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Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-associated liver disease with an incidence of 0.25% to 1.5% in the USA and Europe[1–3] and as high as 5.2% in China. ICP usually presents in late pregnancy with pruritus and abnormal liver function tests. The symptoms of ICP resolve rapidly after labor but are likely to recur in subsequent pregnancies. The clinical significance of ICP is associated with its increased risk for adverse pregnancy and perinatal outcomes, including preterm delivery, meconium staining of amniotic fluid (MSAF), low Apgar score, and stillbirth. The increase in total bile acids (TBA) seen in ICP may involve the cholestatic effect of reproductive hormones, and it is thought that the accumulation of toxic bile acids in the fetal compartment may underlie the deleterious effects on pregnancy outcomes. Ursodeoxycholate (UDCA) is now widely utilized for the treatment of ICP. UDCA decreases maternal symptoms and serum bile acid (SBA) levels, but whether it improves fetal outcomes is unclear.
Currently, the American College of Obstetricians and Gynecologists does not have a guideline on the management of ICP, whereas the Royal College of Obstetricians and Gynecologists (RCOG) and the Chinese Medical Association for Obstetrics and Gynecology published guidelines for the management of ICP in 2011. Due to concerns regarding stillbirth later in pregnancy, the widely adopted practice in western countries is to recommend delivery at 37 weeks or at diagnosis if this is made later than 37 weeks.[11–13] In contrast, the Chinese guideline recommends the induction of labor at 34 to 37 weeks of gestation in women with a SBA level >40 μmol/L and a continuation of pregnancy until the estimated due date in women with a SBA level <30 μmol/L; for women with a SBA level of 30 to 40 μmol/L, it is recommended that an individual decision be made carefully by the obstetrician.
It has been reported that severe ICP (defined as a SBA level >40 μmol/L) is associated with higher incidences of preterm delivery, MSAF and adverse neonatal outcomes than mild ICP (SBA level ≤40 μmol/L).[14–16] Furthermore, several studies have provided evidence that, compared with control populations, severe ICP is associated with adverse fetal and maternal outcomes (including spontaneous preterm delivery, fetal asphyxia, MSAF, and preeclampsia) whereas mild ICP is not.[3,17,18] Furthermore, for maternal SBA levels >40 μmol/L, significant relationships were identified between SBA level and preterm delivery, spontaneous preterm delivery, stillbirth, and MSAF. However, it remains unknown whether the risk of adverse perinatal outcomes remains elevated in women who are initially diagnosed with severe ICP but whose SBA levels are subsequently maintained <40 μmol/L by treatment.
We hypothesized that women with severe ICP who are successfully treated (such that their SBA levels fall <40 μmol/L) would not have an increased risk of adverse perinatal outcomes. Therefore, we conducted a retrospective cohort study to determine whether successful treatment of severe ICP would reduce the risk of adverse perinatal outcomes.
2 Patients and methods
This retrospective study included consecutive patients diagnosed with ICP at the Shanghai Public Health Clinical Center of Gynecology and Obstetrics (August 2013–June 2016). Our Institutional Ethics Committee approved this study. Individual written informed consent was waived, as the study was retrospective, anonymous and used only existing data.
The inclusion criteria were:
- a diagnosis of ICP was made based on fasting SBA >10 μmol/L, elevated levels of liver transaminases and pruritus;
- other causes of liver dysfunction were excluded, such as viral hepatitis, preeclampsia, HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome and autoimmune liver disease; and
- ICP resolved within 4 weeks postpartum.
The exclusion criteria were:
- multiple pregnancies;
- women with a fasting SBA >40 μmol/L at any stage during their pregnancy whose SBA level did not respond sufficiently to treatment with UDCA with or without S-adenosylmethionine (SAMe), that is, their SBA levels after treatment did not fall below 40 μmol/L;
- women who delivered preterm (i.e. at < 37 weeks of gestational age); and
- data required for the analysis were missing from the medical records.
The patients were divided into 2 groups: women with SBA ≤40 μmol/L at all times during pregnancy (mild ICP group) and women with SBA >40 μmol/L at some stage during pregnancy but whose SBA fell to <40 μmol/L after treatment (severe ICP group).
2.2 Management of ICP
Patients were managed according to the guideline provided by the Chinese Medical Association for Obstetrics and Gynecology. The patients were recommended a course of UDCA (10–15 mg/kg/d, taken orally and divided into 2–3 doses/day; Daewoong Pharmaceutical Co. Ltd, Seoul, South Korea) to decrease the SBA level. In addition, those with SBA >20 μmol/L were also administered SAMe (1000 mg/d, either by once-daily intravenous injection or by twice-daily oral administration; Abbott Laboratories, Lake Buff, IL). Liver function was monitored every week after diagnosis. The Chinese guideline recommends a continuation of pregnancy until term for women with SBA <30 μmol/L, individualized management (according to the wishes of the patient and/or concerns of the physician) for women with SBA of 30 to 40 μmol/L, and induction of labor at 34 to 37 weeks of gestation in women with SBA > 40 μmol/L. However, in our institution, term delivery was achieved in some women with an initial SBA >40 μmol/L whose SBA level decreased to ≤40 μmol/L after pharmacologic therapy; thus, the present study was able to include only women with term delivery.
2.3 Collection of clinical data
The following information was extracted from the medical records and anonymized for analysis: baseline demographic and clinical characteristics, results of laboratory investigations, and maternal and neonatal outcomes. The laboratory investigations included measurements of alanine transaminase (ALT), aspartate transaminase (AST), TBA, total bilirubin (TBIL), direct bilirubin (DBIL), cholinesterase (CHE), total protein (TP), albumin (ALB), gamma-glutamyltransferase (GGT), leucocyte count, and lymphocyte count. The perinatal outcomes analyzed included gestational age at delivery, labor onset, mode of delivery, stillbirth, birth weight and centiles, and 1/5-minute Apgar scores. Adverse perinatal outcomes were defined as macrosomia, low birth weight infants (full-term fetus <2500 g), small for gestational age (SGA), large for gestational age (LGA), premature rupture of membranes, fetal distress, oligohydramnios, meconium contamination, neonatal asphyxia, and postpartum hemorrhage.
2.4 Statistical analysis
Statistical analyses were performed using SPSS 18.0 software (SPSS Inc., Chicago, IL). All data were tested for normality. Normally distributed continuous variables are presented as mean ± standard deviation (SD), non-normally distributed continuous variables are presented as median and interquartile range, and categorical variables are presented as n (%). Statistical comparisons between groups were made using Student t test (normally distributed continuous variables), the Wilcoxon rank-sum test (non-normally distributed continuous variables), or the Chi-squared test or Fisher exact test (categorical variables). Variables with P <.1 in these statistical analyses were subsequently entered into univariate logistic regression analyses to identify factors associated with adverse perinatal outcomes and with MSAF (separate analyses). Factors with P <.1 in the univariate logistic regression analyses were then subjected to multivariate logistic regression analyses (using the enter method) to identify factors independently associated with adverse perinatal outcomes and MSAF (separate analyses). P <.05 was considered statistically significant.
3.1 Baseline demographic and clinical characteristics
Among 126 patients screened for possible enrolment in the study, 3 were excluded due to twin pregnancy and a further 50 were excluded due to preterm delivery. Therefore, a total of 73 patients were included in the final analysis, with 47 in the mild ICP group (SBA ≤40 μmol/L at all times during pregnancy) and 26 in the severe ICP group (SBA >40 μmol/L at some stage during pregnancy, but SBA fell to ≤40 μmol/L before delivery in response to therapy) (Fig. 1).
The baseline demographic and clinical characteristics of the study participants are shown in Table 1. Pruritus was significantly more common in women in the severe ICP group than in women in the mild ICP group (65.4% vs 40.4%; P = .041). However, there were no significant differences between the 2 groups in age, family history, gravidity, parity, or rates of gestational diabetes mellitus, anemia, thrombocytopenia, subclinical hypothyroidism, overt hypothyroidism, gallstones, or lipid metabolism disorders (Table 1).
3.2 Comparison of laboratory parameters between groups
The results of laboratory investigations are summarized in Table 2. TBA was significantly higher in the severe ICP group than in the mild ICP group at first visit (P <.001) and at peak value (P <.001) but not before delivery (P = .049) and at 4 days postpartum. DBIL was significantly higher in the severe ICP group than in the mild ICP group before delivery (P = .049) and at 4 days postpartum (P = .014). Additionally, GGT was significantly lower in the severe ICP group than in the mild ICP group at peak value (P = .029), before delivery (P = .002) and at 4 days postpartum (P = .003). However, there were no significant differences between groups in ALT, AST, TBIL, CHE, TP, ALB, leucocyte count, or lymphocyte count (Table 2).
3.3 Comparison of pregnancy outcomes between groups
As shown in Table 3, there were no significant differences between groups in type of delivery, estimated amount of hemorrhage, or prevalence of abnormal liver function (as detected by laboratory tests of liver function). However, the duration of the liver function abnormality was significantly longer in the severe ICP group than in the mild ICP group (P = .011).
3.4 Comparison of fetal outcomes between groups
Body weight at birth was significantly lower in the mild ICP group than in the severe ICP group. However, there were no significant differences between groups in any of the other fetal outcomes assessed (Table 4).
3.5 Logistic regression analysis of factors associated with adverse perinatal outcomes and MSAF
Variables with P <.1 in the above analyses were entered into a univariate logistic regression analysis to identify any associations with adverse perinatal outcomes or MSAF. No variables (including patient grouping based on SBA level) were identified as having significant associations with adverse perinatal outcomes or MSAF (Table 5). Therefore, multivariate logistic regression analyses were not performed.
The objective of this retrospective study was to examine whether successful treatment of severe ICP (i.e. a reduction in SBA to below 40 μmol/L after therapy with UDCA) would decrease the risk of adverse perinatal outcomes. The main finding was that the incidence of adverse perinatal outcomes was similar between the mild ICP group and severe ICP group. This novel observation indicates that pregnancy in women with severe ICP who respond sufficiently to pharmacologic therapy can be managed in the same way as pregnancy in women with mild ICP. We envisage that our novel data will provide new and useful guidance that will facilitate future clinical practice.
In China, the current guidelines recommend that women with mild ICP (i.e. SBA ≤40 μmol/L throughout pregnancy) be managed expectantly with a view to a term delivery, whereas delivery at 34 to 37 weeks is recommended for women with severe ICP (i.e. SBA >40 μmol/L at some stage during pregnancy). This guidance is based on previous research indicating that severe ICP is associated with adverse fetal and maternal outcomes. A study of women with dichorionic diamniotic twin pregnancies found that severe ICP increased the rates of preterm delivery (before 34 gestational weeks), MSAF and composite adverse neonatal outcome, as compared with mild ICP. Moreover, another investigation found that women with severe ICP had higher rates of MSAF, admission to the neonatal intensive care unit and neonatal global morbidity than women with mild ICP. Similarly, Qi et al observed that patients with severe ICP had higher incidences of MSAF, newborn asphyxia and admission to the neonatal intensive care unit than those with mild ICP. Additionally, various reports have suggested that severe ICP but not mild ICP is associated with poorer perinatal outcomes when compared to control populations. For example, Furrer et al found that MSAF was observed more often in women with severe ICP than in women without ICP, while Raz et al determined that severe ICP increased the risk of preeclampsia, as compared with controls. Notably, Glantz et al reported that the risk of fetal complications (spontaneous preterm delivery, asphyxia, and MSAF) increased by 1% to 2% per additional μmol/L of SBA above 40 μmol/L. In agreement with this, Geenes et al observed significant relationships between SBA levels above 40 μmol/L and various adverse outcomes (preterm delivery, spontaneous preterm delivery, stillbirth, and MSAF).
However, pregnant women with severe ICP and subsequent successful treatment represent a relatively uncharacterized subpopulation that has not received attention in previous studies.[20,21] In particular, it is important to understand whether this population should be managed in a similar manner to patients with persistently mild ICP. The guidelines in China and elsewhere do not take into account the response of severe ICP to therapy, hence decisions regarding the management of pregnant women with currently mild but previously severe ICP are challenging. The present observational study has yielded novel data indicating that women with severe ICP that are treated successfully do not carry increased risks for adverse maternal and neonatal outcomes. If subsequent studies confirm these findings, we would suggest that revisions to the guidelines be made recommending that women with severe ICP whose SBA falls to below 40 μmol/L after treatment should be managed along the same lines as women with mild ICP.
UDCA has been widely used in the treatment of ICP and shown to improve maternal biochemical parameters, alleviate pruritus and lower SBA levels. However, the impact of UDCA treatment on fetal and neonatal outcomes has not been confirmed by adequately powered studies. Although meta-analyses of trials comparing UDCA with other therapies found that its utilization reduced the likelihood of adverse perinatal outcomes, these analyses were limited by a lack of direct comparisons of UDCA with placebo.[23,24] Here, our study has added novel evidence to support the effectiveness of UDCA therapy. Since a study comparing UDCA-treated women with UDCA-untreated women would raise ethical concerns, we utilized a unique study design to focus on patients with previously severe ICP who were then successfully treated with UDCA. All the women in our severe ICP group responded well to UDCA, and their liver function tests showed significant improvement following therapy. Indeed, the serum level of GGT at the time of delivery was lower than that of women with persistently mild ICP. Importantly, the risk of adverse perinatal outcomes was comparable between the severe ICP and low ICP groups, strongly indicating that UDCA therapy is effective in reducing the incidence of adverse perinatal outcomes in women with severe ICP who respond well to treatment. However, patients with severe ICP do not respond equally to UDCA, and this study excluded those defined to have an insufficient response (these cases were managed mainly by preterm delivery, in accordance with the guidelines). The causes for the varying response to treatment are currently unknown but may include differences in UDCA dosage, time of diagnosis (early vs late), genetic factors and environmental factors. This is a question that warrants future investigation.
Another interesting observation in our study was the significantly higher birth weight of infants born to mothers in the severe ICP group. Previous studies have shown that women with ICP are more likely to develop gestational diabetes mellitus and dyslipidemia and have proportionately larger babies. Elevated maternal glucose may induce hyperinsulinemia, while elevated serum triglycerides can promote fetal growth independent of glucose levels; both mechanisms may contribute to increased fetal growth in women with ICP. This particular finding of our study is a reminder that metabolic changes induced by ICP can have important consequences, and the impact of severe ICP on fetal growth can be detected even after successful treatment with UDCA. Whether or not the metabolic changes induced by ICP are permanent or only temporary remains unclear, although there is recent evidence for a long-lasting effect. For example, children of women with ICP have been reported to have a higher body mass index and higher rates of dyslipidemia, obesity and metabolic syndrome in later life. Therefore, the long-term effects of ICP on both the mother and child should be further addressed.
This study has some limitations. First, this was a retrospective study, so it may have been prone to selection bias and/or information bias. Especially, serial SBA measurements in time and in relation to treatment were not available for the mild ICP group. Second, as this was a single-center study, the generalizability of the results remains unknown. Third, the sample size was quite small, so the study may have been underpowered to detect some real differences between groups. Fourth, a control group of women without ICP was not included because pregnancy was terminated before full-term in women with ICP and SBA >40 μmol/L, as per the Chinese guidelines. Fifth, long-term outcomes were not assessed. Additional research is needed to confirm and extend our findings.
In conclusion, women with severe ICP do not have increased risks for major adverse perinatal outcomes if they are successfully treated. Therefore, pregnant women with severe ICP who respond well to pharmacologic therapy can be managed in the same way as women with mild ICP. We envisage that our novel data will provide useful guidance to obstetricians treating women with ICP.
We thank all the staff in charge of the clinical database for their help in data acquisition.
Conceptualization: Jielian Yang, Min Liu, Shuye Zhang.
Formal analysis: Jielian Yang, Chong Chen, Shuye Zhang.
Funding acquisition: Min Liu, Shuye Zhang.
Investigation: Min Liu.
Methodology: Jielian Yang.
Project administration: Chong Chen.
Resources: Min Liu, Shuye Zhang.
Supervision: Chong Chen, Min Liu.
Validation: Shuye Zhang.
Writing – original draft: Jielian Yang, Min Liu.
Writing – review & editing: Jielian Yang.
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is common among patients’ first-degree relatives. Acta Obstet Gynecol Scand 2013;92:1108–10.
. Martineau M, Raker C, Powrie R, et al. Intrahepatic cholestasis of pregnancy
is associated with an increased risk of gestational diabetes. Eur J Obstet Gynecol Reprod Biol 2014;176:80–5.
. Glantz A, Marschall HU, Mattsson LA. Intrahepatic cholestasis of pregnancy
: relationships between bile acid levels and fetal complication rates. Hepatology 2004;40:467–74.
. Wang XD, Yao Q, Peng B, et al. A clinical analysis of intrahepatic cholestasis of pregnancy
in 1241 cases. Zhonghua Gan Zang Bing Za Zhi 2007;15:291–3.
. Ovadia C, Williamson C. Intrahepatic cholestasis of pregnancy
: recent advances. Clin Dermatol 2016;34:327–34.
. Wikstrom Shemer E, Marschall HU, Ludvigsson JF, et al. Intrahepatic cholestasis of pregnancy
and associated adverse pregnancy and fetal outcomes: a 12-year population-based cohort study. BJOG 2013;120:717–23.
. Dixon PH, Williamson C. The pathophysiology of intrahepatic cholestasis of pregnancy
. Clin Res Hepatol Gastroenterol 2016;40:141–53.
. Chappell LC, Gurung V, Seed PT, et al. Ursodeoxycholic acid
versus placebo, and early term delivery versus expectant management, in women with intrahepatic cholestasis of pregnancy
: semifactorial randomised clinical trial. BMJ 2012;344:e3799.
. Kenyon AP GJ, Girling JC. Obstetric Cholestasis [Internet]: RCOG Press, London; 2011.
. Obstetrics section, obstetrics and gynecology branch, Chinese medical association. The clinical guideline of intrahepatic cholestasis of pregnancy
[Article in, Chinese]. Chin, J, Obstet Gynecol 2011;46:391–5.
. Lo JO, Shaffer BL, Allen AJ, et al. Intrahepatic cholestasis of pregnancy
and timing of delivery. J Matern Fetal Neonatal Med 2015;28:2254–8.
. Saleh MM, Abdo KR. Consensus on the management of obstetric cholestasis: national UK survey. BJOG 2007;114:99–103.
. Wensink MJ. The risk of infant and fetal death by each additional week of expectant management in intrahepatic cholestasis of pregnancy
by gestational age: various objections. Am J Obstet Gynecol 2016;215:807–8.
. Mei Y, Gao L, Lin Y, et al. Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy
with dichorionic diamniotic twin pregnancies. J Matern Fetal Neonatal Med 2019;32:472–6.
. Garcia-Flores J, Canamares M, Cruceyra M, et al. Clinical value of maternal bile acid quantification in intrahepatic cholestasis of pregnancy
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. Qi HB, Shao Y, Wu WX, et al. Grading of intrahepatic cholestasis of pregnancy
. Zhonghua Fu Chan Ke Za Zhi 2004;39:14–7.
. Furrer R, Winter K, Schaffer L, et al. Postpartum blood loss in women treated for intrahepatic cholestasis of pregnancy
. Obstet Gynecol 2016;128:1048–52.
. Raz Y, Lavie A, Vered Y, et al. Severe intrahepatic cholestasis of pregnancy
is a risk factor for preeclampsia in singleton and twin pregnancies. Am J Obstet Gynecol 2015;213:395.e1-8.
. Geenes V, Chappell LC, Seed PT, et al. Association of severe intrahepatic cholestasis of pregnancy
with adverse pregnancy outcomes: a prospective population-based case-control study. Hepatology 2014;59:1482–91.
. Friberg AK, Zingmark V, Lyndrup J. Early induction of labor in high-risk intrahepatic cholestasis of pregnancy
: what are the costs. Arch Gynecol Obstet 2016;294:709–14.
. Jin J, Pan SL, Huang LP, et al. Risk factors for adverse fetal outcomes among women with early- versus late-onset intrahepatic cholestasis of pregnancy
. Int J Gynaecol Obstet 2015;128:236–40.
. Gurung V, Middleton P, Milan SJ, et al. Interventions for treating cholestasis in pregnancy. Cochrane Database Syst Rev. 2013;(6):CD000493.
. Grand’Maison S, Durand M, Mahone M. The effects of ursodeoxycholic acid
treatment for intrahepatic cholestasis of pregnancy
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. Bacq Y, Sentilhes L, Reyes HB, et al. Efficacy of ursodeoxycholic acid
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: a meta-analysis. Gastroenterology 2012;143:1492–501.
. Williamson C, Geenes V. Intrahepatic cholestasis of pregnancy
. Obstet Gynecol 2014;124:120–33.
. Martineau MG, Raker C, Dixon PH, et al. The metabolic profile of intrahepatic cholestasis of pregnancy
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. Papacleovoulou G, Abu-Hayyeh S, Nikolopoulou E, et al. Maternal cholestasis during pregnancy programs metabolic disease in offspring. J Clin Invest 2013;123:3172–81.


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The Financial Crisis Inquiry Commission, a panel created by Congress to look into the causes of the financial crisis, holds its first hearing today. But, as the Wall Street Journal points out, its members aren’t exactly neutral investigators:
(The panel) will begin taking sworn testimony Wednesday from the chief executives of several big Wall Street banks, including Goldman Sachs Group Inc. and J. P. Morgan Chase & Co…Business interests (are) complaining that some panel members’ ties to a major plaintiffs law firm could aid litigants seeking to sue financial firms.
The San Diego-based law firm with ties to the commission, Coughlin Stoia Geller Rudman & Robbins, has filed dozens of lawsuits against major banks since 2007, according to federal court records. A longtime lawyer with the firm, Byron Georgiou, sits on the 10-member commission. A senior commission staffer, Christopher Seefer, is on leave from his position as a partner with the law firm.
The commission chairman, former California Treasurer Phil Angelides, was a trustee of state pension funds that periodically used Coughlin Stoia’s predecessor firms in securities litigation against the likes of former telecommunications giant WorldCom, which collapsed in a massive accounting fraud that resulted in a 25-year prison term for its CEO. Mr. Angelides received about $250,000 in contributions from lawyers with the firm during his 2006 campaign for governor.
Some panel members and staffers have close ties to businesses. Vice chairman Bill Thomas, a former Republican congressman, is a government-relations adviser with a law firm that has banking clients. Peter Wallison is a fellow at the conservative American Enterprise Institute and a critic of many financial-regulation proposals. The commission employs a number of lawyers who previously worked for law firms that typically defend corporations, including banks.
CBS’ Jill Schlesinger points out that although the panel attorneys are “counterbalanced” by others on the panel, “if these guys are asking questions to the FCIC witnesses primarily to create a permanent record to be used later to sue these firms, we’re not going to get very far in the regulatory reform process.” That’s absolutely true.
Reuters is liveblogging the inquiry here.
The New York Times has a list of questions that should be asked of the bankers.
Here are photos and profiles of each of the commissioners.
Found out more at the FCIC website.

domain: law


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The Museum Society is pleased to organize a gallery walk to view some of the exceptional works of art at Christie's Spring Sales 2013. Guided by Rosemary Scott and Pola Antebi, we will see highlights from The Imperial Sale – Important Chinese Ceramics and Works of Art; In Pursuit of Refinement – A Legacy of the YC Chen Collection (雅趣流芳: 陳玉階珍藏中國藝術精品); and Reverence and Perfection – Magnificent Imperial Cloisonne Enamels from a Private European Collection. Members and friends are welcome to view the other galleries after the tour.
Rosemary Scott is Christie's International Academic Director of Asian Art, who has successfully expanded Christie's educational programs in Asian art, lecturing and conducting scholarly research for Christie's Asian art sales worldwide. She holds an honors degree in Chinese Art and Archaeology from the University of London. Her career has spanned various important positions in her chosen field, including deputy keeper of the Burrell Collection, Glasgow, with curatorial responsibility for Oriental art; the curator of the Percival David Foundation, University of London; and head of the Museums Department of the School of Oriental and African Studies, University of London. Scott is also past president of the London Oriental Ceramic Society between 2006-2009.
Pola Antebi joined Christie's Hong Kong in 1990. Since 2000, she has been the Department Head, as well as International Director of the Chinese Ceramics & Works of Art in Hong Kong, which has grown exponentially under her leadership. She travels extensively sourcing objects for sale, and has been instrumental in garnering some of the most prestigious private collections offered at Christie's HK sales. Her areas of expertise include imperial ceramics, jades and works of art from the Yuan to the Qing periods. Antebi holds degrees in French Literature and Art History from the University of Vermont in the United States.

domain: artistic


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Elon Musk tweeted Thursday night an image of the completed Starship test-flight rocket from a SpaceX facility in south Texas. The company plans for the rocket to be its first vehicle to carry astronauts.
Ultimately, the Starship rocket will be the vehicle that transports humans as part of Musk’s plan to colonize mars. Starship will carry up to 100 passengers and be launched by SpaceX’s upcoming “Super Heavy” rocket.
Musk said there will be differences in a test version of the rocket and the orbital version.
This is for suborbital VTOL tests. Orbital version is taller, has thicker skins (won’t wrinkle) & a smoothly curving nose section.
— Elon Musk (@elonmusk) January 11, 2019
The engines are expected to be test-fired next month, and Musk has said he expects the first Starship test flights in March or April. A trip to Mars is planned for as soon as 2020.


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How can I best help these cats that are in the garbage area?
You look for all lost souls, don’t you my dear? You want to help those that have been discarded whether they be an animal or a person. You may not admit this, but it is truth.You give attention to these beings for you know what it feels like to not have a voice.
How to help these beings? Well, if you feed them they form a dependency. If you help nurture them they will follow you home. You are afraid of them but you can being the attention of where they be to someone who can come and capture. Yes, capture. You are afraid of that that they will then be put down. There are many groups that will only help. That is one way. You must choose what way you want to be part of.
You labor over choices my blessed one. You are to run into the burning building and help all, but you fear of being burned. You have been burned, of course I speak this of a metaphor, but you know what I mean. You have been hurt by people you loved. You have been hurt by people that you thought were very wise and now perhaps feeling their wisdom is not yours.
Does that still mean you must follow their speaking or follow the teacher that lies within you, your own wisdom? Difficult, but not an impossible choice to make.

domain: psychology


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Santa Cruz del Quiché & K'umarcaaj
Located some 19km (12 miles) north of Chichicastenango is the small mountain city of Santa Cruz del Quiché, or simply Quiché. Slightly off the main circuit, Santa Cruz del Quiché (the capital of the Quiché province) is much more representative of a modern highland Maya city than its more touristy neighbor. The pace of life here is quite slow, except on Saturday market days.
Quiché is also the gateway to the post-Classic Maya city of K'umarcaaj, also known as Utatlán, and sometimes spelled Q'uma'rka'aaj. K'umarcaaj was the ancient capital of the Quiché region, and is even mentioned in the Popol Vuh. The Maya K'iche offered some of the fiercest resistance ever encountered by the Spaniards. However, they were technologically outmatched and eventually defeated. K'umarcaaj was captured and mostly destroyed in 1524 under the orders of Pedro Alvarado, who had recently defeated the Maya Ki'che King Tucún Umán outside of Quetzaltenango. In fact, the story goes that the surviving Maya Ki'che had put forth a cordial invite for Pedro Alvarado to visit K'umarcaaj, where they planned to ambush him, but he wised up to the plan and sacked the city instead.
The ruins sit on a hilltop surrounded by steep ravines, a testament to the city's strategic wartime position. Little has been done here in the way of excavation, but the ruins of several temples, a ball court, and some well-maintained plazas can be visited. K'umarcaaj is still considered a sacred site by modern Maya, and it's not uncommon to find them performing rituals here. This is particularly true of a long tunnel or cave, known locally as la cueva. It's wise to plan ahead, bring a flashlight, be respectful, and definitely ask permission of the park guards and anyone you encounter there in prayer before entering the cave.
K'umarcaaj is located just 3km (2 miles) outside of Quiché. The ruins are open daily from 8am to 5pm. Admission is Q15 ($2/£1). There's a small museum (tel. 502/7702-0362) near the entrance with a detailed scale model of the city. A taxi from Santa Cruz del Quiché should cost around Q75 ($10/£5) round-trip, with an hour or more set aside to explore the ruins.
Quiché is serviced by frequent buses from Chichicastenango and Guatemala City. If you need or want to spend the night here, check into the Hotel Rey Ki'che, 8a Calle 0-39, Zona 5 (tel. 502/7755-0827).
Negaj & the Ixil Triangle
The Ixil Triangle is a remote region of northern Quiché populated by the Maya Ixil people. The people of this region are deeply tied to their Maya roots, and many speak only their local dialect and little or no Spanish. The small village of Nebaj is the heart of the Ixil Triangle. The town has cobblestone streets and a lovely colonial-era church. The two other principal towns forming the triangle are Chajul and Cotzal. This mountainous region is surrounded by tiny villages and communities, which are tied together by heritage and an active barter economy.
The Ixil Triangle suffered brutal repression during the civil war, particularly under the reign of General Ríos Montt (1982-83). Despite this past, the area is actually one of the safer regions for independent travelers. The local populations tend to be relatively open and friendly to foreigners, although you should still be very respectful and always ask permission before taking anyone's photograph.
The distinctive Nebaj huipiles are some of the most beautiful in Guatemala. Predominantly fashioned of purples, greens, and yellows, they feature incredibly tight embroidery of human and animal figures as well as complex geometric designs. The women wear a headdress of colorful ribbons with fluffy pompoms. As in Chichicastenango, market days here are Thursday and Sunday.
Most of your travel needs in and around Nebaj can be arranged with the folks at El Descanso restaurant and their sister operation Guías Ixiles (tel. 502/5847-4747; www.nebaj.com). This place is the central hub for many travelers into and around the Ixil Triangle. Multiday and overnight hikes and mountain-biking tours are offered around the Ixil Triangle, the most popular to the nearby villages of Acul and Cocop. They can also hook you up with language classes and homestays with local families.
If you need to spend the night here, check out the Hotel Villa Nebaj, Calzada 15 de Septiembre 2-37 (tel. 502/7756-0005 or 5614-2506; www.villanebaj.com), a modern hotel in the heart of Nebaj. A room with private bathroom and cable TV is less than Q900 ($120/£60) double occupancy. Backpackers and budget hounds should head to Hotel Ixil (tel. 502/7756-0036) or MediaLuna MedioSol Hostal, at the corner of 3a Calle and 4a Avenida (tel. 502/5749-7450; www.nebaj.com). For meals, I recommend El Descanso or Popi's (tel. 502/7756-0159).
Nebaj is located 95km (59 miles) north of Santa Cruz del Quiché. Buses between Santa Cruz del Quiché and Nebaj leave roughly every hour or two. The ride takes around 3 hours and costs Q12 ($1.60/80p).
Note: This information was accurate when it was published, but can change without notice. Please be sure to confirm all rates and details directly with the companies in question before planning your trip.

domain: travel


SKU: R1795 Dana 60 High Steer Arm Driver Side
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OFF ROAD USE ONLY


July 13, 2017 – Fire Department rules designed to assist first responders.
The to-do lists for co-op and condo boards just keep on growing. Heres the latest addition: the Fire Department of New York (FDNY) has passed a rule that requires multi-family dwellings to place reflective signs on all apartment and stairwell doors to assist first responders in the event of a fire or other emergency. Buildings with apartments with more than one floor (duplexes and triplexes) had to comply by March 30 of this year; buildings with only single-level apartments will have to comply by March 30, 2018
Learn more here:


Download "Pyramid Lake" for Free HERE!
Tell us about the inspiration for the new album…
It was half inspiration half experimentation. We sort of rushed to the studio to record what was originally going to be a set of demos, to see how the 6 man band sounded in a studio setting. After laying down a couple tracks, we were extremely pleased with the sound, so we took the opportunity to record as much as possible. We laid down 10 tracks live with the whole band at The Sound Emporium in Nashville, and those 10 tracks became the album.
The inspiration for this album came from a couple of places. We all grew up on classic rock: Jackson Browne, Led Zeppelin, Van Halen, etc. On the other hand I was listening to a lot of different albums at the time that I wrote Pyramid Lake. My morning jacket, LCD Sound System, Vampire Weekend, a little bit of Arcade Fire, and Kanye West thrown in there too.
The title, “Pyramid Lake” came from a trip to Pyramid Lake in Nevada to watch the Solar Eclipse. It was originally just the title of our first single, but we felt that the song and the trip itself really represented the fun and experimental nature of the album.
How has Archer’s Paradox evolved from its beginnings?
Archer’s Paradox has come a long way over the last two years. It started with Seth writing music on his MacBook by himself. “I had no real vision for Archer’s Paradox at this time, I was just trying to stay creative and write music” – Seth. The electronic pop melodies that he had created resonated very well amongst some of his closest friends, so he decided to take it to the next level. Working with close friend and now lead guitarist Alex Solin, they created a sound with guitars to go with the electronic pop melodies. This is where the “band” began to form. Seth knew he had something special going on and took advantage of having close friends (and roommates) with a similar drive and determination to play great music. After a couple months of learning the songs as a 6 man band, they played their first show at Rohs Street Tavern on April 7th of 2012 and haven’t looked back since.
It’s really a unique group of guys. Every band member has a different musical background. Mark (bass) and Alex (lead guitar) are both big into heavy metal. You can hear a lot of that in alex’s numerous solo’s on the album. Stefan, Seth, and the Juice (Josh) had all played in pop punk band Ellison together. And Cam (keys) listens to a lot of rap. Being able to put together a group of guys from different backgrounds to create the sound that they have, is a paradox in itself.
What do you love about being a musician in Cincinnati?
Being a part of a growing music culture is very appealing. Inside a growing urban environment, like OTR. We have been a part of the great OTR community, working at bars and restaurants. Watching the growing arts scene first hand has helped to fuel us even more
Big Cincinnati bands have played a role in that growing music culture too, bands like Foxy Shazam, Walk the Moon, The National.
What are the future plans for Archer’s Paradox?
World Takeover, but seriously, we just released our first album and we are looking to get back into the studio to record another album. Continue to write, always continue writing, that’s important. We are starting to do some writing as a group, which is new for us. We also want to get a little creative, do some bazaar things on stage, do a handful of smaller more intimate acoustic shows too. It’s important for a new band like us to get out and be heard. We have a couple huge shows coming up in Cincinnati, the Indie Summer Concert Series and MPMF, but A Midwest Tour is definitely in order before the end of the year.


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'Foster' Tells Firsthand Stories of Those Navigating the Child Welfare System
In honor of National Foster Care month, Foster is coming to HBO on Tuesday, May 7.
With one in eight American children suffering a confirmed case of neglect or abuse by age 18, there are currently more than 400,000 children in foster care in the U.S., a number that continues to grow each year.
Drawing on unprecedented access, this documentary explores the often-misunderstood world of foster care through compelling stories from the Los Angeles County Department of Children and Family Services, the largest county child welfare agency in the country.
Ginnifer Goodwin on Being in Front of & Behind the Camera for Lifetime's 'I Am Somebody's Child' (VIDEO)
The new Lifetime movie, premiering April 20, takes a closer look at the foster system.
Mixing firsthand accounts of people navigating the system with insights from social workers, advocates and others, the film offers a realistic but hopeful perspective on a community that needs society’s support.
Producer Deborah Oppenheimer and writer-director Mark Jonathan Harris (HBO’s Oscar-winning Into the Arms of Strangers: Stories of the Kindertransport) reunite to upend some of the most enduring myths about foster care, going beyond the stereotypes.
Foster visits courtrooms, foster homes, juvenile centers, hospitals and the neighborhoods of Los Angeles to tell moving stories of the foster care system in the United States. One literally begins in the cradle, focusing on an infant born to a mother who tests positive for cocaine at the child’s birth.
Elsewhere, the documentary features the accounts of: a teenager who entered the system through tragic circumstances and is on probation for a typical adolescent act that might not have been prosecuted in the case of someone from an intact home; a young woman transitioning to college and independence, who has lived in more homes than she can remember; a former foster child who has overcome her painful past to become a powerful advocate for children; and a foster mother who has provided support to more than 100 children.
Foster, Documentary Premiere, Tuesday, May 7, 8/7c, HBO

domain: news


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At the turn of the Millennium, Burger King handed out adorable tiny Game Boy Colors
The Grove IoT Commercial Developer Kit is co-produced by Intel and Seeed for Internet of
We are filmed in a new series of documentaries from WIRED UK! Wired UK team visited
(Picture from Google Image) For the past two weeks, we have invited makers in our
Two weeks later, Wake Me Up with Wio Activity has several prize-winners. Wait, before we
Dear users: We are very excited to announce the launch of our newly designed website.


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Acute mesenteric ischemia (AMI) remains a vascular emergency. Our aim was to explore readmission for AMI. We identified all patients admitted for AMI from the state of California through the Healthcare and Utilization Project from 2005 to 2011. Our primary end point was the rate and etiology for readmission. Our secondary end points were the length of hospitalization and in-hospital mortality. Cox proportional hazard regression was utilized to assess risk of 30-day readmission. There were 534 (9.9%) readmissions at 30 days. The mean age was 67 ± 17 years and 209 (39.1%) were male. The five most common etiologies for readmission were AMI (7.6%), cardiac events (5.3%), severe sepsis (1.2%), dehydration (1.1%), and acute kidney failure (1.1%). Once readmitted, these patients were most likely to experience cardiac catheterizations (25.4%), red blood cell transfusions (23.6%), intubation and mechanical ventilation (17.6%), biopsy of the large intestine (13.9%), reoperation for small bowel resection (10.9%), administration of total parenteral nutrition (10.5%), and transfusion of other blood products (6.9%). This hospitalization was 8.8 ± 12.7 days long. In-hospital mortality was 36 patients (6.7%). On multivariable Cox-regression analysis, severe (hazard ratio [HR]: 2.1 [1.4-3.2], p = 0.0005) and moderate (HR: 1.5 [1.03-2.13], p = 0.04) Elixhauser Comorbidity Group, complications (HR: 1.5 [1.2-1.9], p = 0.0007), and longer index hospitalization (HR: 1.02 [1.01-1.02], p < 0.0001) were predictors of readmission. Conclusion AMI remains a vascular emergency. Readmissions have a significant rate of morbid invasive procedures and can lead to an in-hospital mortality of 6.7%. The adoption of guidelines similar to the European Society for Trauma and Emergency Surgery should be considered.
- acute mesenteric ischemia
- length of hospitalization
- mesenteric ischemia
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine

domain: medical


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[Journal:] International Journal of Financial Studies [ISSN:] 2227-7072 [Volume:] 3 [Year:] 2015 [Issue:] 1 [Pages:] 49-55
This paper compares the "simple-sum" monetary aggregates (M1 and M2) published by the Saudi Arabian Monetary Agency (SAMA) with the new monetary aggregates (D1 and D2)-known as the Divisia monetary indexes. The former aggregates are constructed from a simple accounting identity, whereas the Divisia aggregates are constructed using statistical index number theory and aggregation theory. The findings suggest that both D1 and M1 are identical, given the perfect substitutability of the monetary components within those aggregates. For the broader monetary aggregates where perfect substitutability assumption is not realistic, the two monetary indexes differ substantially. SAMA could benefit by using both monetary indexes simultaneously to better monitor liquidity in the market.
monetary aggregation Divisia monetary aggregates index number theory

domain: finance


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- Welding large-diameter carbon alloy steel pipes: Canada made the first double-reverse sunset review final ruling. Recently, the Canada Border Services Agency made the first double-reverse sunset review final ruling on welded large-diameter carbon alloy steel pipes originating in or imported from China. The Canadian International Trade Court is expected to make a double-reverse sunset review before August 3. Industry damage Final verdict.
- The International Air Transport Association recently released a report pointing out that the airspace closure measures in the Russian-Ukrainian conflict have had a serious impact on the aviation industry. Flights had to be diverted or cancelled due to airspace closures, with routes between Asia and Europe and North America being the most affected. In terms of cargo, air cargo between Europe and Asia accounted for 20.6% of global air cargo revenue over the past 12 months.
- Restricted by the shortage of chips, German auto production has not yet recovered to the level before the covid19 epidemic. The recent outbreak of the Russian-Ukrainian conflict has brought new challenges to the auto industry. Many German automakers have recently announced production cuts or even suspensions. It is expected in the industry that the conflict between Russia and Ukraine is likely to affect the supply of neon, an important raw material for making chips, thereby affecting European semiconductor production and causing serious disruption to automobile production.
- The conflict between Russia and Ukraine and the shortage of nickel inventories have led to high nickel prices. It is judged that nickel prices are expected to maintain a strong trend. Russia is the third largest nickel producer in the world, accounting for about 9-11% of global nickel ore supply. The main reasons for the rise in nickel prices are as follows. First, the conflict between Russia and Ukraine and the sanctions imposed by overseas countries have caused the market to worry about the supply of nickel in Russia. Second, global nickel inventories have fallen sharply. With the strong production of electric vehicles, higher downstream demand has kept nickel inventories at a low level.
- Food and Agriculture Organization of the United Nations: Global food prices hit a record high in February. Global food prices hit a record high in February, rising 24.1 percent from a year earlier, driven by higher prices for vegetable oils and dairy products, the Food and Agriculture Organization of the United Nations said.
- eMarketer: India’s e-commerce market will reach $100 billion by 2023. E-commerce sales in India are forecast to soar 25% to $80 billion by the end of 2022. It is expected to maintain steady double-digit growth from 2021 to 2025, with its sales more than doubling, and to surpass the $100 billion mark for the first time in 2023.
- Wish announced its earnings report, with both revenue and gross profit plummeting. ContextLogic, the parent company of cross-border e-commerce platform Wish, announced results. In 2021, the platform’s annual revenue will be US$2.085 billion, down 18% from US$2.541 billion last year, and gross profit will be US$1.108 billion, down from US$1.594 billion last year. 30%.
- The Panama Canal issued a statement calling it permanent neutrality.
- FedEx announced an increase in international shipping surcharges. A few days ago, FedEx announced that due to the disruption of the global supply chain caused by the Russian-Ukrainian war, it will increase the peak surcharge for international parcels and freight from March 7. Surcharges in most of Asia Pacific will increase by 20 to 30 cents per kilo; international parcels in Europe will rise by 11 cents per kilo.
- Passenger Car Association: In February, the retail sales of passenger vehicles in China reached 1.246 million units, a year-on-year increase of 4.2%, a month-on-month decrease of 40.0%, and the overall trend was strong; the retail sales of new energy passenger vehicles reached 272,000 units, a year-on-year increase of 180.5%, month-on-month Down 22.6%. Ideal, Nezha, Xiaopeng, Weilai, Leapmotor, Weimar and other new power car companies’ sales performance were generally better year-on-year and month-on-month.
- CCTV Finance: In the past year, women have invested more in smart devices. Sports trackers, smart watches, VR glasses, and drones have become the most popular products for women. Among them, women aged 46-55 spend more on smart devices. The transaction value increased by 122% year-on-year. Commodities related to swimming, ice sports, skiing and other sports also increased significantly.
- On the eve of and on the eve of International Women’s Day on March 8, women’s own consumption has become a new growth point for fresh food e-commerce platforms. Since March, the sales of various seasonal flowers have continued to grow. On the festival day, the sales of flowers on an e-commerce platform are about 4.5 times the usual, of which the online order volume is 4 times the usual. In addition, desserts, drinks, etc. also ushered in a sales peak.
- Shell Research Institute: Recently released the “Women’s Housing Consumption Survey Report 2022”. In terms of rental and purchase consumption trends, the proportion of female consumers has been on the rise for five consecutive years. Female buyers of housing in Dongguan, Hangzhou, and Shenyang performed prominently, accounting for 51.68%, 44.27% and 45.75% respectively in 2021. On the whole, safety, quality, and cost-effectiveness have become the hot spots for female customers to live and consume.
- Recently, a number of feed companies such as Zhengbang and New Hope have announced feed price increases. Most of the price increases are around 100 yuan per ton. The main reason is the increase in raw material prices. According to practitioners, the price of soybean meal rose sharply after the Spring Festival, from about 3,600 yuan to about 4,800 yuan, an increase of about 30%, which directly pushed up the cost of feed production. In addition, the supply of imported soybeans is in short supply, and a large number of oil plants have been shut down at present.
- According to data released by the State Administration of Foreign Exchange recently, as of the end of February 2022, China’s foreign exchange reserves stood at US$3,213.8 billion, which has been above US$3.2 trillion for the 10th consecutive month.
- In late February, the four major state-owned banks in Guangzhou announced a reduction in the mortgage interest rate in the Guangzhou area, and the first-home buyers were lowered to 5.4%. Entering March, banks in Guangzhou have sufficient mortgage loan quotas, and the mortgage interest rate has been stable with some declines. Some banks can lend at the earliest in a week. According to the industry, mortgage interest rates are expected to be further lowered during the year.
- By the end of 2023, China will initially establish a security system for the Internet of Vehicles. The Ministry of Industry and Information Technology recently issued the “Guidelines for the Construction of the Internet of Vehicles Network Security and Data Security Standard System”, which proposed that by the end of 2023, the Internet of Vehicles network security and data security standard system will be initially established.
- Wang Zhigang, Minister of Science and Technology: In the past year, science and technology work has played an important role in promoting the high-quality development of the country’s reform and opening up and modernization. In 2021, R&D investment will reach 2.79 trillion yuan, an increase of 14.2%; the technology contract turnover will reach 3.7 trillion yuan, which greatly exceeds the 2.79 trillion yuan invested in R&D by the whole society. At the same time, the ranking of China’s innovation index rose to 12th in the world, an increase of 22 places.
- China Economic Net: The adult smoking rate in Shanghai has dropped for 7 consecutive years to 19.4%, which is at the leading level in the country and has reached the “Healthy China 2030” mission ahead of schedule. Five years after the implementation of full indoor smoking ban, Shanghai’s tobacco control work has been continuously advanced, and the construction of a “smoke-free city” with Shanghai-style characteristics has achieved remarkable results.
- Yonghui Supermarket: From January to February, the total operating income was about 20.4 billion yuan, a year-on-year increase of about 3%, of which same-store growth was about 1.6%; the operating net profit was about 760 million yuan. During the reporting period, due to the impact of non-operating factors such as changes in the stock price of foreign investment, there may be a provision of about 150 million yuan to 200 million yuan.
- SMIC: From January to February, the total operating income was approximately US$1.223 billion, a year-on-year increase of 59.1%; the net profit attributable to the parent company was approximately US$309 million, a year-on-year increase of 94.9%.
- Meta: $1 billion will be paid to creators by the end of 2022. To incentivize creators, various bonus features are being tested, such as Reels Play, Stars Double. But most of these projects have yet to be announced, as they are still in early beta testing and have limited scope for testing. So far, the bonus program has been invite-only.
- Moderna’s full-year revenue and net profit both rose sharply. Moderna announced its 2021 results, with revenue of $7.211 billion in the fourth quarter, compared with $571 million in the same period last year; net profit of $4.868 billion, compared with a net loss of $272 million in the same period last year. Full-year revenue was $18.5 billion and full-year net profit was $12.2 billion.
- IKEA closed offline stores in mainland China for the first time.
- According to the Bloomberg Billionaires Index, Berkshire Hathaway Chairman Warren Buffett has re-entered the ranks of the world’s top five richest people, with a cumulative increase of 7.79 billion US dollars in personal wealth since the beginning of the year; Tesla founder Elon Musk remains firmly on the throne of the world’s richest man , but its personal wealth has evaporated by US$62.2 billion since the beginning of the year, ranking first in the list of the world’s richest people.
- According to a report released by the Agricultural Economics Office of the Ministry of Agriculture of Thailand, since 2015, the prices of three important agricultural products, pork, chicken and eggs, have continued to rise. The main reason was that the prices of feed raw materials such as corn, wheat and soybean meal continued to rise, up 14%, 43% and 15% year-on-year respectively.
- Japan: Foreign trade and other data showed a deficit. According to a report by Kyodo News on March 8, the preliminary balance of payments for January released by Japan’s Ministry of Finance showed that the current account, which reflects the transactions of goods, services and investment between Japan and overseas, showed a deficit of more than 1.18 trillion yen.
- South Korea: Shipbuilding companies ranked first in the world in terms of orders received in February.
- Myanmar: Large-scale power cuts will be implemented. The Ministry of Electricity and Energy of Myanmar recently issued a notice that due to factors such as rising natural gas prices and switching of natural gas field pipelines, large-scale power cuts will be implemented across Myanmar from March 12 to 18.
- Lebanon: Central bank opens credit line for wheat imports. The Ministry of Industry of Lebanon said recently that the Central Bank of Lebanon has opened a credit line for wheat imports. Eighty percent of Lebanon’s grain needs to be imported, and it is now seeking to buy wheat from Australia, the United States and Canada.
- Germany: New industrial orders increased sequentially in January. Data released by the German Federal Statistical Office recently showed that, driven by the growth of new foreign orders, after adjusting for seasons and working days, German industrial new orders increased by 1.8% month-on-month in January this year, the third consecutive month-on-month increase.


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The plastic surgery uses a lot of techniques, but there are several techniques that are often used:
– Skin grafts. This is a technique of moving a healthy skin to the damaged skin area.
– Skin flap surgery. This is a technique of moving body tissue and also all the blood vessels are still fresh.
– Tissue expansion. This is a technique of stretching out the skin tissue so that it can grow in place of the damaged tissue.
In addition to the above 3 techniques, plastic surgery also has other techniques such as fat transfer or grafting where fat is transferred from one area of the body to another, the vacuum closure where the wound is applied to improve the healing process, camouflage make-up or cream, prosthetic equipment to replace the damaged part of the body like a limp leg replaced with a prosthetic limb.
All operating procedures must be at risk. Especially for plastic surgery, the risk of plastic surgery depends on various factors, such as how large the area to be operated on. However, if you want a safe operation, you can visit our website. We also offer plastic surgeon las vegas breast augmentation services.

domain: health


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The event aims to celebrate the flavors of African-American, African and Caribbean cuisines. It also features a culinary showcase with top local chefs and a bartender competition.
The participating restaurants are:
- Meals from the Heart, 1100 N. Peters St.
- Neyow's Creole Cafe, 3340 Bienville St.
- Sassafras Creole Kitchen, 2501 Leon C Simon Blvd.
- We Dat's Chicken and Shrimp, 1407 Canal St.
- Blaze Bistro, 5941 Bullard Ave.
- Beaucoup Eats, 3911 Washington Ave.
- Tasty Treatl 5000 Old Gentilly Road
- Pra_Lees, 3600 St. Bernard Ave.
- Heard Dat Kitchen, 2520 Felicity St.
Black Restaurant Week started in Houston in 2016 and has spread to other cities including Oakland, Philadelphia, Atlanta and Los Angeles. This is the first year it's being held in New Orleans.

domain: geography


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DePuy Bails from the Metal on Metal Hip Replacement Market by Withdrawing its Pinnacle Metal-on-Metal Line
In the past, DePuy vigorously supported the continued use of metal-on-metal hip implants, even when mounting evidence through the registries and surgeons’ experiences showed that these types of hip implants had catastrophic results as compared to other safer alternative designs such as metal on polyethylene hip implants. DePuy will likely continue to deny that the Pinnacle Metal on Metal products are defective because they are fearful of the negative implications this would have with the massive number of patients who have filed lawsuits against DePuy, alleging that their metal on metal hip implants are defective. However, amidst mounting pressure from the FDA, surgeons’ negative experiences, and increased patient revision rates, DePuy has finally thrown in the towel and stopped its aggressive support of the metal-on-metal hip industry by announcing that it will be discontinuing sales of its Pinnacle metal-on-metal hip implants.
At the end of 2009, DePuy announced to US surgeons that it would be discontinuing sales of its DePuy ASR XL by the end of 2010. DePuy cited a decrease in sales as its motivator for discontinuing sales of the ASR XL, and DePuy vigorously denied that there were any safety issues with the DePuy ASR at that time. During this time period, US surgeons using the DePuy ASR were pitched on switching from the DePuy ASR XL to the Pinnacle metal-on-metal products and DePuy continued to support the use of metal-on-metal hip implants despite growing concerns of increased failure rates caused by cobalt and chromium metal toxicity.
In June 2012, the FDA held a panel discussion consisting of presentations from implanting surgeons, manufacturer representatives and patient advocates. Dr. Kwon discussed in detail his own observations of revising patients with metal-on-metal hip implants that needed to be removed due to high concentrations of cobalt and chromium being shed from the hip implants. He stated that numerous patients had necrotic metal stained tissue, joint fluid build-up, bone destruction and even pseudotumors that developed as a result of toxic concentrations of metal particles being shed from the hip implant.
In January 2013, the FDA issued a Med Watch safety alert to patients with metal-on-metal hip implants or those who were considering having a metal on metal hip replacement implanted (http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm340655.htm). The FDA also gave the ultimatum to companies to either discontinue selling metal-on-metal hip implants or provide clinical studies which adequately addressed the risks and benefits of implanting metal-on-metal hip implants. Rather than provide the required clinical trial support that the FDA sought for these Pinnacle metal-on-metal implants that DePuy had already been selling for nearly a decade, DePuy made the decision to simply discontinue sales of these Pinnacle metal-on-metal hip implants by August 2013.


Every week World Para Swimming will be looking at the countries who finished at the top 10 at Rio 2016 on our website and social media07 Oct 2020
Lichao Wang leading China to victory in the mixed 4x50m freestyle relay 20pts at the World Championships in London
ⒸAlex Pantling/Getty Images
By World Para Swimming
The country that topped the Para swimming medals table at the Rio 2016 Paralympic Games kicks off the Country Week, a new series on World Para Swimming website and social media that will take a closer look at the top 10 teams at the last Paralympics.
Check who are the swimmers to watch at Tokyo 2020 and the numbers behind China's great results in the pool.
China left Rio de Janeiro with 92 medals in Para swimming events. 37 golds, 30 silvers and 25 bronze, finishing in first place ahead of Ukraine.
Chinese swimmers also dominated the pool in the first World Championships in the new Paralympic cycle at Mexico City 2017.
The country topped the medal standings with 30 gold medals, 16 silvers and 10 bronze (56 in total).
Two years later, China ended in sixth place at the London 2019 World Para Swimming Allianz Championships. This time with 13 golds, 11 silvers and 17 bronze medals.
In the all-time Paralympic Games swimming table, China is currently ranked seventh, but another performance like at Rio 2016 could see them jump to the all-time top 5.


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Home » Why Laser Lipo and Vein Center? » Reviews » Janet R.
“My expectations were met 100% here at the Laser Lipo and Vein Center. The staff were very helpful and supportive, and I definitely recommend coming here for your leg pain and vein problems.”
Janet R. 12/15/09
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It’s officially November, and even though winter doesn’t *technically* start until December 21, around here we start calling it winter when the temperature drops below 65 degrees. As the weather cools down, we’ve set our sights on destinations that are still heating up, and we’re rounding up some of the best places in each warm winter destination to give you getaway inspo.
Get in girl, we’re escaping winter.
Nestled a little over two hours from the Southern California coast, Joshua Tree National Park is sort of like Palm Spring’s cool younger sister. This desert town is known for its incredible hiking and artsy airbnb’s (including experiences like glam-worthy airstreams and tee pees). It’s also not far from Pioneertown, a quaint desert oasis complete with a saloon and the infamous Pappy & Harriet’s, known for great barbecue and live music. Though temperatures tend to drop here at night, the desert sun usually stays high and there’s plenty of tanning opportunities to let you bask in vitamin D.
Desert destination complete. Taylor wears the Rio bottom & 'Nalo top in espresso.
Florida is full of winter-friendly gems like Miami, the Keys, and Panama City. Since this sunshine state is situated closer to the equator, waters are warm and sun is high year round. Head to Miami for the dance party of your life and incredible Cuban food, the Keys if you want to feel like you’ve stepped into a tropical oasis complete with manatees, Coco beach to visit Kelly Slater’s home wave, or Panama City to see where the largest population of bottlenose dolphins call home.
Florida sunshine stops for no season, and neither does the Tulum, shown here on Avianna in steel, our perfect blue.
Sayulita, Mexico comes alive in the winter, with swells coming in to make this surf spot extra lively. Grab locally caught, delicious fish tacos at the famous Maria’s, go whale watching from December to April as humpbacks migrate with their young, take a day trip to Islas Marietas, the small, uninhabited islands a few miles off the coast of Sayulita, surf, zip-line, or horseback ride along the beach.
This winter destination is perfect for the adventurer. Pairs well with the Malibu Surf Suit in plaid, seen on Amy, or the ‘Nalo top & Rio bottom in plaid, seen on Zion.
We’ll be adding these destinations to our vision board and quietly sobbing as we unpack our winter clothes. Thank goodness for hot tubs, backyard tanning, and indoor pools. Summer ‘24 is only 298 days away (not that we’re counting).


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Exploring the Levels of Creation
Have you ever wondered about life and Creation? Is there life after death? Why do we have to go through these trials and tribulations? Why do we have thoughts and dreams that run from the sublime to those that are nightmarish and bizarre? Why do goodness and evil go hand in hand in life ... or do they? The answers to these questions and more are brought to light by author and spiritual teacher Sylvia Browne. She once again shares her psychic gifts and years of research in order to enlighten us and give us more insights into God and the realities of life. This time she tackles the structure of Creation by showing us that there is purpose and order in our sometimes seemingly chaotic world and existence. She outlines the structural levels of Creation of not only life as we know it; but the reality of the afterlife and the heretofore-unexplored structure of the Lower Levels of Creation. From the beautiful and perfect life of the Other Side to the wondrous, weird, and strange Lower Levels, to the everyday intricacies of life on this planet, Sylvia takes us on another journey of exploration and truth.
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domain: literature


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A massive ‘marriage proposal’ was spelt out in giant letters framed by King’s College Chapel.
A mystery woman known only as Alice went to huge lengths to pop the question to ‘Andy’ in a grand gesture which appeared along Cambridge’s historic Backs – forcing drivers and cyclists to do a double-take.
The bobble-hatted woman was spotted putting up the sign made from tin foil and rope at 7.30am this morning.
The message simply stated ‘Andy, will you marry me?’. A note was attached promising “any authorities concerned” the ‘installation’ would be removed before 9pm last night.
The huge sign received a mixed reaction from passers-by who thought it was either romantic or embarrassing.
Rachel Walker, 25, a librarian of Chesterton Road, thought it may leave Andy red-faced.
She said: “I think it’s nice but I would find it a bit embarrassing if it happened to me – but it’s good to see it’s the other way around and a woman proposing to a man.”
But Xveying Mojo, 25, a tourist from Shanghai, China, said: “I think it is romantic and I would love to get a proposal like that. I have never seen anything like it.”
However, it later emerged that the proposal was not a romantic gesture but a ‘college marriage’ – a traditional ritual among Cambridge University students (see below).
Alice told the Varsity student newspaper that Andy was a friend who lives on her corridor and was “an obvious choice for a college husband because he’s so lovely”.
She added that she had been inspired to pop the question so extravagantly by a previous proposal in her college that took the form of a Viking raid.
What is a college marriage?
College marriages are an informal ritual among students at Cambridge, whereby one student proposes to another in an often extravagant manner, and they are then married at a formal.
Girls marry girls at all-female colleges, while those with a heavy gender imbalance often see women taking on multiple husbands.
Couples are then allocated fresher students as their college children, which involves them looking out for them, particularly on nights out.
One former student at Murray Edwards College told the News: “Most colleges do it. Basically you find a friend and marry them at a formal.
“I had a college wife as I was in an all-female college. At colleges with a heavy gender imbalance women will take multiple husbands.
“You can marry as many people as you want.
“I had a male friend who proposed by making a banner and lying it outside a girl’s window. He laid it on the floor and threw some gravel at her window to grab her attention so she would come to the window and look out.
“The marriage means you get college children. It’s all fairly informal. Husband and wife are given freshers the next year and they become their college children. You are allocated them and are generally responsible for getting them drunk.
“I had a really nice college family, although my college kids did not really buy into it so I never saw them.”


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University researchers lead study of nanoplastics in Portugal’s rivers
A team of scientists from Science and Technology faculty of the University of Coimbra have been studying the damage that nanoplastics have been generating in Portugal’s freshwater ecosystems.
The results have been published in the scientific journal Fungal Ecology, focused on the process of leaf decomposition, considered a crucial indicator for assessing the function and quality of freshwater systems. For this, the team used five species of hyphomycetes – aquatic fungi that play the main role in the decomposition of leaves.
In experiments carried out in the laboratory, with fungi isolated from Swiss streams and leaves harvested in Coimbra’s Parque Verde, on the bank of the Mondego river, researchers found that exposure of the fungi to nano-sized plastics (100nm and up to ~ 100mg / L), interferes with their ability to break down the leaves.
“We have shown that nanoplastics reduce the ability of fungi to decompose leaves at concentrations of 1.6 mg / L. This value is about four to six times higher than the concentration of microplastics reported in the U.S. and Europe,” said Seena Sahavedan, a researcher at the Center for Marine and Environmental Sciences at Coimbra and the principal author of the scientific paper.
“Our findings document that nanoplastics can interfere with ecological functions in aquatic ecosystems. However, since different fungi differ in their sensitivity, it remains to be seen what would happen in a natural multispecies system,” notes the researcher.
Pollution from plastics is known to be a serious threat to aquatic environments. Plastics production is estimated at 8,300 million metric tons and it is predicted that by 2050, about 12,000 million tons of waste plastic will either be in landfills or in the natural environment.
It is estimated that every year, from the rivers of the world, between 1.15 and 2.41 million metric tons of plastic will enter the ocean. Plastics can be fragmented into particles of very small sizes (‘nano,’ that is, one hundredth of a millimetre) whose environmental effects are still unknown, but of great concern.
Sahavedan points out that nanometre-sized plastics are also used in a wide range of products such as toothpaste, water paints and biomedical products, also, polystyrene, “which is a very versatile type of plastic and is nowadays used in a wide range of products – food packaging, cosmetic containers, medical pipettes, etc- which are single-use products and are not biodegradable with the polystyrene molecules contributing significantly to the debris found in aquatic systems.”

domain: chemistry


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To further expand its subscriber base, Netflix is continually negotiating new licensing agreements with television shows, networks and film producers, or investing in its own content production. When a content license is granted, the rights are acquired by the owners of a television show or a film that broadcasts content on a service such as Netflix. A licensing agreement is entered into between content owners and Netflix. Any agreement depends on the needs of both parties. For example, the owner of a television show might agree to allow Netflix to broadcast all seasons of its show for one, three or five years. The license agreement may restrict or exclude Netflix to certain regions. A British crime show could be available worldwide for online distribution, with the exception of the UK, the domestic producer market. When the license agreement expires, both parties can negotiate an extension, or Netflix could remove the show from its library if the viewer`s interest does not guarantee the fee. A content owner can license programming on multiple streaming platforms such as Hulu or Amazon Prime Video, meaning that licensing agreements between parties are not exclusive.
Licensing agreements that are not exclusive are generally less expensive to obtain because non-exclusivity reduces the value of the content. Examples of licensed content include movies and shows such as Showtime`s Shameless, How to Do with ABC`s Murder, Universal`s The Office and Paramount`s The Godfather. Examples of Netflix originals, which are nevertheless licensed content, are MRC`s The House of Cards, Orange is Lionsgate`s New Black and Sony`s The Crown. The films and shows that Neflix produces and owns include Stranger Things, Mind Hunter and The Irishman. The fees collected by subscribers, coupled with the raising of capital through new debt issues, allow Netflix to invest in content, either through in-house production or licensing agreements with content providers. Online entertainment companies typically rely on advertising or a subscription business model, or a combination of it to support their operations. For example, Hulus` basic plan combines advertising and subscription fees, although customers can also pay more for viewing. Netflix has opted for a business model based solely on subscription revenues. It offers three price levels that allow customers to access exclusive and non-exclusive television shows and films that the company has either produced itself or licensed by the content owner. Securing licensing agreements is one of the most important expenses for Netflix. At the end of 2019, Netflix had $24.5 billion in content assets on its balance sheet, up from $20.1 billion the previous year.
Exclusive licensing agreements are much more expensive than non-exclusive agreements, although they have the potential to get more subscribers over time. As competition continues to saturate the market, streaming service providers recognize the importance of proprietary content.


Mosquito Magnum Hotend from Slice Engineering
Newly updated Mosquito™ Magnum (latest version, with coated heat break)
The Mosquito Magnum is best for nozzle sizes 0.40mm or larger. You can use a smaller nozzle, but it will be more difficult to print detail than with a standard Mosquito hotend.
Be sure to select a 12v or 24v fan above, if needed.
- Bondtech BMG-M compatible
- For 1.75mm diameter filament
- Extended melt zone, so you can print faster and still achieve the high resolution benefits achieved with the standard Mosquito
- Melt zone is extended upwards, so the the Mosquito Magnum is the same size as the standard Mosquito Hotend
Optional Parts (not included):
For 12v printers: Mosquito Heater Cartridge 12 volt
For 24v printers: Mosquito Heater Cartridge 24 volt
Buy the Bondtech BMG-M extruder here. It has been designed specifically for the Slice Mosquito hotends and is a great upgrade over stock extruders.


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Just some copy work that I'm doing occasionally; nothing to see here.
Feel free to copy it on your own a few times and see if you can pick out anything in the writing. Or you can just use it to practice your typing.
Harry kept to his room, with his new owl for company. He had decided to call her Hedwig, a name he had found in A History of Magic. His school books were very interesting. He lay on his bed reading late into the night, Hedwig swooping in and out of the open window as she pleased. It was lucky that Aunt Petunia didn't come in to vacuum anymore, because Hedwig kept bringing back dead mice. Every night before he went to sleep, Harry ticked off another day on the piece of paper he had pinned to the wall, counting down to September the first.


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Collection location: Forest near Elgin St., Pembroke, Ontario, Canada [Click for map]
LBMs in Zone 05. Hygrophanous cap margin, tan/light brown gills with darker edges and notched attachment.
|I’d Call It That||3.0||0.00||0|
sum(score * weight) /
(total weight + 1)
Created: 2009-07-21 20:26:26 CDT (-0400)
Last modified: 2009-07-21 20:26:26 CDT (-0400)
Viewed: 14 times, last viewed: 2017-06-06 01:52:27 CDT (-0400)

domain: biology


text: MLSs with ZOOM PANs of vast snowy plains or snow-covered river, with mountains in background and isolated houses, shot at different times of day and in different lights. Several TRAVELLING SHOTs from road, in rosy late-afternoon light, of snowy fields and coniferous and deciduous forest. MLS with long PAN over same with reflections of setting sun on snowy field, spruce woods in background, long PAN over field to isolated farm. MLS with ZOOM OUT to LS of snow-covered rock face, with frozen, snow-covered river in foreground. MLS with PAN over frozen river and shore in background. Still MLS of same. Some MLS TRAVELLING SHOTs over snowy field with mixed forest in background. Some MSs with camera movement over trees, white birch, spruce, and ZOOM OUT to saplings. MLS of country road through snowy fields with wooded hills in background. Some MLSs with PAN and ZOOM over small farms scattered along country road and some MLSs with PAN over forest and snowy fields.


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Recently сообщалось, as at a hearing in the U.S. Senate, in a committee on the affairs of the armed forces, the commander of the European command of the U.S. armed forces and the supreme commander of the NATO armed forces in Europe, Tod Walters said that Russia has a certain military superiority over the Alliance in the Baltic region and the Arctic. In addition, the general reported to the senators that the US missile defense system (ABM) needs to be improved.
It should be noted that at the hearings mentioned, Senator Angus Stanley King, Jr. (Angus Stanley King, Jr., born in 1944) reminded the general of the “leaky missile defense”. King is an independent. He has been a member of the Senate from Maine since 2013. Prior to that, between 1995 and 2003, he was Governor of the State of Maine.
So, King recalled to the general how, in September 2019, drones launched an unpunished attack on the Saudi Aramco refinery in Saudi Arabia, as well as Iran’s missile attack, on military facilities in Iraq in January 2020 (after which the Pentagon announced the transfer of an additional the number of air defense / missile defense systems in the region).
What are our capabilities in protecting against such attacks because it did not work in Iraq and did not work in Saudi Arabia?
the senator asked.
She's improving, but she needs to get better. We have a plan related to integrated air defense, which fully takes into account what happens at high altitude and long range, as well as low altitude and shorter range
- reported the general.
After that, King asked Waters to clarify whether he considers the missile defense problem to be a “significant gap” in US defense.
This is a flaw, and we must continue to work on it.
- answered the general.
For objectivity, it should be clarified that according to the statement of the Crown Prince of Saudi Arabia, the second deputy head of government, the head of the Ministry of Defense of this country and the chairman of the royal court, Mohammed bin Salman Al Saud, the American Patriot and Hawk systems are not designed to destroy drones.


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Stay up to date on current News & Issues.
NAR cheers bill to extend Fair Housing protections to LGBT
Upper Southampton Authority inspecting sump pump connections at point of sale
Chester County awarded $3.7M to preserve farms
U.D. school board OKs study of proposed new school on Clifton fields
Norristown Day set for April 6
Philadelphia launches $40 million home repair loan program
Update 3/20/2018: The U.S. Supreme Court and a federal district court both rejected lawsuits to overturn the revised Pa. congressional map.
Read about the rulings here: https://goo.gl/TM3vT6
The Pennsylvania Supreme Court on Feb. 19, 2018, released its map updating congressional districts in the commonwealth. Below is an interactive version of the new map, created by Kerrin Garripoli of Ceisler Media.


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Canon gives EOS 7D a firmware overhaul
August 7, 2012
Canon says firmware v2 – which was introduced following customer feedback – boosts the 7D’s maximum raw file burst rate to 25 raw files, or 130 JPEGs.
In-camera editing includes raw file processing, while control over Auto ISO levels during still and movie recording allows users to limit ISO speeds ‘within the native ISO 400-6,400 range’ according to Canon.
The update also adds new manual control of audio levels with a choice of 64 sound levels.
The EOS 7D is compatible with Canon’s GPS unit, the GP-E2, allowing users to geo-tag their images, using longitude, latitude and altitude data.


Wastewater Laundry Operations (Part 1) Changes, improvements in systems over past decade
Water reuse systems have been applied to centralized and decentralized scales, and water has been reused for a wide range of activities, such as agricultural/land application, commercial/industrial processes, toilets, and even potable water.
To keep costs down, industry is shifting focus toward reuse systems that are fully automated, have minimal operator requirements, require few chemicals and use semi-permanent filters.
And as wastewater treatment systems improve, laundry and linen services are making use of them to drive down costs and be more environmentally responsible.
Part 1 of this four-part series looks at changes and improvements in systems over the past decade.
CHANGES AND IMPROVEMENTS
Chad Folkerts, vice president of field operations and engineering at Norchem Corp., a chemical solutions/water technologies company based out of Los Angeles, says that over the past 10 years water recycling systems have become much more efficient, are utilizing remote access and machine intelligence for trouble shooting, and more automating of the process requires minimal interaction from an operator.
“Systems are now using a fraction of the energy required to recycle the same amount of water, which adds to the savings an operation will realize,” he shares. “With the increased efficiency comes a lower capital cost, which when combined with the savings, results in a much more attractive ROI for the customer.
“Some operators may have looked at the technology five years ago and it did not make sense financially, but now with more efficient systems and lower capital cost for the same recycling capacity, the same operator may find the technology make great financial sense.”
Overall system designs have evolved to help maximize heat recovery and reduce water consumption by utilizing current plant infrastructure and washer designs, says Folkerts. Based on the design of a plant and the washers being utilized, he says Norchem has seen “fresh water” reductions on a conventional wash floor of up to 80%, with an 80% reduction in water heating cost.
Folkerts goes on to say that automation and machine intelligence continue to advance to help improve the efficiencies and ease of operation of the systems.
“We have systems that require no operator interface,” he points out. “Once the system is started, it will filter and recycle wastewater, automatically clean when required, and then automatically start up when required based on wastewater levels throughout the system.
“Our NorVision machine monitoring system allows operators to see everything happening throughout the system. Troubleshooting guides will pop up on the screen if an alarm is present to help walk them through, step-by-step, for any alarm. The system also acts as a CMS system notifying operators when it is time to perform preventative maintenance. The systems will also automatically send text messages or e-mail reports or alarms to key plant personnel when required.”
Bob Fesmire, president of Ellis Corp. in Itasca, Illinois, a manufacturer of washing technology with a wastewater division, says that in the past decade, wastewater systems in the laundry industry have shifted from traditional treatment for city compliance to a heavy focus on recycling water, which allows for heat capture and contaminant removal so that the most amount of water remains in the building for repurposing.
“The drivers for this shift come as utility costs consistently rise and municipalities lower the levels for the contaminants they are willing to accept and treat,” he says. “Few end users have real estate available in their facility (do you ever see large, unused spaces in an industrial laundry?), so all new solutions are required to be as compact as they can.”
In addition to this, Fesmire says that all treatment options need to be able handle variable contaminant loading in the waste and differences in compliance limits throughout the country.
FULL ARTICLE AND SOURCE AMERICAN LAUNDRY NEWS


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Here’s a preview of what I’ll be discussing on Talking Numbers today around 3:20 to 3:30 pm EST on CNBC:
With AAPL on the tip of everyone’s tongue, I’m going to revisit the AAPL chart today. I laid out last month why I thought AAPL had made a long-term top, but today I want to detail why we might be close to a short-term bounce.
First, the weekly chart of AAPL since the start of the bull market:
I’ve drawn the trend channel that AAPL respected so well from 2009 to the start of 2012. It was a healthy uptrend that exhibited no signs of euphoria. However, the stock started to go parabolic in February, and broke outside of the trend channel, a much more unhealthy form of appreciation on a long-term basis. The stock has spent the last 9 months outside of the trend channel (circled in red), but its recent selloff has finally brought it close to that long-term trend. I think AAPL’s selloff is close to done, and risk/reward of buying the stock here is much better than it has been in the past 9 months, but I view one last move lower back into the trend channel as a distinct possibility.
Contrast AAPL’s bull market chart with JCP during the same time period:
I’ve drawn the red line at the important 19-20 support level, where it bounced from this morning. This is a 40% short interest name with a lot of bad news priced in, so I think it could bounce as well.
However, I’m more confident that AAPL is close to a bounce because of its longer-term strength. But you might get one final washout before this selloff is over.


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In October, I had the privilege to be invited as a panelist to the Sydney Symposium on Literary Translation, organised by the Writing and Society Research Group at the University of Western Sydney.
The Group has recently made the recordings available on their website, and in the coming weeks I will be linking to the different sessions and share some thoughts.
First things first, so you can listen to Ivor Indyk’s welcome speech to start.
Most importantly, do not miss the opportunity to listen to the first keynote lecture, delivered by the amazing Esther Allen. She is currently translating some documents from the Dossier Flaubert (0:30 – 3:25 for the background story) and her paper was absolutely captivating, mixing literary criticism, translation theory and translation practice.
I was particularly intrigued by her reference to “linguistic untranslatable” and “biographical untranslatable” (8:27 – 10:48), brought about by a reference to a dream in one of Flaubert’s letters, namely, “the dream of Pimpenpohè”. Listen to her reflections on this very evocative word to see a great example of the challenges literary translators face on a regular basis.
The lecture lasted more than an hour, but went by in a flash, and I am sure that no one will regret listening to it, if they find the time. From the parallel between realism in sculpture and in literature to the way she mercilessly exposed Nabokov’s trivial and sometimes plain incompetent criticism of Eleanor Marx’s translation of Madame Bovary, Esther showed how translation and translation studies can be not just of great academic significance, but also very entertaining for a more general readership. Enjoy.


Music is the divine way to tell beautiful, poetic things to the heart.
Nandini Shankar, one of the exceedingly talented daughters of Mr. Shankar Devraj and the violin maestro Dr. Sangeeta Shankar, began her training in music from the tender age of 3 under the tutelage of her mother and illustrious grandmother, Padmabhushan Dr. N. Rajam, the ace violinist of the country.
Having been born and brought up in an atmosphere surcharged with high caliber music round the clock, Nandini has taken to music as a duck takes to water. Her progress has been enormously astonishing and she has reached a high level of proficiency on the violin. Nandini has been highly applauded by music enthusiasts for being one of the most promising faces of Indian Classical music.
She has performed in many prominent music festivals and places in India and abroad. She is also a part of various collaborations. She is currently a faculty for music and composition at Whistling Woods International, a premier film institute in Mumbai.
Academically, she has completed her Masters in Music from SNDT University and also is a qualified Chartered Accountant.
Started learning at the age of 3 from her mother and grandmother
First public performance at the age of 8 with her sister at Bhopal
First full-fledged solo performance at the age of 13 in Dharwad
Performed at the prestigious Carnegie Hall in New York
- Sawai Gandharva Mahotsav (Pune)
- Dover Lane (Kolkata)
- Saptak (Ahmedabad)
- ITC Sangeet Sammelan (Delhi)
- IMG (Mumbai)
and many other festivals and cities
- USA & Canada
- UK, Netherlands, Belgium, France, Germany, Hungary
- New Zealand
- South East Asia
A pure Hindustani Classical concert portraying the unique style of Gayaki Ang (Singing Violin)
Creative collaborations with exceptional artists of different genres
Grandmother, mother and 2 sisters together weave magic with their soulful notes
Learn the best technique of reproducing the Indian (Hindustani) vocal style on the violin from Nandini, who is part of the world renowned and highly acclaimed violinist family of Dr. N. Rajam through online classes. The Gayaki Ang, literally meaning ‘to play as though sung’ refers to the technique developed in violin by Dr. N. Rajam, which helps violinists to produce sounds through the violin, which emulate the human voice. Hence the subtleties and emotions of the human voice are reproduced on the violin. People all over the world are mesmerized by this form of music, as it has the capacity to touch and move millions of hearts. For more information on lessons, visit Rajam School of Violin .