Mark Green on his nomination as Secretary of the Army.
While Tennessee is losing an excellent senator, American's national security team is gaining a true servant leader. Mark's experience and the qualifications for this job overlap perfectly and then some. His experience as a soldier, a senator, a business owner and a physician will make him an invaluable asset to our nation and its army. Senator Green has worked hard for his constituents, passed excellent legislation and served honorably as our Senate Republican Caucus Chaplain. I appreciate all his contributions to the success of our state and I look forward his future role in making America great again."
Sen. Lamar Alexander: "This is a good opportunity for the rest of the country to benefit from Tennessean Mark Green's leadership skills, military experience and dedication to service members."
Sen. Bob Corker: "As a West Point graduate and former military officer, Mark Green is well-suited to serve our nation as Secretary of the Army," said Corker. "He is respected in both the military and business communities, and I know the people of Tennessee State Senate District 22 have greatly valued his leadership and dedication over the past four years. Mark has a true sense of duty, and I was proud to recommend him to President Trump for this distinguished position."


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Rockbox mail archiveSubject: RE: iPod accessories and Rockbox?
RE: iPod accessories and Rockbox?
From: Robin Kipp <robin.kipp_at_gmx.de>
Date: Sun, 26 Nov 2006 17:17:50 +0100
Ah, too bad. But what about this docking stations where you plug in your
iPod and then you can hear music trough better speakers?
> -----Original Message-----
> From: rockbox-bounces_at_cool.haxx.se
> [mailto:rockbox-bounces_at_cool.haxx.se] On Behalf Of Rocker
> Sent: Sunday, November 26, 2006 5:07 PM
> To: Rockbox
> Subject: Re: iPod accessories and Rockbox?
> No not at this time...rocker
> ----- Original Message -----
> From: "Robin Kipp" <robin.kipp_at_gmx.de>
> To: <rockbox_at_cool.haxx.se>
> Sent: Sunday, November 26, 2006 4:14 AM
> Subject: iPod accessories and Rockbox?
> Hello all,
> After many problems, I finally was able to install Rockbox on
> my iPod Video 30GB. I also copied the voice file to my iPod,
> because I'm blind, so can't see what's on the screen. Now I
> have a question: Is it possible to use iPod accessories with
> Rockbox and will the aditional menus be spelled out to me?
> For example, I was thinking about buying the XtremeMac
> MicroMemo Audio Recorder which looks pretty interesting. So
> what do you think, is it possible to use this thing with the
> Rockbox firmware and voice files? Regards, Robin.
Received on 2006-11-26
Page template was last modified "Tue Sep 7 00:00:02 2021" The Rockbox Crew -- Privacy Policy


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Pakistan's continuing troubles regarding religious discrimination has taken a new face amid Covid-19 Pandemic. The shortage of medical aid, and facilities is being used as an excuse to browbeat the minorities.
In spite of Appeals to be humane, many organizations have succumbed to the radical calling to serve the faithful only. The faithful being the mainstream version of Islam.
In Lyari town of Karachi, Hindus were denied aid bluntly with volunteers claiming that it is not for Hindus. The discrimination was based on Pakistan national identity Cards.
Similarly, Shias faced the brunt of both the virus and the accusations of conceiving the Virus. Covid-19 is being referred to "Shia-Virus" as most believe pilgrims from Iran brought the virus into Pakistan.
Christians in some places were asked to recite the 'Kalima' or forgo the aid. Kalima is the declaration that "there is no God but Allah, and Muhammad is the messenger of Allah."
In fact, what's horrifying is that on April 13, Pakistan's top twitter trends were Anti-minority tags. One tag called for hanging Blasphemers, while the other mentioned the religious obligation to reject Ahmadiyya's as Muslims.
It is ironical that at a time when PM Imran Khan is calling for global effort to end Corona Virus, members of his own country are trying to prove seclusion as the way of life in Pakistan.
USIRF also expressed apprehension regarding the denial of food to minorities in Pakistan. Minorities are often targeted in Pakistan. But without any administrative support to back them, minorities have no alternatives but to fight this pandemic alone.


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"The effective prayer of a righteous man can accomplish much" (James 5:16).
No greater heartache occurs than when one of our children is suffering or experiencing a tough trial. One father knew all too well what this was like as he brought his demon-possessed child to Jesus. Desperate for help, he said, "But if You can do anything, take pity on us and help us!" As Jesus heard his words, He responded by saying, "If You can? All things are possible to him who believes." The man immediately cried out and said, "I do believe; help my unbelief" (Mark 9:22-24).
So often our lives are like this story. We desperately need Jesus to act on our behalf, but we question if He really can. During one particular time in my life, I became so discouraged with my surroundings that my prayer life began to suffer. I was allowing what I could see (my circumstances) to shake my hope, instead of calling on my faith to allow God to strengthen me. After this revelation, everything began to change for the better. "For we are called to walk by faith and not by sight" (2 Corinthians 5:7).
The more time we spend in God's Word getting to know Him, the more our faith will grow. And as it blossoms, our prayer life will take on an entirely different view. We will begin to pray from a place of hope instead of from a place of unbelief.
"And without faith it is impossible to please Him, for he who comes to God must believe that He is and that He is a rewarder of those who seek Him" (Hebrews 11:6).
Prayer is one of the greatest tools we have. God loves to spend time not only listening to His children in prayer, but also answering them as well. Wherever you find yourself today, do not stop praying. Keep seeking, keep knocking, and keep believing. For God will move on your behalf, according to His perfect will, in His perfect timing.
"Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you" (Matthew 7:7).Tweet
"Don't pray when you feel like it. Have an appointment with the Lord and keep it. A man is powerful on his knees."—Corrie ten BoomTweet
Additional readings: Philippians 4:6-7, 1 John 5:14


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As temperatures fall and the air turns crisp, it's time to power down your electronic devices and recharge your personal batteries by getting back to nature. From leisurely walks in the woods to hair-raising urban adventures, our guide to area parks offers a variety of ways to escape digital distractions and enjoy the outdoors.
Outdoor Escapes
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Other Races
19 Oct 2019
3 min read
Malta'19 ○ season'19
View Standings
#Cassandre Beaugrand
#Katie Zaferes
Cassandre Beaugrand and Katie Zaferes will resume battle in what looks set to be a thrilling Final at Super League Malta after both won their Semi-Final groups.
Beaugrand cruised to victory to ensure a Short Chute in the Final in Group A before Zaferes had a real battle with Klamer but kicked late on to match her French rival in Group B.
Two qualifiers from the Junior girl's race will also step up to the Final with Beatrice Mallozi and Bianca Seregni making the cut after a day they could only have dreamed of.
Beaugrand cruised to victory in Group A with Yuko Takahashi sticking with the Frenchwoman for most of the race to come in second.
Beaugrand and Takahashi broke away in the first swim and never let their advantage slip as they edged further ahead of the rest throughout.
There was a brief moment in the first run where Beaugrand looked as though she might go solo, but Takahashi bridged in the second swim and then was only broken in the last run which the pink jersey holder walked home while high fiving the crowd.
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Leonie Periault and Summer Rappaport broke away from the group and gave themselves enough of a cushion to secure third and fourth respectively, while Felicity Sheedy-Ryan provided the big shock by grabbing the last automatic qualification spot in fifth.
Katie Zaferes set-up a thrilling head-to-head Final with Beaugrand by taking the win in the second Semi-Final.
Zaferes, Sophie Coldwell, Rachel Klamer, Taylor Spivey and Ilaria Zane formed a group of five at the front that drifted apart and came back together during the course of the race.
Zaferes and Klamer looked strongest at the front and in the end the American made a break on the final climb to ensure another win.
Klamer came in with a strong second while Coldwell was third with Spivey in fourth and the final automatic spot going to Zane.
Perhaps the most remarkable story of the Semi-Finals was the performance of Beatrice Mallozzi, who qualified via the Junior race in the morning and made the cut for the Final, just dodging the 90 second rule and surviving potential elimination.
Though fellow Junior qualifier Bianca Seregni did fall foul of the 90 second rule, it was late enough in the race to book her place in the final 15.
*Eliminated under 90 second rule but furthest through course
See the full results here
Final qualifiers
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Super League Triathlon © 2023


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Timo Mayer Syrah
Timo Mayer Syrah. The 2012 can be summed up easily. It is a remarkable wine. This is the very best of the Old World style made famous by great Rhone Valley Syrah. It just so happens this one is from the Yarra Valley, an hour outside Melbourne. Open it early and let it breathe. It will continue to unwind for hours, showing spice, violet, black fruit, pitch, and minerality. The near $90-100 price tag is daunting, but this is a classic wine of superb quality, well worth the investment for a special occasion.Share story on Facebook Share story on Twitter Email a Friend.


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Just looking for some advice, I'm deeply relieved that Trump is gone and I felt grossed out by him almost every day, but I'm in a weird spot because I don't like Biden Harris either, I'm already grossed out by them 1 day in, most notably surrounding Title 9 executive order around Trans, I have 2 daughters who are athletes and I shouldn't have to feel like a bigot because they don't want to play tennis or run against boys, I felt like Biden's timing on this was all wrong, I feel like the perfect example of someone wanting to give him a chance, and then I get poked in the eye day one,
Am I just politically homeless, maybe that's ok, there's thankfully not an election anytime soon,
Sorry to spoil your relief around Trump, which I share
There's nothing wrong with feeling politically homeless. Here we have no continuing city, but we seek one to come. (Hebrews 13:14).
One of the many silly things said about me by the MAGA cult where accusation is always confession is that I care more about "loyalty to the Democrats" than I do about the Faith. This coming from a theopolitical cultus that elevated devotion to a dimestore antichrist to a litmus test for Catholic faith and routinely excommunicated me from the Church more times than I can count for failure to believe and profess Donald Trump as the Only Begotten President of God.
In fact, I regard political parties as nothing other than tools for implementing Catholic Social Teaching and firmly believe in dropping them the instant their utility is expended. The idea of loyalty to a party is foreign to me. You might as well feel loyal to a wrench when it is time to use a screwdriver. Use what tool you need when you need it and then use another tool when you need that.
So we don't have to agree with Biden about everything, nor feel loyalty to the Democratic party. He is wrong about some things and right about others. Trump was wrong about virtually everything, as is his evil party of nihilist predators.
That said, Biden is getting an awful lot right so far and the Dems are orders of magnitude closer to pursuit of the common good than the MAGA Freak Show GOP.
With respect to the LGBTQ matter, for many Christians, literally any form of kindness or respect to LGBTQ folk is intensely threatening because many Christians neither believe that the most basic fact about them is their bearing of the Imago Dei, nor that Jesus died and rose for them. For these Christians, (and not a few of them are Catholic) the fundamental and only fact is that they are sinners rejected by God and enemies to be excluded. In short, such Christians begin not with Catholic faith in the Imago Dei, but with the Calvinist notion of total depravity and the conviction that the most fundamental truth about them is sin.
My approach to such things as LGBTQ issues is to start with the fact that LGBTQ folk, like all human beings, are made in the image and likeness of God and to ask, "Does a given policy affirm the basic dignity of human beings or does it constitute an injustice to somebody else?" I'm not super-interested in sports and so such questions as the one you raise have not been uppermost in my mind. I can certainly see the case to be made that this an injustice to women athletes who are not, on average, as physically strong as biological males. I have no idea what the science says about this though, so I'm basically speaking out of ignorance. You may have a real point. I don't know.
But, on the whole, the affirmation of human dignity seems to me to be a more fundamental good than this particular issue. My hope is that people of goodwill can iron out the bugs with respect to such things as sporting competitions and come to some sort of satisfactory arrangement, perhaps via some system of handicapping if the science shows that there really is an injustice occurring.
Anyway, my basic point is that there is not a reason in the world anybody owes mindless fealty to a political party. At the same time, my main impression is that there is an awful lot to be grateful for in the dawning days of the Biden Administration and it would be churlish and graceless of me not to thank God for it.
Blessings on you and yours as your keep striving to navigate these complex times!


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At the workshop, vice Chairman of the Vietnam Chamber of Commerce and Industry (VCCI) Hoang Quang Phong expressed that the country with great demand for infrastructure development and therefore will need resources for this work in the time ahead. PPP model is assessed as an important factor to mobilise investment capital.
PPP has proved effective over the past years, according to the statistic on January 2019, there were 336 PPP projects with their contracts inked, including 140 build-operate-transfer projects and 188 build-transfer ones. The Government now is drafting a law on PPP investment and plans to submit to the National Assembly.


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Yawaskits - The Judge (Ep 87)
By Oladamats on
Download Yawaskits - The Judge (Ep 87) Mp4
Heres a new skit by Yawa which is titled THE JUDGE (Part 4).
Yawa is a popular Instagram comedian who goes by the name Kalistus, and is known for his failure in an attempt to survive in most of his skits.
Watch and download below;


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Buy direct from the chocolate manufacturer
Made using the finest and natural ingredients
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To find out more about our catering chocolate and gifts or to open a trade account, please select a product above or contact our friendly team who'd be happy to help and to welcome you onboard!.
Whitakers Chocolates have been making traditional British chocolates at our factory in Skipton since 1889. Everything produced in our UK chocolate factory is made under the highest food safety regulations and uses only the finest and natural ingredients. All our milk and dark chocolate comes from sustainable sources and most of our products use Fairtrade Cocoa, are gluten free and palm oil free, plus our vegan chocolate products are registered with the Vegan Society. In line with our sustainability goals, all our packaging is widely recyclable or home compostable with minimal plastics.
As one the the UK's leading chocolate manufacturers, we export our chocolates across the globe to Europe, Canada and beyond. So if you are looking to become a stockist, export Whitakers Chocolates products, looking for a chocolate manufacturer to create your own chocolate brand or looking for corporate gifting ideas - we're here to help.
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Lauraette Kirkland
Click any image to see the full size, use the arrows to scroll, and click "x" or press ESC to return.
Lauraette Kirkland is a native born South Carolinian who has always loved art and being creative. "My love of art began when I was very young, says Kirkland. The more she learned about art, she became in awe of old masters like Michangelo and wanted to do realistic art. Although she was a business major in college, she has taken at the USC on art education, art history, drawing and painting while working many years as an accountant. "The most useful thing I have done in learning techniques in art, however, has been from hours of working and experimenting with various types of medium and a number of different subjects. In that way I found how best to express in a tangible and natural way my vision of my creations, my reaction to the subjects, and my emotions about the process" she explains.
In the fall of 2003 because she has always wanted to sculpt, she began working with clay by using hand building techniques with no prior experience or instruction. "I fell in love with the fun and relaxation of working with "mud." She has displayed pieces at a number of exhibits and shows and won several ribbons for her work. Ms. Kirkland has been teaching sculpture classes at the Columbia's Park and Recreation for several years which combines her love of sculpture and working with people. People are one her favorite subjects, especially small children. She loves to paint and sculpture them, capturing them in the activities and moments of their lives. When asked about this choice of subject matter, Kirkland says "I find people to be great subjects! To me every person is different; each person has something to say and has value no matter what their profession, or background. The combination of these unique qualities, inside and out, makes all of us unique. It could be someone's smile, personality, style, or even their charisma that catches my interest. I guess this is why I like sculpting and painting people, because it is so much fun to try and capture their personality. I believe every person brings something individual into the world – every person has a story and I like to tell it with my artwork."
Also, because of her love of trees, she has done several workshops on sculpting trees, too, especially, big oak trees with gnarly, rough, beat up old trunks, and they has been one of her main subjects. When she sculpts trees, particular attention to the details and makes them realistic as possible. Several of her trees have been donated for charitable causes. "Overall, I want my pieces to tell a story, not just be an object. I want the piece of artwork to evoke emotions that someone can identify with and relate to that brings them pleasant memories, based on their own life experiences," explains Kirkland.


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Pandemic Response Challenge Program pillar: Rapid detection and diagnosis
Title: Molecular Assay for Instrumentless SARS-CoV-2 Rapid Diagnostic from Saliva
Closed (closing date: June 15, 2020)
The NRC is seeking a solution for a molecular assay allowing a rapid and efficient colorimetric detection of SARS-CoV-2 from saliva without the use of an instrument. The molecular assay will be integrated with saliva collection and processing technology developed by the NRC. The ultimate goal is the creation of a mass-producible, self-contained diagnostic test that will enable rapid identification of COVID-19 infection or immunity at point of care.
Funding available
Up to 3 projects will be funded for up to $100K to the most promising proposals aiming to demonstrate proof of concept colorimetric detection of SARS-CoV-2 from saliva without the use of an instrument. The goal of this short-term project is to identify the most promising molecular assays. One or more project collaborators may subsequently be invited to submit a proposal for follow-on funding to support further assay maturation and production scale up, as well as the opportunity to work with the NRC research and development teams for its integration in a detection device that will be scaled up with the help of the Canadian industry.
Problem statement
Frequent, pervasive, and timely testing for COVID-19 infection and acquired immunity is key to shaping and directing responses to the current pandemic. While molecular-based detection of the virus is the mainstay of testing, its utility can be hampered by material shortages and delays introduced by centralized lab processing. The availability of a safe and effective diagnostic test, which could rapidly produce a simple result in home and point-of-care settings without need for instruments, would improve the timeliness of both clinical treatment and the public health data that informs adaptive public policies.
A novel solution is sought that can rapidly and accurately, without the need for traditional reagents and highly specialized equipment, detect the virus that causes COVID-19, a component of the virus, or an immune response of an individual recovered from COVID-19 disease. Such a device would facilitate diagnosis in diverse and remote settings, thereby enabling a broader response to the pandemic and its effects. The NRC has pioneered the development of a saliva collection and processing device that can be safely and easily used at home to collect and process saliva samples. The device will deliver a homogenized and filtered saliva sample, and may also perform mixing, filtering, and reagent storage as may be required to integrate with partner technologies. We are seeking both reagent and assay solutions that will be integrated to this saliva processing device in order to provide a sample-to-answer system capable of detecting SARS-CoV-2 or COVID-19 immune response within 30 minutes using only a simple visual result readout.
Desired outcomes and considerations
The solution must meet the following criteria:
- Demonstrate a method for reagent formulation and an instrumentless assay capable of detecting SARS-CoV-2 infection or immunity acquired against SARS-CoV-2
- Upon contact with the collected sample, and gentle mixing provided by the device, the assay should be able to complete without any external instruments or manipulation steps to arrive at a final solution
- Provide results within 30 minutes (at most) from sample collection to diagnosis.
- The sample input must be saliva
- The reagents formulation would need to be compatible with room-temperature storage for up to 6 months allowing for deployment in distributed testing sites
- The assay must be customizable for use in an instrument-free medical device sample-to-answer system—in particular formulation that can be stored in dry and/or liquid formats in polymer devices without loss of sensitivity and selectivity
- The assay must integrate and operate with a saliva collection and processing device developed by the NRC
- The results of the assay must be easily detectable by eye (e.g. colour change, striking by specific optical effects)
- The interpretation of the result should be easy for a lay person (i.e. negative or positive).
- The price of reagents should not exceed $20
- Potential for fabrication of up to 100,000 tests per month
Background and context
As of May 29, 2020, more than 5 million cases of COVID-19 have been reported globally, resulting in more than 350,000 reported deaths. Of this total, Canada has reported more than 80,000 cases and more than 6,000 deaths.
Public health and policy responses to the COVID-19 pandemic can be strengthened by the availability of timely results from frequent and pervasive diagnostic testing. Molecular-based detection of the SARS-CoV-2 virus, which is the mainstay of testing, presently requires the use of instruments which, due to being centralized in Canadian hospitals and diagnostic labs, can contribute to delays in the availability of results. Such limitations in timeliness and availability suggest that there is a significant opportunity to introduce a more rapid, front-line diagnostic test to enable earlier and more widespread detection of infections, asymptomatic carriers, and immunity. The benefits of such rapid detection and reporting could include timelier treatments, strengthened approaches for allocation of scarce public health resources, and adaptive public policies for containment and mitigation of broader pandemic impacts.
The selection of test site for the sample collection is important for obtaining reliable test results. Nasopharyngeal or oropharyngeal samples (NOS) are most commonly used at present for SARS-CoV-2 testing. However, this test method has been affected at times by supply chain shortages that limit availability of reagents and sample collection swabs. Moreover, the use of naso- and/or oropharynx swabs can be uncomfortable for patients, may pose infection risk to healthcare workers, and may be undesirable for self-sampling.
Recent work has demonstrated successful detection of SARS-CoV-2 in saliva specimens with efficacies that match those of nasopharyngeal or oropharyngeal samples. Saliva samples offer a number of advantages: they are less invasive and more convenient as compared to NOS or blood samples; they can be self-administered, thereby minimizing the risk of virus transmission to health care personnel; and, very importantly they can be performed in remote locations or homes. This potential use of saliva seems scientifically reasonable as it has been shown to contain live COVID-19 viruses (To K K-W, Tsang O T-Y, Yip C C-Y. et al. Clin Infect Dis 2020; ciaa149. doi:10.1093/cid/ciaa149), possibly containing a pool coming from the lower respiratory tract, nasopharynx and infected salivary glands. For some coronaviruses, infection of salivary glands occurs very early in the disease process. The content of salivary COVID-19 (viral load) has been shown to be highest during the first week after symptom onset (To K K-W, Tsang O T-Y, Leung W-S et al., Lancet Infect Dis 2020; S1473-). This emphasizes the role of saliva as a potential source of viral transmission and, as it could be detected in the saliva as long as 25 days after the onset of symptoms, suggests its potential use for monitoring viral clearance.
The NRC's Pandemic Response Challenge Program searches to develop a novel approach to diagnostic testing that can rapidly (in less than 30 minutes) and accurately detect from saliva the virus, or a component of the virus, that causes COVID-19 in saliva without traditional reagents or reading instruments. Such a device can facilitate frontline diagnosis and care while expanding into non-traditional clinical environments or home settings. In order to achieve this ambitious goal, the program seeks research partners in academia and industry to contribute molecular assay solutions that can be integrated with the NRC device technologies and manufactured at scale.


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Opinion | Bona Fide | "Little Dark Age"
A Review of MGMT's "Little Dark Age"
In 2007, MGMT took the world on a psychedelic-alternative journey as they created "Oracular Spectacular" within their college dorm room at Wesleyan University.
A surprise to all, including themselves, "Oracular Spectacular" brought something new to the table of played out festival-circuit bands and summer vibes.
But like most groups, MGMT tried to reinvent themselves… twice. On their 2010 release of "Congratulations" and their self-titled 2013 release "MGMT" they threw away what the world loved about them and completely disregarded who they were.
With their two releases after "Oracular Spectacular," the group completely transformed their style. They hid their pop roots and tried something new, which does not always work. But hey, if it aint broke don't fix it, right?
Eleven years since their debut, they reemerge with "Little Dark Age," a return to form for this Connecticut-based duo.
"Little Dark Age" pays homage to 80s synth while keeping their music fresh. Although MGMT once again reimagines themselves, they do it in a way that stays true to who they once were: a band you can vibe to with a psychedelic core.
From the opening track "She Works Out Too Much," MGMT lays down what is in store–psychedelia synth pop. It feels like the beginning of a classic 80s workout with routine ad libs for the listening audience.
The first self-titled single for the album, "Little Dark Age," is a gothic tale that grabs the listener with an extremely catchy chorus and production but somewhat lacks in the lyrical bridge between choruses.
"Policemen swear to God/Love's seeping from the guns/I know my friends and I/Would probably turn and run/If you get out of bed/Come find us heading for the bridge/Bring a stone, all the rage/My little dark age."
"Little Dark Age" is not without its political and social relevance. "TSLAMP" (Time Spent Looking at my Phone) turns its focus on society's addiction to their cell phones and how that addiction has changed how everything works exponentially.
"Last thing that you need/Is the new shiny feature/All the memories you've shared/Developed by perverted creatures/Nothing can compete/With the first time you saw her passing strangers on the street/Spending every moment looking at their phones."
Presently, life is being lived through a screen and without life experience there is an ignorance to the beauty of life itself.
"Hand it Over," the final track on "Little Dark Age," brings an end to the pessimistic yet euphoric album. President Trump is put into the equation as he somewhat influenced a portion of the tracks on "Little Dark Age."
"The joke's worn thin, the king stepped in/Now we'll see who is who/Look who's bending over."
Although strong and poetic, MGMT seems to be more in the headspace of their new-found sound rather than keeping in touch with the lyrics.
MGMT's biggest weakness within "Little Dark Age" is their lyrical sense. The lyrics written attempt to be poetic but fall short of greatness.
They've brought back the catchy choruses missing in their previous two albums, but everything else seems to be a let down. The focus is more on the synth-psychedelia aspect of the production by David Fridmann, producer of The Flaming Lips and Spoon, rather than timely lyrics.
Don't get me wrong, MGMT has created an album that delivers on bringing the band back to the limelight. Six years have passed since their last album, but the lyrics of "Little Dark Age" don't reflect an investment of that time.
Although MGMT's latest outing is a minor disappointment, catchy tracks like "Little Dark Age," "When You Die," "One Thing Left to Try" and "Hand it Over" will satisfy fans for 44 minutes.
Check out MGMT at the Peabody Opera House, March 5.
This is Margherita's fifth semester on staff where he serves as an opinions writer for the EHS_hub. Marghertia enjoys discovering new music, traveling...


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Russia says France has extradited a former regional finance official to face trial on multiple counts of fraud, misuse of funds, and money laundering following a long legal battle.
Aleksei Kuznetsov was "extradited to Russia accompanied by staff from the Russian prison service and the Russian bureau of Interpol," the international police agency, the Prosecutor-General's office said on January 3.
There were no immediate comments from French authorities.
Kuznetsov served as finance minister for the Moscow region between 2000 and 2008.
According to investigators, he, along with "accomplices," caused losses of more than 11 billion rubles ($160 million) to the regional government.
The money was allegedly used to buy property abroad.
Kuznetsov was arrested in southern France in the summer of 2013 and appealed against his extradition in French courts over the following years.
In January 2018, a Russian court convicted Kuznetsov's former wife, Janna Bullock, of large-scale fraud and money laundering and sentenced her to 11 years in prison after a trial in absentia.
Bullock is an American citizen and the United States refuses to extradite her to Russia.
She has said she and her ex-husband were victims of corruption in Russia.


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- Work: Zari Resham Thread Floral Embroidery, Stones
- Weight: 2500 Gms.
- Time Required: 10-12 days
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After I broke my neck, I couldn't walk. But I could still lead.
From OZY and JPMorgan Chase & Co., which have partnered to bring you Leadership Journey, stories and audio about how top execs ascended the corporate ladder. Listen below to hear how the head of disability inclusion at JPMorgan Chase got to where he is today . Enjoy the rest of our special series here . While on vacation, I broke my neck body surfing. I was 25 years old and until then considered myself the best thing since sliced bread. But that life-altering accident changed the focus on everything. I was convinced I was done, that my career was over. But IBM thought differently. I had already been working for them, and they assured me they wanted me back after my 18-month recovery. I took up a job in technical publications and, 39 years later, in 2015, I retired as corporate director of marketing communications. At IBM, I met many people who had a lot of heart. When someone offered me a helping hand, I took it in the spirit in which it was given. But I worked my behind off. I


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Riml Sports Telfs
Info and opening hours
Riml Sports Telfs
Michael-Seeber-Straße 2 , 6410 Telfs
Monday - Friday 9.00 am - 6.30 pm | Satruday 9.00 am - 5.00 pm
Learn more:
A sports shop offering sports fashion and equipment for trendsetters. The selection ranges from equipment for alpine skiing, cross-country skiing and snowboarding to running gear, fitness equipment and sports products for tourers.
E-bike rental is also available: ideal for a cycle ride or a mountain bike tour.


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Evidence-based practice is a mainstream concept in the healthcare community.1 It has had an impact by engendering good practice through judgement of scientific evidence and continued professional development among practitioners. Healthcare professionals may influence injury prevention through advocacy, although their effectiveness for injury prevention has not been studied.2 Advocacy is defined by the World Health Organization (WHO) as a combination of actions to gain "political commitment, social acceptance and system support for a particular goal or programme".3 Evidence-based policy requires policy-makers to acquire objective evidence of effectiveness, public acceptability and cost-effectiveness. Advocacy may narrow the gap between what is known to be effective, acceptable and efficient, and what is practiced.2
However, it is important to note that a wide range of professionals are tasked with delivering services that are specifically intended to reduce the number of injuries on the road. The World Road Association catalogue the organization of road safety "services" (which can include highway design and remediation, law enforcement, as well as educational/training interventions) around the world.4 Autonomous professionals responsible for service delivery are seen in a number of countries working at a local government level. The UK is a typical example where there is national policy (determined by the Department for Transport (DfT)) and local provision is effected by Police Forces and Highways Authorities. Their level of autonomy is attested by governmental publication; for example, the DfT have issued guidance in relation to pedestrian training, which aims to "assist road safety officers and other practitioners to conduct their own evaluations and to be better informed when commissioning an evaluation".5 One …
Competing interests: None.


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Sclerotinia stem rot
What is it?
Sclerotinia stem rot (SSR), caused by the fungus Sclerotinia sclerotiorum, is a disease that attacks canola and other broadleaf plants including lupins, chickpeas, lentils, sunflowers and soybeans. Over 400 species can act as a host for sclerotinia including capeweed and wild radish. Previously it was most commonly found in parts of the northern WA wheatbelt but more recently it has extended to most of the canola growing regions in the state.
Agriculture and Food at the Department of Primary Industries and Regional Development (DPIRD) are at the forefront of research into sclerotinia in canola to minimise yield losses to WA growers. From when the disease first started becoming an issue near Geraldton in 2008, DPIRD plant pathologists have been working on all aspects of the disease. From understanding the lifecycle, to cultural management, fungicide application, and developing a forecasting tool, we are providing the grains industry with information and strategies to help combat this disease.
Life cycle of sclerotinia and how to assess disease risk
The fungus survives as sclerotia (fruiting bodies that look like rat droppings) in the soil for 6 years or more or by colonising other host plants. Risk factors for sclerotinia stem rot infection include: paddock history, rotation with susceptible crops, disease incidence in the last affected crop, distance from last affected crop and conducive weather conditions during the season. For sclerotinia stem rot to develop in crop, there are 3 factors that need to occur.
- Frequent rainfall events combined with temperatures of 10-20°C and high humidity are required for sclerotes to germinate and produce apothecia (small, cream, mushroom-like bodies). Apothecia release large numbers of ascopores into the air which can infect petals.
- Humid moist weather during flowering and while ascopores are being released leads to petal infection.
- Infected petals drop down into the crop canopy after 30% bloom and stick to leaf axils where, if weather remains humid and moist, the fungus invades the leaves or branches and ultimately the stems.
Diagnosing sclerotinia stem rot in canola
Symptoms of sclerotinia on the stem appear as bleached greyish white, or brownish with white fluffy fungal growth. Advanced infections have sclerotia (hard, black irregular shaped to rounded bodies) on the inside and bleached parts of the stem. In moist weather, sclerotia can also form on the outside of infected stems and roots. Canola pods can also become infected and will appear creamish white and seeds can be mouldy.
Sclerote germination experiments
To better understand the lifecycle of Sclerotinia sclerotiorum and why some years or in some regions it is more of a problem than others, sclerote germination experiments are being conducted in Geraldton by DPIRD plant pathologist Ciara Beard and technical officer Anne Smith. In controlled environment conditions in the laboratory, investigations compare the germination of sclerotes sourced from different regions, currently Esperance and Geraldton, under two different temperature regimes (10-22°C/16-29°C) and two soil types (sand/loam). Research is supported by GRDC under the National canola pathology project and the National pathogen management modelling project. Sclerotes are watered regularly to keep them moist. As per past experiments, sclerotes in the current experiment have germinated after 40 days of being kept moist and in day/night temperatures of 10-22°C. This simulates the autumn conditions often found in the southern region such as Albany and Esperance.
In comparison, preliminary results show that no sclerotes germinated in day/night temperatures of 16-29°C despite regular watering. These temperatures simulate the autumn conditions in the northern wheatbelt such as Geraldton. This research assists our understanding of factors that affect sclerote germination in the different regions of the wheatbelt.
Work done by DPIRD Plant Pathologist Dr Ravjit Khangura in the field has shown that sclerotes can produce apothecia as early as 23 days. Further work is needed to understand why the sclerotes take longer to germinate in lab conditions than they do in the field.
Management options in canola
Sclerotinia in canola is currently being managed through the use of fungicides and some cultural practices.
Cultural practices
Some cultural practices that could be useful in reducing sclerotinia risks include:
- Having a 1 in 5 year rotation of susceptible crops to prevent sclerote build up
- Separating susceptible crops by at least 500m from last year's susceptible crop stubbles or paddocks that have a history of sclerotinia in the previous 4 years
- Using seed free of sclerotes to prevent spread of disease in disease free areas/paddocks
- Burning windrows. During his honours project at the Centre for Crop Disease Management (CCDM), Kyran Brooks found that sclerotes can be destroyed by burning windrows if consistently high temperatures are reached. Earlier investigations by Tamrika Lanoiselet (DPIRD) during her PhD found that at lower temperatures sub-lethal burns were occurring. The sub-lethal burns resulted in sclerotes germinating early than unburnt sclerotes. This could lead to an extended window of sclerotinia risk making control more difficult.
- Avoiding sowing early maturing varieties in March/April in high risk areas. This may result in crops flowering in June and July where conditions might be suitable for apothecia germination.
With mouldboard ploughing being used in some areas to reduce the weed seed bank and ameliorate non-wetting, could this also be used as a method of controlling sclerotinia? At the Esperance Downs Research Station, DPIRD plant pathologist Andrea Hills has established a trial where five different sized sclerotia have been buried at three depths (15, 20 and 30cm). The 825 sclerotia used were from a paddock at Scaddan and reflect the wide range of sizes (from 2mm to >15mm) which are produced by the fungus in the southern region (see attached photo for an example). They will remain buried for five years before being dug up to assess whether they are still intact and can germinate. There are some additional sclerotia buried that can be dug up in seven years if the others do manage to survive for five. To simulate the mouldboarding result, the soil was inverted on top of the sclerote pockets that were buried. This GRDC supported research is being funded as part of the National Canola Pathology Project.
Research over the past seven years has identified several products effective against Sclerotinia. Currently iprodione, promcymidone and prothioconazole + tebuconozole and more recently prothioconazole + bixafen based products are registered for sclerotinia control. With reports of fungicide resistance in sclerotinia overseas, the rotation of different fungicide groups will help to reduce the risk of this occurring here.
Since 2012, seventeen trials have been done by DPIRD across WA to compare fungicide timings from 10 to 50% flowering including double application scenarios. Nine of these trials had disease levels of 3% or more main stem infection and were taken through to harvest. Double applications (eg at 10 and 50% flowering) consistently reduced disease and increased grain yields. Single applications of fungicide reduced lesion development in approximately 80% of situations while yield responses varied, with two thirds of fungicides that were applied in the 20 -50% flowering window significantly increasing grain yields. It must be remembered that these trials had fungicides applied regardless of the outlook in weather conditions.
In a recent trial in 2016 at Moonyoonooka, in the Northern grainbelt, DPIRD plant pathologist Ravjit Khangura conducted trials to compare fungicide efficacy and timing for optimum economical return. Hyola 400 was sown under a good disease presence. Three different fungicides (Prosaro®, Sumisclex® and Product C) were applied at various bloom stages. All of the fungicides decreased the disease incidence resulting in increased yields in comparison to the untreated plants. There was no difference in disease incidence between the fungicide product or the timing of fungicide application. A double spray application at 10 and 50% proved to have the best yield response due to prolonged growing season that year. Generally a well-timed single spray application is quite effective in controlling the disease and providing economic returns. However, an economic response from late fungicide applications (50% bloom) may be achieved if the disease epidemics start late in the season as occurred in many areas in 2013. Late spray applications past 50% bloom are not recommended.
Registered foliar fungicides for canola in Western Australia
Dr Khangura also investigated the effect of row spacing, plant density, variety and fungicide application on disease incidence and control in the NAR in 2016. Two varieties were sown (IH30RR and HR600RR) at two different row spacings (44 and 22cm) and two targeted plant densities (30 and 15 plants/m2) with or without Prosaro® applied at 30% bloom at the recommended rate of 450ml/ha. As expected, application of fungicide reduced disease but there was no effect of row spacing or plant densities, Hyola 600RR had less disease incidence than IH30RR. While there are no known resistant canola varieties to sclerotinia, some varieties have shown lower levels of incidence to the disease, most likely due to timing of flowering.
|Main factor Fungicide
|Yield (Kg/ha)
|Fungicide +
|Fungicide -
|Lsd (5%)
|Main factor Row Spacing
|Yield (Kg/ha)
|Lsd (5%)
|Main factor Plant Density
|Yield (Kg/ha)
|15 plants/m2
|30 plants/m2
|Lsd (5%)
|Main factor Variety*
|Yield (Kg/ha)
|Lsd (5%)
Letters in bold indicate significant treatment effects. * = significant treatments
For more information refer to Sclerotinia in canola - ground infections, effect of row spacings. Is it worth spraying after you see the disease?
Managing sclerotinia stem rot in canola
Sclerotinia stem rot in canola GRDC fact sheet
Seasonal variability
Every season is different which means there are no steadfast rules for managing sclerotinia year in year out. Growers need instead to be flexible and assess their risk and best time for fungicide application based on the current season considering:
- Timing of sclerote germination- varies depending on autumn rainfall/the break of the season and temperatures being cool enough.
- Flowering window (affected by variety and time of sowing)
- Weather conditions (humid moist weather) 3 weeks prior to flowering and during flowering favours petal infection and similar weather conditions after full bloom favours stem rot development.
Pathogenic diversity of WA sclerotinia field isolates
Preliminary work done by Dr Ravjit Khangura indicates that there are variations among WA isolates with some isolates more aggressive on certain host varieties; the pathogenicity of 20 different isolates was tested on a range of canola varieties. CCDM is also investigating the genetic diversity to better understand how isolates differ from one another and how fast they can adapt to potentially new resistant canola varieties or commonly used fungicides. There is potential for collaboration between DPIRD and CCDM in this area in the future.
Sclerotinia forecast model
A forecast model that can predict when sclerotes are likely to germinate and produce apothecia (the small mushrooms) has been developed by researchers at DPIRD using epidemiology data generated in WA and NSW. Jean Galloway, a plant pathologist with DPIRD is currently testing this model to see how accurate it is. As part of this testing process sclerote depots have been established at nine locations next to weather stations in the wheatbelt this season. These depots are equipped with smart technology that takes pictures of the sclerotes twice daily. The images are sent to DPIRD, are scanned and the number of sclerotes that have germinated are recorded. The sclerote depot photographs identified apothecia germination occurred at Northam in mid-July and at Wickepin in the first week of August this year. The depot at Wickepin has had apothecia present for the entire four week period between early August through to early September.
The detailed information provided by the 'Smart Sclerotinia Depots' will be used to refine the apothecia forecast model. This work is being supported by GRDC, the National Modelling Project (led by Jean Galloway) and a Boosting Grains Research and Development Flagship project.
To spray or not to spray?
A sclerotinia decision support tool that will be available on tablets is in development. The tool will estimate the net return from spraying to control sclerotinia, including minimum and maximum estimates. The following are the current inputs that growers and consultants can adjust in the tool using the sliders (circles) on the left in the picture below:
- Are you considering a first or second spray?
- What is the target yield of the crop?
- What is the anticipated grain price?
- What are the costs of production other than sclerotinia management?
- Is it a heavy or sandy soil type?
- How frequently have broadleaf crops been grown in the paddock?
- How frequently has sclerotinia loss been observed in past seasons?
- What is the bloom stage of the crop?
- How many wet days have there been in the past 3 weeks?
- How many wet days are expected next week and in the week after?
- What is the cost of the spray?
After entering your situation-specific inputs, the decision support tool produces a table (shown at the right of the screen) for the economic returns for spraying to control sclerotinia versus not doing anything (no spray). It is planned that the sclerotinia tool will be available as a beta (test) version later this season. This tool is being developed by Art Diggle (DPIRD) in the National Pathogen Modelling Project, supported by GRDC, with input from canola pathologists and agronomists in WA, NSW, Victoria and SA.
Sclerotinia in lupins
Sclerotinia stem rot (SSR) is also a damaging disease of crops other than canola. In Western Australia it has historically been a sporadic concern in lupins crops, causing stem and branch lesions as well as infecting individual pods or the whole main stem flower spike. However through the 2015 and 2016 seasons there have been increasing reports of damaging levels of SSR in lupin crops, most likely a result of highly favourable seasons and increasing inoculum pressure contributed by infected canola. In lupins, SSR causes both a yield reduction and considerable additional grain cleaning costs to remove sclerotia from the harvested sample prior to delivery.
A 2016 survey, conducted by Anne Smith from DPIRD, of lupin paddocks in the Geraldton port zone, found that 7/15 crops had SSR present, with incidence of infected plants ranging from 1-10%.
A lack of registered fungicides leaves growers without options for management of the disease. Preliminary field trials, with unregistered products, have demonstrated reduced sclerotinia infection and given a positive yield response in albus lupin (4 – 15%) and narrow-leaf lupin (0 – 14%).
Limited variety screening for sclerotinia has been conducted in lupins. Preliminary testing of released varieties has not detected any significant difference in susceptibility of stem tissue to infection. Paddock observations suggest that crop canopy development, flowering date and regional weather conditions influence incidence and severity of infection more than variety. Research into managing sclerotinia in lupins is supported by GRDC through the Improving grower surveillance, management, epidemiology knowledge and tools to manage crop disease project.
Sclerotinia in canola
Dr Ravjit Khangura
Research Officer
Ph: +61 (0)8 9368 3374
Andrea Hills
Research Officer
Ph: +61 (0)8 9083 1144
Sclerotinia forecast model
Jean Galloway
Research Officer
Ph: +61 (0)8 9690 2172
Sclerotinia spray decision tool
Dr Art Diggle
Senior Research Officer
Ph: +61 (0)8 9368 3563
Sclerotinia in lupins
Geoff Thomas
Research Officer
Ph: +61 (0)8 9368 3262


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An 8-year-old boy is brought to your office because of a chronic cough. His mother says that he coughs frequently throughout the day and will have symptoms 2 or 3 nights a month as well.
Treating asthma
Case: agents used to treat asthma. Questions – Answers
He takes his medication 15 minutes prior to anticipated exercise, which will help to prevent the asthmatic attack but does not produce bronchodilation. She has been taking her medications as instructed, but one of the medications is causing her to have tachycardia, nausea, and jitteriness. She has been informed of the need to measure serum levels of this medication.
Of course, it's most important that you take your asthma medications as prescribed. But in addition to taking your medicine correctly, if you're having symptoms, there are some home remedies you can try to help make yourself feel better too. But remember — these tips should never replace your regular asthma medications.
Case: agents used to treat asthma. Class
Asthma is characterized by acute episodes of bronchoconstriction caused by underlying airway inflammation. A common finding in asthmatics is an increased responsiveness of the bronchi and trachea to exogenous or endogenous stimuli that results in inappropriate contraction of smooth muscle in the airway, and production of thick viscid mucus and mucosal thickening from edema and cellular infiltration. Asthma typically occurs with both an early-phase response lasting approximately 1-2 hours that is triggered by autocoids and inflammatory mediators such as histamine, leukotrienes, and prostaglandins.


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Nearly two acres situated on a corner lot with a deeded boat slip on Lake Keowee in The Highlands on Lake Keowee.
A Crescent Community that is located 30 miles from downtown Greenville, 19 miles from downtown Clemson, and 15 miles from Seneca. Boat slips are close to the main channel north of Hwy 183.
For pricing and details, click here.
Take a video tour here.


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Steph Hadley
Master of Monsters: Omnibus, Free Books, and More!
Two blog posts in as many months? You know that means there's big news!
First things first: The Master of Monsters Omnibus will be released in just over a week. And as usual, I'm making a handful of free copies available in advance of publication. Get yours here! (Don't procrastinate; they're half-gone as of this post.) For fans of the series, this is your chance to get all four novels in one convenient place. And for newcomers, well... same. Reviews are voluntary, of course, but incredibly helpful and greatly appreciated!
And, for those of you who might've missed it, there have been a number of other big releases in the Ansiri-verse over the past month. The first prequel novel, Conqueror of Isles: Ambassador is out, as are audiobook versions of the entire Master of Monsters series. You'll find each of them here:
Ambassador (Conqueror of Isles #1)
Lord of Flesh / Baron of Hearts Audiobook
Count of Souls / Duke of Minds Audiobook
I'm hard at work on a number of projects as well. Renegade (Conqueror of Isles #2) is approximately 20% complete and I've got a few other shorts in progress for my S.L. Hadley pen name.
As always, thank you so much for your support. I couldn't do this without you!


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As your full-service partner, George E. Booth Co., LLC will help and work with you every step of the way.
Will instrumentation and controls play a role within the project to better control the process? Do you have an understanding of what gains can be made to help find a Return on Investment faster? Will better control allow for a higher product quality, reduced cost overruns, or minimized cost of your raw materials?
How can better control and visibility to the process save you time and money?
In developing a project scope, has consideration of a Main Instrumentation Vendor (MIV) or Main Automation Contractor (MAC) come into the discussion? The process would allow for you to have single point of contact for all instruments and controls. Is it important to have single point of contacts for accountability? Make sure to speak with your potential partners up front about this.
What is the expectation for Warranty within the project scope? Warranty periods normally start when the equipment is shipped from the manufacturer. Will the instruments be installed and operational within a short amount of time, or will they be installed several months after delivery? Is it important to understand the needs and timing of warranty scope?
Understanding lead times may vary by product and many projects require the delivery of some items in the early stages and others to be shipped to a skid builder or contractor. Do you have adequate and safe storage for components when delivered to the site? This would allow for access to these devices when needed on-site by contractors. The goal is to have the tagged instruments ready and available to keep the project moving along smoothly.
Do you need embedded engineering support for your project? Are you adequately staffed with Engineering support to meet the demand of the project timeline? Consider looking for a provider that can help develop specifications, sizing, 2D & 3D drawings, and model code execution for products. The position would allow for help early in a project and could extend all the way through execution and commissioning.
Make sure your supplier has a solid line of communication with the manufacturer to understand lead times and orchestrate ordering so everything shows up on time.
Do you need help with the logistics of your project? For example, do you have room to stage all equipment based upon lead times and when you may need the instruments on-site? Do you have the ability to keep track of all items and have them available when needed?
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Most large projects should have a single point of responsibility for MIV/MAC and the following support. We provide this to help guarantee your project gets up and running as smoothly as possible and stays running.


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The finest quality silicone rubber hose; proven flexible, lightweight, and has a long service life. This hose is ideal for steam iron service. No other hose is as flexible, which makes it easier to move the iron. 200 PSI. ¼" ID x ½" OD
Price is per foot.
Made in Germany