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text: Kidney TransplantationDonor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case SeriesGoussous, Naeem MD1; Xie, Wen MD1; Dawany, Noor PhD2; Scalea, Joseph R. MD1; Bartosic, Amanda MBA1; Haririan, Abdolreza MD3; Kalil, Roberto MD3; Drachenberg, Cinthia MD4; Costa, Nadiesda MD3; Weir, Matthew R. MD3; Bromberg, Jonathan S. MD, PhD1Author Information 1 Department of Transplant Surgery, University of Maryland School of Medicine, Baltimore, MD. 2 Department of Biomedical and Health Informatics, Children Hospital of Philadelphia, Philadelphia, PA. 3 Department of Transplant Nephrology, University of Maryland School of Medicine, Baltimore, MD. 4 Department of Pathology, University of Maryland School of Medicine, Baltimore, MD. Published online 11 June, 2020. Received 18 March 2020. Revision received 8 April 2020. Accepted 2 May 2020. The authors declare no funding or conflicts of interest. N.G., W.X., and J.S.B. involved in research design. N.G. and J.S.B. involved in manuscript writing. N.D. involved in data analysis and figures preparation. J.R.S., A.H., R.K., M.R.W., N.C., C.D., and A.B. involved in revisions. Correspondence: Jonathan S. Bromberg, MD, PhD, Division of Transplantation, Department of Surgery, University of Maryland School of Medicine, 22 S Greene St, S8B06, Baltimore, MD 21201. (firstname.lastname@example.com). This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Transplantation Direct: July 2020 - Volume 6 - Issue 7 - p e568 doi: 10.1097/TXD.0000000000001019 Open Metrics Abstract Background. Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive plasma biomarker to evaluate for transplant allograft rejection. The relationship between infectious complications in kidney allografts and dd-cfDNA has received cursory attention in prior publications. Methods. Retrospective review of all renal transplant recipients who underwent dd-cfDNA testing between November 2017 and August 2019. Results. We report on 7 cases in whom infections affecting the transplanted kidney were associated with elevation in dd-cfDNA without concomitant rejection or elevation in serum creatinine. Five patients had BK viremia, and 2 patients had urinary tract infection associated with elevated dd-cfDNA levels. Conclusions. These observations suggest that elevations in dd-cfDNA are not specific to kidney allograft rejection and can be associated with infections affecting the transplanted kidney. This biomarker may be valuable in evaluating infectious complications of kidney allografts. Various events including immunologic, vascular, structural, medication related, and infectious causes can affect kidney allograft function and longevity. Prompt diagnosis and treatment of these insults is essential and could improve the function and prolong the longevity of the graft.1 Histological examination of an allograft biopsy is considered the gold standard for evaluation of abnormal kidney function to diagnose pathological processes, particularly various types of rejection.2 Biopsy is an invasive procedure, carries a complication rate of about 1%, has associated logistic and scheduling burdens, and is resource intensive. Furthermore, variability in pathological diagnosis is common, and up to 25% of reports are nondiagnostic.3,4 Therefore, other noninvasive methods to evaluate different forms of allograft injury are needed. Elevations in plasma donor-derived cell-free DNA (dd-cfDNA) have been described in the presence of graft rejection in liver, lung, heart, and kidney transplant recipients.5-9 Because organ injury prompts cell-free DNA (cfDNA) release, it is conceivable that trauma, infection, ischemia, or immune events may lead to cfDNA increases in the plasma. This is particularly relevant for transplantation where both rejection and infection are common. Moreira et al10 described elevations in plasma and urinary cfDNA levels in the setting of infections, whereas Sigdel et al11 described elevations in urinary dd-cfDNA in infections. We hypothesized that elevations in dd-cfDNA are not specific to rejection, and levels could be elevated in infections of kidney allografts. In this series, we report 7 cases of patients with graft injury causing elevations in dd-cfDNA during bacterial and viral kidney infections. MATERIALS AND METHODS After institutional review board approval, we performed a retrospective review of all kidney transplant recipients who underwent a dd-cfDNA testing (Allosure; Care Dx, Brisbane, CA) between November 2017 and August 2019 at our institution. All patients had the test for surveillance purposes; 28 patients were part of the Kidney Allograft Outcomes Allosure Registry. An abnormal dd-cfDNA result was defined as a value of ≥1%.5 Patients with simultaneous dual-organ transplantation and those with a history of prior organ transplantation were excluded. All patients with at least 1 abnormal dd-cfDNA test and concomitant evidence of BK viremia, BK virus nephropathy (BKVN), or urinary tract infection (UTI) were included. BKVN was defined by the presence of viral cytopathic changes in the tubular epithelial cells and confirmed with positive immunohistochemical staining for SV40 large T antigen.12 BK viremia was evaluated with quantitative polymerase chain reaction of the serum and reported as copies/mL. UTI was defined by the presence of symptoms and a positive urine bacterial culture with a count >100 000 colony-forming units. Donor characteristics evaluated included age, sex, living versus deceased donation, and kidney donor profile index. Recipient characteristics evaluated included age, sex, cause of end-stage kidney disease, type of dialysis, duration of dialysis, induction immunosuppressive regimen, and early graft function. Delayed graft function was defined as dialysis within 7 days after transplantation. Recipient serum creatinine level, microalbuminuria, kidney biopsy results, serial dd-cfDNA levels, BK viral load, and presence of donor-specific antibodies (DSAs) after transplant were examined. RESULTS During the study period, 392 patients had at least 1 dd-cfDNA test performed; 45 patients were excluded due to history of dual-organ transplantation or retransplantation. Twenty-nine patients had an elevated dd-cfDNA, whereas 318 had a dd-cfDNA value within normal limits. Out of the 29 patients with elevated dd-cfDNA, we identified 7 patients with elevated dd-cfDNA and concomitant evidence of infection affecting the kidney allograft: 5 patients had BK viremia, and 2 patients had bacterial UTI. Figures 1–7F2F4F6 illustrate the clinical course of each patient with elevated dd-cfDNA. Trends in creatinine, microalbuminuria, BK viremia, DSA, dd-cfDNA, and biopsy results are displayed for each patient. From the 318 patients with a nonelevated dd-cfDNA, 21 patients had evidence of an infection affecting the allograft: 17 with BK viremia and 4 patients with UTI. Table 1 shows the donor and the recipient characteristic for all 28 patients with infections. Overall, the test had a 25% (7/28) sensitivity to detect infection and specificity for infection of 24% (7/29). The predictive values for infection were 24.1% (7/22) positive predictive value and 93.4% (297/318) negative predictive value.TABLE 1.: Donor and recipient characteristicsFIGURE 1.: Case 1. Elevation in dd-cfDNA associated with BK viremia. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. BKVN, BK virus nephropathy; Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; FSGS, focal segmental glomerulosclerosis; PCR, polymerase chain reaction.FIGURE 2.: Case 2. Elevation in dd-cfDNA associated with BK viremia and BKVN. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. BKVN, BK virus nephropathy; Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody.FIGURE 3.: Case 3. Elevation in dd-cfDNA associated with BK viremia. BKV titers presented as number of virus copies/mL:, DSA specificities presented as mean fluorescence index. Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; PCR, polymerase chain reaction.FIGURE 4.: Case 4. Elevation in dd-cfDNA associated with BK viremia. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; PCR, polymerase chain reaction.FIGURE 5.: Case 5. Elevation in dd-cfDNA associated with BK viremia. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; PCR, polymerase chain reaction.FIGURE 6.: Case 6. Elevation in dd-cfDNA associated with recurrent urinary tract infections with Enterobacter cloacae complex and Enterococcus faecalis and antibody-mediated rejection (AMR). The asterisk indicates the occurrence of the urinary tract infection. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; PCR, polymerase chain reaction.FIGURE 7.: Case 7. Elevation in dd-cfDNA associated with urinary tract infection with Acinetobacter baumannii complex. The asterisk indicates the occurrence of the urinary tract infection. BKV titers presented as number of virus copies/mL; DSA specificities presented as mean fluorescence index. Cr, serum creatinine; dd-cfDNA, donor-derived cell-free DNA; DSA, donor-specific antibody; PCR, polymerase chain reaction.None of the 7 patients with elevated dd-cfDNA and infection had a concomitant increase in creatinine. In the recipients with infection but nonelevated dd-cfDNA, only 2 patients had elevation in their creatinine. The relationships between microalbuminuria and dd-cfDNA were variable. In case (number 6), the patient had microalbuminuria before UTI diagnosis likely to underlying antibody-mediated rejection. However, in case (number 7), microalbuminuria coincided with the diagnosis of UTI. In case number 5, the patient developed nephrotic range proteinuria with no identifiable explanation on the biopsy. In the 2 cases of UTI, elevation of dd-cfDNA occurred in close proximity to diagnosing the infection. In case number 6, the patient had baseline elevated dd-cfDNA to 1.8% from antibody-mediated rejection, but the level rose to 2.8% soon after a UTI was diagnosed. In case number 7, dd-cfDNA rose to 2% 12 days after diagnosing the infection. After UTI treatment, the dd-cfDNA trended down and normalized in both cases. In the 5 cases of BK viremia, all patients had elevations in dd-cfDNA. Four patients had a kidney biopsy within a month of the elevated dd-cfDNA, and biopsies were negative for SV40 staining. One patient (number 2) had a kidney biopsy 6 months prior, which showed BKVN. The relationship between dd-cfDNA and the degree of BK viremia was variable; in case numbers 4 and 5, dd-cfDNA levels paralleled BK virus titers, whereas in case numbers 1–3, there was no correlation. DISCUSSION The use of dd-cfDNA became commercially available in October 2017 and has emerged as a promising and noninvasive biomarker to screen for the presence of allograft rejection. Elevations in dd-cfDNA often predate elevation in creatinine, making it valuable for detection of subclinical injury in transplants, potentially allowing for earlier interventions.13,14 The use of dd-cfDNA to detect rejection has been reported in multiple studies with sensitivities ranging between 59% and 100%, specificities 72% and 85%, and areas under the curve of 0.74–0.82.6,13,15 However, elevations in dd-cfDNA levels in the setting of infections affecting the kidney allograft have been limited to a few case reports. Here, we report on 7 renal allograft recipients with elevation in plasma dd-cfDNA associated with infection: 5 cases of BK viremia and 2 cases of bacterial UTI. Our observations suggest that elevation in dd-cfDNA is likely attributable to graft injury from these infections. Six patients had a biopsy within 1 month of the elevated dd-cfDNA. In 3 cases, biopsy did not show injury in the graft. In 2 cases, biopsy findings were nonspecific and failed to explain dd-cfDNA elevation. One patient had recurrent antibody-mediated rejection with a biopsy showing capillaritis associated with multiple DSAs on multiple evaluations, but acute elevation of dd-cfDNA elevation coincided with recurrent UTI. With treatment and resolution of the infection, dd-cfDNA levels trended back to normal despite persistence of antibody-mediated rejection on biopsy. In one case, BKVN was diagnosed by biopsy 6 months before the elevated dd-cfDNA, but there was no biopsy closer to the dd-cfDNA result. This patient had persistent BK viremia with no additional clinical explanation for the elevated dd-cfDNA. In all 7 cases, the subclinical injury identified by dd-cfDNA elevation was due to infections not captured by findings on biopsy nor reflected by elevations in creatinine or microalbuminuria. These observations highlight the shortcomings of our current tools for detecting and diagnosing graft injury and function. In many pathological processes, the findings are focal and can be missed when evaluating biopsy specimens, whereas elevation in creatinine is a late finding that reflects substantial injury to the graft. Donor-derived cfDNA therefore can be regarded as a marker of injury not limited by the sampling error of a focal pathology affecting the organ. The interpretation of dd-cfDNA results in the setting of infections affecting the allograft must be done cautiously. In our cohort of the 28 patients with infections, 7 (25%) had elevated dd-cfDNA, suggesting either that the sensitivity is low or that most infections do not cause significant tissue damage. Further, of 29 patients with elevated dd-cfDNA, 7 (24%) had infection as the likely cause of the elevation, showing that there are multiple causes of tissue damage, including infection, and that this test identified tissue damage missed by other modalities. For the other 22 patients with elevated dd-cfDNA, the likely etiologies were rejection in 11, elevated DSA in 3, tacrolimus toxicity in 1, elevated dd-cfDNA after graft failure in 1, and there was no definitive diagnosis in 6 cases. For the 3 patients with elevated DSA, none had BK viremia, and 2 had biopsies that showed no rejection or other important abnormality, suggesting that dd-cfDNA may identify early antibody-mediated tissue injury. For the 6 with no definitive diagnosis, none had biopsies, 3 had no BK viremia, and 2 had no DSA, yet all had normal and stable renal function (Table 2).TABLE 2.: Patients with elevated dd-cfDNA and no infectionsDonor-derived cfDNA offers the advantage of being a noninvasive and perhaps a more sensitive biomarker for injury than creatinine or biopsy, but it lacks specificity regarding the type of injury. Because current dd-cfDNA detection techniques cannot differentiate one form of graft injury from another, we utilized dd-cfDNA as a surveillance test for injury of the graft. Elevated dd-cfDNA results prompt us to investigate different causes of injury, depending on the clinical scenario, by obtaining creatinine, urinary protein, urinalysis, relevant cultures, transplant renal ultrasound, allograft biopsy, serum DSA, and/or BKV polymerase chain reaction. Thus, in the setting of known BK viremia or the presence of UTI, elevated levels of dd-cfDNA reflect allograft injury even with a normal biopsy and creatinine. Elevated dd-cfDNA in a patient with known BK viremia could dictate the performance of a biopsy even if the creatinine and urinalysis are normal, whereas if the dd-cfDNA is normal, a biopsy may not be necessary. When evaluating recipients, the sensitivity and specificity of our current tools, such as clinical presentation, blood, and urinary studies, and imaging studies are each limited in their ability to detect allograft injury. Thus, we propose adding dd-cfDNA to current algorithms to enhance our diagnostic sensitivity and accuracy in managing these patients. Our study has several limitations. First, this is a small, retrospective study, making it difficult to prove causality. Second, the level of graft injury involved was not precisely defined, as the cases of UTI could have been cystitis with no graft involvement. In cases of BK virus infection, there is no quantitative direct correlation between the level of BK viremia and graft injury. Third, we used a dd-cfDNA threshold of 1% based on previous studies reporting on allograft rejection,6 but this threshold is not definitive, and the association of allograft injury and dd-cfDNA is likely a continuous one rather than a strict categorical value.16 Fourth, Oellerich et al17 reported on the absolute value rather than the percentage of dd-cfDNA as being more discriminatory to detect graft rejection because the value would be independent of recipient-derived cfDNA. Because we used percentage to define graft injury, it is possible that increases in recipient cfDNA could diminish dd-cfDNA percentage, whereas a decrease in recipient cfDNA could increase the percentage of dd-cfDNA. These measurements could potentially explain the low sensitivity of the test for infection. Elevations in plasma or urinary dd-cfDNA have been previously described during infections.6,10,11 Ours is the first detailed case series reporting on elevations in dd-cfDNA during UTI and BK viremia affecting kidney allografts with in-depth analysis of the cases. Our report highlights that elevations in dd-cfDNA are not specific to rejection, but are observed in infections. We believe that this test will be valuable for surveilling and assessing kidney injury during infections, providing information about the degree of injury, a measure that will be useful for diagnosis, prognosis, and treatment. A future prospective trial is needed to better define the specificity and sensitivity of dd-cfDNA during infections, to correlate dd-cfDNA elevations with BK virus titers, to determine if these elevations signify a worse short- or long-term outcome for the graft, and to incorporate this test in a clinical diagnostic algorithm that also takes into account other tests and clinical metadata.REFERENCES 1. Nankivell BJ, Kuypers DR. Diagnosis and prevention of chronic kidney allograft loss. Lancet. 2011; 15:1428–1437 Cited Here | PubMed | CrossRef 2. Williams WW, Taheri D, Tolkoff-Rubin N, et al. Clinical role of the renal transplant biopsy. Nat Rev Nephrol. 2012; 8:110–121 Cited Here | View Full Text | PubMed | CrossRef 3. Schwarz A, Gwinner W, Hiss M, et al. Safety and adequacy of renal transplant protocol biopsies. Am J Transplant. 2005; 5:1992–1996 Cited Here | View Full Text | PubMed | CrossRef 4. Rush D, Arlen D, Boucher A, et al. Lack of benefit of early protocol biopsies in renal transplant patients receiving TAC and MMF: a randomized study. Am J Transplant. 2007; 7:2538–2545 Cited Here | View Full Text | PubMed | CrossRef 5. Beck J, Bierau S, Balzer S, et al. Digital droplet PCR for rapid quantification of donor DNA in the circulation of transplant recipients as a potential universal biomarker of graft injury. Clin Chem. 2013; 59:1732–1741 Cited Here | View Full Text | PubMed | CrossRef 6. Bloom RD, Bromberg JS, Poggio ED, et al. Cell-free DNA and active rejection in kidney allografts. J Am Soc Nephrol. 2017; 28:2221–2232 Cited Here | PubMed | CrossRef 7. De Vlaminck I, Martin L, Kertesz M, et al. Noninvasive monitoring of infection and rejection after lung transplantation. Proc Natl Acad Sci U S A. 2015; 112:13336–13341 Cited Here | PubMed | CrossRef 8. Schütz E, Fischer A, Beck J, et al. Graft-derived cell-free DNA, a noninvasive early rejection and graft damage marker in liver transplantation: a prospective, observational, multicenter cohort study. PLoS Med. 2017; 14:e1002286 Cited Here | PubMed 9. Hidestrand M, Tomita-Mitchell A, Hidestrand PM, et al. Highly sensitive noninvasive cardiac transplant rejection monitoring using targeted quantification of donor-specific cell-free deoxyribonucleic acid. J Am Coll Cardiol. 2014; 63:1224–1226 Cited Here | PubMed | CrossRef 10. Moreira VG, García Garcia BP, Martin JM, et al. Cell-free DNA as a noninvasive acute rejection marker in renal transplantation. Clin Chem. 2009; 55:1958–1966 Cited Here | View Full Text | PubMed | CrossRef 11. Sigdel TK, Vitalone MJ, Tran TQ, et al. A rapid noninvasive assay for the detection of renal transplant injury. Transplantation. 2013; 96:97–101 Cited Here | View Full Text | PubMed | CrossRef 12. Drachenberg CB, Papadimitriou JC, Hirsch HH, et al. Histological patterns of polyomavirus nephropathy: correlation with graft outcome and viral load. Am J Transplant. 2004; 4:2082–2092 Cited Here | View Full Text | PubMed | CrossRef 13. Knight SR, Thorne A, Lo Faro ML. Donor-specific cell-free DNA as a biomarker in solid organ transplantation. a systematic review. Transplantation. 2019; 103:273–283 Cited Here | View Full Text | PubMed | CrossRef 14. Gielis EM, Ledeganck KJ, De Winter BY, et al. Cell-free DNA: an upcoming biomarker in transplantation. Am J Transplant. 2015; 15:2541–2551 Cited Here | View Full Text | PubMed | CrossRef 15. Huang E, Sethi S, Peng A, et al. Early clinical experience using donor-derived cell-free DNA to detect rejection in kidney transplant recipients. Am J Transplant. 2019; 19:1663–1670 Cited Here | View Full Text | PubMed | CrossRef 16. Stites E, Kumar D, Olaitan O, et al. High levels of dd-cfDNA identifies patients with TCMR 1A and borderline allograft rejection at elevated risk of graft injury. Am J Transplant. 2020; 00:1–8 Cited Here 17. Oellerich M, Shipkova M, Asendorf T, et al. Absolute quantification of donor-derived cell-free DNA as a marker of rejection and graft injury in kidney transplantation: results from a prospective observational study. Am J Transplant. 2019; 19:3087–3099 Cited Here | View Full Text | PubMed | CrossRef Copyright © 2020 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.View full article text


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Zesti – Ine Beerten | Blueprint 2: 21-23 May NYC
3,196 Likes, 36 Comments - Flora Waycott (@florawaycott) on Instagram: "Beetles and plants repeat I created for @lillarogers Menagerie 🐞 #gouache #holbeingouache #beetles…"
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I like to think I am a bit of a curiosity in the world of textile artists. I didn't, like most, learn sewing from my mother or grandmother as a young child, nor have I formally studied textiles. I learned woodwork, aged 4, from my dad. Sewing came later, in my teens, but the making-stuff bug caught from an early
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today i get to share with you my new special edition fabric line called hello, bear for art gallery fabrics. inspired by my son, bear, i've developed a children's fabric line that will easily cross over into adult projects as well. i'm calling it 'special edition' because i'm releasing two lines at once (oh yes!). …
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Commonly known as False mitrewort, Foam flower
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Semi-evergreen - Keeps some of its foliage all year, and will drop some leaves as well.
Herbaceous - Early in the year, typically January till end of March, herbaceous plants might be supplied in 9cm pots to ensure timely despatch. - rhizomatous perennials
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Herbaceous Plants - Video Collection
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Buy Varieties of TIARELLA
TIARELLA cordifolia >
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White flowers, leaves in rosettes
TIARELLA 'Spring Symphony' >
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Green leaves, deeply lobed and blotched with purple. Spikes of pale pink/white scented flowers
TIARELLA wherryi >
Commonly known as: Foam flower.
Creamy-white with pink tinge, leaves in rosettes


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Joshua Nolden - Agent
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Joshua Nolden's entrepreneurial background makes him an ideal Realtor for ones buying, selling and/or investing in real estate. Beginning his career in the industry as a professional architectural and interior photographer; Joshua has more than a half decade of experience in the real estate arena. Having photographed over a thousand homes, in and around the San Antonio metropolitan area, Joshua's love and knowledge for real estate, came from practical experience through his day to day business and interactions with realtors, builders, and interior decorators.
As a proud San Antonio native, Joshua is a devoted Spurs fan and the son of Military parents. Joshua always works with integrity and is devoted to using his background in visual marketing to help his clients get the best possible outcome.


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Hi insertponceyre...
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This is a show about early American history. Awarded Best History Podcast by the Academy of Podcasters in 2017, it's for people who love history and for those who want to know more about the historical people and events that have impacted and shaped our present-day world. Each episode features conve… read more
What would you like to know about Early American History?
It turns out, you wanted to know about the establishment of schools, how the colonial postal service worked, and about aspects of health and hygiene in early America.
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The face-off between Mamata Banerjee and Jagdeep Dhankar, West Bengal Governor deepened further on Thursday with Chief Minister warning him "Bengal will erupt in thunder". She reminded him that she is an elected head of the state and not his servant who is sitting on a chair only to oblige him and his queries, that he shouldn't overdo things. She lashed out and challenged him to prove what he claims, that BJP Hemtabad MLA Debendranath Roy's death was a political murder.
"He had to either prove that it's a political murder or else he is not fit to be on the constitutional chair. CID is probing the matter and the investigation is on. So far prima facie it is a suspected suicide. The Governor should not speak like a political party. He is worse and surpasses any BJP mouthpiece. What Amit Shah even doesn't say, he does. He doesn't respect the constitution" said Mamata Banerjee at the State secretariat hours after the Governor held a press conference at Raj Bhavan saying that the education in the State was " politically caged".
The Governor in his capacity as a Chancellor had called for a virtual meeting of the Vice-Chancellors of all State-run Universities on July 15 over their preparedness to hold exams as per the UGC advisory, something the state had strong objected. Apart from one, none attended the meeting. The Governor had taken offence and said that he will "have to set the process in motion to deal with their ( VC's) conduct in accordance with the applicable Act" The Governor had termed it non-compliance by the VC's and had asked "Can the education department and VCs self-proclaim they cannot be commanded by a chancellor? Are they not accountable?"
The Chief Minister assured the Vice Chancellors of her full support and that their will be no action against them. She said the interference into the university affairs by the Governor is uncalled for, reminding the non-conducive atmosphere BJP had allegedly tried to create at Jamia Milia University and JNU in New Delhi.
The differences between the state and state governor had been in the public domain, Mamata Banerjee has time and again blamed him of toeing the line to push the political agenda of BJP. But on Thursday she has warned him of crossing the line. "Let the good sense prevail. If the language of intolerance impacts our culture,... if someone wants to use power and force then we welcome him to fight the battle politically, democratically and peacefully. People will give you the reply," Mamata thundered.
Check the latest facts on Covid-19 here. Times Fact 'India Outbreak Report' by TIMES NETWORK and Protiviti is a comprehensive analysis that highlights the impact of the pandemic in India and projects the possible number of active cases in the weeks ahead.


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He started by telling me what made him and his wife consider setting up a special online service for disabled clients."The idea came to us in 2015 because we were already operating a dating agency and the current director of this agency for disabled people came to us to find a partner.But that's not the case –you have to want to make it happen.It is the same with finding love, finding the right partner.I am not saying the algorithm is the best in the world and I will not change it in any way, it is still developing.It varies with the social environment and it will not be the same for the Czech Republic and the Slovak Republic, and elsewhere in Europe it may be completely different.It is all up to you, you have to set your mind to it." How do you know that you algorithm is better than anyone else's? "I found my wife over the Internet so we have personal experience with online dating agencies and maybe that was the starting point that led us to this business – the fact that we discovered something was missing on these dating sites.We have studied many of them here and abroad and analyzed all the areas that were taken into consideration, and the results of the criteria used.
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Wed 12.08.20 20:00Atalanta v PSG (Champions League)
Atalanta and PSG meet in the UEFA Champions League quarter-final at Estadio da Luz. Due to the coronavirus pandemic the match will be settled with a single-leg qualifier.
Thu 13.08.20 20:00RB Leipzig v Atletico Madrid (Champions League)
RB Leipzig and Atletico Madrid meet in the Champions League quarter finals at Estadio Jose Alvalade. The match will be settled with a single-leg qualifier due to the pandemic.
Sat 12.12.20 21:00Live Music Penguin Incident
The Penguin Incident are a Mid Cheshire based covers band, doing Rock, a bit of Metal and a spot of Pop/Punk thrown in!


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Search results for : Service Gas Stations
Showing 1 to 10 of 565 results
Gas stations consider self service
With at least one gas station moving towards self service and several other operators toying with the idea, the jobs of gas pump attendants could be at risk, according to Bahamas Petroleum Retailers Association (BPRA) representative Oswald Moore.
While the move toward self service gas stations could increase profits for operators, it would likely fuel crime, said Moore.
He said while the associati...
Diesel to become scarce at gas stations, predicts service station President
By ALISON LOWE
Business Reporter
DIESEL fuel is to "become more scarce" in short order, the President of the Bahamas Petroleum Retailers Association has warned, as retailers face growing problems with cash flow in light of further hikes in the wholesale cost of diesel and gasoline.
Oswald Moore, President of the Bahamas Petroleum Retailers Association (BPRA), said that re...
Rebuild Bahamas ready to launch, invites applications
Two months after Hurricane Joaquin ravaged seven islands in the southern Bahamas with record rainfall and howling winds, closing businesses and schools and leaving many with little more than the clothes on their back, Rebuild Bahamas announced today it is ready to launch funds and volunteers into the reopening of commerce, aiding schools and providing clean drinking water.
Rebuild Bahamas ready to launch, invites applications
Two months after Hurricane Joaquin ravaged seven islands in the southern Bahamas with record rains and howling winds, tossing fishing boats onto land, closing businesses and schools and leaving many with little more than the clothes on their back, Rebuild Bahamas announced today it is ready to launch funds and volunteers into the re-opening of commerce, aiding schools and providing clean drinking ...
Auto payment at pumps sparks layoff fears
Gas retailers are welcoming the addition of automated payment at the pumps, but warned RUBIS not to lay off workers that depend on the stations for employment.
As part of the French multinational's revamp of its 20 gas stations in The Bahamas, automated payment will be included so customers can swipe a card rather than pay an attendant. In fact, a test program is being piloted at the Faith Avenue...
Grand Bahama's Lockdown Has Been Extended
Grand Bahamaâs lockdown has been extended to 5am on Wednesday, August 19, announced Minister of State for Grand Bahama, Senator the Hon. J. Kwasi Thompson, during a press conference on Thursday...
Highlights From The Prime Ministers National Address
HIGHLIGHTS FROM THE PRIME MINISTERâS NATIONAL ADDRESS 3rd AUGUST 2020
-Two-week national lockdown implemented effective Tuesday 4 August 10pm; nearing end of 14 day-period health data will be assessed to determine whether an extension is necessary.
-Grand Bahama will be reassessed near the end of its current lockdown scheduled to end on Friday 7 August at 5am to determine if extension is n...
Relationships Matter During This Pandemic Learn to Pause to Resolve Conflict
With the current curfew in place due to COVID-19, our new norm can be
trying our nerves! The new measures like working from home, social distancing, and staying in are contributors for conflicting feelings or situations...
Prime Minister Minnis Addresses Economic Empowerment Zone Act at Town Hall Meeting
âWe are all our brothersâ keepersâ, Prime Minister Dr. the Most Hon. Hubert A. Minnis told residents during an Over-the-Hill Community Development Partnership Initiative town hall meeting...
Gas station hysteria
Officials of the major fuel companies that service New Providence assured on Sunday night that there is no shortage of supply and therefore no need for the panic that ensued after a message was circulated on social media claiming the island would soon run out.


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Ideal for the family. On two floors. No back neighbors. Direct access to the park. Open-plan ground floor. Lots of windows. No carpets. Close to all services. Cheap... It's going to go fast!! Owner's words: "It's great to be able to keep an eye on my children and those of my guests, and to have access to the amenities of the house when they play with their friends in the park. We're going to miss it." Inclusions Lights, window dressing, dishwasher, laundry machine, shed Exclusions --
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Data & Messaging Features, Internet Tethering
Tips for how you can take your internet on the go, with Wi-Fi hot spots & more.
Receiving PORN texts /blocking features don't stop them
I am receiving Porn texts with EMAIL addresses! I have used all features with my iPhone to stop them or not allow them to come through but the do anyw
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Call history
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Hi....i recently switched to att from T-Mobile and my delivery report doesn't work for text messaging. I use a Samsung S10 and its enabled on my phone
Switching from prepaid to postpaid
To whom it may concern, I'm a customer with a prepaid phone plan. However, the prepaid plan doesn't work in my country which is Saudi Arabia. Theref
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Who is Xavier Jamel Bryant? Was Xavier Jamel Bryant arrested? When was Xavier Jamel Bryant arrested? What was Xavier Jamel Bryant arrested for? Is this a mugshot of Xavier Jamel Bryant? Are there more Mugshots of Xavier Jamel Bryant? Is this the Xavier Jamel Bryant you know? Who decides which Mugshots are Indexed online? Who decides what public records the American public sees? Why should Mugshots remain public record and available to all citizens? Are Mugshot laws unconstitutional?
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Booking Number : 161753
Arresting Agency : Tyler Police Department
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Booking Date : 8/27/2009
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SO Number : 148025
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Psalm 148:13
English Standard Version
Psalm 148:13
English Standard Version
Read full chapter
13 (A)Let them praise the name of the Lord,
13 (A)Let them praise the name of the Lord,
for (B)his name alone is exalted;
(C)his majesty is above earth and heaven.
English Standard Version (ESV)
The Holy Bible, English Standard Version. ESV® Text Edition: 2016. Copyright © 2001 by Crossway Bibles, a publishing ministry of Good News Publishers.
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KCB launches M-Benki in race for micro-depositsTuesday, October 15, 2013 15:16
KCB Group has launched a mobile banking platform targeted at the unbanked population, that allows customers to open a bank account without physically visiting a branch.
The platform dubbed KCB M-Benki, which will be available in Kenya, allows customers to open an account under Safaricom's M-Pesa menu with as little as Ksh1 ($0.01).
The launch of KCB Group's new platform comes almost a year after Commercial Bank of Africa (CBA) and Safaricom launched a banking platform dubbed M-Shwari that allows customers to open up an account and access micro loans from the bank.
"With the growth of mobile phones penetration, the product will be accessible to the unbanked population across the country," said Joshua Oigara, KCB Group chief executive officer adding that other countries will be considered in the near future.
The platform is hoped to bring a larger population into formal banking, benefit the small and medium enterprises and reduce time spent in opening accounts.
For more on this story click here
In the Headlines
1.6m Kenyans exposed to virus -studyBy ELIZABETH MERAB
3 hours ago
InterCon closure derails hotel sale to Moi croniesBy DOREEN WAINAINAH
12 hours ago
Hosea Kiplagat home to be auctioned over Sh378m debtBy JAMES KARIUKI
13 hours ago
MPs now push for Sh11.6m send-off packageBy EDWIN MUTAI
12 hours ago


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Quick Facts
Known ForMor Mahal
Full Name:Jana Malik
Age:36 years old (in 2020)
Date of Birth:April 1984
Height, Weight & Physical Stats
Height:5 feet 6 inches (1.68 m)
Weight:55 kg (121 lbs)
Body Measurements:34-29-34 inches
Bra Size/Breast:34B
Waist:29 inches
Hips:34 inches
Dress Size:12 (US)
Hair Color:Dark Brown
Eye Color:Brown
Jana Malik is a Pakistani film and television actress who mostly appears in television drama serials. Jana was born on 26th April 1984 on Lahore. Jana Malik belongs to a Pukhtun, Kakazai tribe family who has Kashmiri origin. Malik is her patronymic, name not a family name. She got her education in the same city. On 2nd September 2016, she got married to a Pakistani actor and singer, Nouman Javaid. Unfortunately, the couple got divorced in March 2017.
Career Journey
Malik started her career journey at the age of thirteen as a television actress on PTV drama serial "Reizgar".Since then, she has appeared in various drama serials where she playing versatile roles. Her admirable role is Maham in the drama serial "Landa Bazar" along with Ali Zafar, Waseem Abbas, Babar Ali, and Farah Shah which was aired on STN. She also hosted a children's musical show "Aangan Aangan Tarey" which was aired on PTV.
Jana made her film debut in an Urdu film "Muhafiz" along with Nadeem Baig, Shahid, Saima Noor and Saud in 1998. In the same year, she also acted in a Bollywood action film "Zor", starring with Sunny Deol, and Sushmita Sen. Jana also played a comic role in a Famous Geo TV comedy sitcom series "Kis Din Mera Viyah Howay Ga" along with Faisal Qureshi, Aijaz Aslam, and Ali Rizvi. The story revolves around the Choudhury family who lives in Lahore. Currently, she is playing a well-known Pakistani supernatural thriller drama serial of Geo Kahani "Naagin" alongside Wajeeha Khan Durani, Sheen Javed, and Resham. She portrayed the supporting role of Pashi snake-charmer. It is the most-watched show of Geo Kahani in the UK. Drama is the story of a house and serpents died when elders made their house.
Jana's notable dramas are:
- Bulandi
- Jo Chale To Jaan Se Guzar Gaye
- Qissa Chaar Darvesh
- Mere Huzoor
- Jahez
- Topi Drama
- Ek Tamanna Lahasil Si
- Adhura Milan
- Dil Se Dil Tak
- Kaanch Kay Par
- Mor Mahal
Jana Malik is a beautiful, well-known Pakistani actress who has worked on television and on the big screen with the top stars. Although Jana has worked in Bollywood and Lollywood, she is best known for her many interesting features in the television. She has huge fans who are like her acting.
Jana Malik Gallery
Jana Malik Career
Profession: Actress
Known For: Mor Mahal
Debut TV Series/Movie:
Salary: 2 Lac
Net Worth: USD $5 Million Approx
Family & Relatives
Father: Raheal Bari
Mother: Not known
Brother(s): Not Known
Sister(s): Not Known
Marital Status: Divorced
Husband/Boyfriend: Nouman Javaid (m. 2016; div. 2017)
Ex Boyfriends:
Not Known
Jana Malik Favorites
Hobbies: Watching Movies, Long Driving, Shopping
Favorite Actor: Salman Shahid
Favorite Actress: Anushka Sharma
Favorite Singer: Nusrat Fateh Ali Khan
Favorite Male Singer: Nusrat Fateh Ali Khan
Favorite Food: Rice, Daal, Vegetables
Favorite Destination: Pakistan
Favorite Color: Black, White
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Ferris State's Vander Laan On Verge Of Becoming Greatest Rushing QB Ever In College Football
Updated: October 14, 2015
Courtesy of Ferris State University Athletics
Big Rapids, Mich. – The reigning Harlon Hill Trophy winner as the top Division II player in the nation, Ferris State University's Jason Vander Laan, is on the verge of becoming the greatest rushing quarterback in the history of college football at any level.
Vander Laan, who has been the nationally fourth-ranked Bulldogs' starting signal caller for the past four seasons, needs 71 yards entering this Saturday's (Oct. 17) showdown against Ohio Dominican to set a new NCAA all-division record for most career rushing yards by a quarterback.
Presently, Vander Laan has ran for 5,057 yards in 39 career games and is chasing the all-time career mark of 5,128 yards set by Wofford's Shawn Graves from 1989-92. The mark stands as the most rushing yards ever by a QB at the FBS, FCS, D2 or D3 levels.
Thus, Vander Laan could be become college football's all-time top rushing quarterback this week when the Bulldogs and Panthers square off starting at 12 p.m. (ET) in a rematch of last year's NCAA Division II Playoffs at Top Taggart Field in Big Rapids.
"When you think back in the entire history of all the great rushing quarterbacks to have ever played the game in the past century such as players like Fran Tarkenton, Roger Staubach, Steve Young or Denard Robinson, it's really amazing to think what this really means," said FSU head coach Tony Annese. "I've been blessed to coach a student-athlete of his caliber and the young men on our team who have helped him achieve this feat over the past four years. I know our entire team and program will take great pride in this accomplishment once it happens."
Vander Laan has already surpassed the all-time NCAA Division I mark held by former Michigan QB Denard Robinson and is moving in on the all-time mark held by Graves. Additionally, the Bulldog standout presently has 68 career rushing TD's and is six away from the NCAA Division II record for most rushing yards by a QB (72) also held by Graves.
This past Saturday (Oct. 10), Vander Laan became the all-time Great Lakes Intercollegiate Athletic Conference (GLIAC) career leader in total offense in leading the Bulldogs to a decisive 56-21 conference road win over the Tiffin Dragons in Ohio. The Frankfort, Ill., native presently has compiled 12,035 total offensive yards in his career, including 11,008 yards in conference play, which surpassed former Saginaw Valley State quarterback Jonathon Jennings' previous league record.
Behind Vander Laan's play at quarterback, Ferris State has won 20 consecutive regular season contests heading into Saturday's home tilt and the Bulldogs are off to a 5-0 start this season after posting the first-ever 11-0 regular season in 107 seasons of Ferris State football a year ago. Vander Laan is 31-8 as the Bulldogs' starting QB in his career.
In 2014, Vander Laan received the Harlon Hill Trophy as the top NCAA Division II player in the nation, becoming only the third GLIAC player to ever receive the coveted award. He later was also named as the 2014-15 recipient of the NCAA Division II National Scholar-Athlete of the Year honor as the nation's top performer on the field and in the classroom, regardless of sport.
The Bulldogs will play each of their next two contests at home as FSU also hosts Michigan Tech on Oct. 24 in a potential battle of unbeaten teams at Top Taggart Field. Tickets for all home games can be purchased in advance at StarTickets.com or call (231) 591-2888(231) 591-2888 for more information.
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Highlights of the latest monthly summariesView the monthly summary
July 2020 highlights:
- Globally, it was the third warmest July in this data record, behind 2016 and 2019. In Europe, temperatures were below average in the north and above average in the south, with temperatures in the southwest reaching close to record warmth during a heatwave late in the month.
- Arctic sea ice extent for July 2020 was on a par with the previous July minimum of 2012 in this data record, at near 27% below the 1981-2020 average. Antarctic sea ice extent was only 3% below average, a value not unusual during the 1979-2020 period.
- Last month was fairly wet in northern Europe, but dry conditions continued over France and parts of central Europe. It was much wetter than average conditions across central and eastern China, South Korea and Japan.
Monthly climate updateView previous months
June 2020 was the joint-warmest on record, together with June 2019, with temperatures globally an average of 0.5 degrees Celsius above the 1981-2010 average.
For this month's episode of Climate Now, we visited Frankfurt, one of the warmest cities in Germany, to find out how it is adapting to rising global temperatures and staying cool in the summertime.
Monthly summaries
Surface air temperature
This series of monthly maps and charts, generated from ERA5 data, covers global and European surface air temperatures.
Sea ice
We produce sea ice maps every month. Based on ERA5 reanalysis data, these provide near real-time monitoring of the polar ice caps.
Hydrological variables
This series of monthly maps and charts, based on ERA5 data, covers several variables: precipitation, humidity, and soil moisture for Europe and the extra-tropical regions.
Surface in-situ monitoring for Europe
Monthly and yearly State-of-the-European-climate reports provided by C3S partners
European State of the Climate
Featured storyView all
Arctic Siberia's unusual warm spell continues
Last month, the Copernicus Climate Change Service reported an unusual winter and spring in western Siberia, with higher-than-average surface air temperatures throughout the period; up to 10°C higher than are normal for May. In June, however, the western and southern parts of this region saw mainly below-average temperatures. But Siberia is vast and, many kilometres further northeast, the C3S ERA5 dataset recorded a heatwave during the second half of the month that brought June average temperatures in some parts of Arctic Siberia to as much as 10°C above normal.


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How can brands make the most of co-creation?
Marketers and insight experts give their advice on how to get the best results out of online communities, and explain why it's key to go in with an objective in mind.
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Marketers and insight experts give their advice on how to get the best results out of online communities, and explain why it's key to go in with an objective in mind.
The research industry is not offering brands the support to exploit the co-creation opportunity.
Brands are using co-creation more than ever to get instant insight to inform product and service innovations. So what are the key appeals for marketers?
It was always important to Honda founder Soichiro Honda that society was pleased his company existed and that the brand had an emotional bond with consumers.
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The Zoological Society of London, which owns London and Whipsnade zoos, is hoping a two-pronged marketing strategy focused on families and fellows can help it attract the donations it needs to survive the coronavirus crisis.
It's not enough to create content to lure sales leads, you need to understand how warm they are and to tailor their journey to their interests.
A total of seven brands have been nominated for Brand of the Year, with the winner to be announced at the Marketing Week Masters awards in September.
The shortlist for the Marketing Week Masters awards Brand of the Year has been revealed, and here's your chance to have a say in who wins.


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Holiday clubs provide essential spaces of safety during the school breaks. Every year we run holiday club training and have collected low-resource activities that work for our partners.
- Colour by numbers
- Connect the dots
- Find hidden items
- Mazes
- Printable board games
- Card games
- Dice games
- Paper games
"You help us create a safe environment for kids to learn and play."Mandisa, Beautiful Gate.


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As the year is about to end, we take you through the best celebrity wardrobe malfunctions of
It seems that Rihanna enjoyed herself at the bash and she told her Twitter fans had got off to a great start.
Madonna Pop queen Madonna exposed her right boob this time in a concert in Paris after her Istanbul boob act.
Hearing tomorrow, says SC on plea for death warrants against 4 rape convicts.
Top 10 infamous nip slips of 2012
Madonna Pop queen Madonna exposed her right boob this time in a concert in Paris after her Istanbul boob act. She then turned around and dropped her trousers to reveal her bare bottom, wearing just a skimpy black G-string, says The Sun. Tiger Shroff or Wonder Woman? Katie Price Katie Price suffered a wardrobe malfunction and a nip slip, as she enjoyed her first big night out since her split with Leandro Penna. She turned her night into a miniature bar crawl with a stop off at trendy Balans in Soho for a few drinks. The British beauty accidentally exposed her side boob in her low cut Giorgio Armani gown, but it was a flesh-colored pastie, she was wearing to cover her breast, which saved her from further embarrassment, reported Us Magazine.