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Amsterdam is all about its gorgeous canals and dramatic regenerated docks, and people will tell you time and time again that the city is best enjoyed from the water. Whether you are gazing up at monumental buildings from the floating houses known as arks, or birdwatching from a traditional barge on the river, overnighting on the water brings you so much closer to the city than a high-rise hotel.
Place yourself at the heart of the Amsterdam party by booking a boat on the Prinsengracht during King’s Day or Pride and watch the parades stream past your portholes, or drop your anchor further out and retreat to a quiet harbour for a sundowner on deck after a hard day’s sightseeing.
Main photo: Lightship Amsterdam
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1. Lightship Amsterdam, Amsterdam North
Best for striking design
Since retiring from its duties illuminating the British coast, the pillar-box red Lightship has become a beacon of Dutch design thanks to a makeover by award-winning Amsterdam architects OTH architecten, who have revived it as a luxury two-bedroom B&B. Rooms are encased in glass with striking wall-to-wall views of the internal workings of the ship. Industrial styling — caged light fittings and tables fashioned from aluminium flight cases — are softened with luxe touches such as sheepskin-covered chairs and Auping beds piled high with white pillows. Here there’s tranquillity, but five minutes’ bike ride plus five minutes on the ferry and you’re back in the tourist throng.
Price From £295
2. Captain Pippi, Amsterdam North
Best for escaping to nature
Captain Pippi is owned by an international model and frequently rented out for fashion shoots. Its boho-chic interior — think macramé cushions, hanging plants, ethnic tiles — begs to be Instagrammed. In the 1920s it was a Belgian cargo ship; today, the two-bedroom boat is moored in northeast Amsterdam, a location that is the ideal base for cyclists who want to explore the picturesque villages of Durgerdam and Ransdorp and the Waterland region beyond. Guests have the run of the ship. The city centre is a 25-minute bike ride away.
Price From £337
Breakfast No, but organic supermarket Landmarkt is on your doorstep
3. Dreamship Somoya, Eastern Docklands
Best for romance
Beyond the occasional jaw-dropping sight of a passing cruise ship dwarfing the quayside buildings, the broad IJ harbour, a mere 15-minute bus journey from Central Station, is surprisingly quiet. Moored on its northern shore is the one-bedroom Dreamship Somoya, while across the water, a procession of converted warehouses create a glittery backdrop at night. The whole of the upper deck is yours and features a spacious open-plan design with a smart wooden interior and wraparound views. Up on deck, prepare a romantic dinner over the fire pit, swim from the nearby steps, and then get cosy in the barrel sauna.
Price From £312
4. Excelsior, Amsterdam Houthaven
Best for sustainability
Along a pristine jetty edged with potted strawberries and olive trees sits a beautifully refurbished freighter with two chic bedrooms available separately or together. The larger room has stairs to a private deck from which you can watch the ferries yo-yoing between the nearby dock and the beach bars of the NDSM wharf or admire the striking arch of the Pontsteiger building as it lights up at night. Inside, vintage furniture, green velvet lampshades and chunky blankets add cosiness to spacious eco-friendly accommodation, created using many reclaimed materials and warmed by a heat pump run on green energy.
Price From £110
5. Houseboat Jupiter, Amsterdam Centre
Best for people watching
It’s no wonder this houseboat is popular with honeymooners — it’s moored almost touching distance from the city’s most romantic landmark, the Magere Brug, an impressive lift bridge spanning the Amstel river and lit up like a birthday cake at night. This traditional barge, with its simple two-bedroom duplex, also provides front-row seats for the city’s biggest waterborne processions: King’s Day in April, Pride in August, and Sinterklaas in November. For year-round entertainment, visit the nearby Hermitage museum, Botanical Gardens and Waterlooplein market, or cross the bridge to explore the boutiques and restaurants of the charming Utrechtsestraat. A Jacuzzi awaits when you return.
Price From £250
6. Botel, Amsterdam North
Best for value
The red bubble letters perched on top of this huge former river cruiser each contain a cabin. Letter B is for skaters and contains a half-pipe, while business travellers might like T, a boardroom-slash-bedroom. Beneath them are four floors of basic cabins, popular with backpackers on a budget, who can make friends around the pool table and fruit machines of the ship’s retro-red bar. The highlight, however, is the incredible harbour view. Come in summer and the bow deck is home to Sammie’s rooftop bar. Eat Asian street food and sip a cocktail amid the bamboo while the sun sets.
Price Bed in a four-person dorm from £22; doubles from £52
7. 2 Houseboat Suites, Amsterdam Centre
Best for central location
Guests must learn to wave like the King, explains Susan, the cheerful host of this B&B on the Prinsengracht canal, whose visitors sometimes complain of hand ache due to all the pleasure boats greeting them as they pass by. Choose from two immaculate suites, both light and modern with smart — mostly monochrome — décor. With its views up the canal, rather than across it, and a little more space, the Rembrandt has the edge on the Van Gogh and is worth the extra cash – as is the healthy breakfast, served, says Susan, “in royal portions”.
Price Van Gogh suite from £153; Rembrandt suite from £170
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8. Houseboat Tante Piet, Eastern Docklands
Best for cute and cosy design
As DIY projects go, the transformation of this chunky 1940s grain barge into a cute-as-pie floating holiday let was ambitious, but owner Sietske’s can-do attitude and sharp eye for design has created a beautiful family-friendly two-bedroom apartment with a country-cottage feel (red chequered sink curtains, antique furniture, brass portholes trimmed in white lace) just five minutes by bike or tram from Central Station. Have an aperitif up on deck among the geraniums and fairy lights, then stroll to the characterful Mediamatic or Hanneke’s Boom for waterside dining.
Price From £160
Breakfast No, but host can order in groceries
9. The Amsterdam Houseboat Family, Old South
Best for culture
It’s not unusual to wake up to the ducks pecking at your window on this friendly, owner-occupied ark comprising two separate rooms with private entrances. Both are equipped with underfloor heating, ensuite bathrooms and — for those travelling light — everything from nail polish remover to hair straighteners. When you’ve worn down your heels at the Van Gogh Museum and the Rijksmuseum in the nearby museum district, and explored the buzzing market and cafés of De Pijp, lounge on the 40 sq m roof deck strung with coloured bulbs — or launch the canoe moored out front.
Price From £85
10. Houseboat Full Moon, Western Islands
Best for village vibe
Once a survey vessel mapping the icy Baltic sea, this handsome houseboat has now retired to a quiet, sheltered canal bordered with classic red-and-white-shuttered warehouse conversions and bookended by pretty white lift bridges. With its tiny parks and slightly sequestered location, it feels like a secret community, but the buzzing Jordaan is just a ten-minute walk. Cocooned in the former engine room is a light, white studio room, small in size but replete with air con, Netflix and a comfy cabin bed. Sunbathe on deck in warm weather or slip down the ladder for a cooling dip in the canal.
Price From £130
11. Asile Flottant, Amsterdam North
Best for creative nomads
Giving fishing boats a second life is Asile Flottant, a motley fleet of six vessels moored in a quirky regenerated shipyard, now a bohemian business hub created with a beautiful mish-mash of reclaimed materials. Guests get the whole boat to themselves, with options ranging from the cosy one-bed Anneliese with its sunken bathtub, to the wood-panelled De La Soul where, in the ship’s underbelly, a red velvet curtain conceals a home cinema. You’re self-catering for most of your stay, but at weekends, breakfast is available at Café De Ceuvel opposite, a hotspot for vegetarian dining.
Price From £130
12. Houseboat Saturnus, Amsterdam Centre
Best for families
The sister ship to Jupiter, Saturnus sleeps four in a light and roomy former sand barge moored on a quiet canal in the historic centre. Tongue-and-groove throughout creates a fresh New England feel and there’s a mezzanine bed which is popular with kids. With the gigantic science museum (NEMO) and the zoo (Artis) both walking distance away, there’s plenty to entertain youngsters. Grown-ups can nip across the canal for a jar in the tipsy-looking Sluyswacht café, a 300-year-old lockhouse with a lean to rival the tower of Pisa; or tour the Rembrandt House Museum — so close you can watch the shutters change from red to green as the museum opens and closes for business.
Price From £217
13. Casa Karen, Amsterdam North
Best for exotic escapism
Grouped around four wooden jetties is a close community of arks with a shared garden decorated with prayer flags — a surprising Shangri-La hidden beneath a road. Number 84 has one double room and a waterside terrace and is owned by the wonderfully warm Karen, a veteran backpacker whose travel-themed property features teak furniture she brought back from Indonesia, patterned tiles from Portugal, and a wall-mounted suitcase concealing a television. A mezzanine bed up a ladder adds to the sense of adventure, while Karen’s handwritten guide to the area, well-stocked kitchenette and free bikes mean guests quickly feel at home.
Price From £130
Breakfast No, but basics are provided to get you started
14. Kapitein Anna, Amsterdam North
Best for large groups
Boarding this 22-berth 1911 paddle steamer feels like stepping into an Agatha Christie novel. Everything gleams: from the varnished wooden interior to the ubiquitous brass trim. The boat is sometimes booked for cruises and lavish parties, but guests can check in for a bit of old-world elegance whenever it’s docked. Wood-panelled walls, engraved glass doors, and antique wall lights create ambiance in the lobby, while downstairs, the freshly painted cabins feature air conditioning, TVs and ensuite bathrooms. Most rooms are twins. Ask for cabin 11 or 12 for a double bed. Breakfast is vast — and so are the views.
Price From £76


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Rating: 4.5 out of 5 stars
Source: Review Copy from Author
It is 1814 (many events from Pride and Prejudice never took place) and for several years Mr. Darcy has lived in seclusion, away from his family and home and desperately hoping no one recognizes him as Mr. Darcy of Pemberley…
In an effort to dispel his loneliness and at the same time help out a friend very much in need, Mr. Darcy agrees to travel to Hertfordshire and assist Mr. Bingley, who is leasing an estate for the very first time. Since the scandal was years ago and Meryton is a small village, Mr. Darcy feels it might be not so dangerous for him to rejoin society in this setting. Especially as he plans to be known as the insignificant Mr. John Darcy, Mr. Bingley’s impoverished friend. But it turns out people are still curious about Mr. Darcy, even without knowing he has an estate in Derbyshire and is worth ten thousand a year. His evasive replies and lack of details pertaining to his past, his family, and where he lives invite intrigue and speculation. And who is the most intrigued by the mysterious Mr. Darcy? Why the young lady he insulted, of course…Elizabeth Bennet!
With her older sister married to a barrister in London and her dear friend, Charlotte, married to her odious cousin, Elizabeth Bennet is beginning to long for a marriage and establishment of her very own. When Mr. Bingley starts to single Elizabeth out and pay her more attention than any other lady in the neighborhood, Elizabeth begins to question her romantic ideas of marriage. While Elizabeth is trying to make up her mind about how she feels about Mr. Bingley she makes some discoveries about the mysterious Mr. Darcy. Even though he seems rude and aloof, she likes his skill at cleverly turning the conversation and is touched by some of his surprisingly thoughtful and considerate actions. All she has learned (and not learned) about him has made her want to discover more… But will Mr. Darcy let her?
What a magnificently unique Pride and Prejudice variation! Mr. Darcy in hiding? Some scandal attached to his name? Is he forever banned from society? Why? What happened? Sounds deliciously intriguing doesn’t it? YES! It does! 🙂 Not only do I loved the mysterious nature of this variation, I loved how Ms. Fairview executed it all. While I did partially guess Mr. Darcy’s scandal, I greatly enjoyed how Ms. Fairview chose not to reveal it until around the last 20% of the tale. It is fun to be kept in the dark sometimes! In addition, I appreciated the other plausible changes Ms. Fairview implemented in this tale. The new timeline alters the series of events significantly – i.e. no militia regiment coming to town, Mr. Collins’s visit came and went, Jane is already married. And yet it is interesting to see how some things happened the same – such as Mr. Darcy still insulting Lizzy and Mr. Bingley still holding a ball.
I loved witnessing Darcy’s emotional journey and internal reflections in this tale. Ms. Fairview did a terrific job portraying his warring emotions, his feelings of helplessness, and his uncertainty for the future. I was diverted by Mr. Darcy’s thoughts about people treating him differently when he is not known as Mr. Darcy of Pemberley. And I loved Mr. Darcy’s scenes with Elizabeth, all their little meetings and exchanges. Their conversations are quite a bit different in this variation, and I adored them. However, while I thoroughly enjoyed the climatic action of this story and seeing how everything resolves, I wish it was drawn out more. I wanted to spend more time in the midst of the drama and basking in the romantic resolution. 🙂
As a longtime fan of Monica Fairview’s writing, I am thrilled to read another one of her creative, perceptive, and skillfully executed works! Mysterious Mr. Darcy is an entertaining tale and I applaud Ms. Fairview’s inventive yet plausible twists! I highly recommend!

domain: entertainment


Stress test on VeChain’s testnet
Facts and results regarding our latest performance test
Thank you for showing interest in Arkane ❤, we would like to get to know you, so please don’t be shy and join us on Telegram ✨
On October 19th, we launched a performance test on our backend environment which is connected to the VeChain testnet. The goal of our stress test was to see how our own system would behave under high pressure.
Things we were testing:
- Can our system handle the scheduled load?
- Is our VeChain node cluster able to handle the load?
- If we bring down one of the nodes, how does the platform behave?
- Can we recover from a broken node?
- Which service within our platform will be the first to get stressed?
- When the system is pressured, does it trigger a cascading effect or can it keep operating at a reduced performance level? 🐌
Our findings 📝 so far:
- A VeChain node has a hidden limitation on the number of transactions an address can perform on the testnet. At the moment it is unclear what the limitation is (not documented), nor if this also applies on the mainnet 👻.
In collaboration with one of our community members (thx MiRei !), it turns out that each node has a tx-pool, which has a limit of 16 tx per origin address. If transactions are not being mined quickly enough the queue can store up to 16 still to be processed transactions. This is also the case on mainnet. The limit can be increased and at this moment it is not expected to be a limiting factor on mainnet.
- Our Authentication service ran out of memory, even at low loads. The solution here was to increase memory resources for the auth service.
- Our Sign service was the second service to get under stress, here it happened under high load, again increasing the amount of memory solved the issue.
- Other services didn’t show any signals of degraded performance.
- All VeChain transactions were either successful or reverted as expected resulting in no loss of funds. 💯
Our first performance test was useful to make improvements regarding infrastructure requirements and to make better decisions on how to optimize when falling under a heavy performance load.
We will be executing more tests shortly to test more complicated services within our system and more specifically in relation to concurrency.


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John Horton Conway is a great mathematician, certainly one of the greatest living mathematicians. Polymathematical in his mathematical interests (game theory, geometry, group theory, topology and more, not to mention the Game of Life), he's also one of the most eccentric, and that's saying a lot in a field where Cedric Villani is prime eccentricity competition.
As one can imagine, the biographer of an oddball character like Conway faces certain ... challenges ... that most biographers don't face. Memory, obstinacy, whimsy, the whole nine yards.
So it pleases me to say that Siobhan Roberts' recent biography, Genius At Play The Curious Mind of John Horton Conway, rises to the occasion and gives a wonderful and quirky portrayal of a wonderful and quirky figure in the history of mathematics.
But it must be said. If the author of a book about such an unconventional
unusual, irregular, unorthodox, unfamiliar, uncommon, unwonted, out of the ordinary, atypical, singular, alternative, different; new, novel, innovative, groundbreaking, pioneering, original, unprecedented; eccentric, idiosyncratic, quirky, odd, strange, bizarre, weird, outlandish, curious; abnormal, anomalous, aberrant, extraordinary; nonconformist, Bohemian, avant-garde; informalfar out, offbeat, off the wall, wacky, madcap, oddball, zany, hippie, kooky, wacko (here)
figure faces some challenges, so does the reviewer of such a book. How to convey both the book subject's personality and how that personality is reflected in the book itself? Because make no mistake, Roberts does a great job of mirroring Conway's personality
the combination of characteristics or qualities that form an individual's distinctive character.
"she had a sunny personality that was very engaging"
synonyms: character, nature, disposition, temperament, makeup, persona, psyche
"her cheerful personality"
qualities that make someone interesting or popular.
"she's always had loads of personality"
synonyms: charisma, magnetism, strength/force of personality, character, charm, presence
"she had loads of personality" (here)
in the way she tells the story -- fresh, fun, whimsical, a bit wild and offbeat. But not purposefully difficult or obtuse or overly wilful or inventively fanciful with details (like Conway also can be), I guess leaving those aspects out of the direct telling of the tales.
What I'm going to do is leave it to the book itself to tell it's own tale. Here's a bunch of quotes, I won't tell you who from, from Roberts or Conway or one of the other people quoted in the book. 'Cause where would the fun be in that.
- p. 20: There goes somebody looking strange. Ergo it must [be] a friend of Dad's!
- p. 25: You know, it's hard to think what message to send your tongue to get it to do this thing.
- p. 51: I'm a Platonist at heart, although I know there are very great difficulties with that view.
- p. 57: Mercifully, the hiring process for the Cambridge mathematics faculty was then loosey-goosey, somewhere between anarchic and irrational.
- p. 64: "Had the baby?" / Yes. / "Boy or girl?" / Yes.
- p. 74: Were my lectures anywhere near that coherent?
- p. 75: The smitten students loved him as much for his mind as his silly high jinks, and maybe most of all for his singular hybrid of sophistication, sincerity, and lascivious showmanship.
- p. 82: Cue the tremolo whistle that presage a duel in "The Good, The Bad, and the Ugly." It's a mathematicians shootout. Who's the fastest to draw to draw a stellated icosahedron.
- p. 97: During a trip to Montreal there was 8 inches of snow. Conway, as per usual, was wearing only his sandals.
- p. 107: Are there any determinists present?
- p. 124: I like to think of a huge abandoned warehouse equipped with logical devices such as AND, OR, and NOT gates.
- p. 128: It terrifies him that another of his worst nightmares might come true, that his life will in the end be reduced to Life.
- p. 133: You know, when you play a game, if you learn to be good at it, you find what it is you should be thinking about. That is really rather subtle. And that's what we do in mathematics.
- p. 139: Come again? (As the actress said to the bishop.)
- p. 145: Which is to say, Life could calculate pi. It could calculate anything. In the broadest logical sense, Life was a metaphor for all of mathematics; it contained all of mathematics.
- p. 181: No. Yes. I'm not sure, to tell you the truth.
- p. 186: Conway carries the Shannon philosophy to its extreme, often forced by his lack of system to rediscover his own results.
- p. 213: Suppose surreal numbers had been invented first and real numbers second -- suppose it had gone the other way and we had all grown up learning surreal numbers.
- p. 224: Conway's philosophy of study, which has served him well, is to always take his investigations several steps beyond what any reasonable human being would do.
- p. 224: No no no no no! You're being far too REASONABLE.
- p. 237: I arrived at the alcove armed with the "Monstrous Moonshine" paper...in hopes of getting, if not an answer, at least some elaboration about what exactly he and Norton had accomplished.
- p. 242: Conway employs an entomologically inspired algorithm in explaining his own mating patterns.
- p. 244: How, pray tell, does an unkempt nerdy mathematician get so lucky?
- p. 275: It's one of the surest signs of senility in a scientist -- or a mathematician, for that matter -- when after having made a reputation in one subject, he somehow feels he can make a contribution to something else.
- p. 364: We are parasites, we mathematicians, on the proper function of the brain.
- p. 379: But my view is we are trying to find the truth, and there are other ways of finding the truth than proofs. And this is unsettling to mathematicians.
- p. 390: Gareth, it must be said, is as psyched about having a nerd for a father as any boy could be.
You get the idea. And you'll have to get a hold of the book itself to figure out the context of the odder of the quotes above. Parasites. *snort*
Needless to say, this is an excellent book, one that belongs in every library's mathematics collection, academic or public. It is also indispensable for collections in the history of science or math. It would also make an excellent addition to the personal collection of any lover of math or personality.
(Review copy provided by publisher.)
Roberts, Siobhan. Genius At Play: The Curious Mind of John Horton Conway. New York: Bloomsbury, 2015. 480pp. ISBN-13: 978-1620405932

domain: literature


Sringar: On his eighth death anniversary, Wamiq Farooq, a 7th standard student who was killed by government forces on January 30, 2010, was remembered by his relatives, friends and pro-freedom leaders on Wednesday.
A large number people including Wamiq’s relatives, friends, students, human rights activists and pro-freedom leaders assembled in the Martyrs Graveyard at Eidgah and offered Fateha-Khawani for the deceased.
Farooq Ahmad, Wamiq’s father told Kashmir Reader that the wounds of the death of his son were still fresh in his heart and mind.
“Every time I hear someone has been killed by government forces the face of my son appears in front of me,” he said adding that all those who were killed by government forces were like his son and he relives the moment when Wamiq returned home dead.
Farooq said that he suffered emotionally as well as financially while seeking justice for Wamiq’s murder.
“I sold my piece of land at Dargah in order to support my family. In these eight years I have spent around three years in the court in order to get justice,” he said.
“I did not lose nerves nor will I lose them despite the fact that I had and have to face challenges at every step in this battle,” Farooq said adding “I have a faith in Allah that my family would get justice sooner or later.”
Firdousa, Wamiq’s mother, told Kashmir Reader the family fought the legal battle because they did not want any other family to face what they had to.
“I personally did not want any other family to face what I as a mother had to when her child is murdered,” she said adding. “Had justice been delivered in our case we might have not seen day to day killings of innocent civilians.”
Firdousa said that she had lot of expectations from the Chief Minister, Mehbooba Mufti, as she had been speaking against human rights violation when out of power. “There is no difference between the previous government and present government,” she said adding every political party changes colour “like a chameleon” when out of power.
“We saw what happened in 2016 and how many children were killed by government forces. Today when previous government is out of power they speak about human rights while as the reality is they are the ones who started human right violations here.”
Firdousa said on the eight death anniversary of her son Shopian youth Rayees Ahmad Ganie’s killing made her remember every scene of the day when Wamiq’s body was being carried towards the graveyard.
“That day and today is similar to me. In 2010 a mother lost her son and today a mother saw the face of her son for the last time.”


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About Star of Honolulu - Star Sunset
Honolulu, HI 96813
Hours of Operation:
Cruise Departs at 5:30PM
$50 and over
AMEX, Diners Club, Discover, JCB, MasterCard, Visa
Introducing our brand new "60 Years of Aloha" show debuting April 2017. Celebrating a young couple's journey through time across the Pacific Ocean. With colorful and elaborate costumes by renowned local designer Kathe James, we feature the largest entertainment cast on island waters with impressive male hula and state-of-the-art sound and lighting system. Plus, a variety of live entertainment, like no other, starting with the STAR’s pier-side welcome hula, live Hawaiian music during dinner and fun audience participation and dancing until disembarkation.
Self-parking is available at the parking lot in front of Pier #8 - Irwin Park. Present your parking ticket upon check-in at the Star of Honolulu - Reservations Office to validate and receive a reduced parking fee.
Motorcoach transportation at $14.00 per person, from the Waikiki area.
Accessible Accommodations (for transportation and vessel): Available upon request with 24 hours advance notice.
To arrange transportation please contact us 48 hours prior.
Banquet, Dancing, Entertainment, Non-Smoking, Outdoor Smoking Area, Private Room, View, Wheelchair Access, Wine

domain: travel


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Here you will find the latest news and most recent developments on the Samsung Galaxy Note 10 5G, with regular updates and all the information you need.
Samsung Korea has revealed that the Android 10 One UI 2.0 beta program for the Galaxy Note 10 5G and Galaxy Note 10+ 5G is coming soon. The Galaxy Note 10 beta program was originally scheduled for October 21, but as we reported yesterday, Samsung's customer care representatives are now saying that it has been […]
The Galaxy Note 10 will most likely outsell its predecessor, according to industry analysts cited by The Investor, who predict that the Galaxy Note 10 shipments will be up 11 percent compared to the Galaxy Note 9. This wouldn't come as a huge surprise considering how Samsung sold twice as many Galaxy Note 10 models […]
The Galaxy Note 10 and Note 10+ have secured a new record in Samsung's home country: More than a million units of the new Note flagships have been sold in 25 days after they first went on sale. The Galaxy S8 had previously held the record – it had sold over a million units in […]
2 million 5G-enabled Samsung smartphones have been sold by the company this year, revealed JuneHee Lee, senior vice president and head of the company's technology strategy team, during Qualcomm’s presentation at IFA in Berlin. With the advent of the Galaxy Fold 5G and the Galaxy A90 5G, the company now expects the figure to double […]
Samsung started adding a 5G variant to its flagship lineup beginning with the Galaxy S10. The company made the 5G model available in select markets along with the LTE versions. It offered both the options to customers since 5G rollout is still in very early stages while LTE is more mature and widely available. Unsurprisingly, […]
Verizon was the first carrier in the United States to carry the Galaxy S10 5G. Samsung has offered the same exclusivity to the carrier for its upcoming flagship as well. It has been confirmed today that the Galaxy Note 10+ 5G will be a Verizon exclusive. Verizon has confirmed the pricing details for the entire […]
After years of hype and trials, 5G networks finally started going live in select parts of the world this year. This also means smartphone manufacturers launching 5G devices to use on those networks. Samsung has been quite bullish about 5G – both as a network equipment supplier and a smartphone vendor. Naturally, it was one […]
Thanks to our sources, we can confirm that Samsung will offer the Galaxy Note 10 5G with 1TB of storage, in addition to 256GB and 512GB options. The 1TB variant should also have 12GB of RAM. The 1TB model might have a ceramic back as well, but that's only speculation as there hasn't been any […]
Would a ceramic Galaxy Note 10 5G be so far-fetched? Samsung already offers this finish for the Galaxy S10+ so it would make sense to do the same for its next flagship. The 5G variant of the Galaxy Note 10 has been spotted on Geekbench and the numbers hint at the possibility of a ceramic […]
Straight from a South Korean testing agency comes an image of the battery of what we believe to be a 5G variant of the ‘regular-sized' Galaxy Note 10. However, the battery's model code does raise a few questions. Galaxy Note 10 5G battery capacity Straight from the testing labs of the KTR (Korea Testing and […]
There was no doubt about it and now Verizon has officially confirmed it. There's absolutely going to be a Galaxy Note 10 5G. Come to think of it, why wouldn't Samsung launch a 5G variant of a handset it has always aimed at power users? There's already a 5G variant of the Galaxy S10 so […]
It was never in doubt that the Galaxy Note 10 would have a variant with 5G connectivity, and references to this variant have been found in the Galaxy S10's kernel source. The codename for the Galaxy Note 10 was rumored to be ‘Da Vinci’ nearly six months ago, and the kernel code mentions a ‘davinci5G', […]


text:
If I fits I sits.
The good boi enjoying the belly scritches.
This is my life now, a cat bed aka cat referee.
(OP, OC ) Zeke's happy face after feeding.
"RBF" Zeke's happy face after feeding.
Honestly screw anyone who does this
I is dog, i is going boating for the first time. Yayah.
Trying to brighten someone's day.

domain: pet


text:
Hello there! I just recently moved here from America, where I was working as a substitute teacher for about a year and a half. While my main career goal is filmmaking, I come from a family of teachers and have always adored working with kids. I've nannied for a family with a four and nine year old, babysat for a couple different families, and worked for three months as a camp counselor with a bunk..
Issued at: 2 November 2022
- Bachelor's Degree

domain: artistic


© Article funded by SCOAP3 and published under licence by Chinese Physical Society and the Institute of High Energy Physics of the Chinese Academy of Sciences and the Institute of Modern Physics of the Chinese Academy of Sciences and IOP Publishing Ltd. The universality of the weak interactions can be tested in semileptonic b→c transitions, and in particular in the ratios R(D(∗)) ≡ Γ(B→D(∗)τν)/Γ(B→D(∗)lν) (where l=μ or e). Due to the recent differences between the experimental measurements of these observables by BaBar, Belle and LHCb on the one hand and the Standard Model predicted values on the other hand, we study the predicted ratios R(D(∗))=Γ(B→D(∗)τ+"missing")/Γ(B→D(∗)lν) in scenarios with an additional sterile heavy neutrino of mass ∼1 GeV. Further, we evaluate the newly defined ratio R(0)≡Γ(B→τ+"missing")/Γ(B→μν) in such scenarios, in view of the future possibilities of measuring the quantity at Belle-II.
Cvetič, G., Halzen, F., Kim, C. S., & Oh, S. (2017). Anomalies in (semi)-leptonic B decays B±→τ±ν, B±→Dτ±ν and B±→D∗τ±ν, and possible resolution with sterile neutrino. Chinese Physics C. https://doi.org/10.1088/1674-1137/41/11/113102


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These homemade tortilla chips taste incredible with our garden fresh salsa. They’re also great to use for nachos!
We spent some time with Bill Farris at Prairie Wind Nursery in Norman, Oklahoma over the weekend and learned a lot of great information! This clip talks about cilantro alternatives that you can grow once all your cilantro bolts and goes to seed in the heat of summer. We have a lot more footage from our tour that we’re going through now and we’re excited to share everything we learned! Stay tuned and sign up […]

domain: agronomy


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Casey Kenney picked up his first submission win in the UFC.
The bantamweight fighter submitted veteran Louis Smolka on the preliminary card of UFC on ESPN 9, which took place at the UFC Apex in Las Vegas and streamed on ESPN+.
Kenney (15-3-1 MMA, 3-1 UFC) wobbled Smolka early in the first round and then sunk in a one-arm guillotine choke to finish the bout. The official stoppage came at the 3:03 mark of Round 1.
With the result, Kenney bounced back from a loss to Merab Dvalishvili in his most recent outing. He’s now 7-1 in his past eight fights.
Check out Kenney’s submission finish at UFC on ESPN 9 below:

domain: news


The string of star cameos is a big draw of the second season of Fabulous Lives of Bollywood Wives, apart from the amped up catfighting and shifting dynamics between the four leads — Neelam Kothari, Maheep Kapoor, Bhavana Pandey and Seema Sajdeh.
Show producer Karan Johar features in several episodes, almost serving as the fifth important character in the plot, accosting a new celebrity each time. Here are the star cameos to watch out for in the Netflix show.
The first episode promises a Ranveer Singh appearance; you get to see him in the last episode. Karan invites the four leading ladies to the set of his film Rocky Aur Rani Ki Prem Kahani, after they keep pestering him for an invite. Ranveer, who stars in the film, shows up and floors the four. Oh, Karan lets them stay on for the shoot of a scene with Ranveer in the shower, showing off his abs.
The most famous wife of Bollywood appears in several episodes of Fabulous Lives of Bollywood Wives Season 2, giving a peek into her life. You get to see Gauri Khan as an artist as well as an entrepreneur instead of just being Shah Rukh Khan’s better half. Her real-life bond with the four ladies is also evident.
Filmmaker-choreographer Farah Khan’s cameo is one of the most entertaining this season. Farah officiates Bhavana and Chunky Panday’s renewal of vows in the last episode, on their invitation. Farah’s brand of quirky humour finds a perfect foil in the Chunky.
Indian Matchmaking’s star matchmaker Sima Taparia’s cameo is a smart Netflix show crossover that is entertaining as well. Sima is hired by Maheep Kapoor to find a match for Seema Sajdeh, who recently divorced Salman Khan’s youngest brother Sohail Khan. But Sima and Seema are at loggerheads on almost everything related to marriage and relationships.
Manish Malhotra had designed Bhavana’s wedding outfit 24 years back, making her the first Bollywood Manish Malhotra bride. Now he is back again as part of the preparations for Bhavana’s second wedding (to the same man), designing for the “first Manish Malhotra vow-renewal bride”.
The veteran actor makes a grand entrance at the wedding in the final episode. Just as everyone is waiting for Bhavana to walk down, enters Jackie Shroff with his swag. An emotional Chunky shares Jackie’s role in his and his family’s lives over the years. Jackie brings with him a plant as a wedding gift and keeps praising the plant for producing oxygen at night.
The cameos that don’t really leave a mark
Neelam meets filmmaker Zoya Akhtar to talk about her role in the upcoming season of Made in Heaven, but Maheep turns up unexpectedly. What follows is a catty exchange between Maheep and Neelam as the evidently uncomfortable Zoya tries to blend into the background like a houseplant.
Karan invites rapper Badshah on the show as a “blind date” for Seema. Seema tries too hard to get positive reviews of her new clothing line from the musician, making Badshah dismissive of the clothes and the dating prospect. His discomfort over showing up in the show is too obvious to ignore.
Bobby Deol’s discomfort is also palpable from the moment he faces the camera. Roped in to promote Seema’s clothing brand, Bobby is as dismissive of it as Badshah. Seema appears to have crossed a line when she proposed that Bobby and his family model for her clothing line. Bobby awkwardly puts her off, stating that he has always sheltered his children from the public eye and is not interested in letting them work as models.
Shweta Bachchan Nanda
Shweta Bachchan Nanda seems more fed up with the bickering ladies than the show’s trolls. Brought along by Karan for a short appearance, Shweta stays aloof and keeps quiet as the four friends start fighting over Bhavana’s alleged shrimp allergy. After sitting through a tedious argument, Shweta cannot stop herself from blurting out, “I promise I’ll eat the prawn crackers, just end this mindless fight.”


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There is a saying “what you see is what you get.” This is an honest statement from The Natural Sapphire Company! When you come to shop at our company’s website, you will see us advertising on fabulous images of bands, pendants, necklaces, bracelets and earrings that we have designed, alongside the loose stones that you might desire us to use in new pieces.
Sapphire Band and Blue Sapphire
Those colorful images you see on our website are as real as photographs. If you examine those images carefully, you will notice that those images were created using computer generated imagery. It is abbreviated as CGI and also called rendering. As you can see from those images, our company offers numerous gem stones such as Blue Sapphires, Light Blue Sapphires, Pink Sapphires, Light Pink Sapphires, Yellow Sapphires and Light Yellow Sapphires for your choice of bands, pendants, earrings and others.
Blue Sapphire Bracelet and Blue Sapphire
Apart from what we have to offer from our inventory, you can also customize bands with appropriate stone (for instance). Combining your own unique style and desired color with our state-of-the-art technology, we will first generate new and distinctive images before we start casting the real band.
Orangish Pink Sapphire Necklace and Pink Sapphire Earring
With The Natural Sapphire Company, not only you will get to see fabulous CGI images, but also you will be able to create your own distinctive style for pieces that you’ll be proud to stack on your fingers, drape around your throat and wrist, or wear at your ears!

domain: design


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(2018, August) | Useful to Parent Centers when working with Native communities
Infant and early childhood mental health consultation (IECMHC) is a strategy that tribes can use to build the resilience of its youngest members. Through the use of a holistic, culturally sensitive, and collaborative approach, IECMHC brings together everyone within a child’s circle—family, extended family, teachers, tribal elders, and providers—to develop strategies that support the child.
The following resources, made available by SAMHSA’s Center of Excellence, highlight key issues pertaining to IECMHC within tribal communities:
Overview of IECMHC Within Tribal Communities – 2017 (PDF | 471 KB)
Outlines general and specific considerations for IECMHC within tribal communities.
Key IECMHC Resources for Tribal Communities – 2017 (PDF | 630 KB)
Provides resources for tribal, state, and community leaders seeking to implement IECMHC within tribal communities.
Tip Sheet: How to Support a Mental Health Consultant Who is New to Your Tribal Community – 2018 (PDF | 662 KB)
Provides strategies for tribal communities and/or programs that are starting work with a mental health consultant who is new to the community.
All of these resources are available online at:

domain: library


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LOS ANGELES (AP) -Eric Gordon scored 27 points, including a pair of clinching free throws with 4.7 seconds left, and Blake Griffin added 24 points and 13 rebounds to help the Los Angeles Clippers beat the New Orleans Hornets 99-95 on Monday night.
Griffin, who had a breakout game on Saturday night with 44 points, 15 rebounds and seven assists in a 124-115 loss to the New York Knicks, recorded his eighth double-double.
The Clippers (2-13) ended a nine-game losing streak with their first victory in their last 15 meetings with New Orleans since Jan. 8, 2007 at Oklahoma City, where the Hornets relocated temporarily after the devastation caused by Hurricane Katrina.
Center Chris Kaman missed his seventh straight game because of a sprained left ankle. Point guard Baron Davis, who began his NBA career with the Hornets, sat out for the 11th time in 12 games because of a swollen left knee.
Griffin's Achilles heel this season has been his free throw shooting. The first overall pick in the 2009 draft missed eight of 14, lowering his percentage to 54.9.
David West had 30 points and 10 rebounds for New Orleans, but missed an out-of-control layup in the final seconds before the Hornets lost possession out of bounds. Gordon then made his critical free throws to seal it. Hornets point guard Chris Paul finished with 14 points and six assists.
For the first time this season, the Hornets trailed after three quarters - albeit only 77-73. The Clippers maintained the lead until West hit a fadeaway 18-footer to put New Orleans ahead 86-85 with 5:18 to play. Griffin sank two free throws and converted an offensive rebound into a layup while getting fouled, but missed the ensuing free throw to leave the score tied at 93.
The Clippers regained possession on a shot clock violation, and Ryan Gomes got an offensive rebound and putback after a missed layup by Gordon to give Los Angeles a 95-93 edge with 37.7 seconds to go.
Marco Belinelli missed a 3-point attempt at the other end with 28 seconds left, and teammate Trevor Ariza committed a foul away from the ball on an inbounds play before missing two free throws with 21.8 seconds remaining.
Clippers rookie Al-Farouq Aminu, who picked up three fouls in his first 2 minutes on the floor against the Knicks and played 5 scoreless minutes after coming off the bench, bounced back from that game with a fury. He started for the fifth time in six games and scored all of his 16 points before halftime, ending the first quarter with a 3-point buzzer-beater and sparking a 9-0 spurt in the final 1:25 of the second quarter with two dunks to help slice an 11-point deficit to 57-55.
Sixth-year guard Jarrett Jack joined his new Hornets teammates following Friday's trade in which they also acquired Marcus Banks and David Anderson from Toronto and sent Peja Stojakovic and Jarryd Bayless to the Raptors. Jack had 12 points and four assists in 16 minutes off the bench in his Hornets debut, after starting all 13 games with Toronto.
NOTES: After learning of the tragic accident Sunday night at Staples Center in which a 2-year-old boy fell about 30 feet from a third-tier luxury suite after the Lakers-Warriors game and later died at a hospital, Hornets rookie coach Monty Williams altered his usual pregame speech to his players and put everything into proper perspective. ``I thought about it all day today,' a subdued Williams said. ``This is real life, and basketball is a small section of it. So we're going to enjoy the game and try to win, but not forget how blessed and privileged we are to play this game. We have a lot of new dads on this team, and I may have more kids than all of them put together. So to have a child die at an event where you're planning on having a good time, it's got to be a tough tough thing to go through. Somebody's family has changed in an instant, and then we go right back in here playing - almost like business as usual - while the family is still grieving.'
The Associated Press News Service
The Associated Press
All Rights Reserved


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These Fun Frames are Included in ALL our Photo Favor Packages! .......
Look at the photos below to see a sample of our display versus the competiton.
Our set ups includes a professional Photo Backdrop, Professional Lighting, Nikon DSLR cameras, commercial grade dye sublimation printers, our exclusive 7' tall, illuminated 'Fun Folders' Banner (For a more professional looking Set Up). Most companies display their 'Fun frames' by physically setting up a sample of each 'Fun frame' on a separate table. this requires more set up space, more set up time, and 'Fun frames' are cardboard so their easily knocked over when Guests (Esp. kids) handle them when they're deciding which frame to pick.
Our display can be configured for very small spaces and can be quickly relocated to the main party room after cocktail hour ends.
Our Basic Photo Favor display The competition's Display

domain: hobby


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Boondocks’ sequel a fresh addition to the original
Eric Prister | Thursday, November 12, 2009
The next installment of the cult classic series, “The Boondock Saints II: All Saints Day,” succeeded in the most crucial aspect of creating a sequel to a beloved movie — completely changing the plot, but retaining all of the aspects of the first movie that made it so beloved in the first place.
Director and writer Troy Duffy brought back actors Sean Patrick Flanery and Norman Reedus in as the two Boston vigilante killers affectionately called “the Saints.” The sequel follows the twin MacManus brothers on their trip back to Boston after many years of living with their father in Ireland. That quiet life is interrupted after they learn of the murder of a Boston priest, committed in their own style.
The “gratuitous violence” (as phrased by Reedus’ character, Murphy) that was ever-present in the original returns, highlighted in the impressive murder scenes which are characteristically shot in slow motion with a rotating camera angle around the boys. This is coupled with another favorite method used by the director — showing the murder simultaneously with the investigation of the crime — to give “Boondock II” a very similar feel to the original.
Introduced into the story are Romeo, an excitable and over-eager Mexican who joins the crew, replacing their previous accomplice Rocco, who was killed at the end of the original film. FBI Special Agent Eunice Bloom, played by Julie Benz of Showtime’s “Dexter,” follows in the footsteps of her flamboyant predecessor, Agent Smecker, played by Willem Dafoe in the original.
Romeo provides a much-needed comic relief in a movie that can cause numbness with over-the-top violence, and Eunice’s dominant and intelligent style of investigation is quite different, but just as entertaining, as Dafoe’s was in the first film.
Also providing comic relief was the return of three Boston police officers. Their role, more serious in the first movie, becomes humorous and lighthearted, which again is necessary in a movie with such serious and violent content.
As with the original, “The Boondock Saints II” has an excellent opening that draws in the viewers, but becomes somewhat jumbled in the middle. Duffy tries to combine many storylines, and the scenes seem to jump around without any coherent focus. They are eventually brought together in the end, however, and the movie wraps up in an exciting and satisfying way. The “Boondock” movies are by no means meant to be works of theatrical genius, and a second viewing of the movie would surely clear up the seemingly jumpy style.
The music throughout the movie was once again well done, truly capturing the excitement and mood of the movie. Duffy chose only artists who were unsigned in order to create a soundtrack that was uniquely “Boondock.” He once again succeeded with his choices, particularly the music during one of the opening scenes as the boys prepare to leave for Boston. The music is high-tempo and energetic, and truly sets the mood for the movie as a whole.
For those who enjoyed the first film, “The Boondock Saints II: All Saints Day” should be exactly what they expected. It retains the most important aspects of the original without reproducing the same movie, and has a refreshingly new plot line. It could be considered somewhat more substantial than the first, but likely will not change the minds of those who did not enjoy the original. Overall, it succeeds as a sequel, a difficult achievement for which “The Boondock Saints” fans should be thankful.


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I decided to try my hand at a low-carb version of this tasty British food that has now become an American staple as well. My hubby is not so fond of mashed cauliflower, but even he admitted this was pretty darn good and said “Be sure to post this recipe on the blog!” This meal is not suitable for Atkins Induction, but can be enjoyed once you reach the higher carb veggie rung of the Atkins OWL carb ladder where carrots reside. This dish is perfectly OK for Primal-Paleo if coconut cream/milk is subbed in for the cream in the mashed cauliflower.
1 lb. ground beef
6 oz. homemade pork breakfast sausage (or ground pork, or use all beef if you prefer)
2 medium carrots, diced
1 c. zucchini squash, diced
1 c. frozen green beans
2 oz. onion, chopped
Dash salt and black pepper
1 medium (6-7″ diameter) head cauliflower
4 T. butter or ghee
¼ c. heavy cream
Paprika to garnish (optional)
OPTIONAL: ½ c. leftover beef gravy (I save and freeze all leftover gravy)
DIRECTIONS: Preheat oven to 375º. Peel and dice the carrots. Chop the zucchini into ½” dice. You can substitute diced turnips for the zucchini if you prefer. Chop the onion. Place all these veggies and the green beans into a saucepan with water to cover. Bring to a boil, lower to a slow boil for about 5-6 minutes. Cook just long enough to slightly soften them, trying not to overcook, lest their bright color be diminished in the final dish. Drain veggies in a strainer/colander while you do the next step.
Clean and chop the cauliflower into smaller pieces, place in/over water and boil/steam until completely tender. Drain well in a colander and put back into the cooking pot and puree, along with the cream and butter. You can either do this with a stick blender if you have one, or in a food processor or regular blender in small batches to avoid overflow. Season with salt to taste. If a little too thin for your preference, dust 1/8-1/4 tsp. glucomannan powder in and stir well to thicken the mash up a bit.
In a large no-stick pan, brown the beef and sausage, crumbling as it browns. Gently stir the drained veggies into the meat mixture and toss gently. Spoon off and discard as much excess grease/liquid that is in the pan as this can get soupy in the final dish. Stir in leftover beef gravy (if using). Spoon the meat/veggie mixture evenly into the bottom of a greased casserole dish. Using a spoon or rubber spatula, evenly distribute the mashed cauliflower over the top. Sprinkle with paprika to garnish if desired. Pop into preheated 375º oven for about 35 minutes or until the top is beginning to slightly brown. Serve and enjoy!
NUTRITIONAL INFO: Makes eight 1-cup servings, each contains:
288 calories, 22 g fat, 8.18 g carbs, 3.18 g fiber, 5 g NET CARBS, 16 g protein

domain: food


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If you wish to give a couple of extra touches of sparkle for your bed room, then you might want to consider purchasing some cheap sand, that you can use to alter the entire appearance of your living space. You will find really a variety of interior decor projects that you could check out with sand that can help to provide your bed room a distinctive change. On top of that, these projects don’t even require that much DIY understanding and experience so almost anybody can do them! Listed here are a couple of ideas about what you might use cheap sand:
Relight my fire
Should you fill a shallow glass bowl with smooth or faceted sand, after that you can put small tealight style candle lights in among them. Once the candle lights are lit, the sunshine in the flame will reflect from the beads and may produce a range of lovely colors. Although this works with without color beads, additionally, it produces lovely effects if colored sand are utilized. These beads aren’t flammable, so it’s a secure, steady and secure place that you should situate candle lights. This is an excellent choice for those who like romantic candlelight within their bed room, and it is a significantly safer choice than using other kinds of candle holders which could easily fall over.
Capture your dreams
Dream catchers have been in existence for any millennia, and play a significant part in tribal traditions. You’ll be able to help make your own dream catchers with a few additional supplies that you can easily get from the craft store. The most crucial products that you’ll want really are a strong yet flexible hoop and a few twine. How you decide to pursue the primary threading can be you, however should you prefer help, there are many simple to follow guides available on the web. These guides could be particularly useful if you wish to add beads towards the primary structure throughout the threading process. When the primary body from the dream catcher continues to be completed, you can keep to jazz up using extra sand. These may add sparkle for you room once they catch the moonlight!
Reflect your beauty
You are able to really perk up an ordinary mirror frame by decorating it with lots of sand. Due to the wide selection of beads that are offered, it will likely be easy to have some beads which will match the overall color plan of the bed room. Having a creative process exactly like it, the options are nearly endless. You can opt for a large number of small seed beads after which read these to safeguard them from damage, or you might made a decision to use plenty of bigger beads. You don’t even want to use a normal pattern for the beading, just because a complete mishmash of various beads look just like fun and funky. Check out different plans before you decide to stick them lower, to be able to discover which beads perform best.


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The Melbourne Cinémathèque & ACMI present
Forever a Woman (Aka The Eternal Breasts)
Based on the autobiography of poet Fumiko Nakajo, who died of breast cancer in 1954 aged 31, this unflinching namida chodai (tear-jerker) is a rare view of Japanese society from a truly female perspective. Avoiding melodrama and sentimentality, it depicts a rural Japanese woman’s struggle through a mastectomy, divorce, single motherhood and growing independence. Shot using low angles, deep staging and frequent close-ups, Tanaka shows the influence of Ozu and Naruse on her filmmaking, while approaching the story scripted by Sumie Tanaka with her signature lyricism. Starring Yumeji Tsukioka.
Also screening on Wed 15 November
Behind the Screen: Kinuyo Tanaka, trailblazing filmmaker
The Moon Has Risen (1955) – Wed 15 Nov, 7pm
Forever a Woman (A.K.A The Eternal Breasts) (1955) – Wed 15 Nov, 9pm
Love Under the Crucifix (1962) – Wed 22 Nov, 7pm
The Wandering Princess (1960) – Wed 22 Nov, 8.55pm
About the program
Kinuyo Tanaka (1909–77) is one of the greatest and most prolific screen actors and – after Sakane Tazuko – only the second woman to make it as a film director in the Japanese film industry. Appearing in 250 films over the span of 50 years, Tanaka acquired her first screen credit aged 14, while her major breakthrough came in films such as Ozu’s I Graduated But… (1929)...
Plan your visit
Read our COVIDSafe visitor guidelines, information on accessibility, amenities, transport, dining options and more.
About Melbourne Cinémathèque
Australia's longest-running film society, Melbourne Cinémathèque screens significant works of international cinema in the medium they were created, the way they would have originally screened.
Melbourne Cinémathèque is self-administered, volunteer-run, not-for-profit and membership-driven.


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Ukraine coach Oleh Blokhin has been given a new two-year contract, with federation president Grigoriy Surkis hoping his side "will surprise us at UEFA EURO 2012".
Article top media content
Oleh Blokhin will stay on as Ukraine coach until the end of 2014 FIFA World Cup qualifying after agreeing a new two-year contract.
Following a meeting of the Football Federation of Ukraine (FFU) executive committee, president Grigoriy Surkis said: "The FFU are working to give the national team everything it needs. This is no small task. Blokhin, of course, is never completely happy. At the moment he has a lot of key players injured. He is an optimist by nature and sets his goals accordingly. I hope his side will surprise us at UEFA EURO 2012, in performances and results."
Now 59, former FC Dynamo Kyiv and Soviet Union forward Blokhin took charge of Ukraine for a second time in April 2011. He previously held the role from 2003 to 2007, leading them to the last eight at their first World Cup finals in 2006. The UEFA EURO 2012 co-hosts won 2-0 against Uzbekistan in the first game of Blokhin's second spell, then lost their next four fixtures, but have rallied since with three wins and a draw in their last four matches.
Ukraine visit Israel for a friendly next Wednesday. They will take on Sweden, France and England in Group D at UEFA EURO 2012. Meanwhile, England, Moldova, Montenegro, Poland and San Marino await them in Group H of the 2014 World Cup qualifying campaign.


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Definition of stereotactic body radiotherapy
- 3.4k Downloads
This report from the Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (Deutschen Gesellschaft für Radioonkologie, DEGRO) provides a definition of stereotactic body radiotherapy (SBRT) that agrees with that of other international societies. SBRT is defined as a method of external beam radiotherapy (EBRT) that accurately delivers a high irradiation dose to an extracranial target in one or few treatment fractions. Detailed recommendations concerning the principles and practice of SBRT for early stage non-small cell lung cancer (NSCLC) are given. These cover the entire treatment process; from patient selection, staging, treatment planning and delivery to follow-up. SBRT was identified as the method of choice when compared to best supportive care (BSC), conventionally fractionated radiotherapy and radiofrequency ablation. Based on current evidence, SBRT appears to be on a par with sublobar resection and is an effective treatment option in operable patients who refuse lobectomy.
KeywordsOrgans at risk Survival Toxicity Patient positioning Quality assurance
Definition der stereotaktischen Strahlentherapie
Die Arbeitsgruppe „Stereotaktische Radiotherapie“ der Deutschen Gesellschaft für Radioonkologie (DEGRO) erarbeitete eine Definition der Körperstereotaxie (SBRT), die sich an vorhandene internationale Definitionen anlehnt: Die SBRT ist eine Form der perkutanen Strahlentherapie, die mit hoher Präzision eine hohe Bestrahlungsdosis in einer oder wenigen Bestrahlungsfraktionen in einem extrakraniellen Zielvolumen appliziert. Zur Praxis der SBRT beim nichtkleinzelligen Bronchialkarzinom (NSCLC) im frühen Stadium werden detaillierte Empfehlungen gegeben, die den gesamten Ablauf der Behandlung von der Indikationsstellung, Staging, Behandlungsplanung und Applikation sowie Nachsorge umfassen. Die Körperstereotaxie wurde als Methode der Wahl im Vergleich zu Best Supportive Care, zur konventionell fraktionierten Strahlentherapie sowie zur Radiofrequenzablation identifiziert. Die Ergebnisse nach SBRT und sublobärer Resektion erscheinen auf aktueller Datenbasis ebenbürtig. Die SBRT ist die Methode der Wahl, wenn Patienten einen operativen Eingriff in Form der Lappenresektion ablehnen.
SchlüsselwörterRisikoorgane Überleben Toxizität Patientenpositionierung Qualitätssicherung
The principles and practice of stereotactic body radiotherapy (SBRT) were transferred from cranial stereotactic radiotherapy/radiosurgery in the mid-1990s by pioneering work at the Karolinska Hospital in Sweden . This concept was quickly adopted and further developed in Japan  and Germany [3, 4]. At the beginning, SBRT was predominantly defined by frame-based stereotactic patient setup for accurate delivery of conformal dose distributions to extracranial targets in hypofractionated irradiation schemes. Nowadays however, a commonly accepted definition of SBRT does not exist. This is because frame-based stereotactic patient setup has been replaced by image guidance, which renders the term stereotactic misleading.
The Stereotactic Radiotherapy Working Group was asked by the German Society of Radiation Oncology (Deutschen Gesellschaft für Radioonkologie, DEGRO) to provide a definition of SBRT and to give an evidence-based review of current SBRT practice. This article will focus on the definition of SBRT, as well as the indications for and practice and outcome of SBRT for early stage non-small cell lung cancer (NSCLC).
Definition of SBRT
National working groups in several different countries have reported their definitions of SBRT. The definitions of SBRT provided by the American Association of Physics in Medicine (AAPM) Task Group 101; the American Society for Therapeutic Radiology and Oncology and the American College of Radiology (ASTRO and ACR); the Canadian Association of Radiation Oncology—Stereotactic Body Radiotherapy (CARO-SBRT) and the National Radiotherapy Implementation Group of the UK [5, 6, 7, 8] all agree on the following items: SBRT is (1) a method of external beam radiotherapy (EBRT) that (2) accurately delivers a (3) high dose of irradiation in (4) one or few treatment fractions to an (5) extracranial target.
SBRT can be adequately performed with either traditional linear accelerators equipped with suitable image-guidance technology, accelerators specifically adapted for SBRT or dedicated delivery systems. Additionally, the principles of SBRT apply for both photon and particle therapy.
It is of fundamental importance that the entire SBRT workflow be systematically optimized and that appropriate quality assurance (QA) measures are implemented. From a clinical perspective, the term “accurate” covers disease staging; multidisciplinary discussion of the indications for SBRT; tumor site adjusted imaging with appropriate spatial and temporal resolution for target and organ at risk (OAR) definition; highly conformal treatment; image-guided patient setup; active or passive intrafraction motion management and follow-up (preferably at the treating institution). From a physics perspective, SBRT requires additional and more sophisticated QA procedures compared to conventional radiotherapy. These include system-specific end-to-end tests for both static and moving targets, as well as verification of the alignment of imaging and treatment isocenters prior to SBRT on a daily basis.
Radiation doses are at least equivalent to radical doses in conventional fractionation.
Radiation doses are delivered in few fractions (usually but not necessarily in a maximum of 10 fractions). Adjustment of single-fraction dose and total dose to volume and location of the target is essential.
The target is accurately localized using tumor site specific imaging modalities. Simultaneously, the target needs to be spatially separated from critical OARs, without diffuse infiltration into these. Only the macroscopic target and small, immediately adjacent volumes of potential microscopic spread are treated in SBRT.
The term “stereotactic” is still considered appropriate for SBRT, even if no frame-based patient setup using external stereotactic coordinates is performed; the external coordinates are replaced by the internal coordinates of the image guidance procedure. These images must either visualize and locate the target itself or surrogate anatomical structures/fiducial markers that are closely correlated to the target.
Stereotactic ablative radiotherapy (SABR) has been proposed by an international group of authors as an alternative to SBRT . However, our opinion on the appropriateness of “ablative” differs because it does not accurately describe the radiobiology and clinical outcome of SBRT in all its variations. Techniques like radiofrequency ablation (RFA) are ablative irrespective of the normal or neoplastic nature of the tissue in the treated volume, which makes treatment of tumors abutting critical serial OARs impossible. In contrast, SBRT allows tumoricidal treatment of such targets while sparing the OARs through the differences in radiosensitivity of normal and cancerous tissue, as well as through fractionation effects.
SBRT for early stage NSCLC
Rationale for SBRT
After detection of NSCLC at an early stage (as is the case in 20–30 % of all patients), the best overall survival (OS) with cure rate in the majority of the patients is achieved by surgical lobectomy and systematic mediastinal lymph node dissection. However, surgical resection is not possible in a substantial proportion of patients—about 20 % of all patients with stage I NSCLC —because of comorbidities or insufficient pulmonary function resulting from tobacco abuse and consequent chronic obstructive pulmonary disease (COPD). This fraction of inoperable patients is expected to further increase due to aging western populations: only 40 % of patients aged 75 years or older are treated surgically for stage I NSCLC in the Netherlands . If no treatment is offered to these patients, cancer leads to death within few years despite its early stage .
In cases of contraindication for radical lobectomy, the standard treatment options are best supportive care (BSC), conventionally fractionated radiotherapy and sublobar resection. The therapy of choice depends on the patient’s performance status, age and comorbidities.
Based on the California Cancer Center registry, 7 % of all patients with stage I NSCLC are treated with BSC alone because their life expectancy is considered too short for curative treatment . Among the elderly population, this proportion of untreated patients increases to 30 % [11, 12]. However, 5-year lung cancer specific survival rates are less than 20 % in untreated patients, indicating the need for a curative treatment option that is effective and simultaneously safe for this patient population.
Conventionally fractionated radiotherapy is an established curative treatment option for stage I NSCLC, with 3-year OS rates of about 30 % . However, local tumor relapse is the most frequent cause of treatment failure after irradiation with conventionally fractionated doses of 60–66 Gy [13, 14]. Retrospective studies have demonstrated a dose–response relationship for local tumor control and disease specific survival in NSCLC [15, 16, 17], which clearly indicates the need for a radiotherapy methodology that enables a safe intensification of treatment.
Sublobar resection is practiced in borderline operable patients as an alternative to lobectomy. This technique spares lung tissue and preserves pulmonary function compared to lobectomy. However, the results of a randomized controlled trial  indicate that this is associated with inferior oncological outcome.
Clinical outcome after SBRT for early stage NSCLC and implications for patient selection
SBRT vs. BSC in the elderly population and patients with severe pulmonary comorbidities
Two recent population-based analyses from the Netherlands [11, 12] and one from the US  demonstrated an improvement in OS for stage I NSCLC by the introduction of SBRT into the elderly patient population. OS was improved by shifting patients from BSC or conventionally fractionated radiotherapy to SBRT, treatment options which are both inferior to SBRT. Further studies showed that SBRT is safely practiced in patients with severe pulmonary comorbidities and very poor pretreatment pulmonary function and toxicity was not increased in these high-risk patient populations [20, 21]. Consequently, SBRT should be offered to all patients—irrespective of advanced age or pre-existing pulmonary comorbidities—unless their survival expectancy is very short. The SBRT characteristics of a noninvasive treatment delivered in a few fractions on an outpatient basis are expected to enhance acceptability in these patient cohorts.
SBRT vs. conventionally fractionated radiotherapy in medically inoperable patients
Several prospective phase II trials of SBRT in medically inoperable stage I NSCLC patients have reported local tumor control rates of 84–98 % [22, 23, 24, 25, 26, 27], demonstrating consistent results despite differences in SBRT methodology. This improved local tumor control compared to conventional radiotherapy  transfers into improved OS, as demonstrated in meta-  and population-based analyses : 3-year OS is approximately 50 % after SBRT, with pretreatment comorbidities being a strong predictor for OS . Based on these findings and the 1.2013 version of the National Comprehensive Cancer Network (NCCN) Guidelines for NSCLC , SBRT is today considered superior to conventionally fractionated radiotherapy and is the standard of care for medically inoperable patients.
SBRT vs. RFA
RFA has been introduced as a minimally invasive treatment option for stage I NSCLC. No study has performed a direct comparison between SBRT and RFA, but a recent literature review reported improved local tumor control, cancer specific survival and OS after SBRT compared to RFA . Additionally, toxicity and 30-day mortality  were lower after SBRT, resulting in the conclusion that SBRT should be proposed as the initial nonsurgical treatment in high-risk patients.
SBRT vs. sublobar resection in high surgical risk patients
There are few studies directly comparing SBRT and sublobar resection for early stage NSCLC. Grills et al.  performed a single-institution comparison between SBRT and wedge resection. These authors reported improved local tumor control after SBRT, while no differences in regional control and cancer specific survival were observed. The previously cited US population-based analysis showed identical OS and cancer specific survival rates for SBRT and sublobar resection : 30-day mortality rates were 0 and 1.2 % after SBRT and sublobar resection, respectively. Consequently, current data support both SBRT and sublobar resection as viable treatment alternatives for high surgical risk patients. The results of a currently recruiting American College of Surgeons Oncology Group randomized trial comparing SBRT and sublobar resection (ACOSOG-Z4099) are awaited.
SBRT vs. lobectomy for medically operable patients refusing surgical resection
The criteria for being fit enough to undergo lobectomy are described in national and international guidelines. Lobectomy is considered to be the treatment of choice for stage I NSCLC if these criteria are met. Few studies have reported outcome after SBRT where surgical resection was refused by the patients. Two Japanese and Dutch studies described excellent OS rates of 70 % after 5 years  and 85 % at 3 years , respectively. Two recent matched-pair analyses reported equivalent OS  and equivalent disease-free survival rates  after SBRT and lobectomy. Consequently, SBRT is a viable treatment option in the situation of surgical treatment being refused by the patient.
Recommendations for clinical practice of SBRT in early stage NSCLC
Careful assessment of performance status is important to enable a sensible therapy concept. Perioperative morbidity is associated with older age (> 70 years) and the presence of comorbidities [38, 39]. Therefore, pulmonary function tests, as well as cardiac and performance status assessment are recommended before estimating the operative risk. As a corollary of this, the indication for SBRT should be discussed in an interdisciplinary tumor board.
Histopathological confirmation of disease
Histopathological confirmation of disease is recommended. Transbronchial biopsy or transthoracic needle aspiration are primary methods. Nevertheless, demonstration of malignancy is sometimes impossible or associated with an unacceptably high risk because of the medical and/or pulmonary comorbidities of the patient. In this case, radiological criteria of malignancy should be consulted.
Swensen et al.  described a prediction model to estimate the probability of malignancy in solitary pulmonary nodules (SPN) based on clinical and radiographic characteristics. This model was validated by Herder et al. . Inclusion of fluorodeoxyglucose positron-emission tomography (FDG-PET) imaging might further improve the accuracy of the prediction model [42, 43]. If malignancy is highly likely based on the described criteria, immediate SBRT without histopathological confirmation is justified , as is also standard practice in thoracic surgery . Repeated imaging to evaluate the growth pattern is an option in patients with a borderline risk of malignancy, but this might put the patient at risk of disease progression in the time interval .
Staging of disease
In accordance with other groups , the DEGRO working group recommends the following staging procedures prior to SBRT: a CT scan of the chest including the upper abdomen using intravenous contrast is mandatory. A whole body FDG-PET/CT scan should be performed in all cases. The added value of FDG-PET lies in the higher diagnostic accuracy for the detection of nodal metastases (negative predictive value: 90 %) [48, 49]; furthermore, distant metastases and clinically relevant second malignancies can be excluded. The PET/CT scan should not be older than 6 weeks. In case of pathological FDG uptake in mediastinal lymph nodes, further histopathological evaluation, e.g. by endoscopic ultrasound (EUS)- or endobronchial ultrasound (EBUS)-guided biopsy is mandatory. If the situation is still unclear, a mediastinoscopy may be necessary.
After exclusion of nodal metastases, SBRT is recommended for early stage NSCLC with a maximum tumor diameter ≤ 5 cm. Only limited data are available about the safety and efficacy of SBRT for lesions larger than 5 cm, where the risk of toxicity and occult systemic disease might be increased.
Imaging for target volume definition
Obviously, all images must be acquired in the treatment position. The planning CT scan should include the entire lung volume. Acquiring CT scans with a slice thickness of 2–3 mm is recommended. Use of intravenous contrast for CT scanning improves delineation of centrally located primary tumors. However, the use of synchronous intravenous contrast with four-dimensional CT (4D-CT) scans of the thorax is not established.
Due to the risk of artifacts and systematic errors introduced by the nonrepresentative nature of the captured breathing position, the use of a 4D-CT (also known as respiration-correlated CT) scan is strongly recommended for treatment planning and also allows for the evaluation of motion management strategies.
Target volume concept and motion management strategy
A gross tumor volume (GTV) should be defined based on CT findings in lung and soft tissue windows including all small spiculae. Most centers do not use clinical target volume (CTV) margins to account for microscopic tumor extensions. However, practices pertaining to CTV definition are inconsistent. Caution is therefore advised when applying this concept to SBRT target volume definition, as the applied safety margins may unnecessarily increase target volumes.
Integration of breathing-induced target motion into the target volume concept is a prerequisite for ensuring proper tumor targeting in individual patients. Clinical implementation depends on the respective motion management strategy, which in turn is required for SBRT.
Several different approaches can be applied and have already been implemented into routine practice: continuous irradiation during free breathing using (a) the internal target volume concept (ITV; most commonly practiced), (b) the mean target position concept  or (c) real-time tumor tracking. Irradiation in specific breathing phases is performed using (a) gated beam delivery, (b) voluntary breath holding or (c) breath holding using the Active Breathing Coordinator (Elekra, Stockholm, Sweden). Multiple planning studies reported reduced safety margins by the use of individually tailored patient motion compensation strategies compared to population-based margins.
Although patient-specific motion management is strongly recommended, it is important to note that no prospective trials have used advanced motion management strategies. Furthermore, no benefit of advanced motion management strategies like gating or tracking has been found for motion amplitudes < 10–15 mm [50, 51].
Dose, fractionation and prescription
Wherever possible, dose prescription and reporting should comply with the International Commission on Radiation Units (ICRU) Report 83. ICRU recommends prescribing to the median (D50), or alternatively, to the mean (Dmean) dose. Based on experiences with cranial stereotactic radiotherapy, SBRT is practiced using inhomogeneous dose distributions within the planning target volume (PTV); maximum PTV doses range between 105 and 150 % of the prescribed PTV-encompassing dose. Effective doses to the GTV further vary according to the applied GTV-to-PTV safety margins and the size of the macroscopic tumor. We therefore recommend reporting minimum (D95 or D98) and maximum (D05 or D02) PTV doses—where DX is the minimum dose received by X% of the volume—in addition to the doses delivered to the GTV. Ideally, mean dose and the standard deviation of the mean dose should be reported as well as the afore mentioned dose levels. A sensible conformity index (CI) is the one proposed by Paddick . If possible, this CI should be reported.
Normal tissue risk-adapted fractionation is highly recommended, with 1–10 delivered fractions depending on the size and central/peripheral location of the target .
Several groups independently demonstrated a clear dose–response relationship for local tumor control [54, 55, 56, 57]: a minimum biologically effective dose (BED; α/β ratio: 10 Gy) of > 100 Gy to the PTV) achieved local tumor control rates > 90 %. It could be demonstrated that this dose-dependent increase in local control translated into improved OS [54, 58]. A recent meta-analysis reported the best OS rates for medium to high SBRT doses of 83.2–146 Gy BED; OS was worse after SBRT with > 146 Gy BED, indicating a detrimental effect of excessively high doses .
Three fractions of 15 Gy with a dose maximum of 150 % was the preferred fractionation scheme in the German and Austrian patterns of care analysis and resulted in local tumor control rates of > 90 % . This fractionation scheme of 3 × 15 Gy as D95 or D98 to the PTV with a D05 or D02 PTV dose of 150 % is therefore recommended for peripherally located NSCLC ≤ 5 cm in diameter. However, it has to be mentioned that this regimen was planned using type A (pencil beam) dose calculation algorithms in 80 % of cases, which might have overestimated the true dose by about 10 % . Additionally, this recommendation is lower than the 3 × 18 Gy fractionation scheme that is used most frequently internationally.
Limited data are available concerning the safety and efficacy of SBRT for centrally located lesions . Particularly where very high single fraction doses were applied, lethal outcomes have been observed . Therefore, treatment of central lesions should preferably be performed within prospective trials such as the European Organisation for Research and Treatment of Cancer (EORTC) LungTECH trial. Until then, a recommended fractionation scheme for experienced centers is 8 × 7.5 Gy as D95 or D98 to the PTV; dose inhomogeneity within the PTV should be limited to 125 % .
OAR tolerance doses
It is of utmost importance to note that none of the published tolerance doses for SBRT have been formally validated. Nevertheless, as the toxicity after SBRT for peripheral lesions with the published OAR tolerance doses seems to be acceptable (grade ≥ II less than 10 %), adherence to such published protocols is strongly recommended (Tab. 1).
Normal tissue constraints according to published major clinical studies. Radiation Therapy Oncology Group (RTOG) protocols can be found on the RTOG website at http://www.rtog.org/ClinicalTrials/ProtocolTable.aspx
Organ at risk
(Haasbeck et al. 2011 )
Trachea and large bronchus
Dmax 20.2 Gy
Dmax 30 Gy
Dmax 34.8 Gy
15.6 Gy < 4 cc
Dmax 105 %a
18 Gy < 5 ccb
Dmax 44 Gy
Dmax 22 Gy
16 Gy < 15 cc
Dmax 30 Gy
Dmax 34 Gy
28 Gy < 15 cc
Dmax 105 %a
32 Gy < 15 cc
Dmax 15.4 Gy
11.9 Gy < 5 cc
Dmax 25.2 Gy
17.7 G < 5 cc
Dmax 30 Gy
18.8 G < 5 cc
Dmax 105 %a
27.5 Gy < 5 ccb
Dmax 40 Gy
Dmax 17.5 Gy
14 Gy < 3 cc
Dmax 24 Gy
20.4 Gy < 3 cc
Dmax 27.2 Gy
23.6 Gy < 3 cc
Dmax 32 Gy
30 Gy < 3 cc
Dmax 36 Gy
Dmax 30 Gy
22 Gy < 1 cc
30 Gy < 30 cc
Dmax 27.2 Gy
32 Gy < 1 cc
30 Gy < 30 cc
Dmax 14 Gy
10 Gy < 0.35 cc
Dmax 18 Gy (RTOG 0236)
Dmax 26 Gy 28.8 Gy < 0.35 cc
Dmax 30 Gy
22.5 Gy < 0.25 cc
Dmax 28 Gy
Patients need to be informed about the following SBRT-specific toxicities: (1) Toxicities in up to 10 % of cases depending on tumor size and location: radiation-induced pneumonitis, rib fractures, chest wall pain. (2) Rarely observed toxicities: pleural and pericardial effusion, stricture of central airway structures, dyspnea, bleeding. (3) For more central locations, the low risk of life-threatening necrosis/fistula of neighboring organs such as esophagus, bronchi and large vessels, as well that of cardiac arrhythmias should be mentioned (depending on the exact tumor location).
Photon energy should be below 10 MeV in order to avoid excess penumbra blurring. A leaf width of 5 mm at the isocenter is considered sufficiently small. The voxel size of the calculation grid should be 2 mm or less.
For dose calculation, heterogeneity correction and use of a type B dose calculation algorithm  is mandatory to achieve an accuracy of dose calculation exceeding 2 %.
All prospective trials used three-dimensional conformal radiotherapy (3D-CRT) for treatment planning. Intensity-modulated radiotherapy (IMRT) and advanced rotational techniques like volumetric-modulated arc therapy (VMAT) or RapidArc (Varian Medical Systems, Palo Alto, CA, USA) have the potential to increase conformity and homogeneity. The biological effect of these differences and the potential interplay of multileaf collimator (MLC) and tumor motion need to be considered. Flattening filter free irradiation will further reduce treatment delivery times.
Patient immobilization and setup
Customized patient immobilization was used in the majority of trials and is highly recommended to minimize intrafractional patient motion.
Internal shifts of the pulmonary target relative to the bony structures are the major source of positioning uncertainties [65, 66]. These effects cannot be countered by stereotactic setup or bone imaging. Therefore, daily pretreatment imaging is required for online correction of setup errors and base-line shifts. Imaging needs to visualize either the lung tumor directly or implanted markers that act as a surrogate for tumor position. Breathing-induced target motion must be fully integrated into the image-guided radiotherapy (IGRT) process. Post- and/or mid-SBRT imaging is recommended for QA, particularly in single fraction SBRT. Several methodologies for image guidance are commercially available (cone beam CT, in-room CT and orthogonal x-rays for fiducial control) and superiority of one method over the other has not been demonstrated.
Interfractional tumor shifts might occur towards critical OARs and their correction by IGRT isocenter adjustment might result in increased OAR doses. Volumetric IGRT is required to visualize and quantify such effects. Methods for avoiding OAR overdosage are incorporation of safety margins for critical OARs (planning organ at risk volume, PRV, concept), repositioning or even replanning if critical thresholds are exceeded.
Clinical and radiological follow-up should be performed at the treating institution. CT imaging should be performed every 3 months for 2 years and every 6 months thereafter for another 3 years. This examination frequency has not been validated and should be adjusted to the patient’s performance status and suitability for salvage treatment.
Mass-like fibrosis within the high-dose region is observed after the majority of SBRT treatments [67, 68, 69, 70] and its differentiation from local failure is difficult. FDG-PET is recommended in cases where CT-based morphological differentiation of fibrosis and recurrence is not possible. However, FDG-PET results should be interpreted with caution within 6–9 months after SBRT due to the possibility of false-positive findings arising from inflammation processes . Due to the risk of bleeding, bronchoscopic and/or transthoracic biopsies are only recommended if local recurrence is suspected and clinically relevant salvage treatment options are available.
Physical and QA requirements for safe SBRT practice
It is recommended that SBRT be performed by a team consisting of a radiation oncologist, a medical physicist and technicians (radiographers, therapists). All members of the team should have attended dedicated SBRT teaching activities organized within the institution, by national or international societies or in an industrial setting.
Treatment should follow written standard operating procedures (SOPs), which are adjusted according to national regulations, the institution-specific equipment and training and education of the individual radiotherapy team members.
Comprehensive practical guidelines for SBRT are given in several international reports [5, 6, 7, 8, 47]. For Germany it is recommended to apply the appropriate norms defined by the Deutsche Institut für Normung (DIN). In this context the following reports are particularly relevant: DIN 6847-5, DIN 6858-1, DIN 6870-1, DIN 6873-5, DIN 6875-1 and DIN 6875-2.
Verification of the accuracy of the entire SBRT treatment chain is mandatory. This includes all imaging processes, the dose calculation engine, the MLC sequencing, the monitor unit calculation, the monitor calibration, patient positioning, the tracking or gating devices and so forth. Most steps are part of the regular commissioning and QA procedures.
It is paramount to verify that the radiation isocenter coincides with the mechanical isocenter—including couch rotation—and that the lasers are aligned to the radiation isocenter. The same is true for the imaging isocenter. End-to-end tests are recommended for overall uncertainty estimates. If a sufficiently precise independent and redundant localization is not used for every application, the alignment of the IGRT and the treatment isocenter should be tested daily.
Radiobiological considerations of SBRT
Detailed understanding of the radiobiology of SBRT is still lacking. In contrast to conventional fractionated radiotherapy, there is no repopulation, reoxygenation or redistribution of tumor cells in single fraction SBRT. Even hypofractionated schedules still provide short overall treatment times and therefore at least accelerated repopulation has not to be considered. Additional effects of high fraction doses in SBRT may be vascular and  immune effects .
Although the linear quadratic (LQ) model is widely used in the community and has proven feasible for the description of SBRT outcome in several clinical reports, the applicability of this modality has been questioned because it has not been validated for very high single doses . Most likely it is accurate up to single fraction doses of 15 Gy . For higher fraction doses the model might overestimate the biological effectiveness, particularly for low α/β values. This may lead to underdosage of tumors with lower α/β values, such as prostate cancer, whereas it may be less critical for tumors with higher α/β values, such lung cancer. However, for normal tissues it should provide a more conservative approach. Alternative models have been proposed but are more complicated to use and have not been better validated using clinical data. In conclusion, the LQ model should be used, with caution, until more accurate models have been validated.
This report provides a definition of SBRT that is agreement with that of other international societies. Detailed recommendations for principles and practice of SBRT for early stage NSCLC are given. These cover the entire treatment process; from patient selection, disease staging, treatment planning and delivery to follow-up.
This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Compliance with ethical guidelines
Conflict of interest. M. Guckenberger, N. Andratschke, H. Alheit, R. Holy, C. Moustakis, U. Nestle and O. Sauer state that there are no conflicts of interest.
The accompanying manuscript does not include studies on humans or animals.
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Patent attorneys may appear to speak (or at least write in) a different language to most folks, but there are often very good reasons why we choose to use certain words.
You may have noticed that patent specifications are absolutely littered with the word “comprising”, but why is this?
Comprising, in patentese, refers to a non-exhaustive list of items (known as “integers”). So, an invention (say, a coffee cup) may be claimed as:
A receptacle comprising a liquid-receiving part and a grip means.
Translated into English, this is basically:
- A receptacle (a hollow object used to contain something)
- Comprising (that has)
- A liquid-receiving part (the main body of the cup, which holds the coffee) and
- A grip means (a handle)
As an aside, you’ll note that the wording used in a patent claim, wherever possible, makes use of generic placeholders instead of actual nouns (“grip means” vs “handle”) and the reason for this is that by doing so, it potentially broadens the scope of protection conferred by the claim to functional equivalents. In this case, the term “grip means” covers a handle, a knob, a textured outer surface on the cup body, etc., whereas the word “handle”, which could have been used instead, does not cover the latter two.
Getting back to the point of this post…so why do we use the word “comprising“, as opposed to other terms, such as “having“, “consisting of“, “which has“, etc.?
The reason is because, over the course of a great many years of litigation, the Courts have settled on the word “comprising” as having the meaning of inferring a non-exhaustive list. This means that the above claim for a coffee cup is still infringed if a competitor adds additional features (for example, a lid or an outer sleeve) to the patented coffee cup.
However, of the claim were to read instead:
A receptacle consisting of a liquid-receiving part and a grip means.
then the word “consisting” infers that the list of features coming after it is an exhaustive list, and protection does not therefore extend to receptacles also having additional features. In this example, a competitor’s coffee cup that had the liquid-receiving part, the grip means and a lid or an outer sleeve, would (probably) not be held to infringe!
So, why would you not always use “comprising”?
The reason is that you may need to distinguish an invention negatively, that is to say, where the invention subsists in a simplification that omits a certain feature that the prior art has. By way of a very hypothetical example, the prior art may be a car brake that has a brake disc and and two opposing brake pads, i.e. one pad squeezing in on each side of the disc. However, the invention may be the realisation that adequate braking can be obtained using only a single brake pad, provided the disc is sufficiently rigid. In this hypothetical case, you would want to claim:
A brake system comprising a control system and a braking device, wherein the braking device consists of a brake disc and a brake pad.
Now we have a carefully-drafted claim for a braking system that comprises any number of control systems and any number of braking devices, but in which each braking device only has one disc and one pad.
(Clearly, this claim would not pass muster in the real world as the braking device would also need to have a cylinder, controller, hoses etc., but this is just a hypothetical example).
If, on the other hand, the claim had been drafted:
A brake system comprising a control system and a braking device, wherein the braking device comprises a brake disc and a brake pad
then this would likely not be novel over two-pad brakes because the second instance of the word comprising allows each braking device to have any number of brake discs and any number of brake pads, i.e. the one disc/two pad brake of the prior art.
This may all seem a bit esoteric, but it can nevertheless be crucial when assessing the validity and infringement of patent claims. As such, each word in a patent specification is (or should be) chosen very carefully to ensure that the optimum protection is obtained.


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