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It also appeared on the Japanese version of. Org, Download Musik mp3 terbaru Indonesia, download lagu mp3 terbaru gratis. Org, download lagu mp3 Indonesia. Org, Dengarkan musik mp3 terima kasih datang ke situs web Lagu123. Chesnutt chose to cover the song through the suggestion of his record producer , who had heard the Aerosmith version on his car radio.
As the video progresses it reveals that the band is playing in front of what appears to be the fictional Freedom. Com Download baru Aerosmith - I don't wanna miss a thing - Lagu Terbaru 2018 - di SiteLaguMp3. Scroll through the page-list below until year 2019 to obtain certification. Dengarkan dan download lagu gratis Aerosmith - I don't wanna miss a thing - User 270361878 yang tercepat, terbaik - - di Lagu123. Download Lagu Aerosmith - I don't wanna miss a thing Mp3 kualitas bebas - Download Lagu 4shared - di GudangLagu123. Written by , the song debuted at number one on the U. The song stayed at number one for four weeks from September 5 to 26, 1998.
Category : Download Lagu Aerosmith - I don't wanna miss a thing Mp3 Gratis Lirik Lagu Aerosmith - I don't wanna miss a thing Lirik lagu Aerosmith - I don't wanna miss a thing belum, Anda dapat berkontribusi lirik lagu Aerosmith - I don't wanna miss a thing di bagian komentar! His rendition is the first single and title track from his. It was one of many songs written by Warren in that period. The song was also covered by American singer for his album. It was difficult to imagine what kind of touch Aerosmith could put on it and make it our own… As soon as we began playing it as a band, then it instantly became an Aerosmith song. The video begins with shots of the moon in orbit and several asteroids passing by safely and then a view of before zooming in to show Steven Tyler singing. Then smoke surrounds the orchestra and the members of Aerosmith as Freedom takes off from the launch pad.
Archived from on February 1, 2010. Download lagu Aerosmith - I don't wanna miss a thing Mp3 - - Gudang lagu Indonesia 2018 Mp3 baru terbaik - SiteLaguMp3. For the 1999 Mark Chesnutt album, see. . It features an appearance by 's daughter , who plays Grace Stamper in the film. Chesnutt also said that he chose to do the song because he thought that it would help revive his then-flagging album sales and chart performance. Archived from on June 13, 2007.
The shots interchange between the band and viewing the band singing via their monitors. Archived from on September 24, 2012. Finally, the screen goes out as a tearful Grace touches one of the monitors to reach out to her father real life father Steven Tyler in the video; on-screen father Harry Stamper, played by , in the film. In early 1999, his version was a Top 20 hit on the Hot 100, while also topping the charts. It features the band playing the song intertwined with scenes from the film. Com, Download music Aerosmith - I don't wanna miss a thing keinginan Anda bahagia mendengarkan musik, download lagu mp3 terbaru gratis Download mp3 lagu Aerosmith - I don't wanna miss a thing gratis di ponsel Anda - Download Lagu Terbaru - di GudangLagu123.
Org, Download gratis musik mendengarkan musik-senang bersama Lagu123. The original version was a collaboration between Chicago musician Phil Kosch of and , and nephew of chart topping writer. It also won awards for , and Best Video at. The song helped introduce Aerosmith to a new generation and remains a slow dance staple. Along with Aerosmith, a full hand orchestra plays in sync with the melody.
Select Platinum in the Certification field. Com Download lagu Mp3 Aerosmith - I don't wanna miss a thing terbaik - Download Lagu Gratis - di sini, download music Aerosmith - I don't wanna miss a thing terima kasih telah mengunjungi website SiteLaguMp3. Steven Tyler injured his knee the day before the shoot, so they used many close-up shots due to his limited movement. Sólo éxitos: año a año, 1959—2002 1st ed. Download musik gratis Aerosmith - I don't wanna miss a thing - User 270361878 - Download Mp3 4shared Gratis - di Lagu123.
The song also stayed at number 1 for several weeks in several other countries. Com, lagu-lagu terpanas Indonesia yang terus diperbarui, download lagu mp3 Indonesia Gratis 2018, unduh Aerosmith - I don't wanna miss a thing mp3 di GudangLagu123. Select singles in the Format field. Hot Country Songs 1944 to 2008. He also noted that soon afterward, he exited his label after refusing their offer to cover another pop song.
It is also the first of only two singles in his career to reach the , where it peaked at number 17 in early 1999. The song was nominated for both an and a. Bega introduced the two and they penned the initial track, but ultimately Kosch was uncredited. Org mendengarkan musik mp3 Terbaru - di Lagu123. Archived from on November 3, 2012. Archived from on July 9, 2009.
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domain: entertainment


Ben Affleck's Oscar acceptance speech left viewers confused about the state of his marriage, but now Affleck is clarifying his odd remarks.
Accepting the Oscar for Best Picture for "Argo" Sunday night, Affleck thanked his wife of seven years, Jennifer Garner, for "working on our marriage for 10 Christmases," and said, "It is work, but it's the best kind of work, and there's no one I'd rather work with." But according to OK! Magazine, Affleck wasn't trying to imply that their marriage is on the rocks.
"All relationships, to a certain extent, require your work. We work on it together, we try our best, nobody's perfect... She's more perfect than I am," Affleck told the magazine.
Click through the slideshow below for behind-the-scenes photos from the Oscars.


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Bollywood actor Richa Chadha has filed a defamation suit against Payal Ghosh, a news channel and Kamaal R Khan, before the Bombay High Court, for alleged defamatory statements against her. She has also sought INR10.1 million as damages from them, according to the Hindustan Times.
Ghosh, in September, had accused film-maker Anurag Kashyap of sexual assault and mentioned Chadha’s name in her interviews, while elaborating on the alleged incident. She had claimed that in order to convince her into giving him sexual favours, Kashyap allegedly told her that many female actors, including Chadha, did the same for him.
Chadha, has sought an order from the court for restraining Ghosh and unknown others from making any such defamatory statements in the future. Additionally, she has also sought the withdrawal of such videos and tweets, besides demanding an apology on Twitter and other websites.
As per a report in Mumbai Mirror, the petition was filed by Chadha through an advocate, claiming that the defamatory statements had continued despite her sending a legal notice to the actor.
Two days after the interview, Chadha had released a statement, via her lawyer, which had condemned the act of ‘falsely’ dragging her name into controversies. It had said, “Our client Ms Richa Chadha condemns the act of her name being unnecessarily and falsely dragged in a derogatory manner into controversies. No woman should misuse their liberties to harass other women with unsubstantiated or non-existent, false and baseless allegations.”
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domain: news


O.M.LER placed very well in the foundry industry resumption after the second quarter lockdown and it finishes the year 2020 under a meaningful growth. This gives a feeling of optimism for 2021, period when the company will introduce a new and innovative decoring machine
The last weeks of the year represent for every company a period when both financial and operations statements are issued and successful goals and those that are not so successful are analyzed. For O.M.LER s.r.l., located in Bra in the North West of Italy and specialized in manufacturing and selling pneumatic decoring hammers for foundry, 2020 has been a very challenging year. The first months were very successful thanks to the good worldwide sales results. Then the Covid-19 pandemic has changed the situation, as it happened in many Italian and European companies. Despite the difficulties, O.M.LER team kept on to be enthusiastic and optimistic for the future. A few months wait has been enough to see business increasing again. It happened after summer: the Fall wind has brought good results that gave hope for the following months. Optimism meant that the company didn’t break off the relationship with the Indonesian company PT Makmur Meta Graha Dinamika. In June O.M.LER signed in the distributorship agreement with the Indonesian enterprise, in order to be on the market of the low pressure, gravity and lost wax foundry sectors of the Far East Asian market.
Not only the decoring hammer as decoring solution for every kind of casting
The main O.M.LER product is the pneumatic decoring hammer for foundry that is manufactured in two models, RVC70 and AF1470. Each model is available in three versions: Standard, MBR and MBL. Thanks to the two different models and the three available versions O.M.LER hammer can decore every casting type. The company offers not only the pneumatic hammers as decoring solutions for foundries, but also decoring stations. These are decoring benches designed and manufactured according to the specific needs of every customer, where the pneumatic decoring hammers are fastened in a fixed position, vertical or horizontal, depending on the type of casting to decore. The hammers positioning inside the decoring bench has to be defined during the project study phase, when O.M.LER technical and sales staff interact continuously with the customer and with the company design office to find together the most suitable decoring solution. The relationship with the customer is one of O.M.LER’s main strengths: to the European customers the technical and sales team offers technical advice and customer service from the headquarters in Italy as after sales activities and hammer repair service. For the overseas customers technical advice and hammers repair service are guaranteed at the distributors’ facilities both in Eastern as in Western countries. O.M.LER staff look to 2021 with hope and confidence, trusting in an even more important post pandemic growth than the one of the last months of 2020. For this reason the technical and sales team engaged to offer its customers further decoring solutions. During the lockdown period it worked hard to launch on the market in the next year a new and innovative decoring machine. Stay tuned and surf regularly the company’s website to receive important updates: www.omlersrl.com.


IndieGoGo HOGTC Campaign
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Westori reveals global news stories that may have escaped the mainstream media's attention.


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All TIG welded. Exposed weld areas polished to match adjacent surface. Top is sound deadened. Roll formed embossed galvanized hat channels are secured to top by means of structural adhesive and weld studs. Gussets welded to support hat channels.


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Three albums of negatives and prints of photographs taken by Mr Butterfield in the 1920s and 1930s. Most photographs show Yorkshire Dales scenery, a few including cyclists and other individuals. Places photographed include Airedale, Arncliffe, Aysgarth Falls, Eden Valley, Gordale, Grassington, Littondale, Malham, Swaledale. Wharfedale, Whitby and York.
The Fred Robinson Butterfield Collection
- This material is held at
- ReferenceGB 532 BUT
- Dates of Creationca. 1920-1950
- Name of Creator
- Language of MaterialEnglish
- Physical Description0.15 metres
Scope and Content
Administrative / Biographical History
Fred Robinson Butterfield was born in 1905 in Keighley. He took up cycling and became the first Secretary of the newly formed Keighley Road Club. Later he became an honorary member. Photography was his other great interest. In World War 2, he served in the Far East with the Royal Air Force. He returned in 1946 to Farnhill. Mr Butterfield died in 1999.
Available to researchers, by appointment. Access to archive material is subject to preservation requirements and must also conform to the restrictions of the Data Protection Act and any other appropriate legislation.
Donated by Mr Butterfield's son, Irvine Butterfield, in 2006.
Described by Alison Cullingford.
Conditions Governing Use
Copies may be supplied or produced at the discretion of Special Collections staff, subject to copyright law and the condition of the originals. Applications for permission to make published use of any material should be directed to the Special Collections Librarian in the first instance. Copyright in these images has been transferred to the University of Bradford.

domain: library


Learn about advanced telecom and cloud-based networking functions and technologies that are enabling the latest wave of innovations in the telecom industry.
A communication protocol between the control plane (CP) and user plane (UP) functions in 4G and 5G networks. In these networks, the two planes are separated via Control and User Plane Separation (CUPS). However, there was a need for these two planes to communicate across newly define interfaces that connected them. For this purpose, PFCP was defined.


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Times are tough in Greene County, MO. Both the county and the country are experiencing economic decline, with the national GDP in 2020 taking the biggest downturn since records began.
If your business is suffering, is there anything that can be done? Decreased sales, lower profits, and unsold stock is sure to be stressful for any local business owner.
Luckily, you don’t need to accept the decline of your business, as there’s much you can do to regrow your company. To learn more, keep reading to find several ways you can grow your business, even in challenging times.
Change Your Business Model
In tough times, small businesses might need to change their business model. For example, if your company has always been dependent on foot traffic and face to face sales, can you pivot towards virtual or online sales or events?
It’s not always easy, but life as we know it has changed in the last 12 months, so your business needs to change as well.
Work Smarter, Not Harder
With decreased profits and hard economic times, it pays to work smarter, not harder.
What does this mean? We recommend focusing on the core of your business, then outsourcing tasks that you either can’t do well or that take up too much of your time.
One way to do this is by working with a professional employment organization to handle all of your HR needs—browse here to learn more.
Try to also develop procedures and policies that can save you time and streamline operations.
Cut Costs Where You Can
For your business to survive, you might need to cut costs, especially if you’re already running on tight margins.
Staff are often one of the biggest expenses to a business—while no one wants to think about redundancies and restructuring, it’s sometimes necessary to keep the company afloat.
You can also cut costs by downsizing to a smaller office, reducing your product range, or reducing business hours.
If you’re still struggling, check to see if you qualify for any government grants or loans for small businesses, which can be a lifeline during hard times.
Use Technology to Your Advantage
Sometimes, changing the way you use technology can boost your business. For example, if you’re not already on social media, it can be a fantastic and low-cost way to promote and advertise.
Or, can you try out video chatting and conferencing platforms to connect with clients online, instead of face-to-face? Once you start thinking about it, there are plenty of ways to move your business online, without losing clients.
Use These Tips to Help Your Greene County Business Thrive
If your Greene County business is struggling, know that you’re not alone. While many companies are experiencing a decline, the growth tips above can give you the boost you need to regrow and come back to life.
You may want to use these ideas to develop a new business plan and marketing strategy, altering your strategies to meet the changing times. While change isn’t easy, all businesses need to adapt over time.
Was this helpful? If so, please keep reading to find more great content.

domain: finance


Researchers at MIT's Computer Science and Artificial Intelligence Laboratory have developed a deep-learning algorithm that can predict a list of ingredients and suggest recipes just by looking at and analysing pictures of food. The team trained the artificial intelligence system, dubbed "Pic2Recipe", using a massive database filled with over one million recipes on popular cooking websites such as Food.com and AllRecipes.
Using that data, the researchers taught the algorithm how to find patterns, make connections between food images and predict the corresponding ingredients and possible similar recipes. Researchers said the AI was correct 65% of the time. When it isn't able to recognise the dish in the photo, it gives a "no matches" response.
"In computer vision, food is mostly neglected because we don't have the large-scale datasets needed to make predictions," Yusuf Aytar, an MIT postdoc who co-wrote the paper, said in a news release on Thursday. "But seemingly useless photos on social media can actually provide valuable insight into health habits and dietary preferences."
While the system was able to predict the recipes and ingredients in desserts like cookies or muffins, researchers said it had a tough time figuring out the ingredients in more complex dishes such as smoothies or sushi rolls. The system also faced difficulty with food that has tonnes of varied and nuanced recipes, such as lasagna.
To address that issue, the team said they had to make sure the system would not "penalize" similar recipes when attempting to differentiate recipes.
Researchers said they hope to improve the system to be able to analyse and understand food in greater detail, understand how the food is prepared - such as stewing or dicing - and be able to differentiate various types of ingredients. They are also looking into developing the system further into a "dinner aide" that can tell a user what to cook based on their dietary preferences or what is on hand in the fridge at the time.
"This could potentially help people figure out what's in their food when they don't have explicit nutritional information," lead author and CSAIL graduate student Nick Hynes said. "For example, if you know what ingredients went into a dish but not the amount, you can take a photo, enter the ingredients, and run the model to find a similar recipe with known quantities, and then use that information to approximate your own meal."
The team has also provided an online demo for people to test out the system by uploading their own food photos.
"You can imagine people using this to track their daily nutrition, or to photograph their meal at a restaurant and know what's needed to cook it at home later," Christoph Trattner, an assistant professor at MODUL University Vienna, who was not involved in the project. "The team's approach works at a similar level to human judgement, which is remarkable."
Researchers will present the paper later this month at the Computer Vision and Pattern Recognition conference in Honolulu.


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Gravity Rush 2 drops onto PS4 in November
Get it? It's a gravity pun!
Sony recently confirmed that Gravity Rush 2 will head to PS4 in November.
Available from 30 November, you can see Kat’s new mysterious guardian Angel in action below:
Gravity Rush 2 is a PS4 exclusive.


Big oil is turning its attention to Iraq once again. But this time, instead of fear and dread, oil companies are looking to the Gulf state with hope and optimism. In recent years, the Iraqi oil industry usually made the news for all the wrong reasons: sabotages of pipelines, bomb attacks at drilling sites, employee kidnappings, and government corruption. But U.S. and international oil firms are now focusing on the oil-rich nation as the site of expansion efforts that could prove to be very profitable.
Beginning next week, the Iraqi government will auction off oil contracts to foreign firms for the first time since Western companies were kicked out of the country in 1972 in a broad wave of Mideast oil nationalization. By welcoming in foreign contractors, Iraq hopes to boost production at six developed oil fields to levels not seen even before the country’s invasion of Kuwait in 1990. From 120 companies that expressed interest in the project, 35 — including Exxon Mobil, Royal Dutch Shell, and China Petroleum & Chemical — were invited to participate in the auction, according to a report by the Wall Street Journal’s Gina Chon.
Iraq is believed to hold one of the world’s largest proven oil reserves at approximately 115 billion barrels. But following years of war and neglect, production is running at about 2.4 million barrels per day, well below the output levels achieved prior to the first Gulf War. With the introduction of foreign technologies, Iraq hopes to boost its daily volume above four million barrels. As part of the dealings, foreign firms won’t get direct ownership stakes in the reserves, but rather will be paid if they are successful in boosting output. Although not as lucrative as a stake in the reserves, oil companies could still turn a tidy profit in this venture, given the significant size and relatively undeveloped nature of Iraq’s oil industry.
Entry into Iraq doesn’t come without significant risks for foreign contractors. Following the establishment of Iraq’s new government in 2006, the oil ministry was plagued by corruption and violence, as hundreds of employees were murdered or kidnapped. While the government has taken steps to correct these problems, significant risks remain. But apparently they’re not significant enough to scare away foreign investors.
As the bidding process unfolds and Iraq opens its doors to foreign investors, there are several ETFs worth keeping an eye on.
- iPath S&P GSCI Crude Oil ETN (OIL): Pardon me for opening with the obvious. If the expansion goes as planned, Iraq’s production capacity could increase by more than 50%. As any Econ 101 student can tell us, increases in supply generally result in reduced prices. But there are significant upside risks to oil prices as well. Retaliation against Western firms is a very real threat in this effort. If the country’s oil infrastructure were to suffer collateral damage, output could plunge, potentially setting the stage for price increases.
- SPDR S&P International Energy Sector ETF (IPW): The holdings of this ETF are dominated by the participants in next week’s auctions. If these firms do indeed benefit from Iraq’s invitation to boost its oil industry, IPW investors would see the benefit as well. But this is far from a sure thing, as the risks related to this venture are numerous and material.
- Market Vectors Gulf States ETF (MES): While the economies of many Gulf States have become increasingly developed and diversified, the dark cloud of uncertainty hanging over Iraq (and Iran) has shaded the entire region. Iraq’s stability as a nation, for better or worse, is contingent upon the health of its oil industry. If the effort to boost production is successful, government coffers could be refilled, providing the country with the resources it so desperately needs to continue on its long road to recovery. While this stability is obviously good for the people of Iraq, it would give the entire region a boost as well.
Disclosure: No positions.


text:
Carolina Home and Garden, a popular Western N.C. magazine will be interviewing me this week about my art. I'm am very excited to see my works published in a high profile magazine read by diverse subscribers of intellect and architecture. Thank you so much for this opportunity.
This is a new oil painting I am working on. I have a gallery of two dozen ecclectic oil paintings in Kenwood California...In The Valley of the Moon on a magical estate: http://www.fabuloushome.tv/ ...an awesome place to get married or lease out for a getaway...beyond Enchanting.

domain: artistic


text:
CORAL SPRINGS, FLA. (WSVN) - Threats posted on social media against schools are becoming more and more common, and police officers and school officials are being trained to spot the trouble in the hopes of preventing another tragedy.
Non-profit organization Stand with Parkland gathered Thursday to teach educators and law enforcement how to spot the online threats.
“[It’s] not to incarcerate anybody. It’s not to profile anybody. It’s to identify those that need help and then get them the help they need,” said Tony Montalto, who lost his daughter, Gina Montalto, in the Parkland shooting.
Confessed Parkland shooter Nikolas Cruz is an extreme example of a person posting such threats online.
“He had made it very clear that he intended to shoot up a school,” said Ryan Petty, who lost his daughter, Alaina Petty, in the Parkland shooting.
Montalto, Petty and Max Schachter, who lost his son, Alex Schachter in the Marjory Stoneman Douglas High School shooting, added that what students choose to share online can often be a cry for help.
“These are clues that give us a picture into what is going on in the life of that student, so that the right resources can be brought to bear, parents can be made aware,” Petty said.
A workshop at Coral Springs Police’s headquarters was set up to help adults who often do not know the ins and outs of all the different social media networks.
“I cannot stress how much it’s important to really get yourselves familiar with this,” Safer Schools Together founder Theresa Campbell said during the workshop.
Experts said that children are a huge component in spotting threats. They also encourage students that if they see a concerning post or message, they should say something, so that child can get help.
“It is our job, it is school officials’ jobs to really investigate this, to evaluate the threat, the level of the threat and to get the kid the services and the help that they need,” Schachter said. “I was just a dad before this, and I had four children. I only have three now, and in all of us, Stand with Parkland, all the 17 families are just trying to do everything we can to prevent this from happening to other communities around this country.”
Copyright 2020 Sunbeam Television Corp. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


ssh-keygen can be used to create an SSH key pair that is used to authenticate oneself. SSH supports a variety of authentication schemes, including the public-key system (SSH.com).
This article is a summary of an article found on Medium, which is written by Risan Bagja Pradana.
There are different algorithms for generating a key pair that SSH supports. The EdDSA algorithm is most recommended. The SSH term (or variant) for the algorithm is "Ed25519" (Pradana).
Among Pradana's recommended options (Pradana), one seems essential: The
t option, which specifies the algorithm used to generate the key pair. So, for example, using the
t option, the following command can be used to generate a key pair:
ssh-keygen -t ed25519 (Pradana).
After generating the key pair, it is essential that we register the key pair with the SSH Agent. The Agent must first be running. And then, we use either of the following commands to add our new pair (Pradana):
ssh-add ~/.ssh/id_ed25519 # new pair, OR ssh-add # all existing keys
Lastly, we must register the public key with the server we intend to connect to. Use the following command:
ssh -i ~/.ssh/id_ed25519 username@server (Pradana).
More information can be obtained in the cited article by Pradana. It is a Medium article, but it is not a "Premium" article.
Top comments (0)


text:
EDPR reached an agreement in Greece for the joint-development of wind farms
Wednesday21, October 2020
The agreement envisages the joint development of a wind portfolio with a capacity of 900 MW.
EDP Renováveis announces it reached an agreement with Ellaktor, the largest infrastructure group in Greece, for the joint development of onshore wind opportunities in the country, with both companies bringing together and combining the industrial expertise and development capacity.
The agreement envisages the joint development of a wind portfolio with a capacity of 900 MW, currently under different development stages, in a country with attractive renewable prospects.
Through this partnership,EDPR accesses to qualityassets under development and gains further growth visibility in the Greek market on top of the 152 MW already contracted in recent wind auctions to start operations in 2021 and 2022.
EDPR continues to study worldwide opportunities while developing profitable projects focused in countries with low risk profile and regulatory stability.
EDP - Energias de Portugal SA published this content on 21 October 2020 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 21 October 2020 14:04:07 UTC


Costume & Set Designer
Winner of the prestigious Abbiati Award 2019, as best costume designer for the production of Vivaldi's “Orlando Furioso” directed by Fabio Ceresa for the Teatro alla Fenice in Venice, Giuseppe Palella has already had a long career working for the most important Italian and foreign opera houses, specializing in the Baroque repertoire. He started his career iin 2007 with Alan Curtis in the sacred action for music of the "David" in Florence. His musical studies as an opera singer and those of art and sculpture make him an original designer with a classic line.
Among his most notable productions, one finds: "Orlando finto pazzo " Korea Naional Opera , Seul, "Alessandro alle Indie" Theater Castle Bayreuth Baroque Opera Festival, "Turandot" Opernfestspiele St. Margarethen Vienna, "Guglielmo Ractliff" Wexford opera festival ,"Traviata " Lithuanian national opera and ballet theater Vilnius "Andrea Chenier" national opera theater Budapest , "Giulio Cesare" theater St Gallen ,"Barbablù "Gran Teatro alla Fenice Venice.
Upcoming productions in 2023/2024 include "Nabucco" at the State Opera Theatre Karlsrhue, "Traviata” at opera Royal de Wallonie and "Aida"at Opernfestspiele St. Margarethen.


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The Dutch public prosecution department is requesting a man living in Israel and suspected of sexually abusing minors at Cheider, an Orthodox Jewish school in Amsterdam where he taught, be extradited by Israel.
According to the Dutch News, the teacher, Ephraim S., denies allegations against him. His lawyer claims he will resist the extradition back to The Netherlands. He moved to Israel a year and a half ago after being fired in Amsterdam for "inappropriate behavior," and has been tutoring here.
The Cheider school in Amsterdam has 200 students aged two-18 and lessons are separate for boys and girls. Accordign to the report after S engaged in inappropirate sexual conduct with a 16-year old pupil and other students have come forward since he was dismissed.
The school has not issued any comments.

domain: law


A Peer-to-Peer File Sharing System for Wireless
Master Thesis Presentation
Supervisor: Assist. Prof. Dr. İbrahim Körpeoğlu
In recent years, we have witnessed an increasing popularity of peer-to-peer (P2P) networks. Especially, file sharing applications aroused considerable interest of the Internet users and currently there exist several peer-to-peer file sharing systems that are functional on the Internet. At the mean time, recent developments in mobile devices and wireless communication technologies enabled personal digital assistants (PDA) to form ad-hoc networks in an easy and automated way. However, file sharing in wireless ad-hoc networks imposes many challenges that make conventional peer-to-peer systems operating on wire-line networks (i.e. Internet) inapplicable for this case. Information and workload distribution as well as routing are major problems for members of a wireless ad-hoc network, which are only aware of peers that are within their communication range. In this thesis, we propose a system that solves peer-to-peer file-sharing problem for wireless ad-hoc networks. Our system works according to principles of peer-to-peer systems, without requiring a central server, and distributes information regarding the location of shared files among members of the network. By means of constructing a distributed hash table (DHT) and forming a tree shaped overlay network based on the topology of the network itself, the system is able to answer location queries, and also discover and maintain routing information that is used to transfer files from a source-peer to another peer.
DATE: August 31, 2004, Tuesday @ 13:30


text:
- 20 Simple Tips Avoid Pimples on Your Face
- Drink Sufficient Water–
- Visiting a Dermatologist–
- Popping Pimples is Discouraged–
- Choosing Right Makeup–
- Eat Healthy–
- Quality Anti-pimple Products –
- Reduce Stress Levels–
- Avoid Excess Skin Exposure–
- Apply –
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- Apply Ice–
- Aloe –
- Get Rid of Blackheads–
- Moisturization is a Must–
- Applying Mud Mask–
- Apply Orange Peel/juice–
- Using Clean Towel and Face Napkin Mandatory–
- Weekly Change of Pillow Covers–
- Keep Your Clean–
20 Simple Tips Avoid Pimples on Your Face
20 simple tips to avoid pimples on your face – Disgusted with a sudden outburst of pimples on your face? these annoying pimples keep coming back despite your efforts to keep them at bay?
If you answered yes to any of the above questions, it is time that you try these simple tips that work like a charm!
Drink Sufficient Water–
Water helps in flushing out all toxins from the system. As a result, the skin is imparted a vibrant and radiant glow. If your skin is pimple prone, you must definitely drink 8 glasses of water everyday.
Visiting a Dermatologist–
Go see a dermat! While you may think something as simple as acne that can be handled at home needs no medical intervention, you are mistaken! A dermatologist is the best person who can recommend what is good for your skin and what is not. can suggest the right treatment processes and products which are most suitable for your skin type. The expert advice can definitely help in dealing with a nasty attack of acne more effectively.
Popping Pimples is Discouraged–
Keep your hands away from the zits on your face to avoid transferring dirt and oil to it. If you think popping pimples is the way of getting rid of them, you are gravely mistaken. Touching them will worsen the breakout and also leave scars!
Choosing Right Makeup–
The quality of makeup you use has a great impact on the skin. Using excess makeup or the wrong makeup can lead to clogging of skin pores resulting in pimple breakouts. It is recommended to avoid makeup, which is greasy and heavy as it clogs the skin and eventually causes your skin to erupt with pimples. Opt for oil free makeup products that are soft and gentle on your skin. Also, remember to remove makeup before going to bed, however tired you might be. Use a gentle cleanser to remove all traces of make up and rinse your face with cold water before you hit the sack.
A healthy diet is a prerequisite for good skin. Reduce the intake of fatty food and eat more food that are richin zinc and vitamin C. Include citrus fruits in diet for healthy and glowing skin. With lesser intake of oily and greasy food, chances of pimple breakouts are reduced.
Quality Anti-pimple Products –
A number of skin care products are available in the market, which help in restricting pimple breakouts. There are creams, lotions, face packs and face washes which can control oil levels in the skin thus reducing chances of pimples. some thorough research and select products that will be suitable for your skin type.
Reduce Stress Levels–
Stress is one of the main culprits behind pimples and impacts your skin greatly. Higher stress levels can accelerate a breakout of pimples. Stress leads to skin dehydration and clogged pores.
The stress hormone also thickens the lining of the hair follicles leading to whiteheads and blackheads. When bacteria get trapped inside these, they cause pimples and acne. Stay relaxed and happy to get rid of unwanted pimples.
Avoid Excess Skin Exposure–
Higher levels of exposure to the sun might cause pimples and acne. Inflammation and skin redness occurs due to exposure to the UV rays of the sun. case you need to go out in the sun, ensure that you apply sunscreen. Also try and wear protective clothes to avoid direct sun rays on the skin.
is a natural emollient which has antiseptic properties. It helps in skin soothing and healing. The natural cleansing properties and antioxidant properties of honey helps in treating pimples effectively. Not only this, honey also prevents further pimple breakouts by keeping your skin clear and cleansed.
Apply honey on the pimple directly and let it stay for 10 minutes. Then wash off with water. With regular application of honey, the skin remains healthy and smooth and devoid of pimples and acne.
It might sound strange but regular exercising can help in reducing acne breakouts. How, you ask? Exercising helps in improving blood flow in the body.
It boosts your body metabolism that in turn flushes out toxins that cause acne breakouts. Higher rates of perspiration mean removal of toxins, chemicals as well as dirt from the skin. Just 30 minutes on the treadmill each day, can make your skin glowing and vibrant!
Pimples can be done away with the application of ice on the affected area. Ice has a smoothing effect on the skin and also helps in removing oil and dirt, which is trapped inside. Simply wrap an ice cube in a clean piece of cloth and very gently press against the pimple to get rid of it!
If you are looking for a readily available ingredient for fighting pimples, there is nothing better than lemon juice for the same. Along with killing harmful bacteria, lemon juice helps in reducing inflammation and redness almost instantly.
The scars left behind by pimples can also be removed by the regular application of lemon juice. Avoid chemical OTC products and treat pimples by making lemon juice a part of your beauty regimen.
Take a look at quality skin care products and almost all of them have aloe vera in them. This ingredient has innumerable medicinal properties – it is anti-fungal, anti-bacterial and anti-septic at the same time. Aloe vera cleanses the skin and regulates sebum production too!
Thus, it is highly effective in treating as well as preventing pimples. Use a face mask with aloe vera or an aloe vera moisturizer for glowing and healthy skin sans pimples.
Get Rid of Blackheads–
Squeezing your blackheads is a bad habit, stop it right away! The squeezing might lead to scarring, pigmentation, formation of larger pimples or infections. Instead, use a natural face scrubto do away the stubborn blackheads.
If these fail, seek advice from a professional dermatologist for the same. If you do not get rid of blackheads, you are paving a way for an acne breakout. Steaming helps greatly in flushing out not just blackheads but whiteheads too!
Moisturization is a Must–
If you use acne products on a regular basis to control the breakout of pimples, you must also make sure that your skin is duly moisturized. Majority of acne products contain ingredients, which make the skin dry.
Therefore, it is recommended that right after applying the acne product you must moisturize your skin. Moisturizing has many other positive results as well. It helps in flushing away excess oil, dust, dirt as well as makeup, which keep accumulating on the skin and causes acne.
Applying Mud Mask–
Mud mask application is not new. It has been a part of beauty regimen since time immemorial. Weekly application of a mud mask on the face helps in keeping the face skin radiant and glowing.
It also plays a pivotal role in removing the dirt and stubborn oil molecules which lie deep in the skin pores causing pimples and acne. Thus pimple breakouts can be restricted with the use of a mud mask weekly.
Apply Orange Peel/juice–
Orange juice is one of the most effective ingredients, which is helpful in restricting pimple and acne breakouts. The juice of orange needs to be applied on the affected area and left like that overnight.
Make a paste with dried up and grounded orange peels and water. Use this paste for cleaning your face regularly.
Using Clean Towel and Face Napkin Mandatory–
Make sure that the face napkin and towel which is used to wipe the face is washed on a regular basis. This can help in avoiding breakout of pimples on the face.
Using unclean towels might aggravate the risk of pimple breakouts and blackhead problems. Such towels are a great source of germs, which can settle on the skin. Also, avoid sharing towels and other personal toiletries.
Weekly Change of Pillow Covers–
Your pillow cover shares your stress and sweat with you. The sweat and dirt from your face is absorbed by your pillow cover every night while you are sleeping peacefully. If you do not change your pillow covers regularly, you expose your face to all the dirt and oil night after night.
This leads to clogging of the pores in the skin, leading to higher rates of pimple breakouts. Therefore, it is recommended to change pillow covers at least once in a week, so that the problem of acne and pimples can be kept at bay.
Keep Your Clean–
Acne and pimples are not only caused due to excess oil and dirt on the face, they are also caused from oily and dirty hair. people have the tendency of oiling their hair at night.
This might cause pimple breakouts as the hair has high chances of touching the face and makes the face oily as well. Clean and wash your hair on a regular basis so that there are no chances of oil and dirt depositions.
Also refrain from using hair gels and other hair styling products on a regular basis as they lead to clogging of the pores of the skin, which might cause pimples and acne.
All these above mentioned tips are quite simple and easy to follow. It is also true that the problem of pimples and acne varies from one individual to another. While for some the problem is mild; for others it is quite severe.
Whatever be the extent of the problem, ensure that it is not neglected and paid heed to immediately. While investing in skin care products for dealing with acne or pimple, make sure that you consult a dermatologist and understand your skin type.

domain: medical


COVENTRY Police want to speak this woman after an vicious assault in a city pub.
It follows an incident at the venue in Gosford Street on September 11 when a 19-year-old woman was hit in the face with a glass.
The victim was left with a fractured cheekbone and concussion.
Anyone with any information on who she is should call police on 101 or contact officers via Live Chat at west-midlands.police.uk.
The reference for the incident is 20CV/224394G/20.
Support community journalism by making a contribution
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Every contribution, however big or small, you can make will help us continue to do that now and in the future.
Thanks for reading this and the Coventry Observer.


text:
With the help of a talking freeway billboard, a "wacky weatherman" tries to win the heart of an English newspaper reporter, who is struggling to make sense of the strange world of early-90s Los Angeles.
Richard E. Grant
Suffering from writer's block and eagerly awaiting his writing award, Harry Block remembers events from his past and scenes from his best-selling books as characters, real and fictional, come back to haunt him.
Stephanie Roth Haberle
A 43 year old mother and housewife that's facing divorce is thrust back in time when she tries to plan a high-school reunion. Given the chance to change the course of her life she finds herself making many of the same choices. Written by
K. Rose <email@example.com>
Maddie's hair style changes between shots when Peggy first sees her outside at the reunion, when they are inside and Maddie tells Peggy to find a table, and when Maddie and her husband join the table. See more »
[Peggy Sue hands in her algebra test]
And what's the meaning of this, Peggy Sue?
Well, Mr Snelgrove, I happen to know that in the future I will not have the slightest use for algebra, and I speak from experience.
See more »
a classic - in the same mold as "Field of Dreams" and "Frequency"
I rented this film the other night when I knew I would be alone - that's just the way I have to watch this, alone - guess I'm not comfortable with people seeing me cry. I cried when it was in the theatres in 1986 and I've seen it maybe 10 times now - and it gets me each and every time, as if I were watching for the very first time! Sorry to drone on, but it has just the right touch - you've heard a lot of comparisons with "Back to the Future" - believe me, it isn't! If you liked the two movies I mentioned in my header, especially "Frequency" since it is about to be released on video
you will love this film!
Kathleen Turner was excellent - I have seen Debra Winger (originally scheduled to play the title role) in several films, including "Terms of Endearment" and though I respect her as an actress, she just couldn't have done this part justice. Nicolas Cage was great in his role - the whiny voice was a bit much - but it's hard to believe he was only 21 when this film was made. He plays a high school kid and a guy in his 40's equally well - he's always had a gift for that. Jim Carrey - then mostly unknown - displays some of the physical slapstick routines that would later earn him praise and renown. Then there's Joan Allen - as I saw this movie for the first time, I thought how much she resembled former first lady Pat Nixon in her earlier years - and sure enough, that's who she played in Oliver Stone's "Nixon". Helen Hunt portrays Kathleen Turner and Nicolas Cage's daughter - ironic, since she is older than Cage! It was one of her beginning roles as well.
Without a doubt, the scenes with Peggy Sue and her grandparents are the most touching in the whole film. Think about it - if you had the chance to see someone again who had died long before, what would you say to them? What would you do? This wonderful film gives us the chance to find out.
Will "Peggy Sue Got Married" ever be available on videocassette for home purchase again? I hate to have to rent it each time I want to see it!
23 of 23 people found this review helpful.
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text:
Escape game for schools, clubs and associations: frequently asked questions
AGE AND TEAMS
Your class or club can play from age 12-13. Thanks to the hints provided on request in the Sato Code app, everyone will find in the game an appropriate level of difficulty. You will create teams of max 4 participants at the starting location of the game, as indicated in the app.
DOES EVERY STUDENT NEED A SMARTPHONE?
Yes, the game is designed as multi-player game. Each player receives different bits of information, to be combined to advance in the game. This is why it is important that each player has a phone with internet connection (the game requires only 2 MB data). You can open an hotspot for the ones who do not have access to the internet. Not everyone has a phone? Contact us and we'll find a solution!
DO TEACHERS PAY ALONG?
All our games are mainly in pedestrian areas, in the city center. So the students can play alone. But many teachers or organizers play the game too, and have great fun.
The app and the whole games are available in EN/DE/IT. Many French speaking groups played too, using a foreign language, as the texts are not long neither difficult. Basic understanding of one of the languages will be enough. Each player can choose different languages even in the same teams
IS THE SATO CODE APP FREE TO DOWNLOAD?
Yes, it is free to download. You'll need the ticket code to unlock the specific game you're going to play. You will not need anything else (maps, papers…) just charged phones.
DISCOUNT, PAYMENT AND CANCELLATION
As school or club, you'll get 10% discount. As soon as you'll confirm your booking, we'll send you the tickets and invoice. Need to cancel? You'll get the full refund.

domain: hobby


MASSACHUSETTS'S HEALTH CARE
August 13, 2008
Massachusetts's businesses have joined several of the state's health insurers to form a new consumer advocacy group, the Coalition for Affordable Health Coverage. Their goal is to slow health insurance premium increases and prevent the financial burden on employers from being increased through continued attempts by the Massachusetts's government to "universalize" health insurance, says EmaxHealth.
Though experts commend the new effort, many warn that the private sector will have to fight hard to take health care back from the state. Devon Herrick, a senior fellow with the National Center for Policy Analysis, agrees, adding that Massachusetts's current government-based plan is "destined to fail, because it has no cost control whatsoever."
- Businesses within the state were not vigilant enough when former governor Mitt Romney (R) and the legislature imposed a health reform that is proving far more expensive than promised.
- Commercial insurance premiums in the state have increased by an average of 10 percent in each of the past seven years.
- Massachusetts's per-capita health insurance spending is among the highest in the country.
In response, the Coalition has developed such goals that will:
- Allow consumers to choose a consumer-driven plan.
- Attempt to increase financial penalties on employers who do not provide health insurance for their employees.
- Oppose arbitrary changes to the definition of "reasonable employer contributions" to employee benefit plans under future overhauls of the state's health care legislation.
Herrick states that allowing consumers to choose a consumer-driven plan that meets their needs is better than forcing people into expensive plans with low cost-sharing. He adds that, "people can reduce their spending by merely explaining to their physician they have a significant cost-sharing requirement in their coverage plan, and by asking for prices."
Source: Editorial, "Massachusetts Insurers From Coalition to Fight Rising Health Care Costs," EmaxHealth, August 12, 2008.
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Genetics and mechanisms of resistance to Bacillus thuringiensis CRY TOXINS
Genetics and mechanisms of resistance to Bacillus thuringiensis (Bt) Cry toxins in insects. [Collaborative studies with Havana, Rothamsted, Sussex, València]
Cry toxins are the most selective compounds used for insect control, each having a narrow spectrum of activity against members of the Lepidoptera, Diptera or Coleoptera. As spray products, they are valuable components of integrated pest management programmes and organic agriculture. Cry toxins are also the dominant traits expressed in insect resistant GM crops, most notably Bt cotton and Bt maize. Knowledge of the genetics and mechanisms of resistance to Bt toxins is essential to the continual development of resistance management.
Application technology for entomopathogenic nematodes
Development of robust systems for the application of nematodes against foliar insect pests on protected and field crops. The development of polymer-based formulations and delivery systems specifically designed for nematodes have led to major improvements in their efficacy against leafminer and other pest species.

domain: agronomy


NEW YORK: A combative Donald Trump lashed out on the decide and legal professional normal on Monday (Oct 2) on the primary day of a trial for civil fraud that might see the previous president barred from doing enterprise in New York state.
The 77-year-old Trump, who’s going through authorized battles on a number of fronts, denounced the enterprise fraud case as a “sham” meant to torpedo his bid to recapture the White Home subsequent yr.
“This has to do with election interference, plain and easy,” Trump mentioned as he arrived for the opening day of what may very well be a three-month trial. “What we’ve right here is an try to harm me in an election.”
New York Choose Arthur Engoron has already dominated that Trump and his sons Eric and Don Jr dedicated fraud by inflating the worth of the true property and monetary belongings of the Trump Group for years.
New York Lawyer Common Letitia James is now looking for US$250 million in penalties and the elimination of Trump and his sons from administration of the household empire.
“Justice will prevail,” James informed reporters. “Irrespective of how highly effective you might be, irrespective of how a lot cash you suppose you could have, nobody is above the regulation.”
Trump was not required to attend the opening day of the trial however selected to take action, taking a seat on the protection desk flanked by his attorneys.
“It is a rip-off. It is a sham,” he informed reporters earlier than getting into the Manhattan courtroom. “My monetary statements are phenomenal.”


NIE ROCKS Reviewing inaugural history
Inaugurals are a mixture of pomp, festival and gravity, the American equivalent of a coronation. Their rituals are laden with symbols of national purpose, continuity and unity. For 220 years, they hav... Posted on 1/21/13 at 10:02 AM
FARGO — When Prairie Rose Seminole received a call about North Dakota Native American participation in President Barack Obama’s inauguration parade on Jan. 21, she was absolutely interested, but she didn’t have much time to organize it.
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text: Hydrofoil SUP Bag. A perfect Fathers Day gift. Newf Surf’s (www.newfsurfboardnet.con) banana spilt design comes in sizes 6’0”-7’4”, up to 30” wide, 3” thick. Solid on fin side to protect the suns rays, ventilated on top allowing heat & humidity out & padded 360 rail protection. Unique where you can put both your board & foil still attached into the bag & head down the road. A lifetime warranty keeping our bags out of the landfill. 1% of the sale of each bag sold goes to our 1% for the Planet sponsorships.

domain: design


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Thank you card using Swallowtail (#129216 from Spring Catalog pg 18). I embossed it with pewter and underneath I swirled calypso coral ink on photo paper.
For this card I used By the Tide Stamp Set (#129120 from Spring Catalog pg 19). I dyed the Canvas Collections (#129375) with Wisteria Wonder ink. I also used the Vine Street embossing folder from Sale-a-Bration. The medallion was embossed with pewter several times and impressed with the symbol from the By the Tide set.
I loved using the Artisan Embellishments Kit (#129328) on this card. I also used the Feeling Sentimental Stamp Set from Sale-A-Bration and embossed with Pool Party. For the background I used the Pool Party Core'dinations Card Stock (#129321) and the Textured Impressions Embossing Folder (#129378)
My "boys" look so good dressed up! Again I used the Artisan Embellishments Kit (#129328). I crimped the Chocolate Chip card stock.
A great party favor using the Dapper Dad Stamp Set (#129198). I embossed the bow tie with black and used the Natural Composition (#126917) and First Edition (#121878) DSP. For the pocket accents, I cut a slice from another embossed bow tie. I used the "Just for You" stamp from the Pop-UP Posies Designer Kit (#131395).
I am using this box for party favors on my Easter dinner table. Everyone will have one by their plate. I used a Kraft Gift Box (#124106) and cut the top off. I used Gum Ball green for the handle and the Delicte Details Lace Tape (#130966) on top. Paper Dollies (#129399) are from the Spring Catalog and Ears to You! (#132659) is a Single Stamp that may be purchased. The bunnies were embossed with Melon Mambo. The eggs are wrapped in Every Egg (#124089) wheel design that I colored in with our watercolor pencils (#101879). The leaf is Little Leaves Sizzlits (#114511) from the Catalog.


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Meet the women behind BDE and how they navigate the dog-eat-dog world of the dog accessories business!
What’s your background?
I turned 30 on Friday (eek!) and currently work in marketing. Alongside this and BDE, my boyfriend and I are also in the process of setting up an outdoor wedding venue so you could say things have been busy during lockdown! I’ve always loved art and design, so within my marketing jobs I’ve really enjoyed the creative side of the work and love finding new ways to create fun and interesting ways to communicate with people.
What made you want to set up a business like BDE?
Chloe and I have been friends for about 20 years (!?) and when we both got puppies during the start of lockdown (they were planned before lockdown, I promise!), we were buying so many accessories for them before coming to the realisation that we could do it ourselves.
I couldn’t think of a better business partner than Chloe – we’re both as dog mad as each other and she brings fab ideas, as well as her amazing graphic design skills, into the mix! Chloe’s mum, Juliet is also an illustrator so she’s been a great help too.
How important is it for women to lift each other up and what does that mean to you?
Lifting up other women is so important and it’s something that we really try to shout about where we can. We have so many amazing, creative female friends, and we love to support small female-run businesses. We are actually going to start a feature on our social channels where we highlight small businesses each Sunday.
Do you think there are any issues facing women your age who want to start their own business?
Often women my age think they’ve gone ‘past’ setting up their own business and that they should stick with the career they’re in. This isn’t the case! You can start up a side hustle or go straight into a new business venture whenever your want. The only thing stopping you is your own self doubt. You do you!
On International Women’s Day, what advice would you give to a woman looking to start up their own business?
Go for it! It can feel really overwhelming and it’s often easier to come up with an idea and just put it on the shelf as it seems too difficult to even know where to start (getting started is often the hardest part). There is so much help and advice online... the most important thing is a great idea!
And lastly… show us your favourite picture of Bronte!
What’s your background?
I'm 29 years old and have been working in a graphic design/print studio role for around (nearly) 8 years now. I’ve also got a little art and design business called YouBloom which I run with my mom,
What made you want to set up a business like BDE? It came from being passionate about art and illustration, and also, (most importantly!) dogs. Between Yaz and myself, we had the drive to want to create dog apparel using our own designs and artwork. We both got our doggies a similar time, and both found ourselves looking for fun, colourful and bold dog harnesses, but weren’t able to find any. We both have a creative side, with Yaz being amazing at illustrations, so we thought why don’t we do it ourselves!
How important is it for women to lift each other up and what does that mean to you? It’s SO important! 'Celebrate her success without questioning your own' When I was younger, this is something I guiltily didn’t do! However, the older I’ve got, the more I’ve realised it’s NOT woman vs woman. We have it hard enough! Do you think there are any issues facing women your age who want to start their own business? I don’t feel there are too many issues anymore! I think these days, there’s so much support out there, regardless of your gender and age. On International Women’s Day, what advice would you give to a woman looking to start up their own business? Do it!! If it does feel intimidating and overwhelming, regardless of the industry you’re in, I would definitely recommend speaking to someone from The Prince’s Trust. They are amazing, especially with helping young people!
And lastly… show us your favourite picture of Buddy!
Want to ask team BDE a question, or just find out what Buddy's dreaming about?


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Efficacy of dexmedetomidine in attenuating pressor response to laryngoscopy and endotracheal intubation under bispectral index controlled anesthesia: a prospective randomized double-blinded study
Ain-Shams Journal of Anesthesiology volume 15, Article number: 15 (2023)
Laryngoscopy and endotracheal intubation may lead to a remarkable hemodynamic pressor response. Dexmedetomidine, an α2-adrenergic receptor agonist, can be effectively used to attenuate this pressor effect. This study was aimed to compare the efficacy of two different doses of dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) in attenuation of hemodynamic pressor response to largyngoscopy and endotracheal intubation under bispectral index (BIS) monitoring. One hundred twenty adult patients with American Society of Anesthesiologists (ASA) physical status I or II posted for various elective surgeries under general anesthesia were enrolled to receive an intravenous (IV) infusion of dexmedetomidine 0.5 μg/kg (group D1; n = 40), 1.0 μg/kg (group D2; n = 40) or normal saline over 15 min (group C; n = 40). The primary outcome measure was to assess the hemodynamic changes while the secondary outcome measures were to assess sedation, dose of propofol required for induction and side effects.
The mean HR, SBP, DBP, and MAP remained significantly lower in both dexmedetomidine groups as compared to control group after study drug infusion, after induction, at and after intubation (P < 0.05). Group D2 also had significantly lower mean HR, SBP, DBP, and MAP in comparison to group D1 (P < 0.05). The induction dose of propofol was significantly less in dexmedetomidine groups as compared to control group (P < 0.05). Ramsay sedation scale (RSS) score was found to be significantly more in both groups D1 and D2 after study drug infusion (P<0.001). No significant difference was noted in incidence of side effects (P = 0.907).
Dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) was found to be effective in attenuating the hemodynamic pressor response to laryngoscopy and endotracheal intubation with BIS monitoring.
CTRI, CTRI/2020/03/024088. Registered 19 March 2020.
A remarkable increase in sympathetic activity is generally noted during laryngoscopy and endotracheal intubation, which is noxious and deleterious stimuli. The proprioceptors in response to tissue irritation in the supraglottic region and trachea initiated these stimuli. The glossopharyngeal and vagus nerves transmit impulses from these receptors to the brainstem which leads to increased hypothalamo-pituitary activity further resulting into increase in circulating plasma catecholamines. Although this transient response is of no consequence in healthy individuals but even short lasting stimulation may be detrimental for patients with associated co-morbidities like hypertension, ischemic heart disease, coronary artery disease, or cerebrovascular disease in terms of increased morbidity and mortality. (Shribman et al. 1987; Aleem et al. 2012).
This stress response has been reduced by several drugs and maneuvers (Joffe and Deem 2013) with varying benefits and side effects, which include technical considerations to minimize the stimulation of proprioceptors present in airway (Saghaei and Masoodifar 2001; Haidry et al. 2013), topical and regional anesthesia (Ganeshan et al.2020), inhalational anesthetic agents (Zbinden et al. 1994), non-anesthetic intravenous adjuvants and intravenous anesthetic (IV) agents (Hosalli et al. 2014).
A highly selective α2-adrenergic receptor agonist, dexmedetomidine, with a α2:α1 specificity of 1620:1 can be effectively used in attenuating the pressor effect related to laryngoscopy and endotracheal intubation. Due to its action at presynaptic α2-adrenergic receptors located at the locus coeruleus, it has sedative, hypnotic and antinociceptive properties. This results in blockade of norepinephrine release, inhibits sympathetic activity thus terminating the pain signals and thereby blunts the pressor response associated with laryngoscopy and endotracheal intubation (Tanskanen et al. 2006).
The bispectral index (BIS) is a processed electroencephalographic (EEG) parameter which was developed specifically to evaluate patient responses during drug induced anesthesia and sedation (Xing et al. 2018) A BIS score analyzes an index value between 0 and 100 that indicates the patient’s level of consciousness, a value of 100 corresponds to patient being completely awake, whereas 0 corresponds to a profound state of coma or that of unconsciousness (Kelley 2010)
Although different doses of dexmedetomidine (0.5–2.0 μg/kg) have been used in various studies which suggested its efficacy in blunting the hemodynamic pressor response but a few studies have incorporated BIS monitoring which is an indicator of adequate depth of anesthesia. The adequate depth of anesthesia is a prerequisite for minimal hemodynamic changes during larngoscopy and endotracheal intubation which can be best achieved by using BIS monitoring during intraoperative period. (Mahajan et al. 2018) We have chosen 0.5 and 1.0 μg/kg of dexmedetomidine in our study since the adverse effects of dexmedetomidine such as hypotension and bradycardia are more likely to occur at higher doses (> 1.0 μg/kg) and the lower doses (0.5–1.0 μg/kg) reported to have a reduced incidence of adverse effects and more cost effective. We hypothesized that IV dexmedetomidine infusion would be effective in blunting hemodynamic pressor responses to largyngoscopy and intubation with minimal side effects using BIS monitoring. So in present study, we intended to assess and compare the efficacy of two different doses of dexmedetomidine (0.5 µg/kg and 1.0 µg/kg) along with control group to find out its optimal dose in attenuation of hemodynamic pressor response to largyngoscopy and intubation with a BIS range of 40–60 at which the depth of anesthesia is maintained in all patients.
This prospective randomized double-blind study included a total of one hundred twenty patients of either sex aged 18–55 years, weighing 50–70 kg belonging to American Society of Anesthesiologists (ASA) physical status I or II posted for various elective surgeries under general anesthesia. The study was conducted after approval from institutional ethical committee. The exclusion criteria being patient’s refusal, uncooperative patients, patients with respiratory, cardiac, hepatic, or renal disease (ASA physical status III or above), patients with any known hypersensitivity or contraindication to dexmedetomidine, patients with significant neurological, psychiatric, or neuromuscular disorders, patients with history of convulsions, bleeding or thyroid disorder and anticipated difficult airway which requires > 20 seconds to intubate. The study was conducted between March 2020 and February 2021 which is registered in Clinical Trials Registry-India (CTRI/2020/03/024088).
Using a computer generated table of random numbers, the study population was randomly divided into three groups with 40 patients in each group. Patients received an IV infusion of dexmedetomidine (0.5 μg/kg) in 100 ml normal saline over 15 min in group D1 (n = 40); received an IV infusion of dexmedetomidine (1.0 μg/kg) in 100 ml normal saline over 15 min in group D2 (n = 40) and an IV infusion of 100 ml normal saline over 15 min in group C (n = 40), (Fig. 1).
All patients underwent a thorough pre-anesthetic evaluation prior to surgery. A written informed consent was obtained after explaining about the procedure on the night before surgery and alprazolam 0.5 mg was given orally to all patients. All patients were kept nil per oral for at least 8 h before surgery. For the purpose of double blinding, two investigators have participated in this study; an anesthesiologist who was not part of the study prepared the study drug infusions and another anesthesiologist who was unaware of group allocation did the data collection and analysis.
All standard monitors which included non-invasive blood pressure (NIBP), electrocardiogram (ECG) and pulse oximeter (SpO2) along with BIS (Kelley 2010) monitor (COVIDIEN BIS LoC Channel module) were attached after arrival of the patients in the operation theater. IV cannula was procured and a ringer lactate solution was started thereafter. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and ECG were recorded as baseline (TB) vital parameters. Before infusion of the study drug, Ramsay sedation scale (RSS) score was recorded. Patients then received the study drug based on group allocated. After study drug infusion (TA), HR, SBP, DBP, and MAP were recorded at the end of infusion of dexmedetomidine. RSS score was also recorded at the end of study drug infusion.
IV glycopyrrolate 0.004 mg/kg and tramadol 2 mg/kg were administered as pre-medication in all patients. One hundred percent of oxygen was given to all patients for 3 min before induction of anesthesia with IV propofol titrated to achieve a BIS value in a range of 40–60 (± 5). Intermittent positive pressure ventilation (IPPV) was given for 1 min after the administration of IV succinylcholine 1–1.5 mg/kg. An experienced anesthesiologist performed laryngoscopy and endotracheal intubation within a duration of 20 seconds with an appropriate sized cuffed endotracheal tube. The pressor responses were assessed with constant BIS values between 40 and 60 (± 5). Patients who required > 20 seconds for laryngoscopy and who developed bronchospasm or laryngospasm were excluded from the study. The hemodynamic parameters (HR, MAP, SBP, DBP, and SpO2) and BIS values were recorded after the infusion (TA) of study drug, after induction (TI) with propofol, at intubation (T0), at the interval of 1 min till 5 min, and then at every 5 min (10, 15, 20, 25, and 30) till 30 min.
Using a closed circuit throughout, anesthesia was maintained with isoflurane (MAC 1.0–1.2) and nitrous oxide in oxygen (67% N2O + 33% O2) along with controlled ventilation. The neuromuscular blockade was achieved with the initial loading dose of vecuronium 0.1 mg/kg IV and 0.02 mg/kg bolus IV as intermittent boluses when required for maintenance. At the end of surgery, the reversal of neuromuscular blockade was done using IV neostigmine 0.05 mg/kg and glycopyrrolate 0.008 mg/kg followed by extubation after achieving adequate muscle power and recovery from residual neuromuscular blockade.
The hemodynamic changes (HR, SBP, DBP, and MAP) from baseline up to 30 min after intubation were assessed and noted as a primary outcome measure. In addition, secondary outcome measures were assessment of sedation using RSS score preoperatively, i.e., before infusion with dexmedetomidine and after completion of infusion (before induction). After the end of study drug infusion (dexmedetomidine), the dosage of propofol required for induction was also noted and the assessment of the effect of two varying doses of dexmedetomidine on dosage of IV propofol required for induction was also done. Nausea, vomiting, bradycardia, hypotension, and respiratory depression were noted as the side effects/complications.
With an alpha error of 0.05 and power of 80%, an estimated sample size of 35.77 was obtained for each group based on our pilot study and taking heart rate as primary objective. The sample size was increased and rounded off to 40 patients in each group considering 10% loss during follow up. Standard qualitative and quantitative tests were used to compare the data (chi-square test, Kruskal-Wallis test, paired or unpaired Student’s t test and analysis of variance i.e. ANOVA). Microsoft Excel and MedCalc software were used for carrying out statistical analysis. Chi-square test was used to compare categorical variables with percentages and Kruskal-Wallis test was used to compare categorical data like age, sex and weight. Intergroup numerical data were compared using ANOVA and unpaired t test along with Tukey’s test for post-test analysis while intragroup numerical data was analyzed using paired t test. P < 0.001 was considered to be highly significant and P < 0.05 was considered to be statistically significant.
Among the three groups, the demographic profile was comparable in terms of mean age, weight, sex, and ASA physical status (P > 0.05). The mean duration of surgery (P = 0.589) was also comparable among three groups (Table 1).
The baseline (TB) mean HR, SBP, DBP, and MAP were comparable among three groups (P > 0.05). The mean HR significantly increased from the baseline value (TB) at intubation (T0) (P < 0.001) in group C which remained significantly higher till 10 min although it started to decrease after 3 min. In group D1, HR significantly increased (P = 0.014) at intubation, which remained significantly higher from 2 to 5 min (P < 0.001) which started to decrease after 4 min. In group D2, although the HR slightly increased to 70.93 ± 4.13 beats/min at intubation but it was significantly lower than baseline value, (P < 0.001) which remained significantly lower than baseline value at all time intervals thereafter (P < 0.001). On intergroup comparison, the mean HR remained significantly higher in group C as compared to both groups D1 and D2 till 10 min and 25 min, respectively, (P < 0.001). In group D2, it remained significantly lower than group D1 at all time intervals after infusion till 25 min (P < 0.001) (Fig. 2).
In group C, after an initial significant reduction in mean SBP following induction (TI), it was significantly increased from baseline to 131.63 ± 5.81 mmHg at intubation (P < 0.001) which remained significantly higher till 5 min, (P < 0.001). In group D1, mean SBP after induction reduced significantly to 118.50 ± 7.25 mm Hg, (P < 0.001) followed by a significant rise in mean SBP (130.80 ± 8.41 mm Hg) at intubation (P = 0.034) which remained higher than baseline till 15 min post-intubation (P > 0.05) but in group D2, after an initial fall in mean SBP (120.58 ± 8.93 mm Hg) after induction, the mean SBP remained significantly lower at all intervals till 5 min (P < 0.001). Even after 5 min the mean SBP remained lower till 30 min as compared to baseline mean SBP but it was statistically insignificant (P > 0.05). On comparing group C and D1, there was no significant difference in mean SBP between two groups at intubation (P = 0.305) but it was significantly higher in group C 1 min after intubation till 5 min (P < 0.001). In comparison to group D2, from the time of intubation till 15 min, the mean SBP in group C was significantly raised (P < 0.001). The mean SBP remained significantly higher in group D1 than group D2 from the time of intubation onwards till 15 min (P < 0.05), (Fig. 3).
Similarly, mean DBP significantly increased at intubation in group C (P < 0.001) which remained significantly higher till 5 min. In group D1, it was significantly increased from baseline at intubation and 1 min (P < 0.05) while it was comparable to baseline DBP at intubation in group D2 (P = 0.798). There was a significant rise in mean DBP in group C than group D1 at 1 min (P < 0.001) which remained so till 5 min after intubation. Group C had significantly higher mean DBP than group D2 till 5 min (P < 0.001). However, the difference in mean DBP was insignificant at all time intervals from 1 min till 30 min (P > 0.05), (Fig. 4).
MAP significantly increased to 98.86 ± 4.69 mm Hg at intubation in group C which remained significantly higher till 5 min, (P < 0.001). In group D1, a significant increase in MAP was noted at intubation and at 1 min compared to baseline MAP (P < 0.05). In group D2, although MAP increased to 92.93 ± 6.80 mm Hg at intubation (P = 0.173) but it was insignificant both at intubation and 1 min after intubation (P = 0.834). On intergroup comparison, there was a significant rise in MAP in group C than group D1 at 1 min (P < 0.001) which remained so till 5 min after intubation, (P < 0.001). Group D2 had significantly lower MAP than group C till 20 min (P < 0.05). MAP measured at T0 showed a significant rise in group D1 (P < 0.001) till 5 min after intubation (P < 0.05), (Fig. 5).
The mean RSS was comparable among three groups before infusion of study drug (P = 0.898), (Fig. 6). However, after infusion of study drug, significantly more number of patients had the mean RSS of 2 and 3 in group D1 and group D2 respectively (P < 0.001), (Fig. 7).
The mean dose of propofol required in group C (120.75 ± 14.21 mg) was significantly higher than in group D1 (80.50 ± 10.61 mg), and group D2 (68.75 ± 10.42 mg), (P < 0.001), (Fig. 8).The difference in terms of incidence of side effects/complications was not significant among three groups (P = 0.907), (Table 2).
The present study revealed that hemodynamic parameters were stable in group D1 and D2 when compared to control group. Dexmedetomidine (1.0 µg/kg) was found to be better in blunting the hemodynamic pressor response as hemodynamic parameters (HR, SBP, DBP, and MAP) remained lower from their baseline values till 30 min in group D2.
The mean HR at intubation showed a significant increase in both group C and group D1 from their baseline HR while it remained significantly lower from baseline value in group D2. Although the rise in mean HR in group D1 was statistically significant but it was clinically insignificant. When compared to group C, the mean HR returned to baseline values earlier in group D1. However, mean HR remained lower from baseline values in group D2 at all time intervals. This depicted that HR remained stable in both groups D1 and D2 but found to be more stable in group D2. So, when compared to its lower dosage (0.5 μg/kg), dexmedetomidine (1 μg/kg), seems to be optimal dose in blunting hemodynamic pressor response. A similar rise in mean HR was observed in control group as compared to dexmedetomidine group (0.5 μg/kg) by Lee and Kim (Lee and Kim 2017). The mean HR remained significantly lower in dexmedetomidine group till 5 min post-intubation which corresponds to our study. A significant reduction in mean HR was reported by Mahajan et al. and Sharma et al. after study drug infusion in dexmedetomidine group (1 μg/kg) which remained significantly lower from their baseline values at all time intervals and subsequent rise in mean HR following intubation in control group (group C) which concurs with our study (Mahajan et al.; Sharma et al. 2018). Gupta et al. also observed similar findings in which mean HR in group III (1 μg/kg dexmedetomidine) remained lower in contrast to group I (0.5 μg/kg dexmedetomidine) throughout the study which supports the results of our study (Gupta et al. 2016).
Mean SBP, DBP, and MAP were reduced in both groups D1 and D2 which might be attributed to decreased circulating catecholamines due to α2 agonistic action of dexmedetomidine. An adequate depth of anaesthesia was provided by BIS monitoring during laryngoscopy and endotracheal intubation. Since SBP, DBP, and MAP remained significantly lower from their baseline values even during and after intubation, group D2 (1 μg/kg dexmedetomidine) had more favourable blunting of hemodynamic pressor response, thus seems to be more optimal dose of dexmedetomidine.
Lee and Kim noted a comparable mean SBP, DBP and MAP between control group and dexmedetomidine group (0.5 μg/kg) in their study after the infusion of study drug (Lee and Kim 2017). There was a significant rise in mean SBP in control group after intubation which remained so till 5 min post-intubation. These findings concur with our study. There was a significant increase in SBP, DBP, and MAP after intubation in control group and reduction after induction according to some authors which is consistent with our findings; however, it was lesser with 0.5 μg/kg dexmedetomidine. In dexmedetomdine group, Sharma et al. found significantly lesser mean SBP, DBP and MAP (1 μg/kg dexmedetomidine) throughout the study till 10 min post-intubation (Sharma et al. 2018). Gupta et al. reported a significantly lesser mean SBP till 10 min post-intubation in group III (1 μg/kg dexmedetomidine) (Gupta et al. 2016). Both of these studies supported the results of our findings in terms of mean SBP. The lesser increase in SBP and quicker return to baseline SBP in our study may be due to use of BIS monitoring and restricting the time period of largyngoscopy to < 20 seconds. A similar trend was being observed for both DBP and MAP by various authors in their studies which signifies the importance of maintaining adequate depth of anesthesia during laryngoscopy and endotracheal intubation by BIS monitoring which was responsible for hemodynamic stability in patients who received 1.0 μg/kg of dexmedetomidine (Lee and Kim 2017; Mahajan et al. 2018; Sharma et al. 2018 and Gupta et al. 2016).
Patients in both groups D1 and D2 had RSS 2 or 3 after infusion of study drugs. This is due to sedative property of dexmedetomidine. Patients became calm, sedated, and less anxious when compared to patients in group C after infusion of study drug in both groups D1 and D2. Gu et al. recently observed similar findings in their study and concluded that intravenous infusion of dexmedetomidine combined with parecoxib sodium, in addition to prevent stress response of endotracheal intubation, it also calms and resists anxiety (Gu et al. 2020).
Among the three groups, there was a significant difference in mean dose of propofol required for induction. When compared to both group D1 and group C the mean dose of propofol required was significantly lesser in group D2; however, when compared to group C it was also significantly lesser in group D1. Probably due to sedative action of dexmedetomidine there was a significant reduction in dose of propofol required for induction in groups D1 and D2. The dosage requirement of both propofol and remifentanil in the BIS group compared with the non-BIS group (P < 0.001) was significantly lower as reported by Zhou et al (Zhou et al. 2018). These findings also concurs with our study. Dutta et al. reported a similar deduction in dose of propofol needed for induction in both non-dexmedetomidine (1.07 mg/kg) and dexmedetomidine (0.91 mg/kg) groups under BIS monitoring (Dutta et al. 2019) However, dosage of propofol needed for induction was lesser than in our study which might be due to use of fentanyl and continuous infusion of dexmedetomidine in their study. Bajwa et al. and Keniya et al. observed similar findings in their respective studies and concluded that dexmedetomidine also had opioid sparing effect (Bajwa et al. 2012; Keniya et al. 2011)
The postsynaptic activation of central α2A-receptors results in sympatholytic effect which may lead to hypotension and bradycardia. However, in present study, incidence of hypotension, bradycardia and other adverse effects like nausea and vomiting were insignificant among the three groups. Gupta et al. Sharma et al. and Mahajan et al. observed similar findings in terms of insignificant incidence of side effects (Gupta et al. 2016; Sharma et al. 2018; Mahajan et al. 2018). Dutta A et al. reported that 14 patients required atropine (0.6 mg), 9 patients needed mephentermine (6 mg), 2 patients required metoprolol (1.5 mg) and 4 patients required nitroglycerine (750 μg) in their study (Dutta et al. 2019). This higher incidence of adverse effects could be due to bolus dose of dexmedetomidine infused over 10 min instead of 15 min as in our study and continuous infusion of dexmedetomidine as well.
BIS monitoring helps us to maintain adequate depth of anesthesia and being cost effective in terms of reduced intraoperative anaesthetic agents and analgesic consumption. The adequate depth of anesthesia during laryngoscopy and intubation leads to more effective obtundation of hemodynamic pressor response. So, it should be incorporated as an essential parameter to be used during laryngoscopy and intubation. Further studies need to be conducted in patients of ASA PS III and above to find out its optimal dose and prove its effectiveness in terms of hemodynamic stability during laryngoscopy and intubation with BIS monitoring.
As far as limitations of our study are concerned, the hemodynamic parameters were observed up to only 30 min post-intubation, thus any complications occurred 30 min post-intubation (intraoperative or postoperative) were not assessed. In our study, effect of dexmedetomidine and BIS monitoring on consumption of inhalational anesthetic agents was not assessed. The time to recovery after extubation was also not noted in our study. Although we have recorded the dose of induction agent required for induction of anesthesia in all the groups but the opioid sparing effect of dexmedetomidine was not assessed. The postoperative RSS score was also not observed.
We conclude that both doses (0.5 µg/kg and 1.0 µg/kg) of dexmedetomidine were found to be effective in attenuating the hemodynamic pressor response to laryngoscopy and endotracheal intubation under BIS monitoring. However, hemodynamic stability was better in group receiving 1.0 μg/kg of dexmedetomidine. Apart from it, the addition of BIS monitoring with dexmedetomidine reduced the dose of propofol required for induction as well as provided arousable sedation without any significant incidence of side effects among three groups.
Availability of data and materials
Systolic blood pressure
Diastolic blood pressure
Mean arterial pressure
Non-invasive blood pressure
American Society of Anesthesiologists
Clinical Trials Registry-India
Intermittent positive pressure ventilation
- TB :
- TA :
- T0 :
- O2 :
Ramsay Sedation Scale
Analysis of variance
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Ethics approval and consent to participate
The present study approved by Institutional Ethics Committee, J.L.N. Medical College, Ajmer, Rajasthan, India
Reference No. (979/Acad-III/MCA/2019,dated: 15/05/2019)
A written informed consent was obtained from all the patients who participated in this study.
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Jain, K., Sethi, S.K., K.N., H. et al. Efficacy of dexmedetomidine in attenuating pressor response to laryngoscopy and endotracheal intubation under bispectral index controlled anesthesia: a prospective randomized double-blinded study. Ain-Shams J Anesthesiol 15, 15 (2023). https://doi.org/10.1186/s42077-023-00314-w


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Museo degli Affreschi "G.B.. Cavalcaselle"
The convent complex of San Francesco al Corso dates to the 13th century. In 1935, Antonio Avena, director of the Civic Museums, opened to the public the so-called ”Tomb of Juliet“. This site, according to legend, is where the sarcophagus holding the bodies of Romeo and Juliet was placed, and it naturally became a tourist attraction.
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