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A longer version of our In Tents stamp, for those who want a little bigger of a stamper. All Chatty Press address stamps can be customized with first names, last names, apartment numbers, and of course international addresses. Available only as a wood handle stamp
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Huawei has been shut out of some high-profile 5G contracts, as both Deutsche Telekom and Bell Canada have gone with Ericsson.
Huawei has faced increasing pressure worldwide as the US has led a campaign to shut the Chinese firm out of the 5G market. Huawei is already banned in the US, and officials have been working to get their allies to follow suit.
Australia and New Zealand have similarly banned Huawei from participation in their 5G networks. The UK initially decided to allow the company to participate in a limited role, although recent events are forcing the British government to reconsider. Canada, on the other hand, has remained largely undecided.
Bell Canada, however, has decided to exclude Huawei, inking a deal with Ericsson instead.
“Ericsson plays an important role in enabling Bell’s award-winning LTE network and we’re pleased to grow our partnership into 5G mobile and fixed wireless technology,” said Stephen Howe, Chief Technology Officer, Bell Canada. “5G’s high-capacity and near-instant connections will enable next-generation applications like mobile 4K video and immersive augmented reality, connected vehicles and industrial IoT automation on a massive scale, and our plan is to deliver the benefits of the 5G wireless revolution to cities and rural locations alike.”
Similarly, Deutsche Telekom has also selected Ericsson for its network in Germany.
“We listened to Deutsche Telekom and understood their urgency to have 5G-ready infrastructure in order to stay at the forefront of customer service in Germany,” said Arun Bansal, President and Head of Ericsson in Europe and Latin America. “We can run multiple standards on the same baseband hardware and a 5G upgrade will be able to be performed by a simple software download to the radio sites. And, during these deliveries, we will use the experience from our 5G activities around the world to be sure that Deutsche Telekom has the most advanced hardware and software in the industry.”
These are undoubtedly big losses for Huawei and further isolates the company in its efforts to be a leader in the 5G market.


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domain: entertainment


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Faros Old City - Special Class achieves its 4-star rating admirably. Sirkeci railway station is the station that is easiest to reach if you come by public transport. Cemberlitas Hamam, Cagaloglu Hamam and Wall of Constantinople can be reached following a short walk from here. The area is rich in museums: Hagia Sophia and Great Palace Mosaic Museum are popular features in this catergory. Miniature Park, always worth a visit, can be found close to the hotel.
Guests of Faros Old City - Special Class can enjoy a complimentary breakfast. A restaurant and a bar/lounge are also located on the premises. A stay here is guaranteed to be replete with convenient services including a dry cleaning/laundry service. 23 rooms are located in the building. Transport options offered at this location include a paid airport shuttle bus.
One of the services offered by Faros Old City - Special Class is a housekeeping service. You can stay up to date with everything that is happening around the world during your stay in Istanbul as wireless high-speed Internet access (complimentary) is offered. The state of the bathroom is a factor on which many travelers base their choice for their stay. The bathrooms here come with a bathroom amenities set. This hotel conveniently includes a coffee/tea maker amongst the rooms' kitchen facilities.
|Check-in:||From 14:00 Check-out: Until 12:00|
|Internet:||Wireless high-speed Internet access (complimentary), Free wired Internet|
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domain: travel


text: Malaria parasites can enter the body through these mosquito bites, and then live in body tissues such as red blood cells or the liver. This medication is used to kill the malaria parasites living inside red blood cells. Side effects from plaquenil on eye Hydroxychloroquine urticarial vasculitis Benefits of plaquenil for sjogren& 39 Chloroquine works best when you take it on a regular schedule. For example, if you are taking it once a week to prevent malaria, it is best to take it on the same day of each week. Make sure that you do not miss any doses. If you have any questions about this, check with your doctor. A Nigerian man has been left fighting for his life after taking an overdose of chloroquine. A Nigerian man has reportedly landed at the hospital unconscious after he taking an overdose of malaria drug Chloroquine to avoid getting the deadly coronavirus. Symptoms of a chloroquine overdose may include Drowsiness. Dizziness. Blurred vision. Fainting. Headache. Excessive excitability. Mood changes. Seizures. Irregular heartbeat. Slow, shallow breathing. Loss of consciousness. Both drugs may be needed for a complete cure and to prevent the return of infection (relapse). In some cases, you may need to take a different medication (such as primaquine) to kill the malaria parasites living in other body tissues. Chloroquine overdose Medicines for the Prevention of Malaria While Traveling., Coronavirus Scared Nigerian Man Lands In Hospital After. Does plaquenil treat ckdHydroxychloroquine sulphate 200mg side effects Aralen chloroquine is an antimalarial drug used for the treatment of malaria and extraintestinal amebiasis. Common side effects are reduced hearing, tinnitus, nausea, vomiting, and diarrhea. Dosage, drug interactions, and pregnancy and breastfeeding safety are provided. Aralen chloroquine Malaria Drug Side Effects & Dosage. Chloroquine Aralen - Side Effects, Dosage, Interactions - Drugs. Chloroquine Aralen - Side Effects, Dosage, Interactions.. In overdose both chloroquine and hydroxychloroquine cause sodium channel blockade with primarily cardiovascular and central nervous system effects, as well as hypokalemia due to intracellular potassium shifts. Q3. Describe the toxicokinetics of chloroquine. Chloroquine is used to prevent or treat malaria caused by mosquito bites in countries where malaria is common. Malaria parasites can enter the body through these mosquito bites, and then live in body tissues such as red blood cells or the liver. Chloroquine phosphate comes as a tablet to take by mouth. For prevention of malaria in adults, one dose is usually taken once a week on exactly the same day of the week. Your doctor will tell you how many tablets to take for each dose.

domain: health


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Cai, BS; Giridharan, SSP; et al. Differential Roles of C-terminal Eps15 Homology Domain Proteins as Vesiculators and Tubulators of Recycling Endosomes. JOURNAL OF BIOLOGICAL CHEMISTRY 288:30172-30180(2013).
Grant, BD; Caplan, S; et al. Mechanisms of EHD/RME-1 Protein Function in Endocytic Transport. TRAFFIC 9:2043-2052(2008).
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domain: literature


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domain: library


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Notes: The first US edition of Satrapi's autobiographical graphic novel (originally published as two volumes in France) about her childhood in Iran during the Islamic Revolution. Persepolis is widely considered one of the most important graphic novels, pairing simple but distinctive graphics with a beguiling narrative from a child's perspective. The Cambridge History of the Graphic Novel devotes chapter 25 to Satrapi and mostly to Persepolis.
The book has sold more than 1 million copies in English translation but the first printing was not large, as Satrapi was an unknown first-time author and the book was translated. Basis of the film of the same name.
Edition + Condition: First edition (first printing with a numberline ending in 1). A fine copy in a fine dust jacket. Signed by Satrapi on the title page, and uncommon thus.
Publication: New York: Pantheon, 2003.
Item No: #361034

domain: artistic


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Laurier House National Historic Site of Canada
II: Setting the Scene: The Great Depression and the Development of Canada's Social Programs: An Overview
The crash of the New York stock market in October 1929 precipitated an abrupt decline in world trade, which ended the economic boom of the Roaring Twenties and ushered in the Hungry Thirties. As a semi-industrialized nation dependent on the export of grain, raw materials, and partially finished products, Canada was especially vulnerable.
No one in 1929 could have predicted the magnitude and duration of the Great Depression. Prime Minister William Lyon Mackenzie King shared the widespread belief that the recession was temporary and that the economy would recover without the necessity of resorting to drastic or radical measures. As a young man Mackenzie King had studied economics, and later served as the first Minister of Labour (1909 -11). For some years thereafter he had investigated labour problems in the United States. When chosen Liberal leader in 1919, the party's platform had included old age pensions, unemployment insurance, sickness insurance, an eight-hour day, and the right of collective bargaining. However, as Prime Minister (1921-30), the only social program enacted by his government was the Old Age Pensions Act of 1927. While it represented the first serious step toward a national system of social security, it would come into effect only in provinces that agreed to pay half the cost of the pensions.
The impact of the Great Depression varied within communities and across the country. Although most wage-earners were forced to accept reductions in pay, the cost of living also decreased and those in the urban middle classes who were fortunate to retain their jobs were often better off than before. Unskilled workers, the elderly, and youth, however, faced continuous unemployment and hopelessness. Searching for work, men walked the city streets and waited in line at soup kitchens for food; they took to the roads as transients and begged for a bed overnight and a meal; they rode the windy tops of freight cars from place to place. In 1933 one of five in the labour force had no earned income.
The plight of the farmer was different. While not unemployed, the prices for his products dropped to a fraction of what they had been. By 1932 wheat was being sold at an all-time low of 34 cents a bushel, less than it cost to grow. Moreover, the world market shrank, and by 1935 the unsold surplus of wheat in Canada amounted to 200 million bushels.
At the same time, the fisheries and coal industry in the Maritimes stagnated, and British Columbia experienced a marked decrease in the Pacific trade. However, the suffering was most acute on the farms of the prairies where wheat was the staple crop and natural disasters - drought, dust storms, grasshopper plagues, wheat rust coincided. Parts of southern Saskatchewan had nine consecutive years of almost complete crop failures. As a result, many farmers abandoned their land and machinery to the mortgage companies and moved to the treed areas farther north or into the cities. Unable to purchase even the barest necessities, many were forced to accept the humiliation of relief. The treasuries of the western provinces were emptied as they met the unprecedented demand for aid. To ensure that the money was not squandered, relief was often given in the form of vouchers which could be exchanged for food, fuel, and clothing.
In the election campaign of 1930, Mackenzie King opposed federal relief, claiming that this was not within the federal powers included in the British North America (BNA) Act of 1867. In his view, the provinces and municipalities must continue to assume responsibility for relief programs. During the campaign, he made the injudicious remark that he would not give a five-cent piece to any province with a Conservative government for alleged unemployment relief.
The Conservatives under R.B. Bennett, who promised aggressive action on unemployment, won the election. The new Prime Minister began his term of office by instituting a repressive policy toward unemployed marchers, labour unions and radical periodicals; a steeply raised tariff which, strangely, was supposed to blast the way into world markets; and emergency measures including twenty million dollars, an enormous sum at the time, for public works and relief. However, the government's strategy was ineffectual and, as the Depression worsened, Canadians began to lose confidence in the capitalist system which had caused such an economic disaster and in the government which seemed powerless to prevent it. Resentment, rural and urban, focused on the Prime Minister. He had promised decisive action, but his policies had done little to improve the situation.
Increasingly, from all sectors of the population with the exception of big business, there were calls for fundamental change in the role of government to ensure social and economic welfare. The monetary theories of the British economist, John Maynard Keynes, attracted considerable attention. According to Keynes, the Great Depression could only be conquered if governments deliberately incurred deficits by cutting taxes to increase purchasing power, and by spending on public works and other large-scale investments to stimulate industrial activity. In the West, two protest parties emerged: Social Credit in Alberta in 1932, with an inflationary panacea in the form of monthly social dividends of twenty-five dollars a month to be issued to every citizen in the province; and the socialist Co- operative Commonwealth Federation (CCF) in Saskatchewan in 1933. In Quebec, discontent had an added nationalist dimension, for business interests were predominantly English-speaking, and wage earners French-speaking. The economic problem of unemployment therefore became a cultural problem, and in 1936 the Depression would bring L'Union Nationale to power.
Fearing political unrest, Prime Minister Bennett surprised even his own party by a series of radio broadcasts in January 1935 in which he admitted that there were grave defects in the capitalist system and announced a New Deal for Canada which would result in greater social justice. Bennett's proposed reforms would include unemployment insurance, maximum hours of work and minimum wages in industry, extension of farm credit, and a natural products marketing board. However, voters were not convinced of the Prime Minister's sincerity, and in the election of 1935 the Conservatives were soundly defeated. The Liberals, with the slogan King or Chaos, returned to power after a five-year absence with the largest majority in Canadian history up to that time.
Back in office, Mackenzie King proceeded cautiously. He had questioned whether the federal government had the jurisdiction to pass the New Deal reforms, and now referred the matter to the courts for decision. The Judicial Committee of the British Privy Council, the highest court of appeal for Canada, declared most of the proposed legislation beyond the federal powers. For his part, Mackenzie King believed in the remedies of the past economical government, debt reduction, low taxes, moderate tariffs. Deficit spending was, in his view, undesirable. He was hesitant to intervene in the social order. Inflation seemed morally wrong. However, the unity of the country, always his prime goal, was at stake, and he adapted to the rising demand for social welfare. The provinces had been adopting various social measures since the late nineteenth century, but their financial resources were simply not sufficient for the critical needs of the twentieth century. In 1937 Mackenzie King appointed a Royal Commission on Dominion-Provincial Relations to study the distribution of powers and revenues and bring the federal system into balance. This was a significant assertion of federal leadership on the part of the Prime Minister, a recognition that the national government had social responsibilities and regulatory functions not envisaged in 1867.
In 1940 Mackenzie King, desirous of maintaining industrial peace during World War II, secured the agreement of the provinces to an amendment of the BNA Act which empowered the federal government to establish national unemployment insurance. This was followed by the enactment of the Unemployment Insurance Act. In 1944 the government established the Department of National Health and Welfare, and passed the Family Allowances Act by which parents would receive a monthly allowance for each dependent child.
The Unemployment Insurance Act and the Family Allowances Act were notable pieces of social legislation and set Canada firmly on the path to a social welfare state. They would be followed over the years by many others: for example, the Old Age Security Act of 1951, the Canada Pension Plan of 1964, the Canada Health Act, a comprehensive national health insurance program (or medicare, as it was popularly known) in 1966. The Great Depression had served as the catalyst for these fundamental reforms, revealing the economic insecurity of modern society and leading to the expansion of federal government activity in assuming responsibility for major social welfare services.
Bliss, Michael. Right Honourable Men: The Descent of Canadian Politics from Macdonald to Mulroney. Toronto: Harper Collins, 1994.
Bothwell, Robert, Ian Drummond, & John English. Canada, 1900 1945. Toronto: University of Toronto Press, 1987.
Creighton, Donald. Canada's First Century 1867 1967. Toronto: Macmillan, 1970.
Grayson, L. M. & Michael Bliss (eds.). The Wretched of Canada. Toronto: University of Toronto Press, 1973. Introduction: pp. vi-xxvi.
McNaught, Kenneth. The 1930s, in J.M.S. Careless & R. Craig Brown (eds.), The Canadians 1867 1967, pp. 236-269. Toronto: Macmillan, 1968.
Neatby, H. Blair. The Politics of Chaos: Canada in the Thirties. Toronto:
Pickersgill, J. W. The Mackenzie King Record. Vol. 1: 1939-1944. Toronto: University of Toronto Press, 1960.

domain: sociology


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March 6, 2024, Santa Rosa, CA - The Music Department of Santa Rosa Junior College presents a jazz concert by the Bennett Friedman Quartet on Thursday, April 4 at 7:30 PM in Newman Auditorium on the SRJC campus. Guitarist Randy Vincent, bassist Jeff Denson, and drummer Kendrick Freeman will be featured. Admission to the event is $15 general and $10 for students and seniors. There is a $4 fee for parking on campus. Proceeds from the concert benefit the SRJC Foundation Jazz Studies Fund.
The performance will feature works of Horace Silver, John Coltrane, Antonio Carlos Jobim, a Friedman original, and others.
Randy Vincent has been teaching jazz guitar at Sonoma State University since 1981. He has performed with Bobby Hutcherson, Joe Henderson, and Dizzy Gillespie. He has authored six books on jazz guitar, published by Sher Music Co.
Bassist Jeff Denson has performed and recorded extensively with legendary jazz saxophonist Lee Konitz. Jeff graduated cum laude from Berklee College of Music in Boston, received his MM in Jazz Studies from Florida State University, and his Doctor of Musical Arts from UCSD. Jeff has also performed with Anthony Davis, Joe Lovano, Jan Ira Bloom, Kenny Werner, Dave Douglas and many others. Dr. Denson is currently Dean of Instruction at the California Jazz Conservatory in Berkeley.
Kendrick Freeman has background in both drum set and hand drums, having studied with American artists and musicians from Ghana, Congo, and the Caribbean, with an emphasis on the music of Haiti.
Kendrick leads a jazz ensemble at Sonoma State University.
Saxophonist Bennett Friedman has performed at the Monterey Jazz Festival, the Stanford Jazz Workshop, the San Jose Jazz Festival, the Healdsburg Jazz Festival, the Monterey Bay Blues Festival, and the Russian River Jazz Festival. He has been featured as a soloist with Frank Sinatra, Rosemary Clooney, Natalie Cole, and Marvin Gaye. Friedman has taught Jazz Studies at Santa Rosa Junior College since 1977. He is the recipient of a National Endowment for the Arts grant for jazz composition.
For further information, please call 527-4255 or email email@example.com


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You’re visting the House of Hackney website from US. Would you like to shop the US site?Yes take me to the US site
A painterly portrayal of the great British horse chestnut tree, CASTANEA brings the beauty of the outdoors into the home. The spring-like colour palette of verdant greens atop pure white and iced pink stripes will brighten up any space. Our wallpaper is made using PVC-free, eco-friendly materials and promises minimal environmental impact at every stage of production.
Dimensions: W: 29.7cm x H: 42cm

domain: design


|2 - Bedroom
The site of the former Brentwood Blood Centre on Crescent Drive is set for an exciting transformation. This redevelopment project will bring a mix of 1, 2, and 3 bedroom apartments to the area, catering to a variety of needs and preferences. The apartments are perfectly positioned for those looking to take advantage of the diverse amenities that Shenfield and Brentwood have to offer. From a rich selection of shops and eateries to leisure facilities, there's something to satisfy everyone's needs. Families will find particular appeal in the range of Ofsted-rated schools available, ensuring quality education options for children.
For professionals and anyone else needing to travel to the capital, the easy commute to London Liverpool Street presents a significant advantage. This accessibility is poised to improve further with the anticipated full operation of the Elizabeth Line by mid-2022, which will connect 41 stations across the capital and beyond. Additionally, Shenfield Station, which is set to swing its doors open in January 2022, will offer efficient services to London Liverpool Street in just 25 minutes and to Southend in under 40 minutes.
The area is not just about the convenience of transportation. The development will also see Brentwood enhanced with public open spaces along with new commercial and leisure facilities over the next 30 years, ensuring a vibrant and sustainable community. For those who appreciate the charm of independent restaurants, boutique shops, and handy amenities, these will all be within walking distance, blending convenience with community spirit.
For nature enthusiasts or anyone simply looking to relax and unwind, Warley Country Park offers a nearby green open space that promises tranquility and a break from urban life. This comprehensive development is more than just an apartment project; it's a gateway to a balanced and fulfilling lifestyle, melding modern living with community values and easy access to both local and London-wide attractions.
|Shenfield Rail Station
|Brentwood Rail Station
|West Horndon Rail Station
|Billericay Rail Station
|Theydon Bois (Central)


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Chelsea midfielder Ruben Loftus-Cheek won’t be part of the England squad for the 2017 U-21 Euros in Poland.
The 21-year-old has been struggling with a back injury and will not make the trip to Poland next week.
Loftus-Cheek has been struggling with a back problem and made just 11 appearances for Chelsea last season.
Another Chelsea youngster won’t be travelling with the U-21 team to Poland next week.
Chelsea forward, Izzy Brown, who spent the just concluded season on loan with Premier League newcomers Huddersfield Town didn’t make the team as he is also struggling with an injury.
However, three Chelsea players were selected in England’s U-21 team and they are Nathaniel Chalobah, Lewis Baker and Tammy Abraham.

domain: news


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on the sidebar you'll find a new blog, which is dedicated to all things Vespa.
It's Paul Harts Site, who I met at a small campsite close to Ilfracombe in North Devon during my trip through the UK. He's a photographer of classic cars and bikes,
he was a really cool guy. On his site you can find my 12m and by clicking the pic, you can find more pics of it on Flickr.
His main website is www.vespamore.com/


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Buon Appetito is a cozy, modern, creative Italian restaurant nestled in the heart of Little Italy. The restaurant is reminiscent of Italy's passion for food, wine and art. Pulsating with warmth and artistry, the restaurant features local artists showcasing their creations on the walls and bringing creative classics to the table. The menu is fresh and seasonal featuring, Quail, rabbit, lamb, homemade gnocchi, lasagne and ravioli. There is also a gluten free menu, whole grain pastas for the health conscious and a large variety of vegetarian dishes for vegetarians. Their bar serves over 100 bottles and more than 20 by the glass to bedazzle you from boutique wineries all around the world. A great place to be merry and relish the sublime food, Buon Appetito will warm your souls.
- Open Hours: Monday to Thursday from 11:00 AM to 10:00 PM, Friday to Saturday from 11:00 AM to 11:00 PM, Sunday from 12:00 PM to 10:00 PM
- Credit Cards Accepted: visa, mastercard, amex, discover
- Takeout Available: Yes


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What are some fun activities you can do for a hen party?
Are you looking for a great way to bring the group together? Try planning some hen party games such as Never have I ever or 2 truths and a lie, or perhaps the following:
Pin the Groom on the Groom
Pin the Groom on the Groom is a game played at a hen party or bridal shower. It involves a blindfolded player being asked to put a picture of the groom in the right place on a poster of the groom. The player who places the picture closest to the right spot wins the game.
Makeup Challenge blindfolded
This involves a blindfolded player being asked to apply makeup to a partner in the correct way. The player who applies the makeup the most accurately wins the game.
Bride & Groom Trivia
1. What did the bride and groom do for their first date?
2. What was the bride’s favourite flower growing up?
3. What does the groom do for work?
4. Where did the couple first meet?
5. What is the bride’s favourite colour?
6. What did the groom do for the bride on their first anniversary?
7. What is the bride’s favorite type of cuisine?
8. What is the groom’s favorite hobby?
9. What was the first song that the bride and groom danced to at their wedding reception?
10. What is the groom’s favorite sports team?
Mr and Mrs questions
What is your favourite quality about your fiance?
How did you two meet?
What was your first impression of him?
What do you two like to do together?
What is the best thing about being in a relationship with him?
What was the most romantic thing he has ever done for you?
What would you say is his best trait?
Hen party games help to create bonding on your hen party weekend, have you thought about someone entertaining your group? Would you be interested in a hen party yoga class?
I hope you enjoyed these hen party games, if you are looking for more entertaining ideas to bond with your bride-to-be squad on your hen party weekend, why not try a hen party yoga class for a unique and fun experience?
From fun partner poses to a more zen hen yoga class this is an ideal way to bring your group closer together and celebrate the bride-to-be’s upcoming nuptials!


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Tess of the D'urbervilles Author:Thomas Hardy Complete and unabridged, according to the cover. Cannot find date of publication on the book, but this paperback appears to have come out in the 1960's, or possibly 1950's. The original price in the upper-left hand corner of the book was 50 cents. The cover illustration despicts a brown-haired woman looking to the side, while a fair-haired ma... more »n appears to be galloping after her, with two horses.
Introduction by Alice H. Hogan; "Classics Series CL82," an "Airmont Classic"« less


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Why not enter some details and get an accurate price?
Let your troubles ebb away at Ebborways Farm near Wells, in the scenic heart of Somerset. Perfect for those in pursuit of an authentic camping experience, simplicity is the key here: it’s just you, a field - and a campfire if you like - in sumptuous, serene surroundings. Facilities are limited to a water supply and composting loos, and you can pitch wherever you like, alone or in groups.
However, you’re not too far from a bit of civilization: it’s a short walk to a handful of pubs - including a couple that do top-notch food - and a farm shop, in the local village of Priddy (and it is, too).
Please note that you’ll need to bring your own wood for campfires, or ask the owners to buy some for you in advance of arriving.
Campfires are allowed on this site, but you most provide your own wood (or we can arrange to purchase some for you). Anyone found cutting our trees or hedges will immediately be ask to leave.
Check availability at Ebborways Farm…
You can now make a booking for up to 30 adults and 30 children on Pitchup.com.
Many sites set a maximum occupancy of 6/8 people per pitch, so try breaking your booking down into smaller groups to generate more results. For example, if you’re a group of 10, enter 5 people in your initial search and then book 2 pitches.
Use the 'Special requests' box on the booking page to ask to be sited together when booking multiple pitches: the campsite or park will try to grant your request.
Large groups: check the listing page for any group restrictions set out in the terms and section titled ‘Please note’.
Large tents/caravans: check the restrictions on unit dimensions to ensure your unit is suitable for the space you will be provided with.
Max. persons: unlimited
Ground type: Grass
Campers are free to set up anywhere in the field, but please respect other campers.
Based on a 2 night stay for 2 adultsPricing in Pounds (£) Pricing in Euros (€) Pricing in Australian Dollars (AU$) Pricing in US Dollars ($) Pricing in Swiss Franc (Fr)


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SFL Members save 10-15% on this item. Join Now!
Fennel (Foeniculum Vulgare) is a perennial that flowers and also produces the seeds that are used as a cooking spice. The root and stalk of Fennel also have culinary applications. In medieval Europe Fennel seeds were chewed on church fasting days to suppress hunger and Fennel was used as a breath freshener. The flavor of Fennel is similar to Anise or Licorice.
Fennel Seeds are often use in breads, cakes, cookies and some hot drinks, such as spiced tea. Fennel is also used to flavor butter, cheese spreads and salad dressings. Fennel blends well with game and some grains such as barley and rye berries.
Dried Fennel Seeds
Fennel is most often used whole and occasionally cracked or coarsely ground. To grind, use a pepper mill, electric spice grinder, or mortar & pestle. Store leftover ground fennel in an airtight glass jar.
Posted by Jodie, OH on 20th Jun 2018
Fresh, firm and full of flavour. These are top quality seeds at a great price. Recommended.
The Best Fennel seeds
Posted by Unknown on 17th Oct 2016
I love the fennel seeds that I put it in all my dishes and soups. It is also good for you to chew on.
Posted by RJ Sorretto, Ashland, OR on 3rd May 2012
I needed some fennel seeds for my homemade Italian sausage. The price here was so good that I thought the quality might be less than perfect-- WRONG. These are fragrant, sweet and beautiful on the tongue, with just the right touch of mild licorice-like flavor. It isn't fair to describe them as licorice-like though. Fennel stands on its own as a wonderful spice. Great quality from Spices For Less.
Posted by tommy on 16th Apr 2012
really flavorful and great quality.
exaclty what i needed
Posted by Jake, Tampa on 29th Nov 2011
First time shopper, but will definitely be back. Quick delivery and great quality fennel.
Shipping's On Us
Just spend $25 and you'll enjoy free standard shipping to the Continental United States. For all other orders, shipping is just $5. We make it easy and affordable to stock up on all your favorite spices, herbs and seasonings - you might even want to pick up something exotic while you're at it!
Let's Get Cooking
Put our amazing selection of spices and seasonings to work with one of our delicious recipes. Have your own family recipe you want to share? Send it to us and we'll send you a coupon as our way of saying "thanks" for sharing!
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domain: food


“wow! finally, someone has spoken up about such an important animal welfare issue”
Says it all really.
Pedigree Dogs Exposed has aired on the other side of the great pond known as the Atlantic and Canada’s dog lover’s were as shocked as ours.
Read forum reactions to Pedigree Dogs Exposed and UK dog lovers who are perhaps some way more advanced in debating what is now referred to as the ‘aftermath of that programme’ may wish to join in with their fellow Canadian dog lovers in discussing the pivotal documentary.
Click here to see forum reactions.
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The yoke is no joke. For those of you anticipating the new Lexus “Steer by Wire” system and its yoke-like steering contraption to be the most distinctive, forward-looking, and ultimately compelling reason to consider the 2024 Lexus RZ 450e, you would’ve been in the minority. Most of us rolled our eyes, hard, when RZ interior pictures were released. Having seen Tesla’s gimmicky yoke in action
, skepticism was understandable. In short, though, this is not just a yoke bolted onto the steering column for drivers to pretend they’re Batman. It is in fact an intrinsic part of an entirely new steering concept that could revolutionize the way we interact with the front wheels of a car.
Which is why I’m going to talk about it an awful lot here in the beginning of this RZ review, because, unfortunately, this late-availability option is a much bigger deal than the electric crossover it’s attached to. (Though if you want to skip ahead, click here


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If you are an enthusiast of gorgeous pictures then this is a post that you ought to check out as here you will get to see pictures of landscapes that are absolutely gorgeous . All that you have to do is click the web link provided right here and also you will certainly be welcomed by never before seen snaps. All these photos are really stunning and one look at these will certainly assist in providing you an excellent experience. You will feel like checking out these locations in reality. The pictures are outstanding and the imagination of the photographer need to be praised. So have a look at pictures of landscaping you always needed.
If you’re browsing for amazing landscapes, you have actually stay on the best website.
Via : boredpanda.com

domain: hobby


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Preliminary plans to finish a downtown townhouse development were pitched to the Lake Zurich village board Monday night.
Icon Building Group wants to complete the final 19 units for the Somerset townhouse subdivision near the village's namesake lake. Somerset was supposed to have 39 townhouses.
Village board trustees Monday gave Icon a thumbs-up to move forward in the official approval process, starting with the advisory plan commission.
Responding to a question from Mayor Thomas Poynton, Icon Vice President Jeremy Blackstock said he hopes the work would start in May on the last 19 homes of the long-unfinished project.
"We could build a townhome building in less than four months," Blackstock said during the village board's informal courtesy review of Icon's proposal.
Somerset's 20 lakefront townhouses are in a special taxing zone that village officials enacted in 2002 in an attempt at downtown redevelopment. The village is still trying to lure developers to revitalize the area.
McCaffery Interests Inc. of Chicago was selected to reshape downtown, but it never finished the final 19 homes at Somerset and failed to do other work before being fired by Lake Zurich in December 2007.
In 2008, the village paid almost $1.2 million to McCaffery and Bank of America as part of a foreclosure settlement. Lake Zurich provided nearly $1 million to help McCaffery with the half-done Somerset project, officials said.
Last year, M/I Homes Inc. of Columbus, Ohio, received village board approval to complete Somerset. However, M/I never proceeded to construction, and the property meant for the 19 homes remains vacant.
Blackstock said three buildings with the townhouse units would be constructed by Algonquin-based Icon to round out Somerset. He said water and sewer lines already are at the property.
Lake Zurich has what's called a tax increment financing district meant to rejuvenate downtown. The special taxing zone is supposed to expire in 2025, but the village wants to extend it by another 12 years so it does not have to contend with balloon payments on debt and possibly dipping into the general fund to cover the tab.
In a TIF district, property tax revenue is frozen at a certain amount and any additional revenue goes into public improvements rather than to local governments, such as Lake Zurich Unit District 95.
Lake Zurich has about $28 million in outstanding debt associated with the long-stalled downtown effort. Poynton has said about $16 million of the debt is attributed to property purchases within the special taxing area, but the current worth is unknown.


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Temperatures increasing 30 degrees up, some northern provinces are officially under drought alert. Days like these make me wanna go back to Romania (yes my husband is Romanian) to get away from this sticky and humid weather of Manila.
When we went there almost 2 years ago, it was the height of their summer time. It was hot but unlike in Manila, it wasnt humid at all. Nights are extra cool and temperatures can drop into single digits. Something like Baguio but less cramped. If ever I'd get a chance, I want to visit again Poiana, Brasov
Poiana Brasov is Romanian Ski Resort (expensive!) located about 30-40 kms away from Bran. The most popular (and cheapest!) thing to do here is to go up the mountain using the cable car.
Expecting that the weather will be warm that day in Poiana, we brought mostly summer clothes (except for jackets which a must since temperatures can drop to single digits at night). So it was a big surprise when we found out that that morning the temperature was about 6 degrees! We didnt have any choice but to layer clothes. Both Sofia and I were wearing leggings under our pants.
See, I'm even wearing my crocs. It's either that or flipflops:
Here we are before leaving the cable car station:
The cable car ride took us about 1,700+ m. high up the mountain. It was so foggy. There was one point when we couldnt see anything but fog:
Upon reaching the end of the cable car, we decided to "hike" further up the mountain to the old communication tower/station which is at 1800+ metres above sea level. That's my husband carrying our little girl:
After a quick hot chocolate and coffee in a tiny cafe up the peak, we went down the mountain and drove to the Brasov's City Centre for lunch. If there's one word to describe the City Centre, it is BEAUTIFUL!!! If ever we decide to relocate to Romania, I want it in Brasov. Who wouldnt want to live in a place like this:
More pictures here.

domain: geography


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KUPPIYAWATTE MUSLIM CEMETERY
- Country Sri Lanka
- Total identified casualties 25 Find these casualties
- Casualties from First & Second World War
- GPS Coordinates Latitude: 6.92735, Longitude: 79.87513
From the area of the prison service headquarters on Baseline Road, a major dual carriageway leading out of Colombo, Sri Lanka, turn left into JD Fernando Road and then right into Sridhamma Road, and the cemetery will be found on the right hand side. Follow the avenue from the main gate to the rear of the cemetery where the Commonwealth War Graves Commission Plot is on the right hand side. There are 3 Commonwealth war graves of the First World War and 22 of the Second World War here.
Before considering a visit to Sri Lanka the Commission strongly recommends that you check the advice given by the Foreign & Commonwealth Office on the travel section of their website: www.fco.gov.uk/en/travel-and-living-abroad/travel-advice-by-country/


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About this project
CraftsBeadwork • Jewelry Making •
I got the pattern for this ring on youtube. If you search "beaded snowflake ring" it should come up. There are 2 or 3 parts to the tutorial. Check it out!
How To Make Simple Jewelry A Crown Ring With 3 Easy Steps
Jewelry Handmade Rings out of Red String and Gold Beads


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We believe high quality pet nutrition starts with understanding nutrients, not just ingredients. Helping your pet live his best life means we formulate our pet food based on a smart blend of nutrients that supports your pet’s overall health.
We craft 99% of our pet products right here in the U.S.A. so we can keep a close eye on every step. We know exactly what goes into every batch. Who made it. When it was made and where it was going. We provide nutrition for over 1 million pets every year, so quality is our top priority.
Your pet products are crafted in one of our 20 factories nationwide.
Quality ingredients start at the source. Some pet food brands are content with buying straight off the shelf from their suppliers, but we demand more.
That’s why we trace every single ingredient that passes through our doors to its original batch. Our experts evaluate every detail of our ingredients origin—from weather patterns to air quality to livestock management practices.
One way we keep your pet's food safe, is by using near-infrared technology (NIR). This technology “fingerprints” or evaluates select ingredients for purity and quality before they make it into your pet’s food.
“Don’t talk about your abilities – demonstrate.”
— William Danforth, Purina Founder
OUR PET FOOD PRODUCTS
Purina offers formulas designed for any dog or cat's unique needs and preferences. We'll help you find the perfect match.

domain: pet


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Close reading Irrational Games’s 2013 BioShock Infinite to consider how notions of the wild circulate at the site of the both absent and present Indian, this essay argues that the ontological turn in technology studies is predicated on the juridical, racial, gendered, and colonial violences enacted in the spaces between the civil and the savage, the beast and the human. The recent ascendancy of object-oriented theory within videogame studies along with the object-oriented coding languages used to construct those games raises questions about structures, systems, and sovereignty at the site of interpretation and methodology. By placing videogame studies into critical conversation with critiques of ongoing settler colonialism, this essay suggests that settler colonial governance and racial capitalism persist in the spaces between representation and play. By drawing upon recent conversations in queer theory and critical indigenous studies, this essay offers some preliminary insights into the nature of sovereignty and the discourses of colonialism that continue to be informed by the presence of indigenous peoples within the philosophical precepts and ontological givens of code and software.
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Jodi A. Byrd; Beast of America: Sovereignty and the Wildness of Objects. South Atlantic Quarterly 1 July 2018; 117 (3): 599–615. doi: https://doi.org/10.1215/00382876-6942183
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2 edition of Legal archeology found in the catalog.
|Other titles||Studies in cases in context|
|Contributions||University of Toronto. Faculty of Law|
|The Physical Object|
|Pagination||2 v. ;|
Intwo years after the first settlers arrived, the House of Commons passed legislation prohibiting slavery in Georgia. These beliefs today may seem as projections of rabbinical values onto heaven, but Legal archeology book rabbis believe that they themselves are projections of heavenly values onto earth. Sources[ edit ] The first historical mention of the Pharisees and their beliefs comes in the four gospels and the Book of Acts, in which both their meticulous adherence to their interpretation of the Torah as well as their eschatological views are described. Yet enslaved people resisted their owners and asserted their humanity in ways that included running away as well as acts of verbal and physical violence. Five hundred years before Columbus, a Viking woman named Gudrid sailed off the edge of the known world.
Thousands of sites Legal archeology book been excavated. Sunday school teachers have a more theological answer: Jesus fasted for 40 days and died on a Friday. The book focuses on how decades of market fundamentalism have transformed increasing numbers of rights-bearing citizens into socially excluded internally stateless persons. Only one chapter of the Mishnah deals with theological issues; it asserts that three kinds of people will have no share in "the world to come :" those who deny the resurrection of the deadthose who deny the divinity of the Torahand Epicureans who deny divine supervision of human affairs.
If so, let us know by emailing us at bigquestions mentalfloss. In other words, when Legal archeology book have a ferrous metallurgical industry, you have these evidences of the detritus that is left over. Some Anglicans picked the practice back up, but Protestants—who were strongest in Continental Europe—didn't need to take the bait. The situation changed dramatically in when Oglethorpe defeated the Spanish at the Battle of Bloody Marsh and returned to England. The major difference, however, was the continued adherence of the Pharisees to the laws and traditions of the Jewish people in the face of assimilation.
Atlas of Benign Gynecologic and Obstetric Surgery
nature of marriage and problems of divorce.
2004 Bachelors Degree recipients at Maryland public institutions
Neonatal medications & nutrition
Wiggle to the laundromat.
Antique oriental rugs and carpets
Food in Colonial America
Virginias public defender system
Early Polish Americana
The decision to ban slavery was made by the founders of Georgia, the Trustees. Within twenty years some sixty planters Legal archeology book owned roughly half the colony's rapidly increasing slave population dominated the apex of Lowcountry Georgia's rice economy.
The notion that the sacred could exist outside the Temple, a view central to the Esseneswas shared and elevated by the Pharisees.
In an interesting twist, Abraham Geiger posits that the Sadducees were the more hidebound adherents to an ancient Halacha whereas the Pharisees were more willing to develop Halacha as the times required.
Significance of debate and study of the law[ edit ] Just as important as if not more important than any particular law was the value the rabbis placed on legal study and debate.
The Pharisees washed themselves before Sabbath and festival meals in effect, making these holidays "temples in time"and, eventually, before all Legal archeology book. Outside Judea, the synagogue was often called a house of prayer. Non-LDS scholars of first magnitude, some who want to Legal archeology book our friends, think we have real trouble here.
It also sheds new light on the society that gave rise to a woman even more extraordinary than legend has painted her, and illuminates the reasons for its collapse. R' Yitzhak Isaac Halevi suggests that this was not, in fact, a matter of religion.
He spent time in London lobbying members of Parliament and trying to secure a broad base of public support for his arguments.
Churchgoers around Detroit can guiltlessly munch on muskrat every Friday. Moreover, the rabbis believed that "the heavenly court studies Torah precisely as does the earthly one, even arguing about the same questions.
They received important backing for their policy from two groups of settlers.
The evidence is absent. And they are Legal archeology book things non-ferrous metallurgical industries have similar evidences. See also: Afterlife Unlike the Sadducees, who are generally held to have rejected any existence after death, the sources vary on the beliefs of the Pharisees on the afterlife.
What about the guilt of the followers of Judaism, Christianity, and Islam? Every Jewish community in a way possessed their own version of the Oral Torah which governed their religious practices.
The Roman period[ edit ] Main article: Judaea Roman Legal archeology book Pompey in the Temple of Jerusalem, by Jean Fouquet Legal archeology book to Josephus, the Pharisees appeared before Pompey asking him to interfere and restore the old priesthood while abolishing the royalty of the Hasmoneans altogether.
Animal fossils When Beringer announced his intention to publish, Roderick and Eckhart spread rumors about the fossils' authenticity. The Trustees, bowing to the inevitable, agreed that the ban on slavery be overturned but only after they had consulted their officials in Georgia about the conditions under which slavery would be permitted.
Those attitudes hurt England's fishing industry so much that, inHenry's son King Edward VI—who was just 10 at the time—tried to reinstate the fast to improve the country's fishing economy. Thus, the Legal archeology book were in fact a political party not a religious sect.
Anglicans and the King's sympathizers made it a point to eat Legal archeology book on Fridays. They promised Zanger "much money and many favors if he would state that the Hehn brothers made the stones.
The Pharisaic legacy[ edit ] At first the values of the Pharisees developed through their sectarian debates with the Sadducees; then they developed through internal, non-sectarian debates over the law as an adaptation to life without the Temple, and life in exile, and eventually, to a more limited degree, life in conflict with Christianity.
The planters and their slaves flooded into Georgia and soon dominated the colony's government. Given the Spanish presence in Florida, slavery also seemed certain to threaten the military security of the colony. As the growing wealth of South Carolina's rice economy demonstrated, slaves were far more profitable than any other form of labor available to the colonists.The legal difference is, at heart, like any other legal distinction: the difference is codified by the state, like the difference between bank robbery on one hand and cashing a check on the other, based on the context of the act.
The legal differe. Jan 30, · In his new book, THE KING JAMES VERSION REPEATED WORD COMPARISION PHENOMENON: The Life Code Revealed, Jason Christopher Shandor claims that he had "Signs from God" on top of a mountain in Northern. In Search of Book of Mormon Geography.
Below is the modern map of the area of Smith's Youth. The Book of Mormon is supposed to be a history of real people living in a real place.
For the first years of Mormonism's existence, everyone thought it was a story about a people who left the Middle East and came to South or Central America, and who fought wars clear up into New York state where.Visitors since October Pdf counters provided by Andale.
The links pdf this web site are provided for reference purposes. CyberPursuits has no control over the content of off-site links and cannot be held responsible for any harm -- real or perceived -- incurred as a result of launching to another site through a URL located on this Web site.Jun 01, · A piece of wood with the Roman alphabet written on it in AD60/ Photograph: John Stillwell/PA The oldest are less chatty, but earlier than the cache of .Get this from a library!
Archeology. [Jane McIntosh] -- Ebook is a spectacular and informative new guide to the fascinating world of archaeology.
Superb, full-color photographs of bronzes, buildings, paintings, and pottery offer a unique "eyewitness" view.


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Find time to relax with this ideal teapot that brings the beauty of the popular Autumn pattern to your table. Teatime has never been more elegant - and beautiful. Crafted of ivory fine china and accented with gold and enameled jeweling, this teapot holds a full 10 cups.
Crafted of Lenox ivory fine china accented with 24 karat gold accents and enameled jeweling. Dishwasher-safe. Made in USA. Capacity: 40 oz.


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Andy Duncan gets £731,000 pay-off from Channel 4
Former Channel 4 chief executive Andy Duncan received £731,000 in lieu of 12 months' notice when he left the broadcaster, according to Channel 4's 2009 annual report which was published this morning.
Duncan resigned on 17 November and the extra £731,000 brought his total pay for 2009 to £1.48 million, an increase of 116% from his total pay in 2008. Excluding the pay-off, Duncan earned £750,000, up 9.6% from the £684,000 he was paid in 2008.
This was made up of a base salary of £514,000, £11,000 in benefits and a £225,000 pay-out from a two-year loyalty incentive scheme ended 30 June 2009.
The pay-out had been set at £450,000 but in early 2009 Duncan offered to waive 50% of his entitlement and this offer was accepted by the remuneration committee.
There is no loyalty scheme for new chief executive David Abraham, according to a Channel 4 spokesman.
The next highest paid exec was former director of television content Kevin Lygo, who has left to join ITV as head of its production arm ITV Studios. He earned £785,000 in 2009.
Lygo's total package in 2009 was down 30.9% from the £1.136m he earned in 2008 due to a reduction he took in his basic salary in 2009, which dropped from £773,000 to £644,000, and a payout from a long-term incentive plan in 2008.
Andy Barnes, sales director of Channel 4, got a total remuneration package of £513,000 which was made up of £400,000 in salary and fees, £13,000 in benefit and a £100,000 bonus.
Nathalie Schwarz, the director of new business, who was hired to lead Channel 4's ill-fated push into digital radio and resigned on 26 March 2009, was paid a total of £70,000.
Channel 4's report showed record profits from digital media and rigid cost control helped Channel 4 break even during 2009 despite losses on the core channel and ad revenues falling 10.5%.
TV advertising revenues at Channel 4 were £706.7m, down 10.5% from £789.7m in 2008, which Channel 4 said amounted to an unprecedented drop but compares favourably to a broadcast TV ad market decline of 11.9%.
Total revenues at Channel 4 were £830.3m in 2009, down 8% from £906.1m in 2008.
This article was first published on mediaweek.co.uk
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- Tesco media review pits Initiative against MediaCom and ZenithOptimedia
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- 'Advertisers are snake oil salesmen', says Peter Oborne


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"I support intelligent design," Bachmann told reporters following her speech at the conference, CNN reports. "What I support is putting all science on the table and then letting students decide. I don't think it's a good idea for government to come down on one side of scientific issue or another, when there is reasonable doubt on both sides."On behalf of all educated and sensible Minnesotans, I would like to apologize for Mrs. Bachmann's continuing presence in the political arena.
"I would prefer that students have the ability to learn all aspects of an issue," Bachmann said. "And that's why I believe the federal government should not be involved in local education to the most minimal possible process."
23 June 2011
Michele Bachmann supports intelligent design


Pressure washers can be used for anything from cleaning your car, to cleaning your patio, to removing dirt and paint from your house in preparation for re-painting. Not only do pressure washers make cleaning quicker and easier, they save water since they only take about 1/5 the water a garden hose would use to do the same job.
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Whether Seattle-based Gen Con and local officials can now reach an understanding on technology could spell the difference between Indianapolis’ hanging onto its most prized convention and potentially losing it to another city.
Local hoteliers and hospitality officials are bracing for a soft 2018. And some in the industry are pointing to the fallout from a controversial 2015 law as the culprit responsible for an expected one-year downturn.
More than 30 foreign ambassadors—representing countries across four continents—are scheduled to be in Indianapolis to learn about Indiana’s economy and explore potential business relationships with Hoosier firms.
The impending arrival of the full-service Embassy Suites with convention and banquet facilities may have attracted yet another hotelier to the critical mass of operators just west of Indianapolis International Airport.


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Case Report - Current Pediatric Research (2018) Volume 22, Issue 1
Advanced case of sitosterolemia with a novel homozygous mutationTaher Z1*, Ibrahim B2, Saifaldeen R3, Albar R4
- Corresponding Author:
- Ziad Abdullah Taher
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences
Jeddah, Kingdom of Saudi Arabia
Tel: +966 567 475 123
E-mail: [email protected]
Accepted date: January 27th, 2018
Sitosterolemia is a genetic lipid metabolic disorder characterized by increased intestinal absorption and decreased biliary excretion of plant sterols. The intestine and gallbladder work to balance plant sterols by ATP-binding cassette sub-family G member 5 and 8 proteins which are encoded by ABCG5 and ABCG8 genes. An eight year old girl who was misdiagnosed with familial hypercholesterolemia for two years, presented later with xanthoma, ecchymosis, easy tiredness, paleness, arthritis and abdominal pain. Her lab tests were: total cholesterol 5.3 mmol/L, hemoglobin 9.4 g/dL, platelet 160 × 1012/L, and CRP 15 mg/L. Specific testing for levels of sterols show very elevated levels of β-sitosterol, stigmastanol and campesterol. Genetic testing for ABCG5 and ABCG8 gene confirmed a novel mutation at ABCG8 gene (NM-022437.2). She was treated with ezetimibe 10 mg once daily. The symptoms disappeared after eight months of treatment although sterols were high. Her brother and sister were tested for β-sitosterol level as well as ABCG5 and ABCG8 gene mutation. Results of her brother and sister were positive for the diagnosis of sitosterolemia of the same mutation.
Sitosterolemia, Xanthoma, ABCG8, Ezetimibe.
Sitosterolemia is a very rare lipid metabolic disorder. It is considered as an autosomal recessive genetic disease. Sitosterolemia is characterized by significant elevation of serum plant sterols due to mutations in ATP-binding cassette sub-family G5 (ABCG5) or G8 (ABCG8) genes [1,2]. These mutations lead to an increase in intestinal absorption and a decrease in biliary excretion of plant sterols and cholesterol resulting in high serum plant sterol.
Sitosterolemia resembles the primary clinical picture of familial hypercholesterolemia (FH) and it is possible to be misdiagnosed as homozygous FH or as a pseudo homozygous FH [3,4]. Most of pediatric patients with sitosterolemia have significant elevation in total cholesterol (TC) and low density lipoprotein (LDL) level [5-7]. Moreover, patients with sitosterolemia mainly present with xanthomas and accelerated atherosclerosis compared to FH patients . It is thought that several sitosterolemia cases are still misdiagnosed with FH, which results in a wrong estimation of the prevalence of the disorder.
It is believed that hypercholesterolemia in a young child is explained by FH. Although this is the situation in most of the patients, some patients who are treated as FH may present with a progressive deterioration of the symptoms and lifestyle with correction of cholesterol level. The suspicion of sitosterolemia should be highly expected in these cases.
Here we present the first case of sitosterolemia in Middle East, up to our knowledge. It is a case report of a pediatric patient who was initially presented with xanthomas and eventually diagnosed as a case of sitosterolemia based on genetic testing.
The patient is an 8 year old Jordanian girl, who was born without any perinatal complications. Her parents had a second-degree consanguineous marriage. Her father has dyslipidemia, currently on ezetimibe and her older brother has yellowish skin nodules at Achilles tendon without any established diagnosis. There was no additional phenotype noticed in the family. Her parental history is positive for an aunt who died prematurely due to cardiac disease. The patient is not known to have any disease or health issues.
First, her mother noticed for the first-time small yellowish spots over the back of her knees at age of two years. The mother ignored these spots as she thought it is just a normal skin discoloration.
At the age of five years, the spots became larger in size and the family sought medical advice (Figure 1). After consultation and examination, she had two xanthomas in the extensor surface of each of her knees, irregular in shape and 2-3 cm wide with about 1 cm elevation over the skin. No corneal arcus or xanthelasma noticed. Her lab results are: TC 10.0 mmol/L, LDL 8.0 mmol/L, high density lipoprotein (HDL) 1.1 mmol/L, Triglyceride (TG) 1.5 mmol/L. She was diagnosed with FH and started treatment with high sterol diet (olive oil, nuts and seeds) and avoiding high cholesterol foods to lower the cholesterol level. After that, her TC decreased to 5.4 mmol/L.
At six years old, the patient became worse and developed ecchymosis all over the body, easy fatigability, paleness, abdominal pain, arthritis in the knees and elbows and failure to thrive (her weight was 16 kg) (Figure 2). The laboratory works were done (Table 1). Abdominal ultrasound showed splenomegaly. Blood film manifests polycythemia, hypochromic red blood cells and large platelets. Electrocardiogram and echocardiography were normal. She was started on ezetimibe 10 mg once daily.
Figure 2: Arthritis with joint swellings at knees and elbows, image captured at age of 7 years after starting ezetimibe
|Analyte||Result at Presentation Time||Result after Treatment||Reference Range|
|Total cholesterol||6.36*||3.72||<=5.18 mmol/L|
Table 1: Lab findings at presentation time and after ezetimibe treatment
At seven years old, serum analysis for sterols was ordered (Table 2). Genetic testing was done for the patient and for her parents. Results confirmed homozygous ABCG8 gene mutation at (NM-022437.2, exon 7, c.965-1G>C) which is consistent with a genetic diagnosis of sitosterolemia. This mutation was not detected or reported previously in a homozygous state while there are only 6 detected cases in a heterozygous state. Parents were carrier for variant ABCG8 gene (heterozygous). The patient was treated with low sterol diet and continued ezetimibe 10 mg once daily.
Table 2: The result of sterol analysis. The patient was on ezetimibe for 12 months before the analysis and the establishment of the diagnosis of sitosterolemia. Hence, she was on ezetimibe while doing sterol analysis. Unfortunately, no former analysis done before
After 8 months of ezetimibe treatment, patient's health improved. Paleness, arthritis, abdominal pain, and ecchymosis were all gone and disappeared. Abdominal ultrasound showed no splenomegaly. Her weight increased to (22 kg) which is optimal for her age. Her lab results were (Hgb 12.5 mmol/L, platelets 350 mmol/L, TC 3.5 mmol/L, LDL 1.7 mmol/L). However, plasma sterol level remains high even after the treatment. Unfortunately, plasma sterol level baseline was not obtained because the patient started ezetimibe treatment before the establishment of the diagnosis and sterols analysis.
After the establishment of the diagnosis of sitosterolemia in the patient, we examined the rest of siblings who are two: a 9 year old girl and a 12 year old boy. Surprisingly, β-sitosterol levels were very elevated in both siblings. Genetic testing was done which confirmed ABCG8 gene mutation (NM-022437.2) in a homozygous state as well (Table 3). There was no clinical manifestation apparent for the 9 year old girl yet. While there were only two small Achilles tendon xanthomas of the 12 year old boy which developed at the age of two years and did not grow or cause any complications.
|Analyte||Results of the Main Case||Results of the 9 Year Old Sister||Results of the 12 Year Old Brother||Reference Range|
Table 3: Result of sterol analysis of the family siblings
Sitosterolemia is a genetic disease with an autosomal recessive mode of inheritance confirmed by ABCG5 and ABCG8 gene responsible for ATP-binding cassette subfamily G member 5 and 8 proteins that cause a defect in plants lipid metabolism. They are responsible for intestinal and bile metabolism of the plant lipid by Neimann-Pick C1-Like1 (NPC1L1) transporters [1,2,8]. Sitosterolemia was first described in 1974 by Bhattacharyya and Connor . Its prevalence is estimated to be less than 1/1,000,000 depending on about 100 literatures .
Clinical manifestations vary between patients and start at different ages. A reported case of a Korean girl starts having yellow plaques on the surface of her flexors at the age of 15 months . Another patient started complaining of arthralgia at the age of three years with thrombocytopenia, paleness, tuberous xanthoma at the extensor surface of the knees and elbows . In our case, the patient developed xanthoma for the first time at two years of age and complicated by other symptoms for the next 5 years. These symptoms include: arthritis, paleness, easily tiredness, ecchymosis and splenomegaly on ultrasound.
Sitosterolemia can be easily misdiagnosed as FH because the similarity in presentation between the two conditions. Indeed, it is thought that many sitosterolemia patients are misdiagnosed as FH. In many cases, physicians face a trigger event which made them think of other possible diagnoses other than FH. Decreased lipid level with a high range was the main event. Reiner et al.  presented a case with marked hyperlipidemia and were started on infliximab (Remicade) therapy. After a while, they noticed increased liver enzymes which are not consistent with FH. Therefore, they started to think of other diagnosis. In the end, they found high level of plant sterols . Another recent case found to have very elevated LDL and TC levels. In this case, the patient was started on low cholesterol diet. The TC levels decreased, but remained within a relatively high range. This peculiar finding made them look for another justification which ended up being sitosterolemia . In other situations, developing new manifestations or developing a complication can be the reason to look for other diagnoses. In our case, TC and LDL remained high after providing the treatment of FH. TC and LDL were decreased, but sustained within a high range. The patient developed new manifestations which was the trigger to seek another diagnosis. Therapy of FH should aim to decrease levels of TC and LDL to the normal range, and relieve the symptoms. Otherwise other possible rare diagnoses, such as sitosterolemia, should be in mind. Lastly, Kawamura et al.  showed a case discovered to have sitosterolemia at age of 25 after developing a serious complication, which was acute myocardial infarction.
In our case, the patient was undiagnosed for 3 years and misdiagnosed with FH for 2 years. The final diagnosis was made genetically since ABCG8 gene was positive in the child along with her brother and sister. Parents were carriers for variant ABCG8. Management of sitosterolemia consists of dietary restriction of phytosterol containing food, which include margarine, nuts, chocolates, vegetable oil, and shell fish as well as medical management with colestipol and cholestyramine which are bile acid sequestrates. Studies showed little evidence for using statins . Studies showed beneficial effects of liver transplant .
Ezetimibe targets intestinal NPC1L1 transporter to inhibit sterols absorption. It reduces plasma plant sterol levels, corrects most of the hematological abnormalities and treats xanthomas [16-18]. After initiating ezetimibe in our patient, the level of TC, LDL, TG, RBC, Hgb, WBC and platelets were normalized. However, HDL level increased, but did not reach normal levels. In comparison with other studies, there was a discrepancy. For example, some studies did not show any significant decrease of TG while others exhibited a marked decrease of TG [17-20]. It is worth mentioning that sitosterolemia patients have high variability in TG levels which can be the reason for this debate [21-23]. Unlike our patient, level of HDL was corrected in some patients. The level of plant sterols is expected to return to the normal range. In this case, even though the patient was using ezetimibe for 12 months sterol analysis, and sterol level, especially β-sitosterol, were significantly high (Table 1). Unfortunately, no baseline sterol analysis was done before using ezetimibe to monitor its effect.
The differences between our case and former cases in clinical manifestation and lab findings may be attributed to the novel ABCG8 gene (NM-022437.2, exon 7) mutation and the state of homozygosity in this patient, which is discovered for the first time in this patient and her family. Also, it is not usual to have different presentation of the same gene mutation in the same family. Many previous mutations were discovered in a heterozygous form but did not progress to advanced manifestations as in this case. In fact, patients with the heterozygous form might get diagnosed when they develop a new complication because their disease is not severe to show early clinical manifestation .
Sitosterolemia is a rare genetic disorder that is misdiagnosed frequently. It should be in the differentials and appropriate genetic testing should be applied in patients with high cholesterol levels.
We would like to thank Mr. Oday Saleh Qurashi and Mrs. Cecille Cielo Selda for their help to provide valuable comments on the paper, and the patient and her family who gave the consent to publish this case.
- Berge KE, Tian H, Graf GA, et al. Accumulation of dietary cholesterol in sitosterolemia caused by mutations in adjacent ABC transporters. Science 2000; 290:1771–1775.
- Lu K, Lee MH, Hazard S, et al. Two genes that map to the STSL locus cause sitosterolemia: Genomic structure and spectrum of mutations involving sterolin-1 and sterolin-2, encoded byABCG5andABCG8, respectively. Am J Hum Genet 2001; 69:278-290.
- Salen G, Shefer S, Nguyen L, et al. Sitosterolemia. J Lipid Res 1992; 33: 945-955.
- Goldstein JL, Hobbs HH, Brown MS. Familial hypercholesterolemia. In: Scriver CR, Beaudet AL, Sly WS, Valle D, editors. The metabolic and molecular bases of inherited disease. New York: 8th edn. McGraw-Hill 2001: 2863-914.
- Park JH, Chung IH, Kim DH, et al. Sitosterolemia presenting with severe hypercholesterolemia and intertriginous xanthomas in a breastfed infant: Case report and brief review. J Clin Endocrinol Metab 2014; 99: 1512-1518.
- Niu DM, Chong KW, Hsu JH, et al. Clinical observations, molecular genetic analysis and treatment of sitosterolemia in infants and children. J Inherit Metab Dis 2010; 33: 437-443.
- Tada H, Kawashiri MA, Takata M, et al. Infantile cases of sitosterolaemia with novel mutations in the ABCG5 gene: extreme hypercholesterolaemia is exacerbated by breastfeeding. JIMD Rep 2015; 21: 115-122.
- Patel SB, Salen G, Hidaka H, et al. Mapping a gene involved in regulating dietary cholesterol absorption. The sitosterolemia locus is found at chromosome 2p21. J Clin Investig 1998; 102: 1041-1044.
- Bhattacharyya AK, Connor WE. β-Sitosterolemia and xanthomatosis: A newly described storage disease in two sisters. J Clin Investig 1974; 53: 1033-1043.
- Kidambi S, Patel SB. Sitosterolaemia: Pathophysiology, clinical presentation and laboratory diagnosis. J Clin Pathol 2008; 61: 588-594.
- Torres-Jiménez AR, Solís-Vallejo E, Sanchez-Jara B, et al. Xanthomas and macrothrombocytopenia: Sitosterolaemia is the answer. Reumatolgia Clinica 2016; 12: 164.
- Reiner Z, Guardamagna O, Nair D, et al. Lysosomal acid lipase deficiency - An under recognized cause of dyslipidaemia and liver dysfunction. Atherosclerosis 2014; 235: 21-30.
- Renner C, Connor WE, Steiner RD. Sitosterolemia presenting as pseudohomozygous familial hypercholesterolemia. Clin Med Res 2016; 14: 103-108.
- Kawamura R, Saiki H, Tada H, Hata A. Acute myocardial infarction in a 25 year old woman with sitosterolemia. J Clin Lipidol 2017; 20.
- Chalès G, Coiffier G, Guggenbuhl P. Rare thesaurismosis and xanthomatosis. Best Pract Res Clin Rheumatol 2011; 25:683-701.
- Escola-Gil JC, Quesada H, Julve J, et al. Sitosterolemia: Diagnosis, investigation and management. Curr Atheroscler Rep 2014; 16: 424.
- Salen G, von Bergmann K, Lutjohann D, et al. Ezetimibe effectively reduces plasma plant sterols in patients with sitosterolemia. Circulation 2004; 109: 966-971.
- Othman RA, Myrie SB, Mymin D, et al. Ezetimibe reduces plant sterol accumulation and favorably increases platelet count in sitosterolemia J Pediatr 2015; 166: 125-131.
- Cedó L, Blanco-Vaca F, Escolà-Gil JC, Antiatherogenic potential of ezetimibe in sitosterolemia: Beyond plant sterols lowering, Atherosclerosis 2017; 3: 34.
- Lutjohann D, von Bergmann K, Sirah W, et al. Long-term efficacy and safety of ezetimibe 10 mg in patients with homozygous sitosterolemia: A 2 year, open-label extension study. Int J Clin Pract 2008; 62: 1499-1510.
- Wang J, Joy T, Mymin D, et al. Phenotypic heterogeneity of sitosterolemia, J Lipid Res, 2004; 45: 2361-2367.
- Hansel B, Carrie A, Brun-Druc N, et al. Premature atherosclerosis is not systematic in phytosterolemic patients: Severe hypercholesterolemia as a confounding factor in five subjects. Atherosclerosis 2014; 234: 162-168.
- Othman RA, Myrie SB, Mymin D, et al. Effect of ezetimibe on low-and high-density lipoprotein subclasses in sitosterolemia. Atherosclerosis 2017.
- Heimerl S, Langmann T, Moehle C, et al. Mutations in the human ATP-binding cassette transporters ABCG5 and ABCG8 in sitosterolemia. Hum Mutat 2002; 20: 151.

domain: medical


As we near the beginning of the DTM season, BMW Motorsport Director Jens Marquardt took time out at the recent DTM Media Day, to talk about his views on how things have changed for the Munich outfit, which saw it win all three titles in its comeback year, as well as having several notable changes in how the squad operate in its title defence. You then have to factor in the new technical challenges for the team, how the car has been developed in the off-season, as well as new members joining the BMW family for 2013.
“Based on the experience we gained last season, we have generally made the car more robust,” stated the former Toyota F1 team boss, who said that aerodynamic development is incredibly limited, meaning a new area of focus has become paramount on developing the cars for the 2013 season. “In particular, improvements to the set-up of our BMW M3 DTM can make all the difference on race weekends. The race engineers in the individual teams, together with the drivers, play a key role in that regard.”
Now the race weekends have been compressed to just two days on each of the ten stops on the calendar, Marquardt said that getting used to the processes that came thoughout the ‘comeback’ season was a challenge that the team stood up to, but now that the race weekends have been shortened, it makes things more demanding for all: “When preparing for the 2013 season, we primarily tried to improve the interplay between the mechanics in the garage, as well as the communication between engineers and crews. We strived to make the entire structure more efficient. In order to simulate the new conditions, we erected everything just as it would be on a race weekend for the first time at the test in Hockenheim – from the pit wall to the radio network. Generally speaking, we welcome the new race format, as we believe it will make the weekends more compact and more exciting.”
BMW has gone in the opposite direction of Mercedes-Benz, as it extends its ranks to eight, as Team MTEK‘s Ernest Knoors, Timo Glock and Marco Wittmann have had to adapt quickly to get up to speed in order to make sure they are competitive from the minute first practice gets underway at Hockenheim, with integration being difficult for all at Munich: “Furthermore, we at BMW Motorsport obviously had to adapt the entire infrastructure to suit four teams and eight cars. The structure of meetings also changed, because you simply need more time for everything, particularly communication between everyone involved when you have eight drivers and eight cars. That also fell into place very well during the preparations.”