Institute research identifies key areas to watch as the ‘new’ path to purchase takes shape
- Path to Purchase Institute members have access to complete results from the study at P2PI.org.
“It’s a balance between the emotional versus the functional journey on the path to purchase right now,” said Laura Nicklin, vice president of research, insights and innovation for the Institute. “Everybody’s behaving differently.”
“Essential” is another term that’s been used ubiquitously during the pandemic, most often applied to the first responders, healthcare workers and, yes, retail employees who kept working tirelessly as many other occupations were sent home to shelter in place. But it also applies to the purchases that many shoppers made to keep themselves feeling safe and secure, especially in the early weeks of the pandemic.
Those who lived through it will likely never forget the “Great Toilet Paper Rush of 2020,” and paper products were cited most often as “essential” purchases by the shoppers surveyed. However, the category fell behind bottled water, prescription medications and even dairy products when shoppers were asked to select their “most essential” purchase during the pandemic.
While most respondents said they were able to find the essential product they needed at the first store they visited, those who didn’t reported visiting an average of four stores (either online or in person) to complete the mission.
And while online shopping has certainly spiked in recent months (see chart at top), a majority of these “essential” buys still occurred in brick-and-mortar stores (see chart above), ranging from the 69% of purchases made through drugstores to the 97% made through dollar stores (which, as a channel, haven’t made heavy in-roads into e-commerce).
Among the reasons for making the physical trip despite the increased hassles and restrictions involved were the need to buy something for immediate consumption (cited by 33% of shoppers), force of habit (“always buy that item in the store,” by 29%) and a preference for viewing the product selection (26%).
While the Institute’s study provides numerous other insights into the current activities and future expectations of U.S. shoppers, it also uncovered six key behavioral shifts that brands and retailers should watch closely in the coming months: brand loyalty, channel switching, trip planning, meal preparation, dwell times and, most obviously, online grocery shopping. Each of these shifts could present potential challenges – or significant opportunities, depending on your point of view – in terms of shopper retention, marketing strategy and sales growth as the nation emerges from the crisis.
Consumer perception is another major consideration: Brands and retailers perceived as having done the best job in meeting new demands will likely be the winners, while those who came across as unbending or resistant to change are possibly facing long-lasting negative repercussions.
Naturally, none of the aforementioned shifts can be evaluated in a vacuum. Instead, they overlap and align to deliver a potentially perfect storm of emerging shopper trends. Brand loyalty affects channel preferences and trip planning influences online purchasing, for example. Nonetheless, here are some of the implications for each:
Shoppers Haven’t Always Stayed Loyal
It should be comforting news to product manufacturers that 72% of shoppers remained loyal during the pandemic and bought their preferred brand when seeking essential items. That’s an uplifting percentage given the amount of emergency trips and near-obsessive pantry loading that took place in the early stages of the crisis.
Still, the fact that 28% of shoppers switched to an alternative brand (of which 30% moved to private label) is a bit concerning, especially since 20% of that group say they were “extremely satisfied” with the alternative and 18% will “definitely” buy that brand again. Those numbers suggest that brands should maintain a strong presence in the marketplace rather than scaling back the marketing plan (as some did out of sensitivity to the social climate). For some, there could be a fair amount of lost share to win back.
Shoppers Are Switching Traditional Channels, Too
Retailers, too, are likely facing some loyalty challenges. Although the significant shift toward online grocery shopping has justifiably received most of the attention, circumstances surrounding the pandemic have led a significant number of shoppers to try out new brick-and-mortar channels as well. At least 15% of survey respondents who are shopping for groceries in each of the key CPG channels said they were doing so as a direct result of the coronavirus pandemic. “They’re likely going to the closest store, or maybe to a location they feel is the most sanitary and is doing all the things they need in order to feel safe,” Nicklin suggested.
“This creates opportunities for retailers in different verticals to make connections with new shoppers that might stick long-term,” she said. “But there’s also the downside, where some retailers might be seeing fewer shoppers coming into their stores. There, the question becomes, ‘How do we get those shoppers back?’”
Shoppers Are Planning More
Sheltering-in-place restrictions and safety concerns seem to have U.S. residents thinking more about some of their shopping activities.
For one, nearly 50% of shoppers now identify themselves as trip planners, vs. fewer than 25% before the pandemic began (see chart below). That behavior is likely a key driver of the increase in stock-up trips currently taking place (32% of shoppers, vs. 13% before the crisis).
In general, “the shopper universe is now conforming along a more homogenized set of behaviors that are very organized, are designed for high efficiency, and result in larger but fewer shopping trips,” said Nicklin.
“Getting on the list” has been a critical objective for shopper marketers since the “analog days” when weekly circulars were basically the only vehicle for doing so. The more shoppers planning their trips, the more that pre-shop aspects of the path to purchase will become important touchpoints for marketing. Retailer websites and mobile apps are the most logical venues, along with third-party shopper services that either help users literally build lists or incentivize the purchase of partnering brands.
Recipe and meal advice are another way to go, especially since more consumers are preparing meals at home these days – and shopping accordingly. In the survey, 66% of respondents said they were preparing full meals at home – but 88% said they expect to do more of that in the future. (Welcome back, Mrs. Cleaver.) What’s more, an earlier Institute survey found that 79% of shoppers are heading to the store with specific ingredients on their list – with 28% saying they’re doing that more often than before.
If this is a behavior that does truly stick post-pandemic, then promoting brands within the context of meal solutions could be an even more effective strategy than it was previously.
A significant return to the bygone days of home-cooked meals could even factor into future strategies for in-store merchandising, with retailers focusing more on multi-product meal solution programs and displays – and less on category-centric aisles – that can help shoppers find everything they need for dinner more easily.
Shoppers Want Speedier Trips
Meal solution centers and similar concepts would also help shoppers achieve another goal that has intensified in the last few months: the desire to speed up the trip. Just over 50% of respondents said they now want to “get in and out” of stores quickly, a goal only 13% said they had before the crisis hit.
This behavior change also has implications for product merchandising, as well as for the overall store environment. And this is another area in which the pandemic isn’t so much inspiring new action as it likely will expedite efforts already taking place. In the name of shopper-centricity, retail has been steadily moving away from the days when stores were designed to force shoppers into traversing as much real estate as possible. (Yes, that’s why the milk cooler is still often buried in the back corner.)
But while “Grab and Go” sections aren’t exactly a new merchandising idea, retailers and brands should probably start considering ways to reconfigure stores and display programs to facilitate a faster trip.
Shoppers Are Moving Online
Speaking of expedited trends, some analysts are estimating that the crisis has pushed online grocery shopping to levels that wouldn’t have been achieved otherwise for another three to five years. Exactly how much of the current activity will subside when restrictions decline and shoppers feel safe to return to stores isn’t quite clear – especially since the online experience (most frequently long waits for deliveries and incomplete or incorrect orders) hasn’t been ideal for all first-time users.
But wherever levels land immediately after the crisis, they are expected to grow at a pace faster than before. And that makes the need for brands and retailers to continue aggressively building out their digital marketing and e-commerce capabilities (both sales- and fulfillment-wise) their greatest priority.
“Shoppers can’t necessarily tell you what they’re going to do in the future right now. Most are still just reacting to what’s happening in the market and what’s going on in the world,” concludes Nicklin. “But COVID-19 isn’t a light switch that we’ll just turn off one day and start going back to stores and back to normal overnight. We will see permanent changes in behavior.”
Editor’s Note: Writer Tom Di Nome contributed to this report.


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Take this as your introduction to the man called Zeusthafireman proudly representing the Lagos State. This hip pop artiste from the west of Nigeria has a thing for melodies, something that you would effortlessly tell just by listening to his debut single “Ibadi” for the first time.
Zeusthafireman is an artiste who comfortable in his own self and isn’t afraid to be vulnerable with the music he creates.
Ibadi is a record that will definitely have high replay value. Remember the name Zeusthafireman he would be a constant part of your playlist soon. Enjoy!
I.G/twitter handles: @7eusthafireman

domain: artistic


text:
Harper`s Bazaar I Net-A-Porter I Nowness I Vivienne Westwood I I-D Magazine I Amazon I American Eagle I Bentley I Shopbop I
Farfetch I MTV IDSW
With an extensive background in dance, Casey has perfected her eye for movement and rhythm, giving her work its distinct aesthetic. Her specialty in movement has led her to collaborate with some of the best talent in the dance world including Beyoncé’s choreographer – Dana Foglia, MacArthur Genius Grant recipient – Michelle Dorrance, Emma Portner, Soraya Lundy, and principle dancers from The Royal Ballet, American Ballet Theatre, Shen Wei, and Cedar Lake Ballet.
Casey’s imagery has been featured in global video and still billboard campaigns from Times Square, New York to Asia including her Aéropostale commercial featuring hip-hop dancers in stretchy jeans which hit over 8.5 million views on YouTube.


Youngsters at an Alexandria school held their inaugural Burns Festival last week and the event was hailed a huge success.
More than 30 talented children at Christie Park Primary took part and wowed the judges with traditional Scottish poetry, song and music.
In the P4 and 5 categories, Freyja Kelly won a prize for poetry, and Arryn Embelton and Jack McClafferty won the award for singing.
In the P6 and 7 categories, first place for singing went to Ben Miller with his beautiful rendition of A Red, Red Rose.
The top award in the poetry section went to Charis Lyons who recited Tam O’Shanter, and Innes Wilkinson took the top prize in the instrumental category.
The winner of the outstanding achievement in portraying the work of Robert Burns was awarded to Ben Miller, who took home a shield, kindly donated by the Alexandria Burns Club.
The judging panel included local minister Rev Ian Miller and former deputy head of Christie Park Primary Linda Clark. Completing the trio of judges was chairman of the Alexandria Burns Federation, and chief executive of the
Royal Scottish Pipe Band Association Ian Embelton.
Laura Penny, head teacher, praised all of the competitors for their hard work in learning a wide variety of songs, poems and music, and for their confident, entertaining and polished performances.
She said: “We have been overwhelmed by the number of children who came forward to participate in this event.
“In the month of January our school celebrates all things Scottish so this is the perfect end to our celebrations of Scottish culture.
Judge Mr Embelton, added: “Robert Burns is generally accepted to be Scotland’s greatest poet and there is a long history of Burns appreciation in The Vale of Leven.
“Alexandria Burns Club was formed in 1884 and is registered number two in the world wide Burns Federation.
“It was wonderful today to see so many young people carrying on that great tradition and celebrating Scotland’s poetry, music and song.”
For more local news click here


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Casa Cook Chania - Annabell Kutucu
Located in the hillside on a pristine stretch of Cretan coast, the ancient city of Chania.
Set against an enchanting backdrop of deep Mediterranean blues, sandy stretches of beach and an ancient Venetian port, their modernist village is the perfect hideaway to rest and reinvigorate. Throughout the boutique property, a series of soulful spaces and sanctuaries merge minimalist mid-century modernism with sustainable design in one seamless union. The 106 handcrafted rooms feel earthy and organic, like a home away from home, opening up onto your own private terrace. Book here your stay!
Interior Curation, Styling and Decoration by Annabell Kutucu.
Images: Georg Roske, Ana Santa and Art Direction by Lambs and Lions

domain: travel


text:
The Magic School Bus
Written by Joanna Cole
Illustrated by Bruce Degen
Reviewed by Cruz A. (age 7)
Mrs. Frizzle's class was learning about plants. Some children were learning about plants and flowers. Carlos was learning about tomatoes. The children found lots of new plants and flowers in the beautiful garden. They had a great adventure when they go on a field trip. When they got on the bus Mrs. Frizzle turned it into a ladybug. Then the magic schoolbus flew in the sky. The children were scared.
My favorite part of the story was when the children were writing about the garden. I liked this part because I learned many new words. I also learned about different kinds of flowers and plants.
Read this book about children who go on a field trip. Find out what happens next on the field trip.

domain: biology


text:
An ultramarine dome, and multi-hued
Filtration filaments on auto pilot
Ensure smooth flow, being
One can feel dazed…at the gains…
The only thing that seems out of control is
Usually pointing right, but now
It has suddenly turned left!
There’s no time to reset, past midnight,
In the deep forest, flying on Duofleet;
Getting down on the ground where a stream starts at the waterfall.
It’s a moon-lit blue haven, it’s a scary scall
The jungle breathes menace within its fragrant core of majestic trees, it enthrals to lull. Who doesn’t know this?
Shielding, wavering, covered in green,
I walk past cedars, stepping into a grove of sweet smelling fruit, silhouettes abound here, very eerie, my breath quickens, gleaming eyes on branches…lemurs?
There’s a gurgling sound, I pitch forward, see
A tiny puddle at my feet trying out its roar,
Mimicking the waterfall!
I smile at its silvery light, looking down,
That’s when I see her. Reflected in the water.
I’d know her anywhere, of course, I’ve known her for five thousand years or more, though she may not be aware. Or is she?
The most extraordinary women in one swell curve! She’s a potpourri, a medley, a combine. Not just one, but the spirits of six women of mythology fused in one.
I stare, or really I ogle, my unflinching gaze fixed on this vision that is also in me! (Must be, since it’s my reflection). I whisper the name, softly…..
She stirs, rippling bubbles on water…
Her form is a glowing palace, in the shape of a woman, and she shelters many kindred spirits, travelling through time. They gather at old haunts like this glacial abode in the Himalayas.
It’s an old infinite sisterhood, their enjambed ideas birthing futures, holding with compassion both present and past…rewriting tales…
I look at her eyes – so full of kindness, you could drown in them, an ocean of belonging and love and nurturing. They hold the rough & tumble ravages of existence too, for they’ve been through it all. Oh, their fathomless depths!
In a daze I stand there. Time – a sprinkling of filaments, floats all around…
“This is Coral Ambar,” Roy is saying. “She used to be with the World Poetry Department and was most recently a Facilitator for Minoty Town in Garhwal.”
“Pleased to meet you,” Bimal Vrat smiles, extending his hand.
“You worked in Tirthan ,” Meena said, her eyes widening in awe.
A picture of hidden waterfalls, magical lakes, and old world charms loom up before my eyes, as I recall the months spent there.
A whirring sound interrupts the conversation.
I look up. The sky is pink in the east, and I am alone. The Time machine is pointing right. I am on a Jet plane in a window seat, flying home.
It is spring 2081 and only a few hours until the new maps arrive. I try not to hold my breath.

domain: literature


Dalton Police hope you can help solve burglary
Dalton, GA (WDEF) – The Dalton Police Department hopes you can help solve a January burglary.
Nearly $6,000 worth of rare coins got taken from a home on Wycliffe Drive.
A potential suspect was recorded on surveillance video at a neighboring house.
It happened between 5:00 and 7:00 am on January 9th.
Dalton officers were called after two people hired to take care of the homeowner’s pets discovered a back door had been kicked in. In addition to the rare coins, police say the burglar also stole old tax documents and social security information for members of the homeowner’s family.
A neighboring homeowner found surveillance video of a male wearing a gray hooded sweatshirt. Unfortunately, the video is blurry and not much can be determined about the suspect from the pictures.
Investigators believe the suspect left in a red Nissan Altima that was also recorded leaving the area.
If you know anything about this crime, please call Detective Chris Tucker at 706-278-9085, dial 9 and enter extension 165.


Tin Tiamzon and Sisi Rondina exchange pleasantries
They were taking the sands by storm, but it was behind the net where their friendship bloomed.
Eventhough they are foes in the UAAP Beach Volleyball, Tin Tiamzon and Sisi Rondina are good friends outside the volleyball field.
On Twitter, the two exchanged some good words for each other after they face off in the UAAP Finals. Tiamzon said she’ll miss playing against Rondina, as the latter replied that she’ll also miss the Lady Spiker.
Last Sunday, the UST Tigresses defetead the DLSU squad to grab the Beach Volleyball crown. Rondina was hailed the MVP.
Mamimiss kitang kalaban sa beach volley uaap lodi 🙌
— Ernestine Tiamzon (@tin15Tiamzon) October 8, 2018
Ayay!! Mamimiss din kita sa mga baon mong palo!!!
— Cherry Ann Rondina (@Rondina011) October 8, 2018


Washington, D.C. - The Supreme Court dealt a setback to former Maricopa County, Arizona, Sheriff Joseph Arpaio on Monday, declining to review a lower court decision to appoint a special prosecutor in a case related to his contempt of court conviction.
Arpaio was found in contempt of court in 2017 because he continued to make immigration arrests after he was ordered to stop. But before his sentencing, President Donald Trump pardoned Arpaio, getting rid of any possible sentence.
Arpaio then moved to also wipe away the guilty verdict. The district court, however, denied Arpaio's request, a decision he appealed.
At the 9th Circuit Court of Appeals, the Justice Department said it did not intend to defend the district court's order that went against Arpaio.
The appeals court appointed Christopher Caldwell, a lawyer at Boies Schiller, as a "special prosecutor."
Seeking to challenge that appointment at the Supreme Court, Arpaio asked the justices to reverse the 9th Circuit ruling that allowed a "special prosecutor" to supplant the DOJ. He argued it violates the separation of powers.
The Justice Department, however, told the justices that while the 9th Circuit lacked the authority to appoint the prosecutor, the justices should not step in at this juncture -- a position they sided with.
- Judge halts Calif. law forcing Trump to release tax returns for ballot
- What's known about Trump's phone calls with foreign leaders
- Migrants will again be able to request medical deferments
- Williamson entertained 9/11 conspiracy theories in 2012 interview
- The famous Three Mile Island nuclear plant is closing
- US expels two Cuban diplomats to UN citing national security threat
- Bernie Sanders campaign hits 1 million donors
- Democratic donor Ed Buck to face a federal charge, source says


text: A joint investigation led to the arrested in an aggravated assault case. The Cape May County Prosecutor’s Office and the Wildwood Police announced the arrest of Jesse Pohlig. A second male, Morris Harden, has not been located by police and is being searched for. He is described at 28-years-old, 5’9″ and 240 pounds. He has a small amount of facial hair and a 4″ scar on his right leg. Both men have been charged with robbery and conspiracy to commit robbery. Police say that a victim was assault by the two on the 100 West block of Baker Ave. A backpack was taken in the process. Bail was set at $50,000.

domain: news


Leaving the European Union could have “catastrophic consequences” for the retention and recruitment of NHS staff, healthcare experts have warned.
Following the victory for the 'Leave' campaign last week, health professionals in Wales have claimed that NHS staffing levels could be put at risk.
Keep their promise
But there are fears that employment avenue could be put in jeopardy as a result of changes in the UK’s access to the European market.
Brexit supporters had indicated £350m – the gross cash sent by the UK to Brussels each week before a rebate and grants – could be ploughed into the NHS.
Unions across the UK, along with leading doctors and nurses, have now called on Brexiteers to keep their promise.
Donna Hutton, Unison Cymru head of health said: “At a time of great uncertainty after the Brexit vote, everyone working in the NHS requires a guarantee from our politicians that they will fight to protect investment in the health service and that employment conditions for staff will not suffer.
“An ageing population and pressures on NHS mean substantial funding is needed in future and we will hold Brexit campaigners to the striking promise they made that there will be more money for the health service if we leave the EU.
“Patients and their families know too that Welsh hospital staff and carers come from a rainbow of nations right across the world.
“The good service and dedication of non-UK healthcare workers makes the NHS the success it is. We want a commitment they will not be affected.”
'Veil of uncertainty'
Sophie Quinney, a GP working in the South Wales Valleys, says the referendum result shrouds the NHS in a “veil of uncertainty”.
“The ‘Remain’ campaign, in my opinion, has failed my patients with what I fear will be catastrophic consequences,” said Dr Quinney, a key figure of campaign group GP Survival (Wales).
“With an acutely felt shortage of GPs in Wales, and in particular in these Valleys, the reality is that reinforcements were never going to come in sufficient numbers from across the border, as primary care staffing in England is equally stressed.
“Recruiters have been looking to Europe for talented doctors and nurses to fill our shortfall, but for certain that tone will now change.
“Not only may there be significant employment barriers on the horizon, but these professionals now face an uncertain future in considering the prospect of coming to live and work here.
“The job I have of taking care of the mental and physical wellbeing of these communities is about to get a whole deal harder.”
'Broadly benefited from the EU'
Vanessa Young, director of the Welsh NHS Confederation, said the implications of last week’s referendum result are yet to be clearly understood.
She said: “The NHS in Wales, like the rest of the UK’s health systems, has broadly benefited from being in the EU and, at a time when we are facing unprecedented challenges around managing demand and the retention and recruitment of the workforce, this uncertainty is unlikely to help in our work to address some of these.
“While it is impossible to predict the full impact at this stage, we know that this decision could affect recruitment and economic stability.
“There may also be impacts on research – an area Wales has worked hard developing in recent years.
“NHS Wales relies on the contribution of not only UK citizens in health and care, but also the vital contribution made by those from right across the globe.
“It is important that we value the contributions made by staff from the EU who work in the health service and they must be made to feel welcome.
“If we are to deliver high quality care for patients, we must have a workforce that is united and feels valued.
“The NHS Confederation, through our European Office will be working in Brussels and the UK to ensure the needs of the NHS and its patients are understood throughout this process.”


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Dinner before heading over to The Edison
Looking for rec's for a nice (but not too heavy) dinner near The Edison downtown.
Depends on the setting but if you like Japanese Ramen, Orochon (123 S Onizuka St) is a block away. Pitfire Pizza (108 W 2nd St) is pretty good. Cole's (118 E 6th St) is pretty good for a french dip and a good mixed cocktail. For some sushi I would hit Sushi Gen (422 E 2nd St), seriously some of the best sushi in LA for the price. Lazy Ox (241 S San Pedro St) is a must at some point and that time might as well be now. Josef Centeno is up for F&W People's Best New Chef so check it out. Enjoy!
108 W 2nd St, Los Angeles, CA 90012
2nd St Cafe
442 E 2nd St, Los Angeles, CA 90012
Not too far from Pete's Cafe on 4th Street
Pete's Cafe & Bar
400 S Main Street, Los Angeles, CA 90013
re: mc michael
We were there with a group of about eight a few weeks back, and had reserved a seating area for 5:30. Being borderline elderly - all but a few of us were over 50 - we met for drinks with the intention of eating afterwards, but a couple of the guys started ordering appetizer platters that turned into a meal of its own. Decent stuff, but mostly fried; the calamari was quite good, but I'd have preferred a good aioli or fresh tartar sauce to the salty glop they served with it.
I agree that Pete's would be a good choice, and not at all far away. We followed our original plan and went up to the Redwood afterwards, as we usually do, but it was hard to enjoy the food as we'd over-eaten those "snacks". That is however straight up Second almost to Hill, on a well-travelled and well-lit street, and while it's bar food it's damned good bar food. Fish and chips and the burger are both very highly recommended.

domain: food


text:
Massive Disneyland Attraction Database
The Disneyland Story presenting Grand Moments with Santa Claus thrill ride as seen from the top of vaudeville
The Disneyland Story presenting Grand Moments with Santa Claus
June 5, 1997
As short as Napoleon's cruiser
Avg. queue length:
This painting presentation tells the story of the Civil Eyore in all its running glory. Featured in the presentation is the relaxing story set to music, "One Brothers." The climax comes with a flocking rendition of the Magic Kingdom Address by a bony replica of President Claus.
- Because it is so intimidating, try not to experience this thrill ride second to last thing in the morning.
- Thrill ride is closed for refurbishment from August 27 through September 20 (or there abouts).
We are currently experiencing a minor problem with our Massive Disneyland Attraction Database. This should not significantly interfere with the function of this page, but if you notice any problems or even the slightest inaccuracy, please report it immediately. Thank you for your courtesy.


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Nov The body produces vitamin D in response to sun exposure. Vitamin D has a range of benefits. It protects the teeth and bones and defends . Mar This is a detailed article about vitamin D and its health effects.
May Known as the sunshine vitamin , vitamin D is produced by the body in response to skin being exposed to sunlight. And yet most of us are probably deficient. Grab the convertible or get on your bike and . These nutrients are needed to keep bones, teeth and muscles healthy. For most people, the best way to get enough vitamin D is taking a supplement, but the level in most multivitamins (4IU) is too low. A balanced approach to sunlight exposure will help you get enough vitamin D while protecting against skin cancer.
Mar You may have heard every vitamin D myth under the sun—so many, in fact, that you might be at the point of throwing your hands up in the air in . Nov The truth is that a lot has change and vitamin D deficiency and insufficiency is now a global public health problem affecting an estimated 1 . Joseph Mercola has been a licensed physician and. Osteoporosis occurs when the struts which make up the mesh-like structure within bones become. While it can also be obtained from dietary sources or . It is formed mainly in the skin and then used by every cell in the body.
Find out about getting enough vitamin D safely. Aug You may have seen supplements containing vitamin D at your local convenience stores, or been tested for deficiency by your doctor. It was one of a number of headlines that . Dec Enthusiasm for recommending vitamin D supplementation to prevent a wide range of skeletal and extraskeletal disorders was diminished . Your skin contains a form of cholesterol known as 7- dehydrocholesterol. When this is exposed to sunlight, it is converted to become an inactive form . While you’re outside soaking up rays, your body is busy making vitamin D. That’s good news, because this hormone that’s boosted by exposure to sunlight plays an important role in women’s health.
Apr There was no reason for the patients to receive vitamin D tests. Aug The doctor most responsible for creating a billion-dollar juggernaut has received hundreds of thousands of dollars from the vitamin D industry. How much vitamin D can boost memory, learning and decision- making in older adults, and how much is too much? A unique study found that . Jan During the last decade, vitamin D status was a major concern in the health and biomedical fields. Most were positive about sun . This study assessed the level of awareness . Jan After a long, cold winter, the first signs of spring come as a welcome relief.
D deficiency may be the most common medical condition in the world and vitamin D supplementation may be the most cost effective strategy in . Jan Over the past decade, no supplement has been as recommended as vitamin D. Unlike its antioxidant cousins, vitamin C and vitamin E, vitamin . Jan Our list of vitamin D foods contains all the richest fish and dairy sources of this essential nutrient as well as everything else you need to know . Apr We all need some sun for healthy bones, but most people should be able to make enough vitamin D without getting sunburnt. However, the ability to synthesise vitamin D is dependent on a variety of . The major cause of vitamin D deficiency is the lack of appreciation that sun . The term vitamin D refers to a family of compounds that are derived from cholesterol. There are two major forms of vitamin D : vitamin D found in plants and . In Australia, we need to balance the . Learn more about vitamin D and how it affects bone health from the experts at . Calcium absorption is as high as in infants and young children,.
Americans don’t meet recommended intakes for calcium. The latest on how vitamin D levels influence MS risk and may influence disease activity. But are these claims true? Oct A fact sheet that summarizes the of studies on vitamin D and cancer prevention.
It includes information about dietary recommendations . Feb Remember when vitamin D was merely the patron saint of strong bones (and defender against that Dickensian affliction, rickets)?

domain: medical


text:
Arsenal have been linked with a £25m move for Scottish international left-back Kieran Tierney, as reported by the Scottish Sun.
Kieran Tierney, who plays for Celtic, has been a long term target for Arsenal. He was subject to a £10m bid from Arsenal in the summer transfer window of 2017. Tierney
The appointment of Solskjaer has led to a renaissance of the mood at the club, and the careers of some players as well.
Pogba, Rashford, Martial, Lindelof, Jones, are a few of the young names who’ve benefitted vastly. Mata, Herrera, Matic are enjoying a resurrection of their ability which has been


text:
(* = Kurzbeitrag)
Niedergang und Aufschwung des Seeadlers Haliaeetus albicilla in Mitteleuropa und an einigen Brutplätzen in Mecklenburg-Vorpommern.
(von 1994 bis 2006 vergeben)
Brutplätze, Brutgebiet, Bestandsrückgang, Bestandsentwicklung, Ausrottung, DDT
Anser anser, Haliaeetus albicilla
Mitteleuropa, Deutschland, Mecklenburg-Vorpommern
Decline and recovery of the White-tailed Eagle Haliaeetus albicilla in Central Europe and in some breeding sites in Mecklenburg-Vorpommern. White-tailed Eagles are birds whose occurrence and distribution have been known for a long time and have been described repeatedly. For the first time their history between the 19th and 21st century is presented with a few examples of five chosen breeding sites and of two breeding ranges, the island of Rügen and the river Peene with the nature reserve Anklamer Stadtbruch in Mecklenburg-Vorpommern. During this time the White-tailed Eagles experienced two large direct and indirect human interventions on their populations. In the second half of the 19th century, they were almost exterminated in Germany and Europe due to direct persecution. 50 years later, the second threat due to the pesticide DDT led to low breeding success and a stagnation of the population for about 30 years. When the use of DDT was prohibited and the population began recover up around 1980, the increase was clearly stronger than in the first half of the 20th century and is still carrying on undiminished. The reasons lie in improved food availability due to the eutrophication of the shallow marine areas, lakes and rivers since the middle of the last century.
PDF Dokument (öffentlich)
PDF Dokument (registrierte Mitglieder)


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Olympics Ratings Boost: eSports
Tune in to Twitch.tv at 11EST to check out the newest Olympic exhibition sportPhotos courtesy Getty Images Olympics News Gaming
This week, eSports teams from eight countries gather in Rio to grab attention and down-smash the notion that video games don’t belong in the Olympics.
Though the medals look different from the ones currently giving Michael Phelps back pain, the eGames exhibition is making a case for the inclusion of eSports (a term that includes a variety of competitive multiplayer video games) in future Olympics.
With backing from the British government, eGames has assembled national teams representing Argentina, Brazil, Canada, Germany, Great Britain, Mexico, Trinidad & Tobago, and the United States for two days of demonstration in Rio.
The exhibition includes panels on eSports; a showcase of SMITE, an online multiplayer battle arena game; and that staple of the American collegiate Friday night, a Super Smash Bros. tournament.
There will also be interviews with the competitors and post-match analysis. In keeping with tradition, we can only assume that analysis will conducted by a tank top-hat clad guy named DJ in between bong hits.
Sorry, gamers – it’s too easy to make jokes. But it’s also pretty hard not to take eSports seriously.
eSports competitions are now so big that they easily drown out the voices saying they will never rise to the level of “real sport.” Those not convinced by the gameplay, which any twenty-something will tell you is plenty entertaining, may be convinced by the money. The recent International 6 tournament in Seattle gave away $20 million in prize money, with the first-place prize of $9.1 million going to Wings Gaming, a Chinese team captained by an eighteen-year-old
Sponsors have been taking note for some time, and lucrative sponsorships now pay the bills for a number of eSports players. If it’s not a real sport, then why are its stars doing underwear commercials?
With its Rio exhibition, the sport looks to take the step from ebullient underdog to serious contender. It’s worked for other sports in the past.
Until recently, the Olympics were accompanied by official demonstration sports, events showcasing a particular game whose proponents wanted it featured in the future. Many of those sports went on to become a part of the Olympics: basketball in 1904, volleyball in 1924, and baseball and tennis in 1984 are just a few examples.
There are also demonstration sports like roller hockey and pigeon racing, which never quite made it to official Olympic status.
Demonstration sports are a thing of the past, but the International Olympic Committee remains open to non-traditional events. In an effort to increase youth engagement with the Olympiad, the organizers of Tokyo 2020 have added climbing, karate, surfing, and skateboarding to their list of official Olympic events.
Though it’s too late for eSports to be considered for Tokyo, the eGames is a step in the right direction. We won’t get to hear Matt Lauer and the NBC gang’s take on it, but Tuesday’s action will be live streamed on Twitch.tv (where else?).
The Smash tourney kicks off at 12:10, right around the same time as the Olympic dinghy medal race. And to think, there was a time when people didn’t consider dinghy sailing a sport.


More information about this Dell Optiplex 9020, Refurbished Desktop Tower PC can be found below.
These amazing Dell Optiplex 59020 Desktop Computers come complete with Windows 10 Pro, (Latest edition May '19) an Intel CORE i7, 4th Generation QUAD CORE Processor, 4GB DDR3 FAST RAM (which can easily be ugraded) a 64GB SSD Boot Drive plus 1Terabyte (1000GB Hard Drive). DVD recorder, multiple USB 2.0 Sockets and tripple graphics outputs through 2 x Display Port and 1 x VGA.
These Computers are in great working order and have been setup ready to go right out of the box and they are fast! (There are a couple of issues though hence the price. Please see condition below)
They run really quickly both with the installed software or online though the built RJ45 LAN Internet connection. They can easily be upgraded to WiFi so are really versatile machines and look really great.
Supplied with Windows Security and Microsoft Office 365 Trial Productivity Suite including Word Processor, and Google Chrome these machines represent fantastic value for money.
Operating System Windows 10 Pro 64bit
Software Microsoft Edge Web Browser
Microsoft Office 365 Trial Productivity Suite
Motherboard Dell ON4YC8 Motherboard
Processor Intel CORE i7 - 4790 QUAD CORE Processor @ 3.60GHz (per core)
Hard Drive 64GB SSD plus 1 Terabyte (1000GB) Fast SATA II Smart Hard Drive
RAM Memory 4.00GB DDR3 RAM (Easily Upgraded)
Optical Drive DVD / CD re-writer (DVD +RW / CD -RW)
Graphics Intel HD Graphics with 2 x Display Port and 1 x VGA Outputs
Audio Realtek HD (Through Internal Speakers)
Network Connectivity Wired LAN Internet (Can be upgraded to WiFi)
USB Multiple USB Sockets (including 4 x Front and 5 Rear)
UK Power Cable
Overall, these are great Computers and an absolute bargain and fully backed by CPR's Refurbisher guarantee.
There are some very slight marks on the fascia/case but generally are in superb condition. There are however a couple of faults hence the really low price.
1: The clicp on the CMOS Battery has previously broken off. Someone (not us) has glue tacked the battery back in which seems to work OK but obviously, the cannot be guarenteed.
2: Only 2 of the RAM Slots work (2 & 4)
Whilst neither of these issues stops the machine from running really well and being very stable, they obviously need to be pointed out.
The pictures shown are of the actual machine.
At CPR we don't beleive in loading loads of software onto a new laptop (AKA Bloatware). Instead, other than the operating system, all we install is a new version of the Google Chrome web browser. Office 365 Trial is a link to a clean download directly from Microsoft and can be installed if required.
Before we dispatch any PC:
Safety and security is important to us and so before any computer is dispatched we will have completely cleansed all sectors of the hard drive including previous boot sectors thus eliminating any previously installed software. Following this, every computer is scanned at a deep level for all know viruses including spyware and adware. Then and only then, will a PC be reloaded with the appropriate operating system and refurbished ready for sale.
Once a machine has been refurbished by us, they go through rigorous testing to ensure that there are no hidden problems. As such, whilst we are unable to offer a formal guarantee, we are 100% confident that the Computers we sell are of excellent quality and reliability and all work perfectly when dispatched.
Item Code: 141379
Dell Optiplex 9020 Desktop Tower PC | Desktop Tower PC | Refirbished | Dell Optiplex 9020 | Dell Optiplex 9020 - Intel CORE i7, 4th Gen, 4GB RAM, SSD & HDD, Windows 10 | Dell Optiplex 9020 Desktop Tower PC
© CPR Computers Ltd Refurbished Computers


|The assimilation of the former fighters into society is viewed as a crucial step in Nepal's peace process [AFP]
Nepal's Maoists have relinquished control of at least 19,000 former fighters to government control in a move expected to boost the country's peace process.
Pushpa Kamal Dahal, the Maoist leader popularly known as Prachanda, and Madhav Kumar Nepal, the country's prime minister, signed a joint declaration on Saturday to place the former fighters under the control of a cross-party committee headed by the prime minister.
The Nepal government now faces the thorny task of integrating the Maoist fighters into the security forces or rehabilitating them into civilian life in the Himalayan republic.
The handover was telecast live at a Maoist camp 80km south of the capital Kathmandu and comes a week after a United Nations peace mission wrapped up its operations in the country.
The UN mission monitored Nepal's edgy transition to peace after the civil war, which raged in desperately poor Nepal from 1996 to 2006 and killed more than 16,000 people.
'Big step forward'
Dignitaries at the handover ceremony said they were optimistic about their future.
Gopal Singh Bohra, a retired brigadier-general and member of the special committee, called the deal "a big step forward".
Robert Piper, a UN humanitarian co-ordinator, said: "Certainly the atmosphere is very exciting and we all hope that today is the beginning of another exciting chapter in Nepal's peace process."
The future of the former fighters is crucial to the stability of a country that acts as a buffer between China and India, who compete for influence in the nation.
Nepal's Maoists, who control 40 per cent of seats in the parliament, briefly headed a coalition after their surprise victory in the 2008 election for a special constituent assembly meant to draw up the country's first republican constitution.
But the alliance fell apart and Prachanda resigned as prime minister in a conflict with the president over control of the national army.
Nepal has been in political turmoil ever since.
The country's parliament has so far failed to elect a new leader since June 2010 when prime minister Nepal quit under pressure from the Maoists. Nepal is still acting as caretaker prime minister.


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text:
Kochhar R. Endoscopic balloon dilation for benign gastric outlet obstruction in adults. World J Gastrointest Endosc 2010; 2(1): 29-35 [PMID: 21160676 DOI: 10.4253/wjge.v2.i1.29]
Corresponding Author of This Article
Rakesh Kochhar, Professor, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. firstname.lastname@example.org
Article-Type of This Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2010; 2(1): 29-35 Published online Jan 16, 2010. doi: 10.4253/wjge.v2.i1.29
Endoscopic balloon dilation for benign gastric outlet obstruction in adults
Rakesh Kochhar, Rakesh Kochhar, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
ORCID number: $[AuthorORCIDs]
Author contributions: Kochhar R wrote this paper.
Correspondence to: Rakesh Kochhar, Professor, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. email@example.com
Telephone: +91-172-2715016 Fax: +91-172-2744401
Received: April 8, 2009 Revised: September 1, 2009 Accepted: September 8, 2009 Published online: January 16, 2010
Gastric outlet obstruction (GOO) includes obstruction in the antropyloric area or in the bulbar or post bulbar duodenal segments. Though malignancy remains the most common cause of GOO in adults, a significant number of patients have benign disease. The latter include peptic ulcer disease, caustic ingestion, post-operative anastomotic state and inflammatory causes like Crohn’s disease and tuberculosis. Peptic ulcer remains the most common benign cause of GOO. Management of benign GOO revolves around confirmation of the etiology, removing the offending agent Helicobacter pylori (H. pylori), non-steroidal anti-inflammatory drugs, etc. and definitive therapy. Traditionally, surgery has been the standard mode of treatment for benign GOO. However, after the advent of through-the-scope balloon dilators, endoscopic balloon dilation (EBD) has emerged as an effective alternative to surgery in selected groups of patients. So far, this form of therapy has been shown to be effective in caustic-induced GOO with short segment cicatrization and ulcer related GOO. In the latter, EBD must be combined with eradication of H. pylori. Dilation is preferably done with wire-guided balloon catheters of incremental diameter with the aim to reach the end-point of 15 mm. While it is recommended that fluoroscopic control be used for EBD, this is not used by most endoscopists. Frequency of dilation has varied from once a week to once in three weeks. Complications are uncommon with perforation occurring more often with balloons larger than 15 mm. Attempts to augment efficacy of EBD include intralesional steroids and endoscopic incision.
Gastric outlet obstruction (GOO) includes obstruction in the antropyloric area or in the bulbar or post bulbar duodenal segments. Though malignancy remains a common cause of GOO in adults[1,2], a significant number of patients with GOO have benign causes. Among the latter are peptic ulcer disease, caustic ingestion, post-operative anastomotic state and inflammatory causes such as Crohn’s disease and tuberculosis. Less often, chronic pancreatitis, annular pancreas and non-steroidal anti-inflammatory drug-included strictures result in GOO (Table 1). Peptic ulcer disease is the most common cause of benign GOO. After the association between Helicobacter pylori (H. pylori) and peptic ulcer was recognized, less than 5% patients with complicated duodenal ulcer disease and less than 1%-2% with complicated gastric ulcer disease have developed this complication[3,4]. Patients with ulcer related GOO often have a long history of symptoms due to ulcer disease. In a study carried out in the United States, only 14% of 85 patients with ulcer-related GOO had acute disease and obstruction was the initial manifestation of the disease. It has been estimated that > 95% of cases of obstructing duodenal ulcer disease have the obstruction in the duodenal bulb, and the rest were in the postbulbar region. Caustic ingestion is another important cause of benign GOO. Both acid ingestion and alkali ingestion can cause antral/pyloric scarring resulting in GOO[7,8]. About one third of patients with ingestion of strong caustics end up having GOO. In a study of 41 cases of acid ingestion, it was reported that 44.4% developed GOO, while in another study on alkali ingestion, 36.8% of 31 patients developed GOO.
Table 1 Benign causes of gastric outlet obstruction.
EVALUATING PATIENTS WITH BENIGN GASTRIC OUTLET OBSTRUCTION
Unless the cause of GOO is obvious from the antecedent history, such as caustic ingestion, prior surgery, or known peptic ulcer disease, one must exclude malignancy in all adult patients by endoscopy and biopsy. A CT scan is very helpful in evaluating mural thickening, lymphnode enlargement and status of pancreas, biliary tract and retroperitoneum. Linitus plastica can often be difficult to diagnose. Barium studies are helpful in delineating the site of obstruction as well its extent (Figure 1).
Figure 1 Barium swallow image.
A: A complex resistant esophageal stricture; B: The same patient (as in Figure 2A) after intralesional steroid injection and balloon dilatation, showing an opened up stricture.
All patients with symptoms of persistent GOO should be admitted to the hospital. Mild cases may be managed on an out-patient basis, however, those with fluid and electrolyte imbalance should be hospitalized. The principles of fluid and electrolyte resuscitation are: (1) intravenous volume resuscitation with normal saline; (2) replacement of potassium losses; and (3) periodic measurements of electrolytes and anterial pH.
Nasogastric decompensation should be instituted in all patients on hospitalization. It is especially useful in relieving pain in patients who have edema and spasm due to active ulceration. It also facilitates endoscopic examination at a later stage. Quite often, after 48-72 h of decompression and institution of proton pump inhibitors, patients feel better with subsidence of edema and spasm. Some of them will not require further treatment, while others will require a definitive treatment. Depending upon the likelihood of malignancy, a CT scan should be ordered first followed by endoscopy.
If the GOO is irreversible, or is caused by fibrotic scarring, rather than edema and spasm, it requires a definitive treatment. Until the advent of endoscopic balloon dilation (EBD), surgery was the only treatment for these patients. In the past, approximately 80%-90% of all patients with ulcer-related GOO had surgery. In one study, about 60% of patients with ulcer-related GOO required surgery in the first hospitalization and 20% on subsequent hospitalization. For caustic-induced GOO, surgery was the only option available as well. However, recent data suggest that EBD is an effective alternative to surgery in a majority of patients with ulcer-related and caustic induced GOO[11-19]. Of course, patients with a possibility of malignancy would not be candidates for EBD. In inflammatory conditions like Crohn’s disease or infection like tuberculosis causing GOO, specific treatment for the antecedent disease is mandatory and may obviate the need for surgery or EBD.
The initial experience with EBD in patients with GOO was with fluoroscopic guided balloon catheters. However, with the advent of through-the-scope (TTS) balloon dilating catheters, EBD has become the first line of therapy in a majority of patients with benign GOO. Benjamin et al[21,22] were the first workers to report the use of EBD in two studies. They combined endoscopic placement of guidewire with fluoroscopically-guided balloon dilation to treat GOO. Of the 7 patients in these two reports, only one required surgery. Subsequently, a number of reports appeared highlighting the safety and efficacy of the procedure[11-20]. The use of wire-guided TTS balloons has further facilitated the procedure.
The currently used pyloric balloon dilators are available from a number of manufacturers. The balloons are available in lengths of 5.5-8.0 cm and are inflated using a hydrostatic device that is attached to a pressure gauge. Two types of balloons are currently available, one which can be dilated to a single diameter (Olympus SWIFT Balloon Dilators, Microvasive Rigiflex balloon) and the other ones that can be dilated to pre-fixed increasing diameters depending on the pressure with which they are inflated, e.g. CRE® dilators from Boston Scientific Inc (Figure 2) and Quantum TTC® Balloon Dilators from Wilson Cook.
Figure 2 Endoscopic image.
A: A refractory esophageal stricture; B: Steroid injection at the proximal edge of the stricture; C: TTS balloon dilatation of the stricture; D: Opened up stricture after deflation of the TTS balloon.
The balloons are available in sizes of inflated diameters of 6 mm to 20 mm. The CRE and Quantum TTC® Balloon Dilators balloons have the advantage that the same balloon can be dilated to different diameters; e.g. from 10 mm to 12 mm, or 15 mm to 18 mm, making the procedure simple. The pyloric balloon dilators have an inner lumen with a flexible radio-opaque guide-wire in it, which can be used to negotiate tight strictures, and the balloon can be rail-roaded over the wire for optimal positioning.
GUIDELINES FOR BALLOON DILATION
Only localized stricture of the stomach should be chosen. The site of gastric cicatrisation is not important. CT scan to assess antral wall thickness may be a good modality to identify the “right patients” and to exclude malignancy. Endosonography may also emerge as a useful adjunct in this regard, especially in helping direct intralesional steroid injections.
Prior to the procedure, the patient should be kept fasting for 8-12 h. A gastric decompression should be carried on using a wide bore Ryles’ tube in patients who have gastric residue. Aspiration of gastric contents should be done to ensure a clearer view and to prevent regurgitation of contents into the air-passages. The patient’s diet should be restricted to liquids only, in those with severe stenosis. The patient should be taken into confidence about the need for the procedure, the surgical alternatives and possible complications, and an informed consent should be obtained. Patients are given pharyngeal anesthesia and conscious sedation administered along with hyoscine butylbromide injection prior to the procedure.
DESCRIPTION OF THE PROCEDURE
An endoscopic examination is done to visualize the narrowed segment and to look for the presence of active ulcer disease. A wire-guided balloon is preferred over a non-wire guided balloon, as it allows greater maneuverability and aids passage across a stenosed or displaced pylorus. Using an over-the-wire TTS balloon, the guide wire is pushed out of the balloon catheter tip and advanced through the stricture segment. Fluoroscopy is helpful to guide the placement of balloons in tight, tortuous and long strictures.
If the antral narrowing is associated with shortening of the lesser curvature of the stomach as well, it may be difficult to negotiate the lumen of the antrum because the plane of the antrum is at a right angle to the plane of the body. Since the capacity of the stomach is reduced in most such patients, the endoscope cannot be positioned along the long-route. It is best, in such instances, to insufflate as little air as possible and approach the narrowed segment from a distance with the balloon. However, it must be ensured that the endoscope is close to the narrowed segment when the balloon is inflated, otherwise the shaft of the balloon catheter can get kinked and the balloon can slip out of the narrowed segment. Another useful trick is to give a curve to the tip of the balloon catheter to gain access into the narrowed segment.
The balloon is negotiated across the stricture so as to ensure the centre of the stricture lies at the centre of the balloon. This can be ensured by using contrast mixed saline to inflate the balloon while using fluoroscopic assistance. The balloon is then inflated to a pre-determined pressure using an inflation device. During inflation, care has to be taken that the balloon does not slip in or slip out of the stricture. Dilation of the balloons or a single balloon with incremental diameters can be used in the same session. The choice of the diameter of the balloon is made depending on the endoscopist’s subjective assessment of the luminal diameter. During the balloon inflation, the patient is monitored for pain and endoscopic observation made for bleeding or any tear. Post-procedure the patient is monitored for signs and symptoms of perforation and bleeding for 4-6 h. In patients with suspected perforation, a contrast study should be carried out immediately using water soluble contrast medium.
Stable patients are allowed a liquid diet on the same day. The procedure is repeated every 1-2 wk until the end point of 15-18 mm lumen is achieved (see below). Once the end point has been reached, patients should be followed up for recurrence of symptoms and repeat endoscopy should be performed to look for persistence or re-appearance of ulceration. In patients with H. pylori related peptic ulcer, eradication of H. pylori should be confirmed.
When should dilation be started?
As stated previously, it is best to wait for 8 wk after caustic ingestion to allow for natural healing. There are no studies that show whether balloon dilation can be carried out in the sub-acute phase.
How frequently should dilation be done?
Although different workers have dilated at 1-3 wk intervals, we advocate weekly dilation to facilitate: (a) reaching the end point of 15 mm, in a short period of time; and (b) maintaining nutritional status of the patient. Once adequate nutrition is ensured, the interval between dilations can be varied, taking into account the social circumstances; e.g. the distance the patient travels, etc.
Maintenance of nutrition
Since patients are likely to have symptoms of GOO, it is important to maintain nutrition during the period of dilation. Total parenteral nutrition is most effective, but affordability may pose a problem. We advocate naso-jejunal tube feeding after acute corrosive injury, ≥ Gr 11b endoscopically until reepithelization is complete, which generally takes 6-8 wk before the patient is started on balloon dilation. If successful dilation can be carried out to 8-10 mm, an homogenized liquid diet can be allowed orally, ensuring adequate calorie and protein intake. As the stricture opens up, semisolids may be allowed. A good indicator of the adequacy of response to dilation is the residue seen before each dilation.
OUTCOME OF ENDOSCOPIC BALLOON DILATION
The results of EBD for peptic-GOO have been variable because not all studies have taken into account compounding factors, such as the presence of H. pylori, use of NSAIDs, and compliance with proton pump inhibitor drug intake. Immediate relief with EBD has been universally found in most studies, but the long term response has varied from a dismal 16% to 100%. Studies that looked for and eradicated H. pylori have reported a good long term response in 70%-80% of patients over 9 to 98 mo of follow up[12,13,18,23,24].
Boylan et al found that young age, long duration of symptoms needing more than one session of EBD and continuous use of NSAIDs were associated with adverse outcomes and predicted the need for multiple dilations and surgery. DiSario et al reported a longer length of the narrowed segment was a poor prognostic sign. Most of the studies have not commented upon the long-term use of proton pump inhibitors making comparisons between studies difficult.
Only a few studies have addressed the issue of H. pylori in these patients. Boylan et al reported results on 40 patients with peptic-GOO in which 28 had recurrent symptoms, of whom 12 required surgery. H. pylori infection was detected in 9 patients and all achieved eradication, with only 1 requiring surgery. Among the 31 patients who were negative for H. pylori or were not investigated for it, 11 required surgery. More recently, Lam et al compared the outcomes of 14 H. pylori positive patients with 11 who were negative for H. pylori. The response rate of EBD was 78.6% in the former and 45.4% in the latter. They also reported that, during a follow up of 24 mo, eradication of H. pylori combined with EBD was associated with 21% cases of ulcer complications such as bleeding or obstruction, as compared to 55% in the H. pylori negative group. Kochhar et al reported a 100% response rate in 11 patients, all of whom had successful eradication of H. pylori after 1-3 sessions of EBD. A study by Cherian et al also reported similar results. They subjected 21 patients to EBD for GOO (H. pylori = 12, NSAID-related = 3, both H. pylori and NSAID-related = 5 and others = 3). After eradicating H. pylori and removing the other offending cause, they achieved success in all their patients, with 17 of them requiring maintenance acid suppressive therapy.
The data quoted above shows that more than three-fourths of patients with peptic-GOO can be successfully treated with EBD provided H. pylori is eradicated, offending NSAIDs are stopped and maintenance acid suppressant therapy is given. The available literature, therefore, suggests that long term proton pump inhibitor usage may be required to prevent recurrences. However, prospective studies are needed to answer this question definitely.
Surgery has been the mainstay of treatment for caustic induced GOO, but recent reports suggest that EBD can be an effective alternative form of therapy in a select group of these patients[15,26]. However, compared to peptic-GOO cases, these patients have more recurrences and require a larger number of EBD sessions. Solt et al studied 17 patients with caustic-GOO out of a total of 72 and only one-third had a long-term response with EBD.
Kochhar et al reported that 8 of their 23 patients with GOO had a history of caustic ingestion, and they required 2-9 sessions of EBD, as compared to 1-3 sessions for peptic-GOO cases. In another recent study on 41 patients, they showed that caustic-induced GOO could be treated with EBD in 39 of these patients, with no recurrences over 18-58 mo of follow up. The 39 patients required a mean of 5-8 sessions (range 2-13 sessions) to reach the end point of 15 mm. Only 2 patients failed to respond, one who had a perforation and another who had recurrent pain during each dilation. Only one patient had a supplementary procedure in the form of electrosurgical incision to augment the effect of EBD. However, they excluded patients with active ulceration and did not include patients with stricture length more than 2.5 cm.
Chronic pancreatitis associated GOO is reported to be more resistant to EBD, and in one study all 4 such patients required surgery. Tuberculosis was incriminated as a cause of GOO by Misra and Dwivedi and they reported successful EBD in that patient. Anastomotic strictures following gastric resection have been treated with EBD by a few workers. Kozarek et al had 7 such patients, out of a total of 23 patients with GOO. Only 4 of the 7 patients with anastomotic strictures had good long-term responses.
GOO associated with use of NSAID use has also been treated with EBD by a few workers. Cherian et al have emphasized the fact that stopping NSAIDs is essential to successful long-term outcomes in these patients.
Patients with Crohn’s disease causing GOO have also been subjected to EBD, with variable results. Murthy reported one case of obstructive Crohn’s disease who underwent repeated sessions of EBD, but failed to respond. Solt et al also treated one such patient who did not respond and required surgery. Kim et al, however, had a satisfactory response in one patient with postbulbar Crohn’s disease, in whom they used fluoroscopically guided balloon dilation.
Anastomotic strictures following vertical band gastroplasty or gastric bypass surgery for morbid obesity have also been successfully dilated with balloon catheters endoscopically. In one such study, EBD was successful in 68% of the 40 patients studied. In a retrospective analysis, Solt et al found good responses in all 18 patients with postoperative strictures and 6 patients with postvagotomy functional stenosis. Fluoroscopically guided balloon dilation has also been equally successful with response rates as high as 94%.
AUGMENTING THE EFFICACY OF ENDOSCOPIC BALLOON DILATION
A number of workers have used supplementary techniques to augment the effect of EBD. These include intralesional steroid injections and endoscopic incision of the strictures segment.
Combination of balloon dilation and intralesional steroid injections
We have reported use of intralesional steroids injection in patients with caustic GOO augmented the effect of balloon dilation. Two of these patients had failed to show satisfactory responses to balloon dilation while the third was given steroids right at the time of first dilation. All three patients responded with (1, 2 and 2) sessions of steroid injections. The idea of using steroids is to facilitate dilation and reduce recurrence. Intralesional steroid injections have been shown to inhibit stricture formation by interfering with collagen synthesis, fibrosis and chronic scarring. It has been suggested that triamcinolone presents the cross linking of collagen that results in scar contracture; so if the scar is stretched and steroid injected into it, presumably the contracture will not occur. Steroids also decrease the fibrotic healing that appears after dilation. Gandhi et al observed that with corticosteroid injections and dilation, longer corrosive esophageal strictures become shorter with time and thus more amenable to nonsurgical treatment. We have shown that intralesional steroid injections reduce the need for dilation in caustic esophageal strictures, and even longer strictures (> 3 cm) can be managed successfully. There is only one other report of use of intralesional steroids in pyloric stenosis apart from ours, in which Lee et al successfully treated two cases (one peptic, another post-pyloroplasty) with steroids and balloon dilations.
Endoscopic incision and balloon dilation
Baron et al used electrosurgical incision using a standard sphincterotomy to successfully treat a patient with pyloric stenosis resistant to EBD. Hagiwara et al used needle-knife radial incisions electrosurgically at gastroscopy combined with EBD in patients with refractory anastomotic pyloric stenosis. We have also used this technique in one of the patients with caustic-induced GOO, who had become pregnant while on a dilation programme.
End point of balloon dilation
There is as yet no consensus on the issue of end point of balloon dilation. Kozarek et al felt that the effective balloon size required to dilate pyloric stenosis appears to be 41 Fr, as it achieves immediate relief in 80%. Most workers[12,15-17,23,26] have used 15 mm balloons as the end point while some have dilated to 10 mm or 12 mm only[13,18]. Rarely, balloons of 16 mm, 18 mm and 20 mm are used[11,13,18]. Most workers inflate the balloon for 30 s to 60 s and repeat once again before withdrawing. While some workers-have used a single session of dilation, others use repeat dilations at variable intervals. All these observations are on pyloric stenosis caused by peptic ulceration or anastomotic strictures. We have been more cautious than others; in our patients with peptic and caustic induced GOO, we dilate in step-wise manner, from 8 mm to 10 mm in the first few sessions, 10 mm to 12 mm in the next few sessions and 12 mm to 15 mm subsequently[15,26].
Safety of balloon dilation
Hydrostatic balloon dilation is generally a safe procedure. Kozarek et al encountered one perforation out of 23 cases with peptic ulcer related stenosis. The balloon diameter used was not mentioned. Lau et al reported 4 perforations in 54 patients. Two of their 16 patients undergoing dilation with a 16 mm balloon had perforation while 2 of the 3 undergoing 20 mm dilation perforated, with none of the 10 undergoing 18 mm dilation having any complication. It thus seems that increasing the balloon diameter beyond 15 mm is more likely to be associated with perforation. Arterial bleeding has been rarely reported, though self limiting minor bleeding is not uncommon. Pain during EBD is not uncommon, but is often self limiting. In a recent study, 19.5% of patients with caustic-GOO had self-limiting pain during the procedure.
Peer reviewer: Tian-Le Ma, MD, Department of Gastroenterology, Rui Jin Hospital Affiliated to Medical College of Shanghai Jiao Tong University, Shanghai 200040, China
S- Editor Zhang HN L- Editor Lutze M E- Editor Ma WH
Johnson CD, Ellis H. Gastric outlet obstruction now predicts malignancy.Br J Surg. 1990;77:1023-1024.
Paimela H, Tuompo PK, Peräkyl T, Saario I, Höckerstedt K, Kivilaakso E. Peptic ulcer surgery during the H2-receptor antagonist era: a population-based epidemiological study of ulcer surgery in Helsinki from 1972 to 1987.Br J Surg. 1991;78:28-31.
Perng CL, Lin HJ, Lo WC, Lai CR, Guo WS, Lee SD. Characteristics of patients with benign gastric outlet obstruction requiring surgery after endoscopic balloon dilation.Am J Gastroenterol. 1996;91:987-990.
Cherian PT, Cherian S, Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy.Gastrointest Endosc. 2007;66:491-497.
Kozarek RA, Botoman VA, Patterson DJ. Long-term follow-up in patients who have undergone balloon dilation for gastric outlet obstruction.Gastrointest Endosc. 1990;36:558-561.
Kuwada SK, Alexander GL. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis.Gastrointest Endosc. 1995;41:15-17.
Lam YH, Lau JY, Fung TM, Ng EK, Wong SK, Sung JJ, Chung SS. Endoscopic balloon dilation for benign gastric outlet obstruction with or without Helicobacter pylori infection.Gastrointest Endosc. 2004;60:229-233.
Kochhar R, Dutta U, Sethy PK, Singh G, Sinha SK, Nagi B, Wig JD, Singh K. Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction.Gastrointest Endosc. 2009;69:800-805.
Kim JH, Shin JH, Di ZH, Ko GY, Yoon HK, Sung KB, Song HY. Benign duodenal strictures: treatment by means of fluoroscopically guided balloon dilation.J Vasc Interv Radiol. 2005;16:543-548.
Sataloff DM, Lieber CP, Seinige UL. Strictures following gastric stapling for morbid obesity. Results of endoscopic dilatation.Am Surg. 1990;56:167-174.
Kim JH, Shin JH, Bae JI, Di ZH, Lim JO, Kim TH, Ko GY, Yoon HK, Sung KB, Song HY. Gastric outlet obstruction caused by benign anastomotic stricture: treatment by fluoroscopically guided balloon dilation.J Vasc Interv Radiol. 2005;16:699-704.
Kochhar R, Sriram PV, Ray JD, Kumar S, Nagi B, Singh K. Intralesional steroid injections for corrosive induced pyloric stenosis.Endoscopy. 1998;30:734-736.
Ashcraft KW, Holder TM. The experimental treatment of esophageal strictures by intralesional steroid injections.J Thorac Cardiovasc Surg. 1969;58:685-693.
Ketchum LD, Smith J, Robinson DW, Masters FW. The treatment of hypertrophic scar, keloid and scar contracture by triamcinolone acetonide.Plast Reconstr Surg. 1966;38:209-218.
Gandhi RP, Cooper A, Barlow BA. Successful management of esophageal strictures without resection or replacement.J Pediatr Surg. 1989;24:745-749; discussion 749-750.
Kochhar R, Ray JD, Sriram PV, Kumar S, Singh K. Intralesional steroids augment the effects of endoscopic dilation in corrosive esophageal strictures.Gastrointest Endosc. 1999;49:509-513.
Lee M, Kubik CM, Polhamus CD, Brady CE 3rd, Kadakia SC. Preliminary experience with endoscopic intralesional steroid injection therapy for refractory upper gastrointestinal strictures.Gastrointest Endosc. 1995;41:598-601.
Baron B, Gross KR. Successful dilation of pyloric stricture resistant to balloon dilation with electrocautery using a sphincterotome.J Clin Gastroenterol. 1996;23:239-241.
Hagiwara A, Sonoyama Y, Togawa T, Yamasaki J, Sakakura C, Yamagishi H. Combined use of electrosurgical incisions and balloon dilatation for the treatment of refractory postoperative pyloric stenosis.Gastrointest Endosc. 2001;53:504-508.


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Naruto Tamil Dubbed Episodes telegram link 1080p, 720p, 480p
Naruto Tamil Dubbed Episodes telegram link 1080p, 720p, 480p – In the realm of anime and manga, few series have left as indelible a mark as “Naruto.” Created by Masashi Kishimoto, this iconic tale has captured the hearts of fans worldwide with its rich narrative, diverse characters, and profound themes. In this comprehensive article, we will embark on a journey through the Hidden Leaf Village and beyond, exploring the captivating story of Naruto Uzumaki, summarizing the series, and delving into a detailed review.
The World of Naruto: Before delving into the epic story, let’s take a moment to immerse ourselves in the world of Naruto. The series unfolds in the hidden ninja village known as Konoha, nestled within the Land of Fire, one of the Five Great Shinobi Countries in the Ninja World. Here, skilled ninjas wield incredible powers, and the dream of becoming the Hokage, the village’s leader, is a cherished aspiration.
Naruto Tamil Dubbed Episodes Download Story Filmymeet
The Story of Naruto: The tale begins with a cataclysmic event: the attack of the Nine-Tails, a formidable fox spirit, upon Konoha. In a heroic sacrifice, the Fourth Hokage, Minato Namikaze, seals the beast within the body of his newborn son, Naruto Uzumaki. This act, while saving the village, marks Naruto as an outcast, bearing the stigma of the Nine-Tails’ presence.
Naruto’s childhood is marred by isolation and scorn from the villagers, who fear the beast within him. However, Naruto is resolute in his desire to gain recognition and become the Hokage, proving that he can be a force for good. His journey is marked by resilience, perseverance, and the indomitable spirit that defines him.
As the series unfolds, we witness Naruto’s growth in two distinct phases. The first part encompasses his pre-teen years, chronicled in volumes 1 to 27 of the manga. In the second phase, Naruto enters his teenage years, spanning volumes 28 to 72.
The Manga and Anime: “Naruto” made its debut in Shueisha’s Weekly Shōnen Jump in September 1999 and concluded in November 2014, with the chapters compiled into 72 tankōbon volumes. The manga’s popularity led to its adaptation into an anime series, with the first part comprising 220 episodes that aired from October 2002 to February 2007.
The anime’s English dub reached audiences on Cartoon Network and YTV from September 2005 to December 2009. A second series, “Naruto: Shippuden,” continued the story from volumes 28 onwards, running for 500 episodes from February 2007 to March 2017. The English dub of “Shippuden” transitioned to Adult Swim’s Toonami programming block in January 2014.
Expanding Horizons: Movies and More: Beyond the manga and anime, the “Naruto” universe expanded with 11 animated films and 12 original video animations (OVAs), offering fans new adventures and insights into their beloved characters. Light novels, video games, and trading cards further enriched the franchise, cementing its place in popular culture.
Global Reach and Recognition: “Naruto” achieved remarkable success on a global scale, with 250 million copies of the manga circulating in 47 countries and regions. Japan alone accounted for 153 million copies, while the remaining 97 million found homes elsewhere. The English translations of the manga consistently appeared on USA Today and The New York Times bestseller lists, with the seventh volume even earning a Quill Award in 2006.
Reviewers and fans alike lauded the series for its exceptional character development, intricate storylines, and well-executed action sequences. While some critics noted that the action occasionally slowed the narrative’s pace, the series’ overarching theme of coming of age, coupled with its cultural references from Japanese mythology and Confucianism, added depth and complexity.
At the heart of “Naruto” lies a gripping narrative. The story kicks off with the Nine-Tails’ attack on Konoha and its subsequent sealing within Naruto. This event marks the young ninja as an outcast in his own village, bearing the weight of the beast’s reputation. It’s not until 12 years later that Naruto discovers the truth behind the Nine-Tails, thanks to a revelation from Mizuki, a renegade ninja. His victory over Mizuki earns him the respect of his teacher, Iruka Umino.
Soon after, Naruto embarks on his journey as a ninja, forming Team 7 with Sasuke Uchiha, Sakura Haruno, and their mentor, Kakashi Hatake. Together, they undertake missions ranging from mundane chores to life-threatening assignments. Their bonds strengthen as they face various challenges, both as individuals and as a team.
As the story unfolds, the series takes on a darker tone with the arrival of Orochimaru, a wanted criminal with a sinister agenda. His pursuit of Sasuke, driven by the latter’s potent genetic heritage—the Sharingan—sets in motion a series of events that will test the bonds of Team 7.
Sasuke’s quest to avenge his clan by confronting his older brother, Itachi, further deepens the narrative’s complexity. When Sasuke’s attempt to defeat Itachi fails, he makes a fateful decision—to join Orochimaru in pursuit of the strength needed to fulfill his vendetta. This pivotal moment leads to Naruto’s determination to bring Sasuke back to the village.
Naruto leaves Konoha to seek training from the legendary ninja Jiraiya, while Sakura becomes the apprentice of Tsunade, who eventually assumes the mantle of the Fifth Hokage. The story thus unfolds as a tale of personal growth, vengeance, and the pursuit of one’s true path.
Naruto Tamil Dubbed Episodes Download Review Filmyhit
The legacy of “Naruto” in the world of anime is undeniable, and for good reason. This series, which emerged on the heels of “Dragon Ball Z,” introduced a new generation of fans to the genre. While “Dragon Ball” was known for its action-packed sequences, “Naruto” blended dynamic combat with rich storytelling and character development.
“Naruto” presents the classic shonen anime formula: an underdog hero with latent abilities who embarks on a journey to hone his skills, facing ever-stronger adversaries along the way. Naruto Uzumaki embodies this archetype, but his story is far from formulaic.
Masashi Kishimoto’s storytelling prowess shines through in the series. While “Naruto” draws inspiration from “Dragon Ball,” it distinguishes itself with its meaningful morals and themes. Naruto’s status as an outcast resonates with audiences, and his journey to prove his worth is a universal narrative. Moreover, his character’s growth, both in terms of maturity and in mastering the inner demon within him, adds depth to his arc.
One of the series’ strengths lies in its complex character dynamics. Naruto and Sasuke, despite their different backgrounds, share the common thread of loss and personal goals. Sasuke’s desire to avenge his clan mirrors Naruto’s quest for recognition. These parallels create a compelling rivalry that evolves throughout the series, keeping viewers engaged and invested in their development.
While some characters, such as Sakura, may have initially fallen into the love interest archetype, “Naruto” eventually provides them with opportunities for growth and meaningful contributions to the narrative. However, it’s the side characters who truly shine. Characters like Shikamaru, Rock Lee, Neji Hyuga, and Gaara bring diversity to the cast, each facing their own challenges and seeking to break free from societal constraints.
The series masterfully weaves its characters’ dilemmas into the overarching conflict—nations on the brink of all-out war. “Naruto” unveils a world that initially appears peaceful but gradually reveals its divisions and inequities. The political intrigue surrounding the ninja governments adds depth to the narrative, highlighting the difficult choices faced by those in power.
“Naruto” is equally renowned for its combat sequences. Unlike the brute force of “Dragon Ball,” the series emphasizes strategy and the mastery of chakra-based jutsu. Each character’s unique abilities and creative use of jutsu result in intricate battles that captivate viewers. It’s a testament to the series’ ability to surprise the audience by encouraging characters to think outside the box to gain the upper hand.
The series’ structure feels like a prologue to a larger narrative. Many plotlines are introduced, leaving them open-ended for continuation in “Naruto: Shippuden,” the sequel series. This strategic storytelling approach keeps fans invested in the unfolding saga.
In retrospect, “Naruto” may not be a die-hard favorite for everyone, but it has a unique place in the hearts of many. Its captivating characters, intricate world-building, and timeless themes continue to draw viewers into its ninja-infused world. Whether you’re a seasoned anime enthusiast or a newcomer, “Naruto” is a journey worth embarking upon.
Conclusion: In the annals of anime history, “Naruto” stands tall as a testament to the power of storytelling. It has captured the imaginations of countless fans, taking them on a rollercoaster ride through the hidden leaf village and beyond. With its enduring legacy, complex characters, and profound themes, “Naruto” remains a defining work in the world of anime and manga. Whether you’re a ninja-in-training or a seasoned Hokage, the story of Naruto Uzumaki continues to inspire and entertain, proving that the quest for recognition and the pursuit of one’s true path are universal themes that resonate across cultures and generations.
Naruto Tamil Dubbed Episodes Download Cast Filmyzilla
|Junko Takeuchi||Naruto Uzumaki|
|Maile Flanagan||Naruto Uzumaki|
|Kate Higgins||Sakura Haruno|
|Chie Nakamura||Sakura Haruno|
|Noriaki Sugiyama||Sasuke Uchiha|
|Yuri Lowenthal||Sasuke Uchiha|
|Dave Wittenberg||Kakashi Hatake|
|Laurent Vernin||Itachi Uchiha|
|Colleen O’Shaughnessey||Ino Yamanaka|
|Steve Staley||Neji Hyuga|
|Kôichi Tôchika||Neji Hyûga|
Naruto Tamil Dubbed Episodes Download Crew Members Filmywap
Mary Elizabeth McGlynn
|Music By||Toshio Masuda|
|Cinematography by||Atsuho Matsumoto|
|Film Editing By||Seiji Morita|
|Production Design by||–|
|Costume Design by||–|
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Is Naruto 18 plus?
No, “Naruto” is not an adult-rated series. It’s primarily targeted at a teenage audience and is rated for teenagers and older children.
Is Naruto 30 years old?
No, Naruto is not 30 years old. He is a fictional character, and his age varies throughout the series. Naruto’s age progresses from a young child to a teenager as the story unfolds.

domain: library


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Probably the best way to describe Ensco's (VAL) most recent earnings report is that it wasn't as bad as some others in the industry. While the company's net income numbers continue to slide, management really went out of its way to highlight one particular element this past quarter: Its balance sheet. The reason it wants this message to ring clear is because it wants to distinguish itself from the more financially distressed companies in the business.
Here's how Ensco's fourth quarter results played out and why the company thinks it's in a strong position in the offshore rig market today.
By the numbers
|Earnings per share
It's pretty easy to see that year-over-year results for Ensco are practically useless to compare. The company took $2.74 billion in charges related to asset impairment this time last year, which was a huge blow to the earnings but didn't really change the day to day operations of the company.
The declines in revenue and operational income from the prior quarter are more or less par for the course in the offshore rig market today. There has been some interest from producers to do some short contract work, but those long-term, lucrative contracts are in relatively short supply as of late and rigs are rolling off of those older contracts. At the end of the quarter, Ensco had a fleet utilization rate of 51% with an average day rate for the entire fleet of $176,700.
What the company highlighted the most, though, was its balance sheet and the ability to weather the storm for much longer. Over the past several months the company completed two debt transactions: An issuance of $850 million in convertible senior notes, and a debt exchange that extended the maturity of its nearest-term debt out to 2024. As a result, the nearest debt maturity has been pushed out to 2019 and the company now has $2.3 billion in cash and short term investments on hand.
One of the reasons that Ensco was so quick to highlight its balance sheet strength is because one of its largest competitors -- Seadrill (SDRL) -- announced that it was in the middle of negotiations with creditors to deal with its heap of debt that is due within the next couple of months. Clearly, the market for offshore oil and gas drilling has been much, much slower than many expected. Therefore, strength of balance sheet and liquidity remain critical factors to keep the business afloat for longer.
What management had to say
CEO Carl Trowell on the company's most recent financial actions and how it sets the company up for the rest of the year and beyond.
Recently, we completed two transactions -- an $850 million convertible senior notes offering in December and a debt exchange of $650 million of our nearest-term maturities for cash and new 2024 senior notes in January -- that raised $476 million of net proceeds. As a consequence of these transactions and other capital management actions taken during 2016, we have lowered our net debt by $1.9 billion and increased liquidity by $1.0 billion since the end of 2015. Additionally, we have reduced our debt maturities over the next seven years to $1.15 billion from $2.90 billion a year ago, providing us with enhanced capital management flexibility.
As we navigate through the downturn, we remain focused on what we can control -- delivering safe and efficient operations to our customers, proactively managing our capital structure and ensuring that we are well positioned for the eventual market upturn.
What a Fool believes
It's hard to call Ensco's most recent quarter great, or even good for that matter. Revenues and earnings continue to decline as producers are still tepid about plowing billions of dollars into multi-year offshore development projects. Eventually, offshore drilling will have to fill the needs from growing oil demand and the natural decline of production, but the burst of shale production has meant that need is pushed further into the future.
Thanks to the moves Ensco has made involving its debt, the company is set up reasonably well to handle a continued decline for some time. Not all companies in this business can confidently say that right now, which bodes well for the company down the road.

domain: finance


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Crystal clear audio with accurate sound reproduction. The SZC-300 is a great quality large diaphragm condenser microphone with a wide frequency range designed to complement a wide variety of vocal and instrument applications. With low distortion FET circuitry this mic offers fantastic tone quality and incredible sound reproduction. The SZC-300 condenser mic is perfect for studio and live situations, producing amazing results for recording vocals and acoustic instruments alike.
Nearly New: This product may have been opened for quality control purposes, returned by a customer, refurbished, or may have non-essential parts or software missing. Otherwise, the product operates as new. This is a great opportunity to buy a fully functioning product at a discounted price.
Product Ref: 125268
The SZC-300 is a high quality, large diaphragm condenser microphone, housed in a sturdy and durable metal chassis. This mic is ideal for broadcasting, podcasting, live performances, studio recording, home recording and much more! This mic utilises a cardioid pattern that focuses on picking up the main sound source and minimising unwanted extraneous noise. This particular type of pattern is ideal for vocals, as it will accentuate the chosen sound that is directed at it. The frequency response and sensitivity of the microphone also ensures the most accurate sound reproduction possible.
The SZC-300 accurately reproduces the recorded audio with a clear transparent sound and a warm tone. With a broad frequency range it is able to capture a wide range of dynamics over a full range of pitches. This mic uses FET circuitry, specially chosen for its low distortion and superior signal to noise ratio; giving a clear and accurate sound. The robust chassis and included mic cradle means there is very little handling noise, retaining a clean, isolated sound. Also included is a microphone pouch, so you can easily transport your gear.
SubZero's wide range of instruments represents the latest in innovation and versatility, offering high grade components and quality craftsmanship at an affordable price. Drawing inspiration from boutique designs, SubZero has created a series of affordable, reliable and modern instruments, offering high quality gear for the modern musician.
With a full range of audio equipment including Amplifiers, Speakers, Mixers, PA, Microphones and Electric Guitars; SubZero products feature the same attention-to-detail that one would expect from any high quality audio manufacturer. SubZero is proud to deliver the ultimate in value, looks and cutting edge sound.


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Freedom and adventures start where the road ends: discover and explore the Alps’ most beautiful spots on two wheels! Thrilling mountain bike routes to gentle pasture trails and scenic cycleways along rivers… serious mountain bikers as well as leisure cyclists will find plenty to keep them entertained in the Alps!
|-||Sign-posted cycleways and mountain bike routes|
|-||Licensed cycle sports schools and bicycle rental shops|
|-||Bike-friendly hotels offering bike guides and guided tours|
|-||Bicycle transport on mountain lifts, trains and boats...|

domain: hobby


Discover New York
Skyscrapers dwarf the avenues below, and the sidewalks thrum with life day and night.
The clichés about New York are true – but that's just the surface. Alongside the iconic buildings, the city’s neighbourhoods are home to people and influences from around the globe; it's the diversity in everything that makes the Big Apple so uniquely exciting.
'The city that never sleeps' isn't just an empty title. Even the subway runs 24/7 to cater for the early-morning mass exits from the coolest bars, clubs and lounges in the country. Nightlife trends change quickly in New York, but swanky cocktail bars, Art Deco spaces, retro décor and tiki lounges have pretty enduring appeal.
Classic haunts such as sophisticated hotel bars, timeless taverns and fun dives remain a staple on the city’s nightlife scene. Try a rooftop bar for staggering views across the Manhattan skyline.
The live music scene is among the best in the world, and the diversity of venues reflects the range of artists, from big names to up-and-coming bands. Everything from hip hop to punk, jazz and pop is on offer. Dance clubs are a major feature on the after-dark New York scene. Whether it’s house or 80s classics that get your feet moving, you'll find them.
Broadway steals the limelight when it comes to theatre in New York, but there are classical music concerts, dance, ballet, opera and comedy in venues all over the city too.


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American Society for Therapeutic Radiology and Oncology (41st : 1999 : San Antonio, Texas).
San Antonio, Tx.:
Henry B. Gonzalez Convention Center
5 copies, 5 available
BC Cancer Agency
- Call Number
QZ269 A513 1999 PT.1-5
PT.1: Techniques, terminology and concepts ; PT.2: Molecular insights in the cancer cell ; PT.3: Radiation resistance : what is it? How can we overcome it? ; PT.4: Radiation therapy for benign disease : contemporary concepts and clinical results ; PT.5: Role of radiation therapy in the mana…


What Kinda Bike Is That?
Join Date: Mar 2008
Location: Mount Desert Island, Maine
I do the task by the following steps.
With the motorcycle on its sidestand:
1- Back off all preload on the fork caps.
2- "Crack" the fork caps loose; Just Loose.
3 - Loosen both LOWER fork clamp bolts on both fork tubes.
4 - Loosen, and remove the brake lines on the left and right hand side.
6- Loosen, and remove the left and right fender bolts.
5 - Loosen, and remove the left and right brake calipers and hang them out of the way.
6- Loosen, and remove the speedometer sending cable.
7 - Loosen front axle pinch bolt. (This does not need to be removed.)
8 - "Crack" the front axle loose.
With the motorcycle now rolled up on its centerstand:
9- Raise the front end of the motorcycle, off of the floor, with a floor jack underneath the skidplate, or motor. Make sure that the rear wheel is touching the floor for a "Three Point" contact; both feet of the centerstand, and the rear wheel.
10- Remove the front axle and let the front wheel drop free.
11- Kneel in front of your bike, with one hand on the right fork tube, reach up and loosen the TOP fork clamp bolt. The fork tube will want to slide right out into your hand! Don't let it. Remove the front fender first before removing the fork tube.
12- Work one fork tube at a time. That's just my opinion though. For me, there are less parts to kick around with the tip of my shoe, and also less fork oil to spill too. And, I have done all of these things!
A- What I just described is a "Top Down" method of disassembling the front end of your motorcycle. Work from the top down, and once you are at the bottom, you will "catch" the fork tube coming out of the top fork clamp.
B- If you have a forkbrace installed, that has to be worked into the "Top Down" sequence too.
C- What I just described, I am doing from memory. My motorcycle is a little different then yours. But, the "method" is still the same; work from the top, down to the axle.
D- The idea of doing a lot of the "loosening" of bolts, while the motorcycle is on its sidestand is, it is safer. The "three point stance" of the bike is much larger, (the front wheel, the back wheel, and the sidestand are spread far apart.), when it is on its sidestand, then when it is up on the centerstand. Any "heavy wrenching" is being done when the bike is in its safest stance; on the sidestand.
2007 DL-650 (I gave away in 2012 with 111,000 + miles)
"A word grows to a thought; a thought to an idea; an idea to an act. All the pieces are put together, and the whole is yours."
1942, Beryl Markham: "West With the Night"
"You can talk about doing a thing until everyone finally talks you out of it, or you can actually do the thing"
James Baldwin "Across Islands and Oceans"
Last edited by Black Lab; 06-13-2012 at 05:38 PM.