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They start as the same engines, but SBK rebuilds their engines several times. Someone said 25-35 engine rebuilds on a dozen engines or more. Plus, CRTs have to use the Bridgestone rubber, where SBK runs Pirelli. I wonder how much $$$ a factory supported SBK teams spend compared to say the DePunet/Espargaro Aprilia team?


One of the most important skills for a web content producer, is understanding the fundamentals of search engine optimization (SEO). SEO means building contents in a way that makes the pages rank high in search engine results.
In addition to building tailor-made websites and designing memorable corporate identities, nopea.media’s parent company Verkkovaraani helps its customers in the challenges of digital marketing. The different fields of digital marketing, such as SEO and Google Ads, help an organization make the best of the potential web offers.
Millions of Google searches are made daily in a country like Finland, and the scale of daily global search numbers add up to around 3,5 billion. Taking this into consideration, it’s easy to understand, how big of an audience you can achieve with effective digital marketing. Using carefully selected keywords, monitoring your digital presence and investing in other relevant fields of digital marketing, means you get the word out about your products and services to those interested in them. With digital marketing, you reach your desired target audiences easily and effectively.
We Improve Our Customers’ Digital Marketing e.g. by Doing the Following:
- We scan your search engine visibility and use our findings to improve your rankings
- We monitor your Google Ads advertising and optimize it to make it more cost-efficient
- We monitor your Google Analytics and report to you with our findings and suggested actions
- We build newsletter services and teach you how to use them
- We build campaign sites
Improving the Digital Marketing for Tuholaistorjuntakeskus Oy
We help our customer Tuholaistorjuntakeskus (Finnish pest control supplier) in improving their digital marketing. We improve the company’s search engine rankings and Google Ads advertising.
Since we started monitoring and improving the search engine visibility of Tuholaistorjuntakeskus, the rankings of their pages have risen to top 10 with 14 keywords and to top three with four keywords. As much as nine keywords have risen from the original ranking of over 300 to the top 15.
By monitoring the company’s Google Ads advertising, we have been able to pinpoint the weaknesses of advertising, as well as the ads that have performed well. Based on this, we have been able to target the ads better to the right searches. Tuholaistorjuntakeskus has gained more value for their advertising budget. In other words, they have received more contacts and orders.
Read about how SEO and accessibility go hand in hand.
What is SEO?
SEO or search engine optimization is an important part of the content production of a company existing online. SEO aims at achieving as high rankings as possible on search engines – preferably within top three. The higher a page ranks, the better chances it has of been clicked.
Content plays an integral part in determining how a page ranks. By carefully choosing your keywords and using them in copy, headings and images, you help Google understand, which type of content you’re offering and thus which type of visitors would benefit from it. Google’s algorithms evolve constantly, so succeeding in SEO requires following the latest development.
What is Google Ads?
In addition to the so called organic search results achieved by SEO, Google search often shows paid results. These Google Ads advertisements show up right at the top of the search results (and sometimes on the right side or at bottom of the first results page). Google Ads advertising is a useful tool for many organizations to reach their target audiences.
With Google Ads you get several options for advertising your content: from textual ads showing up in search results to display marketing where your videos or images pop up in allocated slots, suchs as banners, on different websites. The price for advertising with Google Ads is determined by the keywords you use and by how many times your ads are clicked.


text:
Thursday, October 19, 2017
Join Kathryn Bradley, professor of the practice of law and director of legal ethics, Duke Law School, and museum gallery guide Ruth Caccavale. Their guided discussion about the U.S. Constitution is part of Durham Reads Together, sponsored by the Durham County Public Library.
New! General admission is free all day Thursday, 10 AM to 9 PM, but tickets are required for the exhibition, The Medici’s Painter.

domain: law


text:
Midnight Express tells the gut-wrenching true story of a young man's incarceration and escape from a Turkish prison. In 1970, Billy Hayes was an English major who left college in search of adventures to write about, like his hero Jack London. He had a rude awakening when he was arrested at the airport in Istanbul trying to board a plane while carrying four pounds of hashish, and given a life sentence.
Regular price: $19.95
The story of Billy Hayes, an American tourist caught attempting to leave Turkey by plane in 1970 with bags of hashish taped to his stomach, for which he was subsequently jailed for five years - and, with only 42 days left to serve, resentenced to life in prison - was made into a major motion picture starring Brad Davis and written by Oliver Stone. But many key aspects of Midnight Express may have been invented by Stone.
Regular price: $0.69

domain: library


text: For this episode of the Eight One Sixty we are joined by special guest Katy Guillen! Her band Katy Guillen and the Girls is coming to an end this weekend with two final blow-out performances — Friday at BB’s Lawnside and Saturday at Knuckleheads. Both shows will be massive, so grab your tickets now, and go early and get in line. We let Katy call the shots on the show today! We listen to BRAND-NEW music from Katy Guillen and the Girls as they say farewell with a four-song EP, "Four Walls." We also hear music from some of Katy’s favorite records and shows of 2018. It's a great time!

domain: artistic


Originally Posted by Gallium
- What distances, what group size, how many rounds per group...and are you shooting from a static two handed position, unsupported?
Distances: 5-7-15-20 yards. GSSF experienced.
Group size: quarter sized to fist sizes when moving the target out. Example: had to pull this out from my old pics...@15 yards...
Stance: Modified Weaver, unsupported.


Re "When government edits the news, we lose": I must assume that the "we" you speak of is "we the media." I don't trust politicians in general, but I trust the media even less. You as a group are as guilty of advancing careers as the government is of protecting careers.
Yes, it is all about "show biz. It's about ratings, marketing, beating the competition," and yes, I am convinced that if you could arrange a 30-minute interview with Osama bin Laden, you would protect his location as a "source." This didn't happen in World War II because reporters knew the value of their own patriotism.
It is obvious that neither you nor any close relative has ever had to fight in a real shooting war. You have no real understanding of what damage the media has done to those who have. I spent a year in Vietnam and know first-hand what was being done there and at home. The media and free speech is what lost the war for us. Never mind the politics of whether we should have been there or not. (Just for the record, as a U.S. Marine in Da Nang, I now believe that we should never have been there in the first place.)
However, since I was there, I saw my friends at home protesting a war being badly blown out of proportion by the media. A media who not only influenced the citizenry, but who also misguided the politicians into running the campaign. Vietnam is the only major conflict in American history led by politicians instead of generals.
The result of all of this was the death of U.S. servicemen who didn't have to die, who would have survived if they had been allowed to fight the war the way they were trained, but could not because three-piece suits in Washington felt they knew better than four-star generals in the field, because the media told them so.
Michael Hager Parkland


text:
Tutu and the Dalai Lama share their joy
“Our world is not beyond hope … join us in creating a world where love and joy win,” writes South Africa’s Archbishop Desmond Tutu in a new book to be released early in October.
The Book of Joy is based on a momentous meeting between Tutu and His Holiness Dalai Lama last year at the latter’s home in Dharamsala, in the Indian Himalayas.
The friends spent a week in deep dialogue discussing how people can find lasting joy in an uncertain world, and reflecting on their own personal experiences and history. The result is a book filled with their wisdom.
“We came together to speak about how we can find joy even in the face of great suffering,” Tutu said and the book is aimed at sharing their insights.
Publisher Penguin Random House publicist Dominique le Grange said the world was facing a tremendous challenge, “many are experiencing unprecedented levels of anger, divisiveness, pain, fear, suffering and isolation”.
“The Dalai Lama and the Archbishop – two men who have endured true suffering – hope to show, in these dark times, that joy and compassion will always win and to show how we can discover joy in the face of adversity and suffering,” Le Grange said.
The book is being released along with a social media initiative #ShareTheJoy, which asks encourages people to make a short video on their smartphone about what gives them joy, and to share it on social media platforms, such as Facebook, Instagram, Twitter and more, using #ShareTheJoy.
Tutu himself is urging people around the world to take part in the campaign, and stars in a brief video outlining why he believes this is important.
“Our goal is to turn this moment into a larger movement that brings the world together … We’re asking people the world over to help us shine a light in the darkness and not let fear, hate or division have the last word,” Le Grange said.
“We are hoping to reach millions with this movement – in the UK we have confirmed support from Richard Branson, Alanis Morissette, Ariana Huffington, Brene Brown, Susan Cain and more … ”

domain: news


text:
I am mentally marking walnut saplings for removal when they fill with migrants: yellow-rumped and palm warbler, ruby-crowned kinglet.
A swarm of maple helicopters. I sneeze and a wren begins to sing. A kinglet rotates in time to the music. We’re in this dance together.
Kinglets drop down out of the trees to join the gnatcatchers hawking insects in the yard. They sing, feint, flash eponymous ruby crowns.
In the green and yellow woods, here and there a red branch. But the kinglets in the birches hide their ruby crowns under olive-green shocks.
As leaves begin to flutter in the rain, I notice the small birds fluttering underneath them, like a flash mob that was there all along.
Where the moon had glowed through ground fog at 4:00, now the sun glimmers. Four ruby-crowned kinglets flutter in and out of the lilac.
Kinglets move through the birches. I think of their statelets: hidden expandable nests, clutch that weighs as much as the bird that laid it.
How does the poison ivy know to turn the same salmon as the red maple it has infiltrated? A phoebe chases a kinglet from the roadside weeds.

domain: biology


How about THAT?!? That game:
- had heart
- had determination from the top of the lineup on down
- had leadership
- had a 60-minute effort
- had physicality
- had a line brawl--haven't seen one of those in a while, leave it to a Nachbaur team to make it happen
- was Yuen's best game I've seen since, I dunno, last season? It was great.
- was Nickles' best game in a while
- had hussle, lots of it
- was Troy "Too Tall" Trombley's first WHL shutout. Kid had an excellent game, and holy crap he's tall.
- WAS AWESOME.
“The win at Portland (on Friday) gave us confidence for tonight,” Rankin said. “We wanted to have one of these games in front of our fans. We felt the love.”The Herald also has the annual Best of the West poll results today, good showing by the Americans:
Trombley, who has been with the team for a couple of weeks, won both of his starts over the weekend.
“I don’t even know what to say,” Trombley said. “It has been way too good for me. The team has put in a lot of work for me. With the big team win against Portland, that gave me confidence for today.”
The Americans (33-32-1-2, 69 points) won for the second night in a row and leapfrogged Victoria into fifth place in the Western Conference standings.
“For the guys in our room, that is the definition of a great weekend,” said Tri-City coach Jim Hiller, whose team knocked off Portland — the top-ranked team in the CHL — and their biggest rival.
The Chiefs (34-22-2-0, 70 points) held onto fourth place, but coach Don Nachbaur was not pleased with his team’s effort.
“They earned it and we got what we deserved,” Nachbaur said. “It was pretty obvious one team prepared for a war and one team came looking for an easy game. Their nine forwards outskated our 12. They wanted it more than we did.” (Herald)
Best Fans: 2nd (Everett 1st)
Top Executive: Bob Tory 4th
Top Coach: Jim Hiller 4th
Best Overage: Justin Feser
Most Valuable to Team: Justin Feser, Comrie 4th
Top Defensive Forward: Feser 2nd
Best Stay-at-Home Defenseman: Zachary Yuen 5th
Top Rookie: Parker Bowles 5th
Best Goaltender: Eric Comrie
Best Skater: Feser 3rd, Stromwall 4th
Top Faceoff Man: Feser 2nd
Must Underrated Player: Feser
Most Accurate Shot: Feser 6th
Most Irritating Player: Brendan Leipsic HAHAHAHAHAHAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA
Toughest Player: Walter 5th, Mychan 6th
Best Pro Prospect: Comrie 4th


Use a :terminal:
" in ~/.vim/after/ftplugin/python.vim
nnoremap <buffer> <CR> :write <bar> terminal python3 %<CR>
" update b:undo_ftplugin
When the command is finished, you can :set modifiable (:set ma) and edit.
In the end I managed to do this by checking the number of modified buffers.
Once the number of buffers reaches 0, only then run rsync.
" See https://vi.stackexchange.com/a/14313/40380
return len(filter(getbufinfo(), 'v:val.changed == 1'))
autocmd BufWritePost path/to/project/*
You may run
autocmd FileType python map <buffer> <CR> :w<CR>:call Exec('!python3 '.expand('%'))<CR>
exec printf('silent %s',a:cmd)
It writes the output of a command in a new tab.
I ended up combining bits of solutions provided by Luc and Maxim, ending up with the following in my .vimrc:
" clear all mappings starting with space in insert mode
" based on https://vi.stackexchange.com/a/26385/40274
" and https://vi.stackexchange.com/a/26384/40274
function! ClearInsertLeaders() abort
let s:mappings = execute('imap &...
Is this possible using QuitPre?
"Quit" means quitting a buffer as in :quit. You probably want ExitPre instead.
can I implement such functionality using Vimscript?
No, AFAIK, the action cannot be aborted by autocmd.
Based on the user's response, Vim should either quit, or cancel the quit
Simply :set confirm and no worries.
vim-polyglot has addressed this issue.
In commit Use setf for ambiguous extensions from Aug 24, 2020, it started converting from set filetype=... to the setf command, then later commit Make loading faster for ambiguous extensions without heuristics from Sep 29, 2020 expanded the use of setf to other extensions such as .template for filetype json.
This makes ...


text:
Enjoy this live webcam view of London's Oxford street. Courtesy of Transport for London. This Oxford street webcam in the centre of London is looking down one of the most famous and popular shopping street in the Capital City. Oxford Street is home to over 300 shops and is reputed to be one of the world's largest shopping streets. View the traffic on Oxford Street from this live London traffic cam and spot many of London's famous double decker red buses. Oxford Street is very well known for it’s Christmas lights during the Festive period. The Christmas lights are switched on at the end of November and switched off on the 6th January. Check out this great London webcam looking down Oxford street.
London Video Streaming Webcams Portal - check out live streaming London video cameras - HERE
This Oxford street web cam in London is made possible by Transport for London
For up to date traffic information throughout London visit http://trafficalerts.tfl.gov.uk/pinpointlite2/
To view more webcams around the world, visit webcam directory www.world-of-webcams.com

domain: travel


Nissan Leaf Deemed 2018 Green Car of the Year by Automotive Journalists at NAIAS
Beating out nine competitors, Nissan’s sales-leading all electric vehicle, the Nissan Leaf, has been named the 2018 FIPA Green Car of the Year. The inaugural title from the Inter-American Federation of Automobile Journalists (FIPA) was announced at the North American International Auto Show, currently underway in Detroit.
“This award is a clear example of Nissan’s global leadership in electric vehicles and autonomous driving technology under the vision of Nissan Intelligent Mobility, where the brand aims to improve people’s lives through a transformation in how vehicles are driven, powered and integrated into society,” said Luis Valls, Nissan Latin America’s chairman.
The sleekly styled 2018 Nissan Leaf is equipped with Nissan’s commitment to engineering innovations such as ProPILOT autonomous driving technology as well as ProPILOT Park tech, which takes over parking maneuvers. The 2018 Leaf offers drivers 150 horsepower and a driving range of approximately 400 km.
The new Nissan Leaf also incorporates advanced technology in the form of e-Pedal, which “allows the driver to start, accelerate, decelerate, and stop by increasing or decreasing the pressure applied to the accelerator,” according to Nissan. “When the accelerator is fully releases, ‘regenerative and friction brakes are applied automatically, bringing the car to a complete stop. The car holds its position, even on uphill slopes, until the accelerator is pressed again. The reactiveness of the e-Pedal maximizes EV driving pleasure.”
The Nissan Leaf made its debut in 2010, and since then has gone on to become the best-selling EV with 300,000 units sold, reports Nissan.


text:
- Aantal Pagina's:108
Although there have been many books written about medieval women, few have focused specifically on the lady. In a book designed as a companion to the author's previous book. The Knight in Medieval England. Professor Coss attempts to remedy this with a work which concentrates on the role of the lady within medieval society, how she was perceived both by herself and by her male counterparts, how she related to and participated within the seemingly prevailing male culture of gentility, how the lives of lords and ladies inter-related, and how they behaved towards one another. An invaluable work for academic historians and students, it will also have a wider appeal for the general reader and for those interested in both women's and gender history.

domain: literature


text:
Total RNA was extracted from HCT-116 and IMCE cells and tumor-adjacent tissues utilizing the RNeasy mini kit (Qiagen, Carlsbad, CA, USA) and conversely transcribed using the TIANScript reverse transcription kit (TIANGEN Inc.
Lysate of tumors and cellular lysate of IMCE and HCT-116 were prepared by sonication and RIPA buffer.
IMCE and HCT-116 cells were incubated with gradient concentration of silibinin in the absence or presence of LPS for 24 h.
To explore the antitumor activities of silibinin, MTT assay was employed to assess their effects on cell viability in the IMCE cell line and HCT-116 colorectal cancer cells.
Relative expressions of IL-6, IL-1[beta], and TNF-[alpha] in IMCE (a) and HCT-116 cells (b) were presented.
(a, b) IMCE and HCT-116 cells were treated with silibinin at indicated concentrations for 72 h, respectively.
Shinmyozu of the Laboratory of Organic Structural Chemistry, Department of Molecular Chemistry, Graduate School of Sciences & IMCE
, Kyushu University, Japan, for supplying the elemental analysis data of the samples.

domain: chemistry


text:
When Rhode Island PBS put out the call in December for the next Our Town
location, residents from two towns were vocal right away. By the time the January 31 deadline arrived, it was clear that support from two towns was equally enthusiastic.
“The people have spoken, and we will visit two towns in 2015 – North Kingstown
,” said David W. Piccerelli, president of WSBE Rhode Island PBS. North Kingstown will be featured in a documentary televised in September, and Portsmouth will be featured in December.
Piccerelli attributes the enthusiasm for this next chapter of Our Town
to the success of Our Town: Glocester
, the first documentary in the planned series. “The comments that we and the participants received since the premiere are positive and inspiring. We’re looking forward to building on that energy as we take the project to North Kingstown and Portsmouth.”
is a community project wherein neighbors become filmmakers and tell the stories of Our Town
. Part fund-raiser, part community builder, part historical and cultural documentary, and part “day-in-the-life” video scrapbook, Our Town
shares with viewers the local legends, historical happenings, and backyard secrets of the particular town and its villages – untold or uncelebrated stories that capture the essence of the town.
gives the community a platform to share stories and perspectives on the town in their own voices,” Piccerelli said. “It's also a meaningful way for us to connect with our community.”
Residents of North Kingstown and Portsmouth are especially urged to participate, but one need not be a resident of the particular town - just have a great town story to tell. Community meetings and a technical workshop lead up to filming. During the planning meetings, participants discuss and choose the subjects and locations they want to include in the documentary about their town. Two days are allocated for filming, but volunteers can film stories anytime before the deadline.
“Those who wish to start filming right away do not have to wait for the filming dates – just contact the station and let us know,” said Jodi Mesolella, Our Town
project director and director of membership and special projects at Rhode Island PBS.
“The content is decided by the participants. They pick what will be in the film. We’re looking forward to seeing what North Kingstown and Portsmouth choose to do,” Mesolella said.
In each town, Rhode Island PBS will recruit 20 to 25 volunteers with video cameras. There are no restrictions as to age or experience and there is no cost or compensation to participate.
“We will offer guidance, technical advice and support to our volunteers, but this is definitely their story as told by them in their community,” said Margie O’Brien, Our Town
project producer. Video recorded by the volunteers will be edited together by Rhode Island PBS to create a one-hour film of each town.
|Wickford Lighthouse in Wickford Harbor, North Kingstown. Photo credit: Walter Sulyma|
The first planning meeting in North Kingstown will be in early March, with the technical workshop for the volunteer filmmakers in early April. The filming deadline will be mid-June.
|Gull Cove, Portsmouth, RI Photo: Jennifer Teichman|
After an initial planning meeting in March, Portsmouth’s first community meeting will be in August, with the technical workshop and filming deadline in September.
For information about joining the Rhode Island PBS Our Town
project, and for details about meetings as the dates approach, visit ripbs.org/ourtown
, or call Jodi Mesolella (project director) at 401-222-3636, extension 209, Margie O'Brien (producer) at extension 225, or email email@example.com.

domain: geography


text:
A study undertaken by the researchers from Harvard University has stated that a twin sibling diagnosed with cancer poses a threat for the other to develop any form of the disease including common cancers such as breast and prostate and rare cancers such as testicular, head, neck, melanoma, ovarian and stomach.
The study for the first time revealed that in twins where both developed cancer, each twin often developed a different type of cancer, suggesting that some families share an increased risk of any form of cancer. This was realized after the researchers studied the variation in cancer risk of the population due to certain genetic factors.
Researchers for the study looked at more than 200,000 twins, both identical and fraternal, who were followed for an average of 32 years between 1943 and 2010. One in three people developed cancer over the course of a lifetime in which, cancer was diagnosed in both the twins for 3,316 pairs. Of these, the same cancer was diagnosed among 38% of the identical twins and 26 % of the fraternal twins. Study also showed that when one fraternal twin was diagnosed with any form of cancer then chances of the co–twin getting cancer was 37 % whereas the risk jumps to 46% in case of identical twins.


text:
Mental health courts are a part of the criminal justice system and require that offenders, who would be prison-bound, do long-term community service while participating in mental health counseling. Due to the war on drugs and other criminalization problems, the first drug court opened in 1989. With the success of this treatment and solution, mental health courts followed similar principles created by the drug courts to help the mentally ill. One of the great aspects of mental health courts is the wide success they have in helping these individuals; however, why mental health courts are successful remains unknown. Mental health courts use a treatment-oriented approach with the principle of therapeutic jurisprudence, an interdisciplinary method that aims to positively influence the patient’s psychological wellbeing. This study researches why mental health court administrators believe mental health courts are successful and gives their perspective on the process from a holistic point of view.
Mental health court administrators were given questionnaires to determine their educational background, work history, and demographics. They were asked about their discretion, support, funding, organization tactics, data collection, and the program’s success. Once the first round of questioning was completed, selected administrators were questioned further regarding the funding, any challenges they faced, how COVID-19 influenced the profession, job preparation, and characteristics of administrations to figure out why the program is successful. The results of this study were later compared to a similar study with drug court administrators.
In the criminal justice system, there is increased tension in combating political ideology, budget limits, legality, and logistics that cause stress within the system. These problems within the system create obstacles for the administrators but offer a special subset of positions for administrators that focus on problem-solving and court treatment.
The mistreatment of the mentally ill is exemplified through wrongful imprisonment rather than necessary psychiatric help, widespread negative stigmas on asylums, and maltreatment of community-based services for the mentally ill. Since these courts became popular, they sought funding and support, which led to research regarding why these courts were deemed successful. One of the issues is that the term ‘successful’ is not a universally agreed upon term and this research aims to focus on the administrator’s perspective for why the mental courts are successful in their terms. This study uses a mixed methodology between mental health courts and drug courts to better understand the role of administrators and the process within them.
Some of the challenges imposed on mental health courts are maintaining funding resources, agreeing upon treatment options, differences about the success of the program, and stakeholder positions upon said success. Stakeholders’ opinions are one of the bigger challenges that court administrators face, especially with mental health courts, since they are the main components of what success means to the criminal justice system, the individuals in the system, and society.
The first survey the researcher sent went directly to the mental health court administrators listed in the US Substance Abuse and Mental Health Service Administration. This survey will be followed up with more questions regarding what challenges mental health court offices face and pose solutions to what can be done to solve these problems.
Dr. Christine Thompson is a graduate of the College of Social Sciences and Public Policy at Florida State University. This post was based on Christine’s dissertation, written by COSSPP Blog Intern, Lindsey Anderson.

domain: psychology


text:
LongExpo - slow shutter and long exposure camera
By EyeTap Soft
Open iTunes to buy and download apps.
** Capture fantastic long exposure and light trail photos **
** Add amazing effects after long exposure photo capture **
(iOS 7 tested and compatible)
LongExpo is a camera app that enables you to capture high quality long exposure, light trail/stream, and low light photos.
** Features of LongExpo:
1. Three shooting modes: standard mode (for regular long exposure photography), low light mode (adjustable more exposure for low light environment), light trail mode (for light trail, light stream photography)
2. High quality and high resolution capture.
3. Natural and intuitive real-time preview
4. Exposure time span adjustment after shooting
5. Create motion trail effects by the motion gradient and freeze functions
6. Adjustment of brightness, contrast and color after shooting
7. Excellent low light camera (along with the low light boost mode on iPhone 5). Take great pictures even under very low light environment.
8. Fantastic light trail, light stream photography
9. Front camera support, Geotag, flash/torch, self-timer, set exposure/focus interest of point, and more !
What's New in Version 2.0
1. Added photo editor function. Now you can add effects, text/sticker etc. to your long exposure pictures.
2. Now iOS 7 fully compatible: Built on iPhone 7 SDK with iPhone 7 UI components
3. Removed the "Full Version" ads on the main UI
4. Name change from "LongExpo Free: Tripod-free long exposure and slow shutter camera" to "LongExpo: slow shutter and long exposure camera".
5. Icon change
This is a really great app and does everything it says it does, I haven't had a problem with crashing (iPhone 5). The only thing I would like to see more is a mode with more manual adjustments, because it defaults to the highest ISO it makes the image very grainy, I would like to be able to lower the ISO and just do a longer exposure... Still a great app though, I strongly recommend it.
Best app with impressive results
I downloaded 3 apps for long exposure photography and found this to be the most accessible.
Everything you need...
Great for taking and making great artistic photos. Worth download, using and experimenting with. Thank you.
- Category: Photo & Video
- Updated: Jan 09, 2014
- Version: 2.0
- Size: 14.6 MB
- Language: English
- Seller: Eyetap Soft LLC
- © EyeTap Soft LLC
Compatibility: Requires iOS 5.0 or later. Compatible with iPhone, iPad 2 Wi-Fi, iPad 2 Wi-Fi + 3G, iPad Wi-Fi (3rd generation), iPad Wi-Fi + Cellular (3rd generation), iPad Wi-Fi (4th generation), iPad Wi-Fi + Cellular (4th generation), iPad mini Wi-Fi, iPad mini Wi-Fi + Cellular, iPad Air, iPad Air Wi-Fi + Cellular, iPad mini with Retina display, iPad mini with Retina display Wi-Fi + Cellular, iPod touch (4th generation), and iPod touch (5th generation). This app is optimized for iPhone 5.
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domain: hobby


text:
Conference name, dates, place
International Conference on Development Studies in Ethiopia, July 11-12, 2003, Addis Ababa, Ethiopia
This paper discusses the reasons for and effects of the dramatic expansion of chat production as a cash crop in the Hararghe Highlands of Ethiopia. Despite the Ministry of Agriculture’s deliberate attempt to marginalize and openly discourage chat production, farmers continue shifting their scarce resources to chat production. Using data generated by a rural livelihood survey from 197 randomly selected households, economic and non-economic factors contributing to the expansion of chat production are identified and its food and nutritional security impact was analyzed. The case study confirms once more again the power of market incentives in encouraging agricultural activity of peasant farmers even in the absence of functional research and extension systems. The study shows that households producing chat have good food security and thus the situation presents a policy dilemma: should the government promote or discourage chat production?
WMU ScholarWorks Citation
Tefera, Tesfaye Lemma; Kirsten, Johann; and Perret, Sylvain, "Market Incentives, Farmers’ Response and A Policy Dilemma: A Case Study on Expansion of Chat Production as a Cash Crop in the Eastern Ethiopian Highlands.\" (2003). International Conference on African Development Archives. 71.

domain: agronomy


text:
Online from: 1899
Subject Area: Industry and Public Sector Management
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|Title:||Predicting breakfast consumption: A comparison of the theory of planned behaviour and the health action process approach|
|Author(s):||Barbara Mullan, (School of Psychology, University of Sydney, Sydney, Australia), Cara Wong, (School of Psychology, University of Sydney, Sydney, Australia), Emily Kothe, (School of Psychology, University of Sydney, Sydney, Australia), Carolyn Maccann, (School of Psychology, University of Sydney, Sydney, Australia)|
|Citation:||Barbara Mullan, Cara Wong, Emily Kothe, Carolyn Maccann, (2013) "Predicting breakfast consumption: A comparison of the theory of planned behaviour and the health action process approach", British Food Journal, Vol. 115 Iss: 11, pp.1638 - 1657|
|Keywords:||Breakfast consumption, Health action process approach, Self efficacy|
|Article type:||Research paper|
|DOI:||10.1108/BFJ-05-2011-0127 (Permanent URL)|
|Publisher:||Emerald Group Publishing Limited|
|Acknowledgements:||The authors would like to thank Kathleen O'Moore for her assistance with creating the online questionnaires. The authors declare no conflicts of interest.|
Purpose – Breakfast consumption is associated with a range of beneficial health outcomes including improved overall diet quality, lower BMI, decreased risk of chronic disease, and improved cognitive function. Although there are many models of health and social behaviour, there is a paucity of research utilising these in breakfast consumption and very few studies that directly compare these models. This study aims to compare the theory of planned behaviour (TPB) and the health action process approach (HAPA) in predicting breakfast consumption.
Design/methodology/approach – University students (
Findings – Using structural equation modelling, it was found that the TPB model was a superior fit to the data across a range of model indices compared to the HAPA. Both models significantly predicted both intentions and behaviour at follow up; however, the TPB predicted a higher proportion of the variance in breakfast consumption (47.6 per cent) than the HAPA (44.8 per cent). Further, the volitional variables did not mediate the intention-behaviour gap, and the data were not an adequate statistical fit to the model compared to the TPB.
Research limitations/implications – The results support the use of the TPB and show that some aspects of the HAPA are useful in predicting breakfast consumption, suggesting that risk perception and self-efficacy be targeted in interventions to increase behaviour. The volitional variables did not appear to mediate breakfast consumption indicating that intention is still the strongest predictor, at least in this behaviour.
Originality/value – The current study is the first to compare the TPB and HAPA in predicting breakfast consumption.
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Digging Deep, Crossing Far_ 1st Encounter: Bangalore has taken itself in search of traces in Bangalore in the southern Indian federal state of Karnataka. Though most Indian soldiers were recruited from North India in the First World War, above all from the Punjab, men from South India also served in the Mysore Imperial Service Troops.
As a city, Bangalore was starkly influenced by the British military and remains to this day an important location for the arms industry. The first Bangalore Torpedo was developed here shortly before the First World War and put to use in that war for the clearance of barbed wire.
Digging Deep, Crossing Far_ 1st Encounter: Bangalore was shown at the Goethe-Institut/Max Mueller Bhavan Bangalore and at the Bangalore Literature Festival from December 4–6, 2015. From January 2–8, 2016, the exhibition could be viewed at Pepper House, Kochi.
Ayisha Abraham, Gilles Aubry, Sarnath Banerjee, Surekha
8 pm / Goethe Institut / Max Mueller Bhavan Bangalore
with the artists and the curators
1 pm / Goethe Institut / Max Mueller Bhavan Bangalore
Screening: Film by Philip Scheffner, 2007, 87’ (OV with English subtitles)
3 pm / Goethe Institut / Max Mueller Bhavan Bangalore
Artist talk and listening session with Gilles Aubry
2 pm / Bangalore Literature Festival
Panel discussion with Elke Falat, Vedica Kant, Steffen Kopetzky, and Julia Tieke
Moderation: Sunil Sethi
5 pm / Pepper House, Kochi
with Elke Falat and Surekha
2 pm / Pepper House, Kochi
with Elke Falat

domain: history


text:
Multicolored Architectural Photography in Spain
#architecture #batiment #maison #escaliers #mur #horsducommun #buildings #house #stairs #wall #especial
DDNTMUC: Fan Huang - 4th Round - 3 Wishes ~ by Pearlsdiner
Modern Fashion doll by Pearlsdiner. This was a hard one. I knew i wanted to go for the bellydancer-look as i really love the style. I also knew i wanted to do a green colourscheme as Fan has already worn red, blue and yellow... I was undecided if to make Fan full on magical or have her wear a costume or even just genie inspired. In the end it turned out like this. Thank you all for voting and commenting! Also, shout out to @Owliegirl for making a very cool genie with green and smoke, i hope…
DDNTMUC: Marisol Ortega - 3rd Round - Reptiles - Blue-Headed Agama Lizard ~ by The_Nameless
Modern Fashion doll by The_Nameless. My reptile is so beautiful! From Southern Africa, they are a gorgeous splash of color amongst the rest of the southern rock agama. The way the blue and yellow and green scales seemed to shimmer looked so much like blue burning fire to me, so I attempted to design a dress that shifts from the black outer scales to fire. It's sort of... experimental, and I'm not sure if I've suceeded. >.< It doesn't help that I lost the doll and had to fit the rest of it…
DDNTMUC: Felicity Greyson 4th Round: 3 Wishes ~ by launing
Modern Fashion doll by launing. Here she is. Felicity as a genie! Well, she looks more like a belly dancer, I think ^v^ As always, I lost the doll several times on the mighty Flash beast *snivel* At the beginning Felicity had a beautiful long plaited braid and hands, but I couldn't recreate it... The 'layer' option in UCD makes it too hard for me. At least, I could finish her. So I'm happy, even if her outfit has turned out not so good. I love the upper part, dislike the middle part and…
Corpse Bride ~ by starshipsally
Modern Fashion doll by starshipsally. I was about to say this was the most extensive DnD I've done in Urban, but then I remembered those HP dolls. Welp.I'm in a halloweeny mood today and I thought Emily would be cute in this maker <3 #corpsebride
DDNTMUC: Marisol Ortega - 9th Round - Drinks! ~ by The_Nameless
Modern Fashion doll by The_Nameless. Back to the basics this round, a nice quick pretty thing. No repos, no background. XP My assignment this round was a femme fatale of a drink, the sweet poison cocktail. Kinda sexy.
DDNTMUC: Fan Huang - 7th Round - Desserts ~ by Pearlsdiner
Modern Fashion doll by Pearlsdiner. This was my assigned desert and what a beauty it was! I orignally wanted to try my hand on a ballgown again (after my disastrous attempt in round 5) but it turned into a mullet dress halfway. I just like showing off some leg! Vote for me via crowns please and get Fan to the next round! This contest has been great fun and i love seeing what the others come up with!
Time crawls on when you're waiting for the song to start, So dance alone to the beat of your heart ~ by Cinder_Elle
Modern Fashion doll by Cinder_Elle. Why the hell did I try a repo? Sigh. For Pigobest's contest, here's what I wore for a Muse concert I think a few months ago. My only wish is that Fall Out Boy decides to visit Dubai like just once, is that so much to ask? -.-
DDNTM UC Round 4: 3 wishes ~ by Mytherva
Modern Fashion doll by Mytherva. We're really late this week, so please vote with crowns to get us to the next round, Thank you! ___________________________________ I know this looks pretty similar to the other entries, but I had a similar idea beforehand. I looked up some of the mythology behind Jinn (or genies, as they're more commonly known), and got a lot of different contradictory info. I read somewhere that they're supposed to be spirits of fire and air, and can be bound to an…
Don't worry, you soon made it! ~ by Kytheira
Modern Fashion doll by Kytheira. Had to make this ... wanted to make a little angel who reminds me that it's soon over. - No, don't worry; nothing bad! - I'm moving, and tomorrow the moving company comes to bring my furniture into my new flat. It was hell the last weeks and it will be hell tomorrow - especially because I have to get up at 5 am in the morning! And I will be busy for some time after. And maybe I have no Internet for some days ... however, I'll come back! ;)
Red and Gold ~ by Mytherva
Modern Fashion doll by Mytherva. This is a request for @bluesmooth127, from winning a contest. I like how the top half turned out, but the bottom isn’t how I wanted it to look. I hope you like it blue!
DDNTMUC: Felicity Greyson 12th Round: Chess - King ~ by launing
Modern Fashion doll by launing. Winner of the 12th Round! Thanks a million (^_^)Felicity is the Black King. Felicity the First! This sounds very good! Hm... Has she a Queen? Well, I can imagine that Felicity likes girls ('^v^') She is the King, but I want to give Felicity an androgynous look. I hope it works?! Anyway: I really like the result of this picture, although the belt looks a bit strange... but I hardly have time to keep on working on it. If you like Felicity and want her to move…


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Erik waited patiently in the shadows; his position was hidden from the patron audience. This had become a nightly ritual, a new part of a carefully ordered routine. He would wake, dress, and then create music for hours on end, but only recently had he begun to watch the girl. It was unusual for him to take much notice of the goings on around him. He ignored others, and others had been happy to ignore him.
It had been a mutual agreement for years.
But then, that girl had appeared and upset his equilibrium. Erik glanced at his watch. The show was set to begin in mere minutes, already he could feel anticipation build in his chest, a strange sense of excitement that was foreign to him.
Come on, hurry up back there, he urged silently as he checked his watch again. Five nights a week the show went on promptly at ten o'clock. There had been opening acts, but she was the star; she was a gem tarnished by a difficult life, yet she shined all the brighter for it.
He had often wondered what it was that this Christine Daae did for enjoyment on the days when she was free from the stage. Did she have any remaining family? Her parents were gone, but perhaps there was a younger sibling. Did Christine have a lover that she had kept secret?
The thought rankled Erik more than he cared to admit. Only three more minutes until showtime…
Erik moved down and changed his position for a better view, moving behind the audience so as not to be seen. It wouldn't do to steal her spotlight and upset the manager, would it? He moved as close to the stage as he could for a better view; no one could see him from where he was, but instinctively he kept to the shadows behind mirrors.
The music came alive, the curtains were lifted, and the girls came to enthusiastic greeting by the audience. Their feet padded over the polished stage, and they moved to their posts. Erik's eyes searched their faces, ignoring the bodies on display. Where is she?
His eyes darted back and forth, but it was difficult to locate her with all the movement and colorful lights. She was not at the curtain, not at stage left or right, where had she gone? He had seen her arrive earlier, he'd heard nothing of her becoming ill before curtain call, so where was the girl?
He searched for her. Then…there!
Erik watched as Christine took her place and began to dance to the eager, devouring delight of her audience. He hated watching her as she gyrated on the stage, her nude body on display for the hungry eyes of the gambling customers. She gripped the metal pole and writhed against it with a sensual smile on her glossy lips. Her body arched backward until her pale blonde hair brushed the stage floor; her long legs twined around the pole, her feet encased in cheap, clear plastic high-heels.
The men crowded around her and littered bills onto the stage. Christine kneeled down to be eye-level with her audience and she began to writhe her slim hips in a grotesque mimic of sex. She cupped her naked breasts and ran manicured nails down her sides, along her loins and thighs.
A man, more daring than the rest, reached to her. Erik's hands tightened into fists as he watched the customer slip a $100 bill into the thin strap of her thong. Christine glanced down to see the amount of money and she smiled that cunning grin Erik recognized far too well.
She leant forward and whispered to the man with the brave hands who'd touched her. They spoke for a moment and then they both nodded in agreement. The man stood and crossed the room, heading towards a section reserved for the higher-profile clients. Christine continued to dance for fifteen more minutes. Erik watched her dance with impassive expression. Why do you do this to yourself…?
Christine then descended the stage and followed the same path that the man had taken, into the seclusion of the back rooms. Erik sighed and glanced down to his watch. May would want to see him soon to go over the new schedule.
"Still after that girl, are you Erik?" May asked.
They were above the audience, in her office. Two-way mirrors served as her windows into the club below them; here they were invisible, while nothing that happened below would be able to escape security's notice. Certainly nothing escaped May's; the woman must have eight eyes, six of them hidden somewhere within the mass of her badly dyed hair. She had an addiction to home hair color- this month's color was christened Radiant Ruby on the box, but from what Erik could see, it should have been labeled Brassy Rust.
Erik shook his head. "What ever gave you that idea? I've never even spoken to her,"
May shot him a knowing look. "Many things I am, but blind ain't one of them. If you like her, Erik, all you have to do is ask. I'm sure that with a little coaxing I could arrange a special night for you."
She held up a hand and rolled her eyes. "Oh, stop it. You knew what that girl was when she walked in the door. She might turn down customer offers- as far as we know- but don't let that fool you into thinking she's some kind of pure saint. If the money's right, I could have her in your room tonight, Erik, chained to the bed and awaiting her master's punishment,"
Erik sat down and sighed. "Must you be so vulgar?"
May ignored his disapproval. "Yes, I must. And if you're suddenly sensitive to vulgarity, then what the hell are you doing here? This isn't the opera or one of your fancy ballets. This is a strip joint. High class, I'll admit it, and without you I'd probably still be in Louisiana, still waiting for my FEMA trailer to arrive. I owe you big, more than my life. I want you to be happy, but I don't think you'll ever be happy watching the girl of your dreams give lap dances to the Johns downstairs. Stop torturing yourself, Erik."
Erik scowled. "Leave me alone, May. I didn't come to be badgered. Tell me about the schedule,"
May sighed lightly and poured him a drink- a whiskey on the rocks- and retrieved the sheet from her file cabinet. She handed it to him. "Remember when I saw your apartment for the first time? I told you that I could have fit my entire house in the living room. I wasn't exaggerating and you know it. You could get any girl in New York and you deserve better than that bottle-blonde pole dancer. She's no better than any of the others down there, peddling her ass for next month's rent. She's nothin' but a trick."
Erik folded the new schedule and slipped it into his pocket. He didn't feel like arguing. "You're wrong about her May, and just for the record: that blonde is natural."
He slipped out of her office and took the employee exit the same way that he'd come into the club; it was a tunnel that followed along the perimeter of the entire club. It ran along all three levels of the building from the main entrance to behind the bar and even behind the secret back room. Mirrors lined the walls of the club interior, forming two-way mirrored windows into every facet of the facility.
The bartenders never gave away free drinks or stole shots themselves for fear of being seen. Eyes were always watching behind the walls at Mama V's Dancing Dolls. Erik ignored the club as he passed it by. He had no interest in the girls on the main stage, the table dancers or the bartenders. He pulled on his gloves and readied himself for the harsh cold that awaited him outside.
The tunnel was dimly lit, it had to be to prevent those in the club from knowing they were being watched- there was a lot to be said for a false sense of privacy. More money changed hands when the customers were comfortable, which May had planned on when she explained her idea of the mirrors to Erik. He only liked it for the privacy it afforded him when he went in and out of her office.
Erik paused on his way out and moved closer to the glass that gave him a view into the back room. Christine was there with her man from the stage. She was smiling and running her hands over the man's chest, giving him the show he'd paid for. She writhed her body against his, simulating carnal desire, as if she was truly enjoying herself. Erik knew better, there was something about her eyes…
He felt sick watching her debase herself like a whore.
Erik turned away from the scene and stepped out into the cold.


text:
Hematologic malignancies can spread to the central nervous system (CNS), either as focal lesions or as leptomeningeal disease. Marginal zone lymphoma (MZL) is a low-grade non-Hodgkin lymphoma and generally presents as an indolent disease. This case report illustrates an unexpected diagnosis of leptomeningeal metastasis in an MZL, presenting as a delirium without B symptoms, pronounced hematologic progression or abnormalities on cerebral imaging.
An 80-year-old patient with a medical history of monoclonal B-cell lymphocytosis (MBL) with a clone indicative for an MZL, presented to the emergency and the geriatric departments with a recent cognitive deterioration and behavioral changes. MMSE score was 18/30. After excluding the most common etiologies through classical work-up including a normal head magnetic resonance imaging, a lumbar puncture was performed. In the cerebrospinal fluid an elevated protein level and increased lymphocyte count were identified, whereas beta-amyloid and tau protein levels were normal. Immunophenotyping of the lymphocytes confirmed CNS invasion by the MZL clone. Staging revealed mild splenomegaly. Prednisolone, intrathecal and systemic chemotherapy were initiated, leading to quick cognitive improvement with a final MMSE score of 28/30.
To the best of our knowledge a delirium in an older patient due to leptomeningeal disease in MZL has never been described. To date, rare reports of CNS invasion by MZL describe focal intracranial lesions. After exclusion of common etiologies, physicians should remain vigilant when confronted with a patient with history of MBL presenting neurological symptoms. This case illustrates the importance of low threshold for lumbar punctures in this population, also for those patients with normal imaging studies.
Malignancies can cause central nervous system (CNS) involvement, either presenting as focal lesions or as leptomeningeal metastasis. The latter mechanism, also called neoplastic meningitis, is mostly seen as a late-stage complication of breast cancer, lung cancer or melanoma, and less frequently in hematologic neoplasms; mainly non-Hodgkin lymphoma, acute lymphoblastic leukemia or multiple myeloma. Leptomeningeal disease is usually caused by multifocal metastases to the leptomeninges [1, 2]. In 70–80% of the cases the diagnosis of leptomeningeal metastasis can be made using high quality T1-weighted magnetic resonance imaging (MRI). But cerebrospinal fluid (CSF) cytology for detection of malignant cells is the diagnostic gold standard .
A monoclonal B-cell lymphocytosis (MBL) is a rather indolent but frequently described condition that is most often diagnosed incidentally in the otherwise healthy older adult. The diagnosis is based on the identification of a clonal B-cell lymphocyte population persisting over a three-month period, without any lymphadenopathy or organomegaly, nor with an associated autoimmune or infectious disease [3, 4]. MBL is subclassified into three groups, the most common form being an MBL with a chronic lymphocytic leukemia (CLL)-like phenotype, for which it is assumed that it is a possible precursor for CLL. The other groups are an atypical CLL phenotype and a non-CLL phenotype . Thus, MBL is a potentially pre-malignant condition for which regular follow-up should be provided [5, 6].
A clonal B lymphocytosis of marginal zone origin (CBL-MZ) describes specific MBL cases of non-CLL phenotype with features suggestive of a marginal zone origin , and can be considered as a potential pre-malignant condition that may or may not evolve into a marginal zone lymphoma (MZL) . This report illustrates a diagnosis of leptomeningeal disease or, more specifically, a leptomeningeal lymphomatosis. It was caused by an MBL evolving to an MZL that presented as a persisting delirium without B symptoms or any abnormalities on radiologic examinations of the CNS.
An 80-year-old, community-dwelling, Caucasian male patient presented at the emergency department with confusion, irritability, word finding difficulties, impaired concentration, disruption of circadian rhythm and a mild tremor. The symptoms had appeared suddenly 1 month earlier and were fluctuating but progressive up until presentation to the hospital.
The patient’s medical history included arterial hypertension, ischemic cardiomyopathy, chronic kidney disease stage 3a, type 2 diabetes mellitus, chronic length-dependent sensorimotor polyneuropathy and MBL. This MBL consisted of an indolent clone of a non-Hodgkin phenotype, indicative for a marginal zone origin (80%) and a smaller CLL-like phenotype clone (7%). At time of diagnosis of MBL, almost 3 years before the actual admission, the patient had no B-symptoms, no nodal or extra-nodal involvement nor organomegaly, so a watchful waiting policy was adopted, according to the prevailing guidelines.
His chronic treatment consisted of low dose of aspirin, bisoprolol, simvastatin, lorazepam, lisinopril and metformin. No changes to the medication were made in the last months prior to his admission. There was no previous history of smoking or alcohol consumption. The patient had worked until the age of 71 years as a commercial agent. His wife denied pre-existing cognitive disturbances. The patient mentioned an increased stress level due to a family conflict. No other medical or socio-environmental problems were detected during the assessment.
At the time of admission to the geriatric medicine ward, the general physical examination revealed no abnormalities, but the neurological examination showed word finding difficulties, a mild action tremor of the upper limbs, more marked on the left side, and a subtle postural instability. No signs of meningeal irritation were present.
Cognitive assessment revealed a Mini Mental State Examination (MMSE) score of 18/30, with decreased scores on orientation to time (2/5), orientation to place (4/5), memory recall (1/3), attention and calculation (3/5) and complex commands (3/5), where language and repetition testing (4/4) as well as immediate memory registration (3/3) were correct. He had a total score of 63/105 in the Cambridge Cognitive Examination (CAMCOG) neuropsychological battery, with subscale scores of 12/27 on memory, 24/30 on language, 5/12 on praxis, 5/7 on concentration, 4/8 on abstract thinking, 6/9 on perception, 1/2 on calculation and 6/10 on orientation testing.
Laboratory testing showed an increased total leucocyte cell count of 20.100/mm3 (reference range 3.600–9.600/mm3), with 13.507/mm3 (reference range 1.200–3.500/mm3) or 67.2% (reference range 19–44%) lymphocytes, compared to 17.000/mm3 or 59.5% leucocytes 1 year before. His hemoglobin level was normal at 13.7 g/dL, as well as the platelet count of 202.000/mm3. Kidney function was stable with a urea/creatinine ratio of 43/1.29. There were no signs of infectious or autoimmune disease, no liver dysfunction or electrolyte disorder.
Electroencephalogram (EEG), 24-h Holter monitoring and carotid duplex ultrasound were considered normal. Computed tomography (CT) of the brain did not reveal any acute pathology. Cerebral MRI showed periventricular and subcortical white matter lesions and a moderate corticosubcortical and cerebellar atrophy, but no recent lesions (Fig. 1).
A non-traumatic lumbar puncture (LP) was performed; analysis of the CSF showed an elevated protein count of 1.010 mg/L (reference range 260–790 mg/L) and a leucocyte count of 144/mm3 (reference range 0–5/mm3) with 98% morphologically normal lymphocytes (reference range 40–80%). Glucose level was slightly lowered with a CSF-to-serum glucose ratio of 57% (normal CSF-to-serum glucose ratio of > 60%). Lactate level was at the cut-off of normality (1.7 mmol/L with reference value < 1.7 mmol/L). A normal cerebrospinal fluid biomarker profile (T-tau, Aβ1–42, P-tau181P and 14–3-3Y) was identified, as such not suggestive for Alzheimer’s disease or Creutzfeldt-Jakob’s disease. An auto-immune and infectious work-up, including syphilis serology and an extensive set of microbiological cultures, was negative.
A flow cytometry on CSF identified a voluminous monoclonal B-cell population with characteristics of the known marginal zone clone, confirming CNS invasion of this non-Hodgkin’s lymphoma (Fig. 2). Staging by chest and abdominal CT showed mild splenomegaly, not described on a CT 3 years earlier. Thus, the primary diagnosis of MZL with leptomeningeal lymphomatosis and splenic invasion was established.
During the in-hospital observation phase of 2 weeks at the geriatric department, the patient showed a fluctuating cognitive status and hyperactive behavior. Main disturbances were a distractibility, nocturnal agitation and insomnia, orientation and memory loss, emotional dysregulation with episodes of abundant crying, frontal behavior with unpredictable verbal aggression toward his wife and the caregivers, slight delusions of intentional harm, depressive thoughts and a remarkable variability in cooperation. Confusion Assessment Method (CAM) and Diagnostic and Statistical Manual (DSM)-V criteria for delirium were present, but the symptoms did not require an antipsychotic treatment. A proactive, non-pharmacological management of delirium was applied. This included, amongst others, early mobilization, avoidance of catheters or physical restraints, providence of orientation cues, behavioral therapy and frequent family visits. A therapeutic trial with mirtazapine was started in addition to psychological support for a mild depression. An attempt to reduce the dose of his chronic treatment with lorazepam was not successful. Despite these pharmacological and non-pharmacological measures, symptoms remained.
As diagnosis of stage IV MZL was made, cytoreductive therapy was initiated. The patient was treated with a short course of oral dexamethasone and four cycles of intrathecal chemotherapy consisting of methotrexate 15 mg plus six cycles of systemic chemotherapy R-COP (rituximab - cyclophosphamide - vincristine - prednisone). The patient’s general condition and age were considered as contraindications for systemic methotrexate therapy, splenectomy and autologous stem cell transplantation.
After 6 days of oral treatment with dexamethasone a subtle but clearly progressive improvement of the cognitive and behavioral status was seen, with normalization of the sleeping pattern, adequate orientation and a stabilization of the emotional regulation. Fourteen days after initiation of dexamethasone and 7 days after the first intrathecal chemotherapy, MMSE score had improved to 28/30 (memory recall score remaining 1/3). An important decrease of the CSF leucocyte count to less than 2/mm3 was documented two and a half months after initiation of therapy, suggestive for a good response on intrathecal chemotherapy. The therapy was well tolerated.
The patient’s mild tremor did not change significantly during hospitalization or afterwards, indicating that he probably suffered from an essential tremor. No follow-up on neurology was desired by the patient, as these symptoms were not experienced as disabling.
Currently, more than 2 years after initiating therapy, no clinical or biological signs of disease progression have been identified. Neither the patient, nor his family report a cognitive deterioration.
Discussion and conclusions
Non-CLL-like monoclonal B cell lymphocytosis rarely progresses towards indolent non-Hodgkin lymphoma like marginal zone lymphoma [3, 8]. In general, marginal zone lymphoma is also indolent [5, 8, 9] and rarely spreads to the CNS . To date, reports of CNS invasion by marginal zone lymphomas describe focal intracranial lesions, for instance mucosa-associated lymphoid tissue (MALT) subtypes mimicking meningioma [11,12,13] and dural MZL .
In this case report, the main presentation was a delirium that appeared suddenly, persisted over several weeks and resolved when the underlying medical condition was treated. Screening for delirium as part of the Comprehensive Geriatric Assessment (CGA) was positive, based on the CAM criteria  of an acute onset and fluctuating course, inattention and disorganized thinking. According to DSM-V [16, 17], a delirium is described as a disturbance in attention and awareness. It develops over a couple of days and is not explained by a pre-existing neurocognitive disorder. It tends to fluctuate and is accompanied by an additional disturbance in cognitive functioning. This neurobehavioral syndrome is a direct physiological consequence of another medical disorder. In this case a CNS involvement by a non-Hodgkin lymphoma was identified as the underlying condition. Soon after initiating therapy, a subjective improvement in cognitive state and behavior, and an objective improvement in MMSE-score were seen, supporting the etiological relationship between the delirium and the hematological diagnosis.
To the best of our knowledge, a delirium in an older patient due to leptomeningeal metastasis by a marginal zone lymphoma has never been described.
Studies revealed a large range of predisposing and precipitating factors for delirium, as well as multiple mechanisms for the pathophysiology of delirium. Local and systemic inflammation on one hand, and direct brain damage due to neoplastic invasion of the CNS on the other, seem to be core precipitant factors to the development of delirium in this case. Leptomeningeal metastasis of a lymphoma can present with a variety in neurological signs and symptoms since lymphoma cells in the subarachnoid space gain access to all portions of the CNS and cause direct brain damage [18,19,20]. Elevations of immunoglobulins and cytokines such as interleukin IL-6 in CSF, indicate a local, intrathecal immune activation in patients suffering leptomeningeal disease [18, 21]. Furthermore, a systemic inflammatory response can be expected due to the underlying hematological malignancy. Studies have shown that peripheral inflammation, i.e. increase and decrease of certain cytokines, influence brain functioning, directly through neurodegeneration, and indirectly by altering sleep, nutritional intake and affecting neurotransmission [18, 22, 23].
These acute precipitant factors are each having their effects depending on a patient’s specific fragility to the development of delirium [23, 24]. In this case report, amongst others, possible predisposing factors were his increased age and age-related factors of CNS decline, such as periventricular white matter lesions, and a depression. According to the systems integration failure hypothesis , this combination of precipitant factors and specific substrates lead to a complex web of pathways of neurotransmitter dysfunction and disruption in neuronal network connectivity, resulting in acute brain failure, presented as a delirium.
Several limitations of this case report can be identified. There is a lack of comparison to reference neuropsychological test results before the onset of the delirium and after completing hematological treatment. Pre-existing dementia is a risk factor for delirium, and on the other hand, delirium is to be considered as an independent risk factor for long-term cognitive decline and dementia . The presumption of a persisting good cognitive functioning is only based upon subjective findings by the hematologists, who are still following the patient on an ambulatory basis, and the family. As memory recall scores remained low despite recuperation on other MMSE test levels after 2 weeks of oncological treatment, the lack of cognitive follow-up is particularly regretful. Furthermore, it is uncertain what role other predisposing and precipitating factors played in the onset of the symptoms, amongst others the mild depression. However, the significant increase of the MMSE score related to the oncological treatment, the significant decrease in caregiver burden and the subjective increase in quality of life in this patient are all arguments for adequate diagnosis and treatment.
After exclusion of common etiologies, physicians should remain vigilant when confronted with elderly with a prior history of monoclonal B cell lymphocytosis presenting neurologic signs as a confusional state. This case demonstrates that the threshold for a lumbar puncture for CSF cytology, in patients with a history of (pre) neoplastic diseases, should be low also for those with normal MRI studies and in absence of overt progression indicated by peripheral blood cell counts.
Availability of data and materials
Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.
Colocci N, Glantz M, Recht L. Prevention and treatment of central nervous system involvement by non-Hodgkin's lymphoma: a review of the literature. Semin Neurol. 2004. https://doi.org/10.1055/s-2004-861534.
Vander Meeren S, Heyrman B, Renmans W, et al. Lymphoma-like monoclonal B cell lymphocytosis in a patient population: biology, natural evolution, and differences from CLL-like clones. Ann Hematol. 2018. https://doi.org/10.1007/s00277-018-3282-0.
Tu PH, Giannini C, Judkins AR, et al. Clinicopathologic and genetic profile of intracranial marginal zone lymphoma: a primary low-grade CNS lymphoma that mimics meningioma. J Clin Oncol. 2005. https://doi.org/10.1200/JCO.2005.17.624.
Bustoros M, Liechty B, Zagzag D, et al. A Rare Case of Composite Dural Extranodal Marginal Zone Lymphoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Front Neurol. 2018. https://doi.org/10.3389/fneur.2018.00267.
LD, NM, MV, ADB and IB contributed to the clinical work-up of the patients’ complaint and final diagnosis. KJ performed histological analysis of the cerebrospinal fluid. TV was responsible for the imaging studies. LD was lead author. NM, MV, BB and IB were major contributors in writing and revising the manuscript. All authors read and approved the final manuscript.
A written consent for publication was obtained from the patient. This is available on request from the corresponding author.
The authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Dreessen, L., Maréchal, N., Verheyden, M. et al. Leptomeningeal metastasis in a marginal zone lymphoma, presenting as a delirium: case report.
BMC Geriatr20, 213 (2020). https://doi.org/10.1186/s12877-020-01608-6

domain: medical


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Cantor Seeks Another Vote on Full Repeal of Affordable Care Act
On Friday, House Majority Leader Eric Cantor (R-Va.) sent a memo to House Republicans outlining a "full legislative agenda" for May, including holding another vote to fully repeal the Affordable Care Act, The Hill's "Floor Action Blog" reports (Kasperowicz, "Floor Action Blog," The Hill, 5/3).
Since the enactment of the ACA three years ago, lawmakers have voted on dozens of measures that would have repealed or defunded part or all of the law (Haberkorn, Politico, 5/3).
In the memo, Cantor said, "While we have not locked in the timing, I expect that the House will vote on full repeal of Obamacare in the near future" ("Floor Action Blog," The Hill, 5/3).
The announcement of a repeal vote follows Cantor's failed efforts to pass a bill that would boost funding for the ACA's temporary high-risk insurance pool program (Politico, 5/3).
Last month, Cantor sent a memo to House Republicans saying one of the GOP's main health care priorities for the spring would include efforts to increase funding for the Pre-Existing Condition Insurance Plan, which was designed to help sick U.S. residents gain coverage ahead of January 2014, when the ACA's ban on denying individuals coverage because of pre-existing conditions is set to take effect.
In February, the Obama administration announced several cost-saving reforms intended to prevent the $5 billion program from running out of money. HHS later said it was halting enrollment in the high-risk pools because only enough funds remained to cover the 100,000 current enrollees (California Healthline, 4/25).
According to Politico, the bill spurred complaints from GOP members that Cantor was trying to help the ACA, not defeat it (Politico, 5/3).
Cantor Restates Effort To Boost Pediatric Research
In his latest memo, Cantor also reiterated another GOP priority to boost federal funding for pediatric disease prevention research, CQ Roll Call reports (Newhauser, CQ Roll Call, 5/3).
Specifically, Cantor said the GOP will support a bill (HR 1724) by Reps. Tom Cole (R-Okla.) and Gregg Harper (R-Miss.) that shifts federal funds from presidential campaigns and party conventions to pediatric research at NIH (Politico, 5/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.


text: One of the first industries we worked with back in the late 1980’s and into the 1990’s was the collectible industry. We worked with both the Franbklin Mint and the Danbury Mint. We Designed, engineered and Prototypes many 1/24th scale Die Cast Vehicles. We would find the most accurate vehicle and send out a team to document it. The model would be drawn in pencil on vellum. This was before the advent of CAD. Then the prototype would be carved. Much of it was carved out of a single block of acetate.

domain: design


text:
Liberty GEOG 200 DB Forum 1
After completing your reading for the module/week, describe the origin/history of some of your favorite foods. Be sure to include and properly reference at least one scholarly source.
Liberty GEOG 200 Module 3 Reflection Essay
Reflection Essay of Pike Place Market
Liberty GEOG 200 Module 7 Geography Project Project Plan


text:
Americans think they know cars and motorcycles. Sure we do, why wouldn’t we? When you’re the land that gave the world the Shelby Mustang, Dodge Charger, and Harley-Davidson, it’s easy to get a little cocky about your place in automotive history.
But let’s think seriously here for a second, if you’re going to really pick a place to visit as the “Land of Motors”, the Mecca of Automobiles, are you going to prefer to book a flight to cold, industrial Detroit, or to the warm foothills of the Italian motor Valley, through Italy’s Emilia Romagna region, and trek through the Apennine mountains? Not convinced?


Learn how you can be a part of a collaborative composition!
From deep, deep within me, a song begins to grow.
My feelings fight to find a voice.
I sing because I have no choice.
Hear my song!
Dear reader, what are the feelings in you that “fight to find a voice?” On day 32 of Project 194, I wrote about the creation of this lyric and the genesis of an idea: what if I could get people all over the world to sing this tune and record themselves selfie-style on video while they did it? It would be amazing to edit those clips together to make a big round, a big sound, a grand composition or mosaic of sound and image.
Here’s your chance to be make your voice heard! Use your phone to record yourself (video or just audio) singing along with the tune I’ve posted. Sing it however it suits you to sing it, with whatever voice and feelings you have. I suggest you use headphones to hear the track and sing along with it, and that you hold your phone horizontally (landscape-style) rather than vertically (portrait-style) while you shoot. If you don’t like the way your video came out, you can always do it over, or do it multiple times in different locations when you’re in different moods. When you’ve got a version you like, email it to me at the email address listed under the “Contact” tab above. I’ve made a how-to video that offers a few more suggestions:
I’ll make a big composition out of the videos I receive, one that I’ll share here on the blog as it takes shape and then premiere as a live interactive event at the birthday concert on July 13. If you want, Instagram it to share it using the hashtags #project194 and #hearmysong. It would be even more amazing if you told your friends to do it too. Let’s make something together!
Here’s the tune: