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The “age-one” dental visit is one of the most important interventions dentistry can provide. The ability to prevent dental disease before it can start may assist in better lifelong health.1 Yet, too few practitioners see 1-year-olds in their office. There are numerous resources available to train general practitioners on how to create an infant and toddler program in their office that is effective in promoting good oral heath while also being financially feasible. This article will provide the basic principles of what to implement into such a program, using the renowned Washington State ABCD program2 as an example of success.
Addressing a Serious Problem
In 1994, a group of concerned dentists, dental educators, public health agencies, the state dental association, the Washington Dental Service Foundation, and state Medicaid representatives came together to address the severe lack of dental access to Washington State’s high-risk preschool children.3,4 The proposed solution was the development of the Access to Baby and Child Dentistry (ABCD) Program.
ABCD focuses on preventive and restorative dental care for Medicaid-eligible children (although the principles of the program are applicable to all children) from birth to age 6, with emphasis on enrollment by age 1. It is based on the premise that starting dental visits early in life will yield positive behaviors by both parents and children, thereby helping to control the caries process and reduce the need for costly future restorative work.3
The first ABCD program opened for enrollment in Spokane, Washington, in February 1995 as a collaborative effort between several partners in the public and private sectors. Its success has led other county dental societies and health districts in Washington to adopt the program, as well as prompted interest from other states.3
The ABCD Program was named a “Best Practice” by the American Academy of Pediatric Dentistry (AAPD) in 2000. The AAPD, under a 3-year Health Resources and Services Administration (HRSA) grant, sought programs that use resources efficiently and are culturally competent, replicable, integrated, and sustainable. More than 28 programs in 15 states submitted descriptions for review by an Academy task force. North Carolina and Washington were selected as two states with especially useful approaches.3,5
In 2003, ABCD won the “Heroes of Health Care” award for collaboration from the Washington Health Foundation. In 2004, the Association of State and Territorial Dental Directors (ASTDD) selected ABCD as one of its “Best State Practices.”3,6 According to the ASTDD, “Best Practice is based on a simple maxim: Don’t reinvent the wheel, learn in order to improve it, and adapt it to your terrain to make it work better. If we can demonstrate success and share what we know, it can enable us to go forward in different ways that may lead to innovation and establish other best practices.” Thirty-nine states submitted 116 descriptions of successful dental public health practices to the ASTDD Best Practices Project.3,6
In 2005, the W.K. Kellogg Foundation named the ABCD program as one of three innovative oral health models nationally.3,7 Oral Health America gave ABCD an “A” grade in its 2005 report titled, “A for Effort.”3,8 For receiving an “A” grade for ABCD, Washington is one of eight states earning top grades for improving oral health. ABCD is also recognized as an effective program to address children’s health disparities in a report by the Children’s Defense Fund.3,8
The ABCD program is designed to begin seeing children as soon as the first teeth emerge. The AAPD has adopted a policy for children to be seen by a dentist at age one.9 Because recognition of the need for early pediatric dentistry is new for many dentists and parents, the ABCD Program provides education and training for both.10
Parent Orientation and Encounters at the Age-One Dental Visit
Parents should be coached at their initial ABCD orientation and in follow-up visits to bring their children to the dental practitioner before there are problems.11 Family oral health education (discussed below), examination, anticipatory guidance,12 varnish application, lift-the-lip examination, oral hygiene instruction, and risk assessment are all part of the age-one dental visit. Periodic follow-up examination after the age-one visit depends on the child’s risk.13 Low-risk children might only be seen annually or semi-annually until the primary teeth are fully in occlusion. High-risk children should be seen as often as every 2 to 3 months.14
Family Oral Health Education
A family oral health education session is carried out twice per year by the dental office. This education may be delivered by the dentist, dental hygienist, and/or other staff. The session should include:15
-“lift-the-lip” training (a videotape and flipchart teaching the parent/guardian how to examine the child’s mouth)
-hands-on training in teeth cleaning
-nutritional counseling and showing the proper use of a cup for drinking
-discussion and prescription of fluoride supplements (as needed)
-follow-up (contact within 3 months as a reminder about teeth cleaning, lift-the-lip exams, and fluoride supplements)
Pediatric Dental Techniques
Dentists and other oral healthcare providers should receive continuing education in early pediatric dental techniques. The ABCD program’s education component is certified by the University of Washington’s pediatric dentistry staff. In the initial training, the dental practitioner is taught the lap-to-lap examination procedure (discussed below) as a better method than using a dental chair for examining very young children.16
Fluoride varnish applications are encouraged for high-risk children. Three applications per year are recommended for moderate to high-risk children. The precise frequency and timing of fluoride varnish applications is currently a topic of discussion. These authors share the belief that even more frequent fluoride varnish application may be necessary for high-risk children, and should be combined with intensive family oral health education.
Atraumatic Restorative Technique
Dental practitioners are encouraged to use atraumatic restorative technique (ART) when providing restorative therapy as a transitional method for restoring teeth in infants and toddlers. This type of treatment, combined with definitive care that may require more extensive behavior management tools (including the possibility of general anesthesia), are used based on a variety of risk and family factors. Glass-ionomer restorative material, which releases fluoride, can be used for treating small- to moderate-sized caries lesions in primary teeth. This process is often referred to as “scoop-and-fill” or “band-aid” restorations. The idea is to stabilize the lesions until the child’s behavior can be better managed and the lesions can be treated with conventional techniques.
Knee-to-Knee Examination Procedure
1. Position the child in the adult caregiver’s lap while the adult sits in a chair. Interact warmly with both the infant/toddler and the caregiver.
2. Ask if the child will allow you to pick her/him up. If you have permission to do so, hold the child—briefly. Bounce, jostle, and interact with the youngster and then return the child to the caregiver. If the child is obviously reluctant to be held or the caregiver advises that the child will not allow you to hold her/him, proceed to Step 3.
3. Give the child a toothbrush (remove from packaging).
4. Determine if the caregiver or another adult assists the child with toothbrushing by asking “How do you take care of your child’s teeth?” If the caregiver does assist the child with tooth cleaning at home, communicate approval and praise. Request that the caregiver demonstrate brushing of the child’s teeth. Catch the caregiver “doing something right” during tooth cleaning and praise that behavior.
5. Assume the “knee-to-knee” posture. If you are sure you can successfully hold the child based on your previous experience in Step 2, hold the child face-to-face and place the child’s legs around your hips. Lower the child’s head onto the caregiver’s lap. Ask the caregiver to continue brushing the child’s teeth. While this is happening, observe the child’s mouth and teeth as much as possible as you supervise the tooth cleaning activity. If you are unable to complete this step, proceed to Step 7.
6. You should continue to lavish praise on the caregiver for appropriate behaviors or skills.
7. Reverse the position of the child by asking the caregiver to take the child from you and reproduce the position you have just completed. Say, “Give your child a hug now and put her/his legs around your hips.” Now gently lower the child’s head onto your lap (Figure 1). The parent/caregiver can assist you by holding the child’s hands as you complete the assessment.
8. Using the child’s toothbrush, quickly assess the child’s oral condition.
9. Use a dental mirror and continue to assess the child’s oral condition and record your findings.
10. Advise the parent/caretaker of oral findings and recommendations for follow-up. It is essential to specifically document areas where closer attention to detail in brushing must be exerted.
What Are We Preventing?
For many years, health- and childcare professionals have recognized a specific pattern of tooth decay in young children. This specific pattern of tooth decay was called baby-bottle tooth decay (BBTD). BBTD was believed to be primarily associated with the use of a bedtime bottle containing a beverage with natural or added sugars such as formula, juice, or Kool-Aid, and generally occurred between the ages of 12 to 18 months.
In recent years, similar cases of early and severe tooth decay have been found in children who do not fit the classic BBTD pattern of bottle use. In light of this, the term early childhood caries (ECC) is being used to reflect a broader concept of the problem of tooth decay in infants and young children. ECC includes cavities associated with any causative factors, including the continuous use of a sippy cup, at-will breastfeeding throughout the night, use of a sweetened pacifier, or where chronic illness requires the regular use of a sugar-based oral medication.
1. It develops rapidly. Progression from the enamel into the dentin occurs in 6 months or less.
2. It affects the upper front teeth first. These teeth usually erupt at around 8 months of age.
3. Primary molars, which begin to erupt at about 12 months of age, are the next teeth to be affected.
4. Finally, the lower front teeth are affected when the disease becomes very severe.
ECC is recognized as an infectious disease. Its extent and severity vary with cultural, genetic and socioeconomic influences. In order for dental caries to occur, three things must be present:
1. A harmful agent, such as the bacterial biofilms responsible for the disease.
2. A susceptible host (tooth).
3. The proper environment, ie, the presence of food and drinks that contain fermentable carbohydrates in sufficient frequency, such as natural or refined sugars.
The bacteria use the fermentable carbohydrates (sugars) to produce acid. The acid comes in contact with the tooth and slowly demineralizes the tooth. As demineralization continues, a caries lesion forms.
Because the above three “conditions” must be present for demineralization to occur, there are at least three opportunities for intervention: eliminate or reduce the bacteria through proper oral hygiene; make the tooth more resistant through the use of fluoride; or reduce the presence of fermentable carbohydrates by dietary changes. Oral hygiene and dietary changes require behavioral change on the part of the child’s family but using fluoride does not. Treatments can be applied to the child’s teeth at the dentist’s or pediatrician’s office. Optimal water fluoridation requires no effort at all on the part of the family.
Main Risk Factors to be Assessed During the Age-One Visit
Mothers or Family Members with Untreated Tooth Decay
Mothers or other family members with untreated caries have higher levels of bacterial biofilms in their mouths and tend to have children with high rates of decay because of the transmission of the bacteria to their children.17 Children are not born with high levels of bacteria that cause caries; they acquire the bacteria from their caregiver, usually their mother, through close proximal contact such as kissing, sharing eating utensils, sharing food, or cleaning off a pacifier by mouth. The period when a child is most susceptible to acquiring the decay-causing bacteria is quite short, beginning as early as 6 months and continuing through approximately 31 months. However, not all mothers have bacterial levels high enough to promote dental decay in their children. This is why it is important that caregivers of young children have good oral health and practice good oral hygiene habits.18 Evidence is emerging in this regard to more strongly support the notion of “maternal-child” oral health.
Poor Oral Hygiene Care for the Child
Poor oral hygiene care makes the infant/toddler susceptible to early childhood caries. It is important for parents or other caregivers to begin a routine of daily oral hygiene for their child as soon as the teeth first erupt.19 Plaque and fermentable carbohydrates that are left on the teeth are metabolized by bacteria to produce acid and new plaque.
The frequency and thoroughness of the child’s oral hygiene routine affects the level of bacteria in the child’s mouth. Parents and caregivers need to clean children’s teeth at least once a day. The time spent cleaning a child’s teeth will be very short, usually less than 2 minutes. It is easiest to do with two people, one to hold the child and the other to actually clean the child’s teeth. It can be done using a very small child’s toothbrush or by simply wiping the teeth off with a wet cloth, although a toothbrush positioned and used properly is preferred. There are several age-specific toothbrush products on the market today to help with oral hygiene compliance in children.
However, the quality of cleaning is just as important, if not more, than its frequency. Few children under the age of seven have the ability to clean effectively. While it is normal for children to want to do things for themselves, until a child is about 7 years old an adult needs to brush the child’s teeth for them at least once a day. Allow the child to brush his or her own teeth, but at least once a day, preferably at bedtime, an adult should carefully and thoroughly brush the child’s teeth.
A Diet High in Sugar and Fermentable Carbohydrates
Whenever teeth are repeatedly exposed over time to fermentable carbohydrates, the bacteria in the mouth metabolize the sugars and produce acid, which removes minerals from the tooth enamel.20 At first look, some foods may seem healthy and good for a child to have as snacks throughout the day. Many parents buy cereals, granola bars, and other healthy snacks because these products are thought to be low in refined or added sugars. They also select foods like raisins and fruit juices because they contain natural sugars and are full of vitamins and minerals.21 Neither food category would be appropriate to allow a child to snack on all day long without brushing the teeth. The fermentable carbohydrates in cereals, crackers, and granola bars will stick to the teeth. Some of these foods and all of the drinks are full of refined/added or natural sugars. Caries-causing biofilms do not distinguish between refined or natural sugars. The bacteria metabolize both natural and refined sugars, after which acid is formed.
Parents can be counseled to avoid foods (especially frequent use) that have a form of sugar listed as the first or second ingredient. If they do buy an item with a high sugar content, they should only allow the child to have it as a special treat, not as a regular part of their diet. Of course, as mentioned, effective oral hygiene can counteract some of the negative impact of high-frequency sugar load.
It is important to remember that every time the bacteria in the mouth are exposed to sugar, whether refined or natural, they produce acid; the more frequently a child eats sugar, the more frequently the teeth are exposed to acid. Parents can reduce the chances of their child’s developing cavities by limiting the frequency and amount of sugar their child consumes. Significant time must be spent during infant and toddler dental visits to review these facts with the parents.
Improper Bottle Feeding and/or Bottle Use After Age 1
A bottle may be used by a parent or caregiver to modify the child’s behavior by giving it during sleep time to stop the child from fussing or crying. Other methods of improper bottle-feeding include propping the bottle or giving the bottle to the child all day. This results in frequent exposure of teeth to sugar.22
Breastfeeding at Will Throughout the Night
The authors recommend and support breastfeeding. Breast milk by itself does not promote tooth decay more than other forms of fermentable carbohydrates. However, once a child starts to consume foods or liquids in addition to breast milk, the combination of breast milk and these other foods will promote tooth decay. As a result, once a child is starting to receive nutrition from sources other than solely breast milk, the child is potentially at risk of developing ECC. These children should not be allowed to nurse at will throughout the night. Babies should be removed from the breast when they are finished feeding, and the teeth should be cleaned.
Using Pacifiers Dipped in Sugary Substances
Some parents may give their children pacifiers dipped in a variety of different sweeteners. Giving children pacifiers dipped in jam, corn syrup, or sugar throughout the day results in frequent exposure of teeth to sugar, which is then metabolized by the bacteria to produce decay causing acid.23
Children with chronic illnesses or special healthcare needs may also be at increased risk of ECC. These children are at high risk for tooth decay because their medication may contain sugar. Parents should be advised that medications frequently contain significant concentrations of sugar. Also, certain medications, such as antihistamines, may cause decreased saliva production, causing the mouth to dry out. Saliva is important because it helps to cleanse the teeth of food particles and acts as a buffer for the acid produced by bacterial biofilms. Daily oral hygiene care for these children is very important because dryness also increases food retention on the teeth, gums, and throughout the mouth.
Certain Characteristics of Parents or Caregivers
These characteristics may affect the likelihood of ECC.24 Some examples of characteristics that may increase a child’s risk of ECC are:
-The single parent or caregiver overloaded with responsibilities so that the bottle is frequently used as a pacifier.
-Parents of children with special healthcare needs. They have added responsibilities because of the daily needs of their child and may be less likely to notice the early stages of tooth decay or know inappropriate feeding behaviors.
-Parents or caregivers with limited support from social services.25 Dental practices are in a good position to educate parents who may lack the knowledge to change unhealthy feeding practices, such as bottle propping or a bedtime bottle. If a parent has limited contact with the various social assistance programs, they may not receive the educational information needed to make healthier choices for their child.
-Families with a pattern of substance abuse. These families often neglect their children’s needs due to their substance abuse.
When ECC is in the advanced stages, it can cause significant pain for the child.
-The pain may prevent the child from sleeping or from being able to learn.
-The overall health of the child may be affected because of the chronic infection and high levels of bacteria in their mouth.
-He or she may be unable to eat the proper foods. The child may select soft foods because of the pain.
-Children with ECC may have problems pronouncing words and may develop incorrect language patterns because of missing teeth due to the extraction of teeth that have been severely affected by the disease.
-Children with ECC have an increased risk of decay in permanent teeth because of high levels of bacteria in their mouths.
-The child can feel self-conscious and uncomfortable about smiling as he or she gets older.
-The long-term effects of having high levels of dental decay can even affect their future abilities socially, in school, and in the workplace.
When a parent or caregiver says, “They are only baby teeth. They are going to fall out anyway,” you may want to inform them of the consequences of tooth decay and remind them that children do not usually start to lose their baby teeth until they are about 6 years old, and that the last baby teeth are not lost until the child is about 12 years old.
One of the first clinical signs of the presence of ECC is the white-spot lesion—usually first seen on the maxillary incisors.26 The development and location of white-spot lesions are linked to:27
-The eruption pattern of the teeth. The primary maxillary incisors are among the first teeth to erupt and, therefore, have a longer exposure to acid-producing bacteria.
-Bottle and tongue position in the mouth. The lower teeth are usually not affected because during sucking the tongue covers them.
-Decreased saliva flow while sleeping. During sleep, the flow of saliva decreases, allowing the sweetened liquids from the bottle to pool around the child’s maxillary incisors teeth for long periods.
White spot lesions represent ECC in its early stage. During the early white-spot stage, the condition can be reversed by using preventive measures such as professionally applied fluoride varnish, gels, and foams.
There are some developmental conditions that can look like early white-spot lesions. One can discern the difference between white-spot lesions and developmental imperfections in the enamel by the location and the time of their appearance on the tooth. Developmental imperfections occur during tooth formation and can be located anywhere on the tooth. Such imperfections will be present when the tooth erupts, while white-spot lesions will begin appearing several months after tooth eruption and will be primarily around the gingival margin.
As the condition worsens, white-spot lesions develop into larger caries lesions. The time frame from early decay to later decay can be as short as 6 to 12 months. At this point, the child may complain about toothache when extremely cold foods are eaten. As the caries process continues, the lesions will appear as brown/black collars around the gingival margin. The child will often begin to indicate the presence of pain.
The time frame from later to severe decay can be as little as 6 weeks. This is because once the decay penetrates through the hard outer enamel layer of the tooth and enters the dentin, it progresses very quickly.
Because ECC can start very soon after teeth erupt and progress quickly, it is very important to examine children’s teeth frequently and regularly in order to intercept any potential problems.28 How can ECCs be detected? One very important way to detect white-spot lesions before irreversible tooth decay develops is to simply look for the presence of early white-spot lesions.
Children should be examined for white-spot lesions frequently. Dental hygienists can educate the parent or caregiver to play an active role in the examination. Active participation by the parent or caregiver can be useful in the counseling process. Parents can be taught how to lift the lip of their child once a month to look for white spot lesions.
One method is age-appropriate guidance, which can be used for proactive counseling of parents or caregivers about the developmental changes that will occur in the child. Age-appropriate guidance should include the following:
-Information that can be passed on in age-appropriate pieces for easier understanding by parents and caregivers,29 organized so that each contact has a specified purpose and goal. This cuts down on repetition and allows time for understanding. Parents or caregivers will be better informed, more involved, and are able to absorb future information.
-Using age-appropriate guidance, the parent or caregiver can be counseled on how to prevent white-spot lesions. Recommend that they do not establish the habit of inappropriate feeding and comforting practices, such as prolonged bottle use after age 1, feeding on demand at bedtime with the bottle or breast, bottle propping, and extended sippy cup use throughout the day.
-A scheduled age-appropriate guidance format for parent counseling allows any hygienist or staff member to pick up the preventive and educational guidance.
-When children are identified with one or more of the risk factors for ECC, dental hygienists can focus counseling on the factors putting the child at risk.
-Remember, change on the part of the parent or caregiver occurs gradually over time. Counseling can be reinforced at each visit to identify and reduce parent or caregiver barriers to change.
For many years dental practitioners in the United States have used fluoride gels, foams, and rinses to stop and even reverse tooth decay. Another type of fluoride administration, fluoride varnish, has been used in Europe for over 30 years. In 1994, this type of fluoride became available for use in the United States. Clinical trials have shown caries reduction as great as 70%.30 The advantages of fluoride varnish are that it:
-does not require a professional dental cleaning before application
-is easy to apply
-takes little time to complete the process of application
-dries immediately on contact with saliva so there is a reduced probability of swallowing excess product
-is safe for and well tolerated by infants, small children, and individuals with special needs
-requires minimal training
Application Technique for Fluoride Varnish
If the patient is an infant, position yourself knee-to-knee with the parent. Place the infant on the parent’s lap with the infant’s head on the parent’s knees and the infant’s legs around the parent’s waist. Treat the infant from behind the head or place the infant on an exam table and work from behind the head.
If the patient is a young child, place the child in a prone or sitting position and work from above the head as with an infant.
Open the child’s mouth. Remove excess saliva from the teeth with a gauze sponge. Apply a thin layer of the varnish to all surfaces of the teeth (Figure 3). The varnish will thicken immediately once it comes in contact with saliva.
Tell the parent or caregiver that the child should eat a soft, non-abrasive diet for the rest of the day. Do not brush or floss the child’s teeth until the next morning.
Once the decay has progressed to the later stages, there are several issues that will affect the type of treatment provided to limit disability and restore function in the child’s mouth—the age of the child, the child’s behavior, the severity of the case, and the training of the parent or caregiver.
Children under 18 months of age are often treated using temporary methods to arrest the decay and to allow postponing treatment until the child is old enough to tolerate the deep sedation or general anesthesia needed for permanent treatment measures.
Most children under the age of three may be difficult to treat and may need to be referred to a pediatric dentist that specializes in treating very young children. Or treatment may have to be provided in a hospital setting where general anesthesia may be administered for the procedure.
The severity of the decay will determine the type of treatment the child receives. Teeth may be so badly destroyed by ECC that extraction is the only option.
Most cases of ECC can be prevented. It is not a genetic problem that we are unable to prevent. Children do not inherit cavities. ECC usually results from a lack of brushing and a poor diet. If discovered during the white-spot lesion stage, the progression of the disease can be halted and possibly reversed. Dental hygienists can work with the parents and caregivers of children identified as being at risk for ECC to develop the routines of daily oral hygiene, modified feeding and comforting practices, and diet. If discovered early enough, the progression of the disease can be halted and possibly reversed through the application of fluoride by either a medical or dental provider.
The age-one dental visit is a productive and extremely important component of total family dentistry. By scheduling patients appropriately and educating the family in oral health during the visits, a productive and effective program can be implemented.
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About the Authors
Joel H. Berg, DDS, MS, Lloyd and Kay Chapman Chair for Oral Health, Department of Pediatric Dentistry, The University of Washington, Seattle, Washington
Peter K. Domoto, DDS, MPH, Professor Emeritus, Department of Pediatric Dentistry, The University of Washington, Seattle, Washington


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Urinary incontinence is particularly prevalent, debilitating, costly and complex in the frail elderly. Frail older adults are at risk for detrusor underactivity (DU), a condition present in nearly 2/3 of incontinent nursing home residents. DU influences the clinical presentation and may impede therapy of acute urinary retention, chronic urinary retention, benign prostatic hyperplasia and detrusor overactivity. Detrusor Hyperactivity with Impaired Contractility (DHIC) is especially common and challenging. Its clinical management remains unsatisfactory since anticholinergic antispasmodic medications may worsen retention, while current DU treatments are ineffective. Presence of detrusor muscle degeneration, fibrosis and axonal degeneration defines DU in human bladder biopsies. Our goals will be accomplished via 4 Specific Aims:
AIM 1. Examine role of urinary retention in promoting bladder muscle loss, fibrosis and axonal degeneration, focusing on those pathways which may be shared with other risk factors, thus permitting the design of targeted interventions for DU, a complex multifactorial condition in the frail elderly. We propose that an atypical cytokine called MIF (macrophage migration inhibitory factor) is involved in the pathways by which urinary retention promotes muscle loss, fibrosis and axonal degeneration following MIFs release from abundant urothelial stores.
AIM 2. Examine role of estrogen depletion in bladder muscle loss, fibrosis and axonal degeneration, focusing on those pathways which may be shared with other risk factors, thus permiting the design of targeted interventions for DU, a complex multifactorial condition in the frail elderly. We propose that MIF is also involved in the pathways by which ovariectomy promotes muscle loss, fibrosis and axonal degeneration.
AIM 3. Examine the impact of aging on the ability of the bladder to respond to urinary retention or ovariectomy, focusing on those pathways which aging may share with the other risk factors, thus permitting the design of targeted interventions for DU, a complex multifactorial condition in the frail elderly. We propose that aging enhances the bladder's vulnerability to develop muscle loss, fibrosis and axonal up AIM 4. Examine impact of aging on the ability of the urothelium to function as a regulatory interface between physical, inflammatory and endocrine stimuli involved in muscle loss, fibrosis and axonal degeneration. We propose that the urothelium represents a regulatory site where physical, inflammatory and endocrine stimuli interact in influencing the synthesis and release of MIF and other inflammatory mediators. We also propose that with aging, non-epithelial bladder tissues assume an unexpected importance as a major source of MIF, shifting the locus of control away from urothelial cells.
|Smith, Phillip P; DeAngelis, Anthony; Kuchel, George A (2012) Detrusor expulsive strength is preserved, but responsiveness to bladder filling and urinary sensitivity is diminished in the aging mouse. Am J Physiol Regul Integr Comp Physiol 302:R577-86|
|Smith, Phillip P; Deangelis, Anthony M; Kuchel, George A (2012) Evidence of central modulation of bladder compliance during filling phase. Neurourol Urodyn 31:30-5|
|Smith, Phillip P; Kuchel, George A (2010) Continuous uroflow cystometry in the urethane-anesthetized mouse. Neurourol Urodyn 29:1344-9|
|Smith, Phillip P (2010) Aging and the underactive detrusor: a failure of activity or activation? Neurourol Urodyn 29:408-12|
|Duque, Gustavo; Kuchel, George A (2010) Moving beyond static body composition paradigms to assessments of change, plasticity, and function. J Am Geriatr Soc 58:377-9|
|Zhou, Xin; Fragala, Maren S; McElhaney, Janet E et al. (2010) Conceptual and methodological issues relevant to cytokine and inflammatory marker measurements in clinical research. Curr Opin Clin Nutr Metab Care 13:541-7|
|Taylor 3rd, John A; Kuchel, George A (2009) Bladder cancer in the elderly: clinical outcomes, basic mechanisms, and future research direction. Nat Clin Pract Urol 6:135-44|
|Taylor 3rd, John A; Ristau, Benjamin; Bonnemaison, Mathilde et al. (2009) Regulation of the prostaglandin pathway during development of invasive bladder cancer in mice. Prostaglandins Other Lipid Mediat 88:36-41|
|Kuchel, George A; Moscufo, Nicola; Guttmann, Charles R et al. (2009) Localization of brain white matter hyperintensities and urinary incontinence in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 64:902-9|
|Jacquin, Claire; Koczon-Jaremko, Boguslawa; Aguila, Hector L et al. (2009) Macrophage migration inhibitory factor inhibits osteoclastogenesis. Bone 45:640-9|
Showing the most recent 10 out of 12 publications

domain: literature


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Serology Blood Test for Viral & Bacterial Infections. The Serology section tests samples to gather the proof of fungal, viral and protozoal infection.
A serology blood test is carried out to identify and measure the levels of antibodies as a result of exposure to a certain bacteria or virus. When people are exposed to virus or bacteria their body’s immune system generates particular antibodies against the organism. Antibody levels help physicians decide if an infection appeared recently or some time ago.
Viral infections, bacterial infections and others can be diagnosed with the help of serological studies. At Apollo Diagnostics we test for blood-borne pathogens and examine blood specimens for vaccine preventable diseases, mosquito-borne diseases and diseases transmitted from animals to humans. The methods used by us produce high level of sensitivity and accuracy while yielding great quality results. DNA & Molecular Genetic Testing at Apollo Diagnostics. Antimicrobial Susceptibility Test. Medical Testing Laboratory. Biochemical Tests & Diagnosis. The Biochemistry division of Apollo Diagnostics is a new generation laboratory, totally equipped with the modern state of the art technology.
Biochemistry is the study of chemical and biochemical components in the body for the preventing, diagnosing and managing of the disease. The division of clinical biochemistry at Apollo Diagnostics provides a comprehensive clinical laboratory services in the extensive domain of clinical chemistry, therapeutic drug monitoring, endocrinology and clinical toxicology.
Diseases like diabetes, heart attacks, infertility, thyroid problems, cystic fibrosis and meningitis can be diagnosed by the examination of body fluids including blood, urine and CSF. With exceptional equipments we not only perform the regular biochemical tests for patient care but also execute an array of investigations. Diagnostic & Laboratory Services - Apollo Diagnostics. Diagnostic Center & Pathology Laboratory in India - Apollo Diagnostics. Apollo Fertility. Apollo Fertility. Infertility has turned out to be a major problem for most of the couples these days.
However, the fear of abandonment lies in the partner who may think it is due to him or her. Women may feel less feminine, and men may feel that they are less masculine when the problem arises. Do not worry as we are here to help you out! While looking for the treatment for infertility, you may be at high levels of stress. We can help you in decision-making and manage stress through counselling. You may wish to approach your independent counsellor either alone or with your partner. Know about Surrogacy Services in India - Apollo Fertility. When you cannot carry a pregnancy because of a problem with either of your uterus or general health, then you can opt for the surrogacy program.
You can have a child with the help of a surrogate mother. The surrogacy process involves carrying a baby through pregnancy on behalf of another woman or a couple and then returning the baby to the intended parents after the delivery. Requirements to be a surrogate mother If you wish to be a surrogate mother, you should fulfill the following criteria: Have delivered a child of their ownIf delivered a baby recently, you should wait 3 months after a vaginal delivery or 6 months after a C-sectionAge between 21-39 yearsPhysically and psychologically healthyBody mass index not more than 34Should not smoke, take alcohol, or illegal drugs Components of the Surrogacy Program Treatment costs Treatment costs vary depending on the individual arrangements.
Important points to consider Surrogacy program is associated with many legal problems. Egg Donation Centre India - Apollo Fertility. Finding a Sperm Donor from a trusted Sperm Bank can be a big trouble these days.
But at Apollo Fertility, Donor program is conducted as a part of the fertility treatment and can help many who are unable to become parents naturally. There are two donor programs, namely egg donation, and sperm donation. People may choose to use donor sperm for a variety of reasons. If the male partner is sterile and therefore unable to provide a sperm sample for use in intrauterine insemination (IUI) or in vitro fertilization (IVF), single women and lesbian couples who want children may take advantage of donor sperm to help them have the children they want. ICSI, Intracytoplasmic Sperm Injection Procedure for Infertility. Best IVF Treatment & Procedures in India - Apollo Fertility. What is In Vitro Fertilisation (IVF)?
IVF Treatment is an assisted reproductive technique in which eggs are collected from your ovaries and fertilized with the sperm in a specialized laboratory. The fertilized egg (embryo) is allowed to grow in a protected environment for some days before being transferred into the woman’s uterus increasing the chance that a pregnancy will occur. Intrauterine Insemination at Apollo Fertility. What is Intrauterine Insemination Treatment?
Intrauterine insemination treatment (IUI Treatment) is one of the commonly used assisted reproductive procedure. Normally, the sperms swim through the female reproductive organs (cervix and uterus and fallopian tube) to reach the egg. Hysterosalpingography Fertility Test at Apollo Fertility. HSG Test or Hysterosalpingography, or uterosalpingography is a medical test performed by a trained professional expert to evaluate the condition of your uterus and fallopian tubes. A contrast medium is injected into your uterus, and an X-ray is taken to determine if the cavity is normal and ensure that the fluid spills out of your fallopian tubes. This fluid usually contains a chromatic dye which accounts for easy detection. As such, X-ray contrast is a process in which a substance like air or metal like barium is used to obtain the contrast of an image through radiography.
A positive contrast medium absorbs X-rays more strongly than the tissue being examined. On the other hand, a negative contrast medium absorbs X-rays less strongly. Best Fertility Treatments & Services - Apollo Fertility. When do you know that you should visit a fertility clinic?
If you are unable to conceive even after frequent participation in unprotected sexual intercourse for one year, you might be having some problems related to fertility. Such condition is known as infertility. Either of the partners or both the partners might be infertile. Approximately 30 million couples in India are facing fertility problems, and this number is increasing tremendously. You can walk into Apollo Fertility at any time. We offer complete range of investigations and procedures that will support us in getting to know root cause of the problem. Apollo Fertility has been able to give many couples the reason to be happy. Best Fertility Hospital & Infertility Treatment Centre India - Apollo Fertility.

domain: medical


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Check Out These 8 Tips on Good Sleeping Habits for French Bulldog Puppies
All puppies need routine and structure to help them to grow into happy well-adjusted dogs with even temperaments. In fact there are different structures depending on whether you are training for a feeding routine or house training routine. This article will just tackle the sleep schedule as a way of helping you and your puppy adjust to living together.
Needless to say sleep is essential for healthy growth, and puppies are no exception. They can sleep up to 18 hours a day, and in their waking hours be bursting with excitable energy. The large amount of sleep is essential to the development of their muscles, brain and immune system.
When awake, puppies burn a lot of energy; learning about their new environment and experiencing how to interact with both humans and other animals. And like children, they wont always be aware of when they are over tired and need time out to rest.
The following are a few helpful tips you can use as a sort of guideline to help you create a healthy napping and night-time sleeping routine.
- Recognize an ‘overtired’ puppy. This may be when playful fun starts to turn into mischievous behavior like being hyperactive, and not listening to commands. Alternatively, the opposite may be observed, like excessive panting and drinking more water than normal. Whichever it is, you need to be observant and ready to stop and guide him to their rest area and encourage them to settle down.
- Show your puppy where to rest. This may be their bed, or it may also be a special spot on a cushion that they will identify as being a quiet place for napping. It may take a while for your puppy to get the idea, but eventually they’ll recognize that spot as the place for rest.
- Do not disturb! This is sometimes the hardest thing to do, especially if there are children in the household who will want to keep petting and cuddling the puppy. Everyone needs to learn to leave him alone and let him wake up naturally. Remember that when he does wake, he will very likely need to go outside to do his business.
- Follow a daily routine. Plan your puppy’s day so that an active time is followed by a quite time to sleep. This is particularly important after a walk or outing to the park. Every puppy is different. Some will nap for 30 minutes while others may sleep for up to 2 hours. All of this sleep is healthy and normal.
- Tips for making puppy beds. Resist the temptation to spend big on getting the best bed. It’s not necessary, and they will likely chew it up anyway. Find a couple of old blankets to line the base of their bed. Soft felt blankets are ideal. Just be aware not to use old wool blankets, as these may be chewed into long strings that can become a choking hazard. The same goes for soft toys. Make sure they are sturdy and cannot be broken up into small pieces that he could choke on.
- Find a quiet sleep area. Some owners like to have their puppy’s bed in their bedroom. If you do, then just make sure that it’s a dimly lit quiet space.ie: no loud TVs. This environment will be your puppy’s cue to relax and sleep. If the puppy’s bed has high sides, another idea is to put a blanket across it like a cover. This creates more of a comfy den-like environment to help them sleep.
- Tricks and Treats. Part of a typical routine would be to make sure they have their walk or exercise before sleeping. Also make sure have a chance to go to the bathroom either during their walk or just after some exercise. Reward him with a treat for getting into bed. That is all part of the routine. It’s really just trail and error, as some puppies will learn routines faster than others. So, just be prepared for some whining or getting up again in the beginning. If that happens, lead him patiently back to his bed again. Eventually, he will go there without any prompting.
- There will be interruptions. Always keep in mind that puppies are learning. Sometimes, they may wake up and need to go outside again during the night. This interrupts your sleep routine, but you need to understand it’s a phase you just need to deal with rather than let it get you upset. If they need to go, then take them outside and speak to them gently. When they’ve finished, then put them right back to bed again.
Need more help with your puppy? Check out our recommended dog training program here.
The most important thing is to not be overwhelmed by the whole process. It seems like a lot of hard work, but you’ll end up with a happy puppy that will come to enjoy the routine, too. Remember, this is the time for developing loving bonds that will last a lifetime.
Related Info And Products:
- Tips To Managing 3 Common Bad Habits With French Bulldog Puppies
- Why Is My French Bulldog Sleeping So Much?
- Do French Bulldog Puppies Sleep A Lot?
- Why Is My French Bulldog Puppy Breathing Fast While Sleeping?
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- Sleeping French Bulldog
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- Why Does My French Bulldog Breath Fast When Sleeping?
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- Why Obedience Training For French Bulldog Puppies?
- How To Sell French Bulldog Puppies?

domain: pet


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Monday, October 2, 2017
Time for Ol' Slim in the Garden
Scarecrows of Slim's sort have been keeping the crows away for centuries, and have had a spooky presence in literature for nearly as long. A Japanese book written in the 700's tells the story of an all-knowing scarecrow deity, Kuebiko. Closer to home, Nathaniel Hawthorne's 1852 story "Feathertop" is about a witch who casts a spell on a scarecrow, bringing him to life in order to woo the young daughter of a rival. And, of course, a scarecrow plays a major role in L. Frank Baum's tale The Wonderful Wizard of Oz, although that scarecrow is notably less menacing.
Down through the years, the scarecrow's primary job was to act as a wildlife deterrent, but it's not hard to see how they began moonlighting in horror fiction. The overall image of a dead man hanging on a pole in the middle of a field is as fertile ground for the imagination as the soil beneath it is for corn.
These days, commercial farmers still use scarecrows, of a sort, but they are now more typically hanging mylar curtains that move in the breeze and reflect sunlight or mechanical devices that issue a loud sound at irregular intervals. The mannequin-style scarecrow has largely been relegated to seasonal decoration or as a nostalgic throwback for small-scale farmers and gardeners. For me it has become one of the cherished rituals of autumn, along with Indian corn and pumpkins.
John's weekly rural lifestyle column FIELD NOTES is now available as part of the Speckled Paw Newsletter. You can sign up to receive thi...
If you were alive in the mid-70s, you probably owned or knew someone who owned a mood ring. These cheesy accessories featured a stone whic...
Thirty-nine years ago this month, the teachers of Port Clinton City Schools went on strike. They wanted better pay--shocking, I know--and ...


This post has been updated.
President Donald Trump has denied a rumor voiced by Congresswoman Jackie Speier (D-San Mateo) that he intends to fire special counsel Robert Mueller before Christmas.
After returning to the White House from Camp David on Sunday, Trump was asked if he was considering dismissing the man investigating whether there was collusion between the president's Republican presidential campaign and Russian officials, according to the Associated Press.
He answered, "No, I'm not," and did not elaborate further.
Speier told KQED Newsroom on Friday that she believes Republicans are trying to shut down the House Intelligence Committee’s probe into alleged Russian interference in the 2016 elections.
"I believe the president wants all of this shutdown," Speier said when asked if she believed House Republicans were bowing to pressure from the White House. “The rumor on the Hill when I left yesterday was that the president was going to make a significant speech at the end of next week. And on Dec. 22, when we are out of D.C., he was going to fire Robert Mueller."
Speier said if the president did fire Mueller, it would cause a constitutional crisis.
"That is Saturday massacre 2.0," she said, referring to President Richard Nixon ordering the firing of Archibald Cox, the special prosecutor investigating the Watergate scandal. “Without a doubt there would be an impeachment effort.”
A spokeswoman for Speier said the congresswoman shared the rumor to put pressure on Trump not to fire Mueller.
On Saturday, White House special counsel Ty Cobb told CNN that no such plans exist:
"As the White House has consistently said for months, there is no consideration of firing the special counsel," Ty Cobb, the White House special counsel, told CNN in a statement.
You can see the full interview with Speier below:
Trump cannot fire Mueller directly but could instruct Deputy Attorney General Rod Rosenstein who oversees Mueller's investigation to do so. Rosenstein told members of the House Judiciary Committee this week that he would only fire Mueller for "good cause," which he says does not yet exist. Rosenstein also told the committee that no one, including President Trump, has asked him to fire Mueller.
Fellow California representative, Adam Schiff (D-Los Angeles), voiced concerns similar to Speier's about the Russia investigation on Twitter on Friday.
Schiff, who also sits on the House Intelligence Committee, says that no witnesses have been scheduled after next Friday, and that dozens of outstanding witnesses have not been contacted. He tweeted that there will be interviews next week, but they will be held out of state while important votes will be keeping members of Congress in Washington D.C.
When rumors swirled earlier this summer that Trump could fire Mueller, two bipartisan bills were introduced in Congress to make that more difficult by allowing a panel of three federal judges review any decision to fire a special counsel.
This is the latest chapter in Mueller's monthslong investigation that has produced inflamed rhetoric on both sides of the political aisle.
Mueller was appointed by Rosenstein in May to oversee the Justice Department investigation into Russian meddling in the 2016 election and possible ties to associates of Trump. In October, Mueller indicted Trump's former campaign manager Paul Manafort and his business associate Rick Gates for several counts stemming from the investigation including conspiracy against the United States.
A few weeks earlier, George Papadopoulos, who had served as a foreign policy adviser to President Trump's campaign, pleaded guilty to lying to the FBI about meeting a professor with Russian ties who had promised to provide "dirt" on Hillary Clinton.
Earlier this month, former National Security Adviser Michael Flynn also pleaded guilty to lying to the FBI about his contacts with the Russian ambassador after the election but before Trump took office. Mueller says Flynn is cooperating with his investigation. The next day, it was reported that Mueller had removed a member of his team who had exchanged anti-Trump text messages with another member of the team during the summer.
That incident has led to increase calls from Republicans that Mueller's probe is politically motivated. Earlier this week, Florida Rep. Matt Gaetz said that Mueller should be fired and called on other congressional Republicans to do the same.
The Associated Press contributed reporting to this story.


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Walking Tel: 0114 2881864
The Trans Pennine Trail and the Timberland Trail pass through Wortley, allowing walkers to enjoy miles of traffic free walking.
For more details on the trails and local walks see the following websites:-
- Stocksbridge walkers are welcome website has some excellent walks, some are less than a mile from the guesthouse.
We have a number of local walking guides and a book of walks around Wortley.
We have drying facilities available for our guests.
Dogs and their owners are welcome to stay in the Guest House.

domain: travel


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We had so much fun with the 30 Days of Roses Challenge that we developed a weekly challenge for painting landscapes. Learn simple painting techniques for trees, water, and clouds. Make decisions confidently as you paint along with David in this new series of landscape painting exercises featuring Heritage MultiMedia Acrylics. We are uploading a new video every week for the next 12 weeks. Want to paint along?
Find the Challenge on Youtube: David Jansen YouTube Channel
Download a study photo here: Landscape Painting Challenge at Jansen Art Online
Heritage MultiMedia Acrylic Colors
Naphthol Red Light
Special Statement about Packaging
Due to recent disruptions in our supply routes, we are employing new packaging solutions. For some colors, you will find a jar of paint in your order instead of a tube. Do not worry- the paint is the same, and the quantity is in your favor. Regular sizes will return in the upcoming months.

domain: hobby


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leek design, perfect picture and sound quality; this is Frame by Samsung. But, what we like best of Frame by Samsung is that when switched off it doesn’t look at all like an ordinary TV. Rather, the painting of our dreams.
- What is it? The Frame by is the new 55 x 65 inch screen TV by Samsung
- What is special about it? When The Frame is switched off it looks like a real painting. It’s up to you to pick the image (you can choose between landscapes, architecture, iconic paintings and photographs), and The Frame automatically adjusts nighttime and daytime intensity. It’ll be just like having bought a new painting.
- How is it made? When switched off, smart technology turns The Frame into a proper painting. In fact, you just need to switch the Arte mode on to chose between over 100 different paintings by 37 famous artists, and see one instead of the standard black screen. The Frame is also fitted with Invisible Connection, an optic cable which gets rid of exposed cables hanging from the back; and with No Gap Wall-Mount, a bracket which finds the perfect position for the TV and reduces the empty space between wall and TV screen. Plus, The Frame can be customized with frames available in various colours.
- Who is it by? Born in 1967, Swiss designer Yves Behar says: “Design doesn’t aim to show the future, on the contrary it takes us to the future”. Founding member of Fuseproject (innovative user experience aimed at evoking different emotions by depicting various brands), Yves has a multidisciplinary approach to his work, blending innovation with emotion.
- We have chosen it because… With The Frame, you can choose your favourite painting just by clicking on it, replacing the standard black screen. And when you fancy a change, you can pick another image or frame. Nothing beats having the painting of your dreams right in your living room.

domain: artistic


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Development of Tourism Statistics and Tourism Satellite Account in Oman
The World Tourism Organization (UNWTO), in collaboration with the Ministry of Tourism of Oman, organized a Workshop on the Development of a Tourism Statistics System for Ministry officials and all related stakeholders, in addition to technical sessions on measuring tourism employment and investment in tourism. These workshops were conducted within the framework of UNWTO’s project for the Development of Tourism Statistics and Tourism Satellite Account (TSA) in Oman which started in 2015 and is scheduled to be completed in 2018 with the compilation of a Tourism Satellite Account for the country.
The overall objective of the project is to develop an accurate and organized Tourism Statistics System to help develop the tourism sector in all its aspects of tourism policy, planning management marketing and promotion.
The workshop was inaugurated by H.E. Ahmed bin Nasser bin Hamad al Mehrzi, the Minister of Tourism of Oman, and attended by Ministry officials and representatives of all related stakeholders of the tourism industry, including National Statistical Office, Royal Oman Police, Central Bank and all other users and compilers of tourism statistics.
The aim of the workshop was to provide capacity building in understanding the essential aspects, definitions of concepts and terminologies, and methodologies in developing tourism statistical systems and to encourage and promote the exchange of information, knowledge and expertise among stakeholders to promote consistency in approaches and methodology.
Related link: http://www.muscatdaily.com/Archive/Oman/MoT-UNWTO-workshop-focuses-on-various-statistical-aspects-52wy#.WZoRbCh_mh4.email


Albedo Telecom - AT-2048
- Designed and manufactured in Europe using the latest technology
- Rugged design with the highest ‘full colour’ screen resolution of 480 x 272 pixels and permanent SoftLED’s
- Supplied with NiMH batteries as standard giving up to 10 hours field use
- Latest connectivity with 2 x USB, 1 x Ethernet, 1 x SD and RJ45 Balanced on R
- Most comprehensive Datacom interfaces RS232/V.24/V.28, X.21/V.11, V.35, V.36, EIA-530, Drop & insert Datacom in E1
- Wander Generator: TIE, Freq. offset, Freq. drift, MTIE, TDEV
- Supplied with Cisco data cables for ultimate quality
Item code: 157103
If you have a technical question, please ask it here. Your question will be answered by an engineer.
|Albedo Telecom - AT-2048 - 1|
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One-button band collar. Pleated bib. Hidden buttoned front. White faux-vest with buckled strap. Long sleeves with French cuffs. Cotton. Imported.
Flat-front tuxedo pants with satin side stripe. Zip fly with hook closure; belt hoops. Slash pockets on hips; welt pockets on back. Slim fit; straight leg. Virgin wool. Made in Italy.

domain: design


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India's Minister of Health, Harsh Vardhan, acknowledged that the government of Narendra Modi has cancelled a railway contract with the Chinese firm in retaliation for a bloody clash in Galvan Valley where 20 Indian soldiers were killed by the People's Liberation Army of China on Monday. The revelation comes hours after an Indian Railways official denied that the contract had been cancelled due to border tension.
"Termination of 470-cr ($62.8 million) contract by @dfccil_india (Dedicated Freight Corridor Corporation of India) with the Chinese company is a first salvo to teach a lesson to those who have harmed our honourable soldiers of Indian Army," the Indian minister, Harsh Vardhan, tweeted.
Termination of 470-cr contract by @dfccil_india with the Chinese company is a first salvo to teach a lesson to those who have harmed our honourable soldiers of @adgpi— Dr Harsh Vardhan (@drharshvardhan) June 18, 2020
Congratulations to @RailMinIndia under @PiyushGoyal ji for taking a leap towards ensuring Swadeshi everywhere 👍 https://t.co/jGdAEtNMKx
Earlier in the day, Indian Railways terminated a contract valued at some $62.8 million with the firm Beijing Signalling & Telecommunication, citing “slow progress” in the work.
"In view of poor progress, it is decided by the Dedicated Freight Corridor Corporation of India (DFCCIL) to terminate the contract with Beijing National Railway Research and Design Institute of Signal and Communication Group Co Ltd", DFCCIL, India’s Ministry of Railway unit said in a statement on Thursday.
The project, allocated in 2016 to the Chinese company Beijing National Railway Research and Design Institute of Signal and Communication Group, was meant for signalling and telecommunications work along the 417-km Kanpur-Deen Dayal Upadhyaya rail traverse.
India and China have been in a border standoff in the Galwan Valley and Pangong Tso since late April. Tensions abruptly escalated following an armed confrontation between the countries’ troops in the Galvan Valley of India's Ladakh region on 15 June.

domain: news


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AUGUST 20 UPDATE: Now on another round-Britain cruise with an identical itinerary, Lirica has moved Friday’s (August 24) planned call at Oban to the port of Greenock and the more sheltered waters of the Clyde. The weather forecast for Friday suggested that tendering ashore at Oban would be uncomfortable to say the least, if not impossible.
High winds in south-west Ireland yesterday put paid to a cruise ship’s planned visit to Cobh – the last port of call made by Titanic on her ill-fated maiden voyage.
The town, near Cork, has a museum commemorating the ill-fated liner’s visit and the sinking of RMS Lusitania, torpedoed by a German U-boat with the loss of almost 1,200 lives in 1915.
But 2,000 passengers on a round-Britain cruise aboard MSC Lirica were unable to go ashore as the captain decided stormy seas would make berthing impossible. The ship spent an extra day at sea en route to Amsterdam, where people scheduled to join it in Cobh will be flown in time for tomorrow’s arrival.
Lirica has visited Edinburgh, Invergordon, Stornoway, Kirkwall and Oban during its current voyage, and on Tuesday was in Dublin. The non-arrival in Cobh deprived passengers of the opportunity to kiss the Blarney Stone or visit the nearby whiskey distillery.
Yesterday’s weather also closed a wildlife park near Cobh and led to the cancellation of an open-topped bus tour of Dublin for Ireland’s homecoming Olympic athletes.


Sharing platform with his Chinese counterpart, Defence Minister Rajnath Singh Thursday said that maritime security, cyber-related crimes and terrorism and threats to the rules-based order are some of the main challenges that ASEAN as a forum has to address. Singh also asked for a collective and collaborative effort to fight against Covid 19.
Speaking at the meeting of the defence ministers of the Association of Southeast Asian Nations (ASEAN), called the ASEAN Defence Ministers’ Meeting (ADMM+), Singh said that “our ability, to collectively respond to challenges in the region based on the fundamentals of freedom, inclusivity and openness will define our future.
“Threats to the rules-based order, maritime security, cyber-related crimes and terrorism, just to name a few, remain the challenges that we need to address as a forum,” Singh added.
The Defence Minister said that “amid the current regional environment with visible strains, we appreciate the central role of ASEAN-led forums, including ADMM Plus in promoting dialogue and engagement towards a pluralistic, cooperative security order in Asia”. He further said that the ADMM Plus, “has grown in the last decade to become the fulcrum of peace, stability and rules-based order in this region”.
Defence Minister Rajnath Singh addresses during the 10th anniversary of the founding of the ASEAN Defence Minister Meeting Plus (ADMM Plus) at Hanoi in Vietnam, via video conference, in New Delhi, Thursday.
The joint statement on Advancing Partnership for Sustainable Security in 2019, which reflected the commitment of the ADMM Plus Defence Ministers to the maintenance of regional peace, stability and security.


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Taken last weekend, the sun was extraordinarily orange, likely due to haze in the skies from wildfires burning to Colorado’s west. It was amazing how it lit up the sky above and the landscape below.
Lacking motivation to go far for photos one day last week, I made a last minute decision to stick close to home. That turned out to be a good thing as I was able to capture a gorgeous sunrise just a few miles from home. At the lower elevations of Colorado, stunning sunrises and sunsets are more common than not and it is easy to take them for granted.
Boy, I could almost flip this image and you wouldn’t know. That sunrise reflection on the water is pretty darned close to a perfect mirror of what lies above. Last week I took a day off to go do some critter viewing. That part of the day did not go so well as once the sun rose it was overcast and animals were elusive.
However, the one saving grace was the way the day started – with this amazing scene on Colorado’s Great Plains. That was topped by the fact I was with my photo buddy, my son, who made sure to remind me when we were viewing this to put the camera down for a while and just take the scene in. A wise young man he is.
My photo excursion on this day didn’t pan out quite as I wanted with worthwhile targets proving to be elusive. The one saving grace was the way the day started – with this amazing scene as the sun began to creep over the horizon.
The brilliant yellows, oranges and reds above would have been cool enough but throw in the same thing reflected on the calm waters of a lake and it was pretty awesome. Here in Colorado the mountains get most of the press but I have seen far more stunning sunrises and sunsets at the lower altitudes to the east.
Air temperatures just below freezing, wind chills near zero. Not a particularly hospitable morning when I captured this scene a couple of weeks ago. However, it was absolutely gorgeous and I relished standing there and watching the sun rise over the frozen lake. Average temperatures here are starting to warm up and that ice will gradually begin receding. In another month or so it should be relatively ice-free and then it becomes a haven for a wide variety of birds.
No, it wasn’t blazing orange like many of the sunrises we get here but I found it no less beautiful. The pastel colors on the horizon giving way to the deep blues of the still dim sky above had a subtle elegance unto itself. Taken this past Sunday at the Rocky Mountain Arsenal National Wildlife Refuge near Denver, Colorado.
One of the first few pictures I took this new year. While waiting for the golden rays to illuminate any nearby critters, I stopped and soaked in the gorgeous scene unfolding to my east. As the sun crested the hill, it lit of the grasses and mullein plants making for a pretty scene right at the first dawn of 2017.
Kind of a cool scene that unfolded yesterday morning in Adams County, Colorado. Low clouds were on the horizon as the sunrise began but they were not very thick allowing you to look right at it and the sun almost looked like a full moon.
I figured those colors were a good omen for tonight’s game between the Denver Broncos and the Kansas City Chiefs. 😉
My son and I were up and at ’em before the sun this morning as usual and ended up at the Rocky Mountain Arsenal National Wildlife Refuge. There, on the shores of Lake Ladora, we watched a beautiful sunrise unfold. Here in #Colorado we almost take these scenes for granted as more often than not, our days begin and end with this kind of beauty. Go Broncos!
This is one from a month ago that I kept forgetting to share. Taken early one morning at the Rocky Mountain Arsenal National Wildlife Refuge. The sunrise was absolutely gorgeous – as they oftentimes are on the Great Plains – and the golden light illuminated the fall colors of a roadside cottonwood tree. It all made for a very pretty scene.

domain: geography


text:
SAN LEANDRO (CBS SF) — He’s only in grade school, but he’s already mastered the piano.
San Leandro resident Christopher Nguyen, 7, can be seen charming passing Oakland International Airport travelers with his electrifying piano-playing skills.
Using a digital keyboard, he said the airport is just another place for him to practice. And the money he gets from tips? It goes toward college tuition, piano lessons for his siblings, and what he’s really hoping for — a grand piano.
The third grader, who has been playing for two years, said he got so good, so fast because “I read the notes.”
Maggie Nguyen, Christopher’s mom, said he was listening to music in the car when he first started calling out notes.
“My husband was like ‘What is that? Is he doing the right thing?'” she said. When they went home, they tested it out, and sure enough, Christopher had identified the right notes.
VIDEO: Christopher playing his favorite song, “The Nutcracker”
[display-posts category=”trending” wrapper=”ul” posts_per_page=”4″]


text:
Jeremy Corbyn, leader of the U.K.’s opposition Labour Party, lashed out at Morgan Stanley on Thursday after the bank warned of the risk to investors of him winning power.
Graham Secker, an equity strategist at the bank, said Monday that the possibility of a Labour government should concern equity investors more than Britain’s departure from the European Union, scheduled for March 2019.
“When they say we’re a threat, they’re right. We’re a threat to a damaging and failing system that’s rigged for the few,” Corbyn said in a video message released on social media. “These are the same speculators and gamblers who crashed our economy in 2008 and then we had to bail them out. Their greed plunged the world into crisis and we’re still paying the price.”
Corbyn has pledged to renationalize Britain’s railways as well as water and energy companies to reverse the privatizations started under Conservative Prime Minister Margaret Thatcher. Secker warned that the implications of a Labour government could be significant, particularly for companies in the utilities, postal services, telecommunications, financials and defense sectors.
“If I am a U.K. equities fund manager, I am more concerned about a potential change in the domestic political government than I am about Brexit,” Secker said at a briefing Monday. “You need to think about tax rates going up, about nationalization, about an economic system which has favored capital over labor for last 10 to 20 years shifting to favor labor over capital.”
Corbyn, whose populist campaigning and raft of redistributive socialist policies erased Prime Minister Theresa May’s majority in the June general election, used his message to stoke the sense of grievance among people struggling to get by while bankers pay themselves big salaries.
The Labour leader accused May’s Conservatives of allowing Morgan Stanley to become too close to policymakers and said Chancellor of the Exchequer Philip Hammond has met with its executives four times in the last year. People with links to the bank have also given large donations to the Conservatives, he said.
“The Tories used the aftermath of the financial crisis to push through unnecessary and deeply damaging austerity. That’s meant a crisis in our public services, falling wages and the longest decline in living standards for over 60 years,” Corbyn said. “Nurses, teachers, shopworkers, builders, just about everyone is finding it harder to get by, while Morgan Stanley’s CEO paid himself 21.5 million pounds ($29 million) last year and U.K. banks paid out 15 billion pounds in bonuses.”
While the next election isn’t scheduled until 2022, speculation that Tory infighting could cause the collapse of May’s government and trigger an early vote has seen business leaders courting Labour as a potential government-in-waiting.
A Labour official said last month that approaches from business leaders or their lobbyists have soared since June’s election, in which Corbyn unexpectedly delivered his party’s best showing since Tony Blair in 2001. The new focus reflects concern among executives that Tory divisions over Brexit and May’s electoral failure put her government on borrowed time.
Even economy spokesman John McDonnell, who was criticized by some in his own party for saying “there was a lot to learn” from Karl Marx’s “Das Kapital,” is being courted by big business. Some lobbyists say access to McDonnell has become the top demand from their clients.
BlueBay Asset Management LLP, which manages $57 billion of assets and is among investors that are speaking to the opposition party, was scheduled to meet McDonnell this week.
“It’s not a surprise there is a swing toward redistributionist policy” because living standards in the U.K. have fallen, Mark Bathgate, a portfolio manager at BlueBay said last week. “Whether it’s good or bad is not for us to decide. We’re making sure we engage with a prospective government.”

domain: economics


text:
Filmmakers speak of crowdfunding as if it is free money. It isn’t. In some instances it isn’t even close to being so.
In Indie Film, where filmmakers are routinely asked to take blood from a stone, you’d think the costs would leap from everyone’s tongue.
So what platform, puts the most money into your pocket? Well, the answer ain’t so easy.
As this is now the era of the six figure crowdfund raise, the answer is a combination of low fees and high user base. How many campaigns truly open up beyond the friends and family base?
The hard facts are a little easier to come by. Costs, in ascending order:
Kapipal • Currently no fee + PayPal processing fee (~2-4%), (must use PayPal, Italian)
IndieGoGo • 4% fee if you make your goal, 9% otherwise, +3% credit card processing fee
Kickstarter • 5% fee, +3-5% credit card fee (only funded if you make your goal)
Eppela • 5% fee + PayPal processing fee (~2-4%), (must use PayPal, only funded if you make your goal, Italian)
RocketHub • 4% fee if you make your goal, 8% otherwise, +3-5% credit card fee
SoKap • 5% fee, 10% fee on product sold via their marketplace, +3% credit card fee
United States Artists • 15% fee + 4% credit card fee


text:
I’m an Art Director with over 5 years of experience based out of New Delhi, India. My work experience ranges across ATL, BTL and digital/interactive media. I’ve worked for premier brands like Kingfisher, Chevrolet India, Bentley, Lamborghini, Hewlett-Packard, Microsoft, Coca-cola, Pepsico India, Airtel, Diesel Jeans amongst others, in reputed agencies like Percept H, Webchutney and Quasar.
I’m presently working as an Art Director at Webchutney Studio Pvt. Ltd., India’s leading full service digital agency.
I wish to work in an esteemed organization like yours.
I look forward to an opportunity to present myself as a deserving candidate for the post of an Art person. Therefore, I'm submitting my brief profile to you.
Hoping to hear from you soon.
Thanks & regards,


text:
Wednesday, April 23, 2014 12:33 AM
(NYSE: AGN) confirmed yesterday that it has received an unsolicited proposal from
Valeant Pharmaceuticals International
(NYSE/TSX: VRX) to acquire all of Allergan’s outstanding shares for a
combination of 0.83 of Valeant common shares and $48.30 in cash per
share of Allergan’s common stock.
Wednesday, April 23, 2014 12:31 AM
A good turnout in Bari for three days of professional and scientific development
Wednesday, April 23, 2014 12:28 AM
A conceptual model that plays with vision
Wednesday, April 23, 2014 12:27 AM
NEW YORK—Services will be held today for Thomas R. Maskery, Jr., 52, who passed away on April 18, after a long illness.
Wednesday, April 23, 2014 12:25 AM
An important milestone for the company that has kept pace with memorable, economic and social transformations
Wednesday, April 23, 2014 12:24 AM
, along with
Perry Ellis International
have announced the renewal of their Original Penguin eyewear license.
The renewal will span five years and includes optical eyewear, optical
sunwear and retail sunwear.
Wednesday, April 23, 2014 12:21 AM
(Nasdaq:TEAR) announced the appointment of Paul Smith to its senior
management team in the newly created position of vice president,
Wednesday, April 23, 2014 12:18 AM
Essilor of America
is launching a national advertising campaign to introduce consumers to
the benefits of progressive lenses and the technology behind
Wednesday, April 23, 2014 12:15 AM
MADISON, Wis.—The Great Glasses Play Day, a volunteer event intended to
celebrate and unite children who are glasses-wearers or are otherwise
visually impaired, is calling on ECPs and the public to join in
commemorating the third annual initiative Saturday, May 3 through
Sunday, May 4, 2014.
Monday, April 21, 2014 12:30 AM
NEW YORK—The Opticians Association of America (OAA) has announced that
the organization, in a partnership with Transitions Optical, will be
hosting a video contest to help define opticianry.
Monday, April 21, 2014 12:27 AM
Optometry Giving Sight
welcomed members to its newly established “Circle of Sight” at a special function sponsored by
Hoya Vision Care
at the Vision Source Exchange meeting in Boston on April 11, 2014.
Monday, April 21, 2014 12:24 AM
provided free eyecare to 1,100 uninsured and underinsured children during “Give Kids Sight Day” on April 12.
Monday, April 21, 2014 12:21 AM
a nonprofit organization supporting research and providing public
education to help eradicate brain and eye diseases, announced yesterday
that it will be distributing more than $8.7 million in grants to 59
research projects in six countries, 19 states and the District of
Columbia to aid in the efforts to cure Alzheimer’s disease, macular
degeneration and glaucoma.


text:
Mehndi / Henna is used to decorate Hands and feet as tradition in India and Pakistan but now using in all over the world with some modifications is called Tattoo. Now a days in India, Pakistan, Arab (Gulf countries), Iran and western countries including UK, Australia and USA(America) are giving preference to Mehndi instead of tattoo, as a body art. In Body Mehendi Art especially some special body places are decorated (like Belly, Shoulders, Back, Waist) with Art Mehndi Styles. Here she9 is going to share some beautiful mehndi designs for 2010 and 2011, which are taken from hennalounge.com for Indians especially young generation.
Mehndi at back waist is most popular fashion in all over the world. In Indian teen age girls used this trend with short body t-shit, lehenga (Modern lehngas) and short blouses. This back waist mehndi art fashion is 1st time properly introduced by Indian famous Celebrity Aishwarya Rai in his song Ishq Kameena. Where she designed this mehendi art at back side. Western Chic girls used this Body henna design especially with jeans pant above the pant belt. Mostly Girl preferred floral mehendi tattoo designs at back side and a lot of best mehndi designer of 2010 and 2011 have a lot of ideas for floral patterns.
Body Mehndi Fashion
Mehndi Design for body especially on Shoulder is also taking popularity in on shoulder or shoulder-less blouses. Mostly Saree designers are also giving importance on shoulder-less blouses for these types of mehndi fashion. Indian teen girls are using this shoulder mehndi (Body Mehndi) designs for college fashion. There are most beautiful floral mehndi tattoos for shoulders.
Body Mehndi for Lehenga
Mehndi Tattoos For Saree
Mehndi at belly and around the belly is also a most useful fashion and fame in India also. This Body art is adopted by young generation of India because in India cultural dress is saree and some sarees have short blouses that's why belly mehendi art can be adopted. Here we are sharing some latest and cultural designs for ladies belly, around the belly and for body waist.
Mehndi for Shoulders
Mehndi for Arms & Legs
Mehndi art at upper arm is also using in India, Pakistan and Arabic countries. This mehndi trend is prominent with sleeveless dresses and brides are also using this body art fashion as bridal mehndi. Girls used Cartoons, lovely heart, Flowers, pea-cock, Birds, Puppies, lovers name or any special thing for upper hand.
Body Henna Designs
Glitter Tattoos for Legs
Joshiv Body Mehndi Art
Back body mehndi design is also used for back-less dresses, Gowns or blouses. These Henna Tattoos contains, floral work or any special signs. Mostly chic girls are adopting this trend as latest fashion.


Prashant Thakur, Head – Research, ANAROCK Property Consultants
Once an anonymous destination comprising of small villages in the peripheral areas of Pune, Hinjewadi is now a prime real estate hotspot. With the launch of the Rajiv Gandhi Infotech Park and consequent entry of various IT-ITeS majors and multinational companies, Hinjewadi has witnessed spectacular growth in working population. The accompanying demand for homes, backed by improving social and physical infrastructure, has made Hinjewadi one of Pune’s fastest-growing micro-markets in Pune.
During the early 2000s, the Maharashtra Government introduced its game-changing IT-ITeS Policy which offered liberal incentives to the technology-driven industries to set up operations in Hinjewadi. Waiving off stamp duties for owned and leased properties built on MIDC land also aided the large-scale development of this region. Thus, the 2,800 acres Rajiv Gandhi Infotech Park, also known as Hinjewadi IT Park, came into existence.
IT Leads the Way
The establishment of the Hinjewadi IT Park acted as a powerful magnet for IT-ITeS companies, whose arrival and expansion have been the primary growth drivers for the real estate market of Hinjewadi. IT-ITeS companies continue to be Hinjewadi’s commercial office occupiers at 85%, followed by manufacturing (10%) and biotechnology (5%). This region contributes around 60% of the state’s total IT exports – and with more than 400,000 professionals employed in here, Hinjewadi is a vitally important economic powerhouse of Pune.
Its residential property market presents an interesting canvas, as Hinjewadi has evolved into a hub for self-sustaining townships popular with the region’s discerning working population. This micro-market also offers a big range of properties from luxury to affordable, accommodating a wide cross-section of demand. Residential property development in and around Hinjewadi has transformed it into a vibrant commercial-cum-residential destination that promotes the walk-to-work concept.
More or less the focal point of Pune’s IT-ITeS revolution, Hinjewadi has extremely well-developed physical infrastructure and enjoys excellent connectivity to other parts of the city as well as Mumbai.
Mumbai-Bengaluru Highway: Located very close to Hinjewadi is the NH-4, linking Pune and Mumbai to Bengaluru, this highway ensures excellent connectivity to Mumbai.
Rajiv Gandhi MIDC Road: The Rajiv Gandhi MIDC Road runs parallel to the Pune-Mumbai highway, and is an alternative route to Hinjewadi Phase I and II that avoids traffic congestion.
The nearest railway station to Hinjewadi is Pimpri at a distance of 11 km, and Pune Junction railway station is at 21 km.
Metro rail: The 23 km Hinjewadi-Shivaji Nagar metro corridor, expected to be operational by 2020, will improve connectivity and reduce travel time to the central areas of Pune.
Residential Supply & Demand
Due to continuous infrastructure upgrades and rapid growth of commercial developments in the precinct, Hinjewadi has seen a massive residential supply with 14,000 units launched between 2013 and Q3 2017. Approximately 40% of these units were launched in 2013, recording the highest new launch supply amidst rising demand.
Although there was a decline in new launches post-2013 due to negative sentiment, inflation and economic slowdown, 2016 saw a gradual revival in new launch activity in Hinjewadi. Out of the total units, around 19% are ready-to-move-in properties while 38% are expected to be completed within the next 12 months. Only 20% of the residential units in Hinjewadi are likely to take more than 2 years to be completed, thanks to developers’ increased focus on completing existing under-projects before launching new ones so as to ensure compliance with RERA norms.
Average residential property prices in Hinjewadi increased from INR 5,110/sf in Q1 2015 to INR 5,470/sf in Q4 2016. While a massive supply infusion restricted exponential price growth in the initial periods, DeMo, RERA and GST impacted prices post Q4 2016. As a result, property prices in Hinjewadi dipped marginally post-Q4 2016 and hover at around INR 5,310/sf as of Q3 2017.
Hinjewadi Tech Park’s Phases I, II and III developed and functional, and Phase IV will be constructed as planned. The existing road network is being widened to 120 feet and is proposed to pass through neighbouring localities such as Marunji, Nere and Kasarsai, and construction in these localities is at full tilt. This and various other infrastructure upgrades in and around this location will boost future residential price growth at Hinjewadi, whose strategic location, excellent connectivity, constantly rising employment opportunities and robust physical infrastructure will continue to define it as a remarkably vibrant real estate hotspot in Pune.
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