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Modified technique for thermal radiofrequency ablation of Thoracic dorsal root ganglia under combined fluoroscopy and CT guidance: a randomized clinical trial
BMC Anesthesiology volume 19, Article number: 234 (2019)
This study is comparing thermal radiofrequency ablation (TRFA) of the thoracic dorsal root ganglia (TDRG) guided by Xper CT and fluoroscopy with the standard fluoroscopy.
This randomized clinical trial included 78 patients suffering from chronic refractory pain due to chest malignancies randomly allocated into one of two groups according to guidance of TRFA of TDRG. In CT guided group (n = 40) TRFA was done under integrated Xper CT-scan and fluoroscopy guidance, while it was done under fluoroscopy guidance only in standard group (n = 38). The primary outcome was pain intensity measured by visual analog scale (VAS) score, functional improvement and consumption of analgesics. The secondary outcome measures were patient global impression of changes (PGIC) and adverse effects.
VAS scores decreased in the two groups compared to baseline values (p < 0.001) and were lower in CT guided group up to 12 weeks. Pregabalin and oxycodone consumption was higher in the standard group at 1, 4 and 12 weeks (p < 0.001). Functional improvement showed near significant difference between the two groups (P = 0.06 at week 1, 0.07 at week 4 respectively) while the difference was statistically significant at week 12 (P = 0.04). PGIC showed near significant difference only at week 1 (P = 0.07) while the per-patient adverse events were lower in CT guided group (p = 0.027).
Integrated modality guidance with Xper CT-scan and fluoroscopy together with suprapedicular inferior transforaminal approach may improve efficacy and safety of TRFA of TDRG for the treatment of intractable chest pain in cancer patients.
The study was retrospectively registered at clinicaltrials.gov on 04/22/2018 (Registration No.: NCT03533413).
Thoracic pain represents approximately 3–5% of patient visits to pain clinic worldwide . Lung cancer is one of the three most common malignancies that are highly associated with pain,together with head and neck, breast cancers, and advanced or metastatic diseases increase the prevalence of pain from 51 to 66% in cancer patients . Lung cancer is the most common cancer worldwide; 1.8 million cases are diagnosed annually (13% of all cancers diagnoses) . Post-thoracotomy pain occurs in 30–50% of patients undergoing thoracotomy .
Pain is the presenting symptom in 20% of cases of lung cancer and it may be more distressing to patients with lung cancer than to patients with other cancers . Pain affects the patient’s psyche, sleep, behavior and ultimately quality of life. The management of such pain is challenging and it may be either medical or interventional. Interventional treatment of such refractory pain due to lung cancer could be attributed to multiplicity of pain generators (visceral-somatic-neuropathic) such as chest wall pain, costo-pleural syndrome, pancoast tumor, rib metastasis, post-thoracotomy pain syndrome, post-herpetic neuralgia and pain related to diagnostic or therapeutic procedures e.g. chemotherapy or radiotherapy-induced pain. Interventional therapies include epidural or intrathecal drug injection, intercostal nerve block, sympathectomy, rhizotomy, and percutaneous cervical cordotomy (PCC) . Rhizotomy refers to the selective, segmental destruction of the dorsal sensory rootlets to interrupt pain perception by the spinal cord. This could be accomplished using neurosurgical or chemical means or using selective percutaneous procedures, such as cryoanalgesia and radiofrequency (RF) ablation .
There are many technical difficulties in approaching the deep-seated thoracic dorsal root ganglia (DRG) through the transforaminal route. The spine is kyphotic, with the tip at T6, and slightly scoliotic to the right side even in normal subjects . Spinous processes are acute, especially at the T5-T8 level. In addition, broad and wide laminae together with narrow intervertebral foramina are also obstacles . The intervertebral foramina are further masked by the facet joints and the crowded nature of the costovertebral and the costotransverse joints .
The extra guidance of Xper CT than conventional fluoroscopy may improve the success of the transforaminal approach to thoracic DRG considering all these factors of technical difficulties due to natural anatomical barriers lowering the efficacy of dorsal rhizotomy (which is still the standard interventional therapy for treating lung cancer pain worldwide). The authors hypothesize that combining the Xper CT scan with fluoroscopy to guide RF ablation through the transforaminal route can enhance its efficacy and safety in relieving the intractable pain of chest malignancies. The current study aimed to compare the results of thermal radiofrequency ablation (TRFA) of the thoracic DRG under combined Xper CT - fluoroscopy guidance with the standard fluoroscopy technique.
This single-blinded, parallel group, randomized clinical trial was conducted in the National Cancer Institute,Cairo University during the period from April 2017 to March 2018 after obtaining the approval of the Institutional Review Board (approval No.: 201617013. 2P). The study was retrospectively registered at clinicaltrials.gov on 04/22/2018 (Registration No.: NCT03533413). The study fulfilled the principles of the Helsinki Declaration and followed the Medical Research Involving Human Subjects Act (WMO). This study adheres to CONSORT guidelines for reporting clinical trials. The purpose, benefits, possible risks and expectations were explained to all patients before their enrollment in the study and a written informed consent was obtained from each patient. Patients were recruited from the pain clinic. Eligible patients were 18 years or older and suffering from chronic moderate-to-severe pain (VAS score ≥ 40 mm), due to chest malignancies and pain was refractory to the maximally tolerated dose of opioids for at least four weeks . The malignancies included lung cancer, pleural mesothelioma, chest wall tumors and metastatic deposits of the chest. The exclusion criteria were sepsis, coagulopathy, malignant epidural invasion, distorted local anatomy, severe cardiorespiratory compromise, neuropsychiatric illness, history of drug dependence and known allergy to contrast media or the medications used.
Randomization, allocation, and concealment
Eighty patients were randomly allocated into one of two equal groups. In CT group (n = 40) TRFA of the thoracic DRG was conducted under Xper Guided CT fluoroscopy guidance, while the procedure was conducted under fluoroscopy guidance only in the standard group (n = 40). The random number list was concealed and checked just before a patient’s allocation by personnel blinded to the study.
Technique for the fluoroscopy-guided procedure
The procedure was conducted in the fluoroscopy room where all anesthetic and resuscitation facilities were available. ASA-standard monitors (NIBP, pulse-oximetry, and EKG) were connected to the patient. A G20 intravenous (IV) line was fixed and O2 via nasal prongs and a 1 g ceftriaxone (Longacef GSK, Cairo, Egypt) IV infusion was initiated. The procedure was conducted under the ASA recommendation of conscious alert sedation with a 0.5–1.0 μg/kg fentanyl IV (fentanyl citrate 50 μg/mL; Janssen Pharmaceutica, Beerse, Belgium) and a 0.5–1.0 μg/kg dexmedetomidine (Precedex 200 mcg/2 mL, Pfizer, USA) IV in addition to propofol (Diprivan 1%, Fresenius Kabi, USA) IV boluses during TRFA application. The patient was placed prone on a small pillow located under the chest, and the back of the patient was sterilized using 8% povidone iodide and draped. The needle was a Baylis RF needle (100 mm length, 10 mm active tip, curved, G20, sharp needle) (Baylis Medical Company Inc. Montreal, QC Canada). The selected level was checked by history, local examination for rib tenderness and possible neuropathic characters, e.g., allodynia. The fluoroscopic postero/anterior (PA) view was taken and squaring (alignment) of the targeted vertebra was attained by cephalocaudal orientation of the C-arm. An ipsilateral oblique view of 15° was completed and then the port of needle entry was located at the lower 1/3 to 1/4 of the lateral vertebral edge, under the articular pillar and the halo of the transverse process. As a rule, the port of needle entry must be within 4 cm of the midline (Rule of 4) to avoid injuring the parietal pleura . Lidocaine 1% (Debocaine 2%, Sigma-Tec, Egypt) was used for local infiltration of the skin and subcutaneous tissues. The RF cannula was advanced using the trajectory (tunnel) technique with a 15° oblique view and then with a dead-lateral view until the needle tip stopped at the lower- or mid-foraminal zone and behind the central line to avoid segmental blood supply and nerve root injury (Fig. 1). After a negative aspiration for blood, air or CSF, 0.5–1.0 ml of iohexol contrast medium (Omnipaque TM, Nycomed, Ireland) was injected to delineate the dorsal root ganglia, nerve roots, epidural space and the intercostal nerve path (Fig. 1). A thermocouple electrode was inserted and sensory stimulation at 50 Hz and up to 0.5 v and motor stimulation at 2 Hz and up to 1–1.5 v was conducted to verify the needle tip position (tingling paresthesia and/or intercostal muscle contraction inside the needle). Neural mapping of the affected dermatomal (intercostal) levels to be blocked was additionally performed by asking the patient if their original pain was at, above or below the level of sensory/motor stimulation and if paresthesia is concordant with his original pain. Additionally, the impendence was checked (normal range is 150–250 Ω inside the neural foramen). The pain level was checked again after injecting a lidocaine-betamethasone mixture (2 ml of 2% lidocaine/segment and 2 mg/ml betamethasone sodium phosphate plus 5 mg/ml betamethasone dipropionate) (Diprofos 2 mg + 5 mg/ml,MSD/Schering-Plough,NJ,USA). After 2 min, thermal lesioning was conducted using Baylis generator at 80 °C for 120 s twice (up and medial then down and medial to enlarge the lesion size of the DRG), and both sensory and motor stimulation were repeated upon rotation of the needle tip. The patient’s back was dressed and the patient was transferred to the recovery unit where vital signs and pain and neurological findings were checked for 1–2 h before discharge. The patient was instructed clearly to consult the pain team if adverse effects happened, namely, chest pain or dyspnea (pneumothorax) and neurological insults (motor deficits).
Technique for the combined CT-fluoroscopy guided procedure
The patient is placed prone on the angio table (Allura Xper FD 20 Flat detector Fluoroscopy with Xper CT, Philips, Netherlands) (Fig. 2) and Xper CT scan of the desired chest levels is performed without contrast to localize the targeted neural foramina with the help of Xper Guide defining the entry point, the needle path and the needle target; thus optimizing the final position of the needle tip. RF stimulation and lesioning are carried out as before, and finally, chest scanogram is performed to rule out pneumothorax (Fig. 3).
In both groups all patients were converted to as needed immediate release oxycodone (Oxynorm® 5- 10 mg Mundipharm) capsules and the average daily required dose to achieve adequate analgesia was calculated then given as sustained release formula (Oxycontin® 10–20-40 mg Mundipharm) in the first visit of the patient after 1 week. Regarding Pregabalin (Lyrica®50–75-150 mg Pfizer), the dose decreased by 25% each week according to patient response with maximum dose 600 mg per day.
A junior clinician of the pain clinic team that was blinded to the study groups was assigned to collect the data. The demographic data included age, gender, chest pathology, body mass index (BMI), duration of the procedure, the side of lesioning, the number of levels/patient, the estimated dose of irradiation exposure (ED), baseline VAS, and medication use. The patient evaluation was conducted 1, 4, and 12 weeks after the procedure. The patients were not allowed to review their previous scores.
The primary outcome measure was pain intensity measured by the visual analog scale (VAS). A 100 mm VAS was presented to the patient as a horizontal line with two ends; the left end represented no pain experienced and the right end represented experiencing the worst pain imaginable. The functional improvement was assessed as a self-reported score after pain procedures representing the percentage of pain reduction; 0–25% means no or minimal improvement, 25–50% means mild improvement, 50–75% means moderate improvement and 75–100% means marked relief . The consumption of analgesics (mg/day) including oxycodone and pregabalin was recorded. The secondary outcome measure was assessed using patient satisfaction with the patient global impression of changes (PGIC) found in Table 1 .
The adverse effects were categorized into minor and major groups. The minor events included back pain, soreness, infection, hematoma, and bruises. The major events included pneumothorax, neuritis, motor deficits, and sensory changes, such as discomforting numbness and hypoesthesia, dysesthesia or anesthesia dolorosa.
Calculation of the sample size
The required sample size was calculated using G*Power Software version 3.1.9 (Universität Düsseldorf, Germany). There were no previous trials comparing the two studied groups of the current trial. The hypothesis was one of “superiority” (that adding the CT to fluoroscopy- guidance would improve the outcome not just matching the traditional approach). We hypothesized that a difference of 3 in the VAS at 12 weeks after treatment would be clinically meaningful. With this difference and a pooled standard deviation of 4, a total of 29 subjects were needed to detect the difference between the two groups at an alpha level of 0.05 and a power of 0.8. Owing to the repeated measures and possible drop outs, the sample was increased by 20% for each condition. Therefore, a sample of 40 patients in each group was recruited in the study.
Data were analyzed using IBM© SPSS© Statistics version 23 (IBM© Corp., Armonk, NY, USA). Data were summarized as a mean and standard deviation or median and range for quantitative data and frequency and percentage for categorical data. The comparisons between quantitative variables were made using the unpaired t-test or the Mann-Whitney test. For comparison of the serial measurements within each group, a mixed linear model was applied. Comparisons of categorical data were made using the Chi-square test or Fisher’s exact test as appropriate. All tests were two-tailed. A p value < 0.05 was considered significant.
Two patients in standard group were lost during the follow-up (Fig. 4). There were no statistically significant differences between the two groups regarding the baseline demographic and clinical characteristics (Table 2) apart from the estimated dose (ED) of irradiation for each injected level, which was highly significant (p < 0.001): the CT-guided group was 2 folds higher than the Standard group. The duration of the procedure was significantly longer in the C Group (p = 0.037) (Table 3).
The VAS scores decreased significantly in the two groups at all of the follow-up points compared to baseline values (p < 0.001 for all comparisons). There was no significant difference in VAS score between both groups at baseline (p = 0.380). The VAS scores were lower in the CT-guided group compared to the standard group at 1, 4, and 12 weeks after the procedure (Fig. 5). However, there was a difference between the two groups at week 4, week 8 and week 12 (Fig. 5). Using a linear mixed model, we determined that there was a clear difference in the average change of VAS score over time between the two groups (P < 0.001), as shown in Fig. 5. As a result of comparing between the two groups at each time point, we found that there was a significant difference at week 4 (P < 0.001), week 8 (P < 0.001), and week 12 (P = 0.001).
Oxycodone and pregabalin consumption decreased in the two groups at all of the follow-up points compared with the baseline values. There was a significant difference between the two groups in oxycodone and pregabalin consumption (Figs. 6 and 7).
Functional improvement (FI) was better (nearly significant) in the CT-guided group at weeks 1 and 4, while it was significant at week 12 (Fig. 8).
Patient satisfaction (PGIC) showed a higher indication of improvement at weeks 1, 4, and 12, but these were not statistically significant apart from week 1 which was nearly significant (Fig. 9).
The per-patient adverse events occurrence was significantly lower in the CT-guided group (p = 0.027) (Table 4). No infection, motor deficits, or pneumothorax were recorded.
The current study demonstrated that selective TRF rhizotomy of thoracic DRG through the inferior transforaminal approach in intractable chest pain cases associated with cancer seems to be of better efficacy if performed under the combined guidance of a CT scan and fluoroscopy (Given the improvement in VAS and FI, and the higher percentages of “very much improvement” in Group C in Weeks 1, 4, and 12, that it is quite likely that the lack of statistical significance for the PGIC was due to insufficient power stemming from the small sample size).
Interventional pain procedures are indicated for refractory pain when analgesic drugs are ineffective or associated with intolerable side effects . In this study, we performed TRFA at the transforaminal station adjacent to the DRG assuming its superiority to many interventions. The transforaminal approach may be considered target-specific (i.e. adjacent to DRG), which allows a lower risk of inadvertent dural puncture . It also demonstrated therapeutic values in managing radicular pain in many clinical trials . Lastly, the selected dermatomal segment is only addressed in cases of TRF-DRG without the need to cover the segments above and below as performed in intercostal nerve blocks (the overlap phenomenon).
Paravertebral and intercostal nerve lesioning are efficient and simple procedures that can be performed at the bedside without guidance . They have many drawbacks, such as short-lived, should be repeated , lower analgesic efficacy , and pneumothorax [13, 16]. Unlike the relative constant position of DRG in the neural foramen, peripheral nerve lesioning may be misplaced in cases of tumor infiltration. Moreover, it may induce deafferentation pain and miss a proximal pain generator .
Dorsal chemical rhizotomy (epidural or intrathecal) may provide satisfactory analgesia for patients with lung cancer pain. However, it is associated by uncontrolled intraspinal spread and high risk for neurological deficits which ultimately limits its use in clinical practice [13, 20].
Although PCC is efficient in cancer-related chest pain  it has many limitations. For example; technical difficulty, 3% mortality, 11% motor weakness, mirror-image dysesthesia, and respiratory, hemodynamic, bladder and sexual dysfunction are all barriers against its widespread use . Similarly, intrathecal therapy and neuromodulation are expensive requiring high standards of aftercare, which greatly limit their use in developing countries. Aside from limited life expectancy, immune compromise and neutropenia, radiation field interference and the possibility of neoplastic epidural invasion are special limitation in cancer patients .
Numerous anatomical barriers against the transforaminal approach in the thoracic spine have been previously described [7, 9]. For accurate RF-DRG application at the T7 level and above, van Kleef et al. created small holes in the laminae of thoracic vertebrae using 14G Kirschner wires to get into the vicinity of the thoracic intervertebral foramina . A CT-scan might provide more precision in locating the thoracic DRG. This can explain the favorable results of combined CT/fluoroscopy guidance in the current study.
The authors assume that the technique of an inferior transforaminal approach may be superior to previously described approaches, e.g. the approach by Charles Gauci . First, the current approach entails less bony contact and periosteal irritation, hence, less patient discomfort. Second, there is little risk of pneumothorax (no pneumothorax cases have been documented in our work).Third, the concept of inferior suprapedicular approach and Kambin’s safe triangle achieves greater validity  due to several proposed benefits such as avoiding injury to DRG in the superior neural foramen . The peridural membrane of the suprapedicular canal has an evident nociceptive role in a manner similar to what happens in the inflamed synovium or periosteum in the case of joint or bone pain .
In the current study, T2-T8 levels were selected to avoid the catastrophic vascular events that may occur below the T8 due to vascular insult of the artery of Adamkiewicz, “which is the main blood supply of the anterior spinal cord below T8 . Murthy et al. have identified the position of the artery of Adamkiewicz using digital subtraction angiography in the upper half of the neural foramen in 97% of patients and absent in the lower 10% of the foramen . Moreover, the T2 to T8 levels - in general - are the segmental dermatomes commonly affected by chest pain pathologies.
The neuroablative RF was applied to the DRG and not the pulsed (neuromodulatory) RF for many reasons. Pulsed RF is for short-term pain relief , and its neuromodulatory mechanisms take 3–4 weeks to work, which is too long for cancer patients with intractable pain . In addition, TRF has been postulated to be more efficient for different types of pain, e.g., idiopathic trigeminal neuralgia , glossopharyngeal therapy for oropharyngeal cancer , and facetal medial branch block . Nonparticulate steroids (betamethasone) were used in conjunction with lidocaine before TRF to reduce the occurrence of neuritis (its incidence was 7.5% in the C group versus 32.5% in van Kleef’s work). Steroids have potential analgesic effects  while lidocaine was used for its analgesic, vasodilator and neuroprotective properties.
In the current work, the extra-guidance technique using the Xper CT reflected a better efficacy with a moderate increase of irradiation hazards (2 folds increase in ED). The implication of CT as a guidance tool has been used for interventional pain procedures, such as celiac plexus and lumbar sympathetic blocks [36, 37]. It allows better visualization of the whole needle path, surrounding soft tissues, and vascular and bony structures . However, CT-associated exposure to excessive irradiation may induce carcinogenesis, genetic mutation and several other hazards [37, 38]. In previous studies conducted by Hoang et al.  and Schmid et al.  comparing irradiation dose during pain interventions guided by fluoroscopy versus CT, Hoang et al. reported 4 times more radiation exposure during CT than fluoroscopy . In recent work published by Maino et al.  in 2018, the ED for lumbar facetal and transforaminal injections was calculated to be 8 to 10 times higher under CT versus fluoroscopy. The lower ED in the current study (2 folds) could be attributed to Xper CT guide technique for fast and accurate RF needle positioning. CT guidance is absolutely contraindicated in pregnant and pediatrics populations; however it improves anatomic localization, technical precision, post-procedures outcome and lessens the complications rate, hence it is widely practiced in many interventional procedures such as CT guided PCC, thoracic DRG-RF and many other techniques according to the clinical situation and physician judgment.
In conclusion, the integrated guidance of Xper CT-scan and fluoroscopy may improve the efficacy of TRF of thoracic DRG for the treatment of intractable chest pain in cancer patients. According to the authors’ knowledge, this is the first RCT studying the efficacy and safety of this technique for thoracic DRG-TRF in intractable chest cancer pain. Moreover, we stressed on the inferior transforaminal suprapedicular technique in the thoracic spine region.
Limitations and recommendations, this study is a single center work and single blinded hence multi-centric meta-analysis is recommended with a larger sample size of patients for verification of the data of the current work. Furthermore, a longer duration of follow up might be helpful for better evaluation and stratification of guidelines in treating lung cancer pain. Surgical confidence was not considered in the current work and should be respected in further upcoming researches.
Availability of data and materials
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Analysis of variants
American society of Anesthesiologists
Dorsal root ganglia
Estimated dose of irradiation exposure
Non-invasive blood pressure
Pecutaneous cervical cordotomy
Patient global impression of changes
Thoracic dorsal root ganglia
Thermal radiofrequency ablation
Visual analog scale
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Limitations and recommendations
Wider scale, multicenter and larger RCTs are required to verify the current data.
Long-term follow up may be needed to study the TRF-DRG efficacy for thoracic pain, e.g., after 9 and 12 months.
The patients could not be blinded to the study due to the nature of the intervention, i.e., a single-blinded study, which might be a source of bias.
Conflict of interest
There is no conflict of interest to disclose
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Ethics approval and consent to participate
The approval of the Institutional Review Board IRB office, National Cancer Institute, Fom EL Khalig, Cairo 11796,Egypt (approval No.: 201617013. 2P) was taken. The purpose, benefits, possible risks and expectations were explained to all patients before their enrollment in the study and a written informed consent was obtained from each patient.
Consent for publication
The authors declare that they have no competing interests.
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Cite this article
Reyad, R.M., Ghobrial, H.Z., Shaker, E.H. et al. Modified technique for thermal radiofrequency ablation of Thoracic dorsal root ganglia under combined fluoroscopy and CT guidance: a randomized clinical trial. BMC Anesthesiol 19, 234 (2019). https://doi.org/10.1186/s12871-019-0906-4

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No one could’ve predicted how insane this off-season ended up being. But here we are. The Falcons, who previously seemed poised to earn a wildcard berth out of the NFC, now have a major challenge on their hands.
Ryan and Brady will go toe-to-toe twice a year for the next two seasons. The Falcons QB has finally broke his silence on how he reacted to Brady’s decision to sign with Tampa Bay during the off-season.
“I was like, you’ve gotta be kidding me, the Bucs, c’mon man,” Ryan told Adam Schein on Mad Dog Sports Radio on Sirius XM, via 247Sports. “Come on down to the NFC South. I kind of, when I heard he wasn’t going back to New England, in my head I’m thinking, man I feel like it’s going to be the Bucs. It might be a good fit. I think they’re moving on from Jameis (Winston), have an opening, have a good defense, good wide receivers. Sure enough my gut was right, he ended up down there. It’s going to be a tough division for sure, but it’ll be fun. Paying against the best is always fun and a great measuring stick of where we’re at.”
We’re certainly looking forward to the Ryan-Brady battles this season.
Of course, Brady will always have the upper-hand thanks to the Patriots’ historic comeback win over Atlanta in Super LI.
But Ryan can return the favor this season by keeping Brady and the Bucs out of the playoffs.
Ryan and the Falcons have to wait until Week 15 to play Brady and the new-look Bucs this season. The NFC South division foes play each other twice in the last two weeks of the regular-season.

domain: news


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WHO IS THE FATHER OF AMERICA ?
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THE SAFFRON COLOR IN OUR NATIONAL FLAG SYMBOLIZES? A)PURITY B)PROSPERITY C)SACRIFICE& COURAGE
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Your client is determined to take a case to court even though you believe he has no chance of winning and have advised him strongly not to do so. What do you do?
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domain: finance


August 16, 2007
Online Survey Seeks Input About Splitting School Districts
By Leigh Dethman and Jennifer Toomer-Cook Deseret Morning News
Want to weigh in on the small-school-district debate? Go online.Salt Lake County Council Chairman Mark Crockett and a friend used their own funds to set up an online survey to query residents on their thoughts of splitting the Granite and Jordan school districts.
The survey, found at www.smallschooldistricts.com, has only been up and running for a couple of weeks. And so far, the feedback is minimal, with only about 50 people filling out the survey, Crockett said.
"We haven't had many people respond," Crockett said. "I'd love to tell you that I knew something really statistical from it."
The brief survey asks people to give opinions on the school district split and public education in general.
For instance, it asks visitors to rate the quality of public schools on a scale of excellent to falling behind, and what they view as the most important issues in the county, from environment to schools, parks to taxes.
It also asks visitors if smaller school districts are a good idea and whether they want to vote on a small school district proposal this November. The survey tries to gauge concerns over the issue, including increased costs, equitable funding, programs, viability of schools and who gets to vote.
"If your concerns were answered, would you then ... be in favor of voting on the smaller district?" poses another question.
The survey also seeks open-ended comments on the issue.
Crockett said he paid for the survey because he wanted more public input before the Salt Lake County Council decides whether to ask voters this November if the Granite and Jordan districts should be divided.
"I wasn't sure how the issues were shaping up, and I wanted to make sure we had the right issues out on the table first," Crockett said.
(c) 2007 Deseret News (Salt Lake City). Provided by ProQuest Information and Learning. All rights Reserved.


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Free Cinema, Ken Russell, and the Teddy Girls
image credit: TopFoto/Ken Russell
Laura Mulvey in Discussion
Today Laura Mulvey's RIDDLES OF THE SPHINX begins exclusively streaming on OVID. In this companion video, Mulvey discusses her feminist manifesto "Visual Pleasure and Narrative Cinema" along with filmmakers Joanna Hogg and Isaac Julien as well as academics John David Rhodes, Tamar Garb, Mandy Merck and Emma Wilson.

domain: artistic


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Asteroid 5LT glyphosate herbicide
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Rate: Asteroid 25ml per 1 ltr water to cover 50m2 (10,000m2 per 5lt pack)
Suggested safety clothing - safety clothing bundle (see Safety Clothing section or click here)
Asteroid herbicide for control of most annual and perennial grasses and broad-leaved weeds
Asteroid is translocated from the treated leaves throughout the plant and to underground roots, rhizomes and stolons. Symptoms such as gradual wilting and yellowing of foliage are rapidly visible in grass weeds but are slower to appear in broad-leaved weeds. Asteroid is inactivated in contact with the soil.
Most perennial broad-leaved weeds are particularly susceptible to treatment when they are actively growing and shortly before flowering. Annual weeds should be growing actively at the time of treatment. Grasses should have at least 5 cm of growth. Broad-leaved weeds should have at least two sizeable true leaves.
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There are legal responsibilities covering the storage and use of professional use pesticides featured on this website. These responsibilities are covered by The Food and Environment Protection Act 1985 (FEPA) and Control of Pesticide Regulations 1986 (COPR). When placing an order with us, you must confirm that you have read, understand and will comply with all FEPA and COPR regulations. For details of these regulations click here
Looking for Pesticide Training? Click here

domain: agronomy


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Recently, companies in the cleaning products industry, Ava Anderson Nontoxic (ed: now PureHaven) and Branch Basics, have had some serious issues with ingredient integrity related to subcontracting their cleaning product formulations and manufacturing to third parties. To borrow a phrase from Ava Anderson, "Ingredients are everything" when it comes to understanding cleaning products, particularly when you are spending hard-earned dollars on products for their presumably lower impact on human and environmental health. A fraudulent ingredient list is a very, very big deal and companies that have issues like these erode consumer trust in the entire industry.
Meliora Cleaning Products takes a different approach. We:
- Develop and manufacture all formulas ourselves. We don’t use an outside supplier to come up with our formulas, and we don’t use an outside company to make the products we sell. We fully understand the complete chemical makeup of each formula. This doesn’t eliminate the chance of, for example, trace contamination of a raw mineral ingredient, but we get to inspect each raw ingredient before it goes into the finished goods we make. We can’t accidentally use a surfactant or a synthetic detergent instead of soap, because we make the soap ourselves. The current issues are not about unexpected contamination; undislosed ingredients were intentionally added to the products without proper disclosure.
- Insist on full ingredient disclosure from suppliers. We buy things like organic coconut oil for soapmaking, and washing soda for blending into laundry powder. We only buy from suppliers that tell us every ingredient they use. We’ve actually been slowed down because of this. For example, we’ve had trouble introducing an oxygen bleach product because many suppliers will only sell sodium percarbonate with a mysterious ‘coating’ that is claimed to be proprietary. No ingredient list = Not going to be something we sell. We’d rather not sell a product than introduce something with a mystery ingredient.
- Provide an honest, accurate, ingredient list. No vague ingredients like ‘plant based surfactants’ or ‘natural scents’. We use internationally-recognized INCI nomenclature to be as clear as possible about the chemical substances in our products. Also, no listing cutesy non-ingredients like ‘love’ or ‘zen’ or ‘bliss’. Ingredient lists are important and are not the place to joke around or be unclear.
- Don’t use ‘proprietary’ blends. Keeping ingredients - yes, even fragrance ingredients - secret does not protect us from competitors knowing our formulas; a bank account, some lab equipment, and a good chemist can tell anyone all they like. Instead, secret formulas withhold information from someone more important - you, the consumer who buys the product. This can create disappointment when the real ingredient lists are revealed and the associated marketing claims and inflated price tags are found to be bogus.
- Have an open factory. Please come and visit our Not Secret Factory in Chicago. We want to show you how our products are made and we’d love to answer any questions you have when you stop by.
We are disappointed that these companies were clearly trying to provide healthy solutions for customers, but did not do enough research on product formulas or ask enough questions of suppliers. You should be able to trust companies to be responsible, open and honest about what they are providing for use in your home. You deserve as much ingredient information about your cleaning products as you do about food and cosmetics.
Meliora Cleaning Products promises to always provide that information. We can’t promise to never have an issue in our supply chain, but by insisting on transparency from every supplier and passing that information along, we believe we are reducing the risk of a nasty surprise.
We will continue to share lots of information about how we do business. Please feel free to ask public (here, on facebook, twitter, Instagram) or private (contact us) questions about us and our products.
Kate Jakubas is the founder of Meliora Cleaning Products, a company committed to understanding and sharing information about product ingredients. We not only disclose all ingredients, but also share the actual recipes used.

domain: chemistry


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January 23, 2010Vintage Crafty Saturday – Vintage Pinch-Pleat Curtains In The Craft Room
I should extend that title to “Make Me Realize I Have Yet Another Project To Finish”.
So, the new craft room has been coming along pretty well. I am mostly just arranging furniture now and starting to move some of the big tables and things into place. I have to pick out my carpet still and I also have to wash some storage shelves with bleach water, but I decided to do some of the fun decorating before that just for the heck of it.
I pulled some vintage curtains out that I had picked up at the local Salvation Army without any real plan of where they might go. Now I had something to do with them. I just had to figure out which set I wanted.
The windows in the craft room have this strange hardware over them.
There are three of these circles on the ceiling above every window in the basement. One on either side of the window, and then one in the middle. I have never seen window hardware like this before, but I assume there was a rod or something that went through the little bracket, and then you were able to hang a curtain on it. If anyone out there knows exactly how to do it, let me know.
I made do with threading a string through it so I could hang the pleat hooks on it, since both sets of curtains I bought had hooks. Then I just had to make a choice. The shorter set with the green and blue ovals.
Or the long blue and whites with the pyramids.
Here you can see the difference in a side by side comparison. The shorter ones are all wrinkley from being trapped in a bag for so long. You have to excuse them.
So, after much discussing with Tom, I decided on the longer pyramid drapes. Only to realize something after they were up.
One side is significantly shorter than the other.
After a few minutes of swearing, I started to set up my sewing machine table. I suppose bleaching the shelves can wait…

domain: design


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Left’s u-turn in Bengal over seat-sharing derails poll pact with Cong
The Left Front had earlier said it would field candidates in four constituencies the Congress had won in 2014 but changed its mind on Wednesday.Updated: Mar 20, 2019 21:25 IST
A u-turn by the Left Front late Wednesday announcing two candidates in Lok Sabah seats held by the Congress has virtually drawn the curtains on the discussion for a poll pact in Bengal.
A day earlier the Left Front had announced 38 Lok Sabha candidates in Bengal but did not nominate candidates for the four seats which the Congress won in 2014, prompting the grand old party to reciprocate on Wednesday by announcing that it will not contest in five constituencies.
But Congress Rajya Sabha MP Pradip Bhattacharya, who announced the party’s decision on Wednesday, flayed Left Front chairman Biman Bose for setting a 24-hour deadline (that expired at 4:30 pm Wednesday) for the Congress to withdraw its candidates in the two seats the Left won in 2014 -- Raiganj and Murshidabad.
“We will not nominate candidates for Asansol, Diamond Harbour, Bolpur, Tamluk and Bishnupur,” said Bhattacharya, who justified the choice of constituencies on the Left’s strength compared to that of the Congress.
“The LF chairman virtually issued a whip by setting a 24-hour deadline for us to withdraw candidates in the two seats (of Raiganj and Murshidabad). We would not respond to his whip,” said Bhattacharya.
Late Wednesday evening, the Left Front announced candidates for Jangipur and Malda (North) Lok Sabha constituencies, both of which currently have sitting Congress MPs. According to a statement issued by Left Front chairman, Biman Bose, Zulfikar Ali and Bishwanath Ghosh, both from CPI (M), will contest from Jangipur and Malda (North) respectively.
Bose also made it clear that if Congress withdraws its candidates from Raigunj and Murshidabad, with sitting CPI (M) parliamentarians, the Left Front might change its stand. However, Left Front is yet to announce candidates for Baharampur and Malda (South) which have sitting Congress MPs.
Bhattacharya also rued the fact that though the Congress was insisting on a full- fledged alliance, the Left was insisting on just a seat-sharing agreement.
Left MLA Sujan Chakraborty indicated that they would not accept the Congress offer made on Wednesday.
Despite the reciprocal gestures, the possibility of a pact between the Congress and the Left was almost nil, said leaders of both camps on condition of anonymity.
The Congress has so far announced candidates for only 11 out of the 42 seats in the state so far.
The four seats held by Congress currently are Malda (north), Malda (South), Jangipur and Baharampur.
Incidentally, in 2014 Lok Sabha polls the Congress got only 1.52% votes in Tamluk, 2.12% in Bishnupur, 3.59% in Bolpur, 4.24% in Asansol and 5% in Diamond Harbour.
During discussions with the Congress, the LF maintained that they won’t nominate candidates for the four seats that Congress won, while the Congress should reciprocate with staying away from the two seats that the Left secured in 2014.
“I do not think that there is a possibility of reconsidering the decision on Raigunj and Murshidabad. The candidates for these two seats have already been announced by our party high command,” said Bhattacharya.
Bitter opponents for decades, the desperation to retain an eroding political base has brought the LF and Congress close in the state.
In 2009 and 2014 Lok Sabha elections, the LF won 43.3% and 29.95% of the votes respectively. The vote share of the Congress went down from 13.45% (2009) to 9.69% (in 2014).
In 2011 assembly polls, the LF won 40.42% of the votes that declined to 25.69% in the 2016 assembly polls. In these two elections the Congress’ vote share were 9.09% (2011) and 12.25% (2016) respectively.
First Published: Mar 20, 2019 21:09 IST


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Ramires and Chelsea's boys from Brazil chill out ahead of the start of the Premier League
- Ramires entertained Brazil stars Oscar, Willian, Felipe Luis and Julio Cesar
- Blues defender Branislav Ivanovic also relaxed ahead of the Premier League
- Jose Mourinho's side are favourite top win the title this year
- Chelsea have brought in Diego Costa, Cesc Fabregas and Didier Drogba
- Stamford Bridge club have won seven of their pre-season fixtures
Ramires was joined by several of his international teammates for what appears to be a typical Brazilian BBQ ahead of the start of their Premier League campaign.
The inexhaustible Chelsea midfielder posted an outdoors Instagram picture in the company of Chelsea's growing collection of samba stars including Oscar, Felipe Luis and Willian - along with Brazil keeper Julio Cesar and Blues defender Branislav Ivanovic.
The picture was accompanied by the caption: 'Having a nice day off with friends and family!'.
Scroll down for video...
Al fresco: (L-R) Willian, Branislav Ivanovic, Felipe Luis, Oscar and Julio Cesar are joined by friends for a BBQ
Blues brothers Ramires (3L) celebrates after scoring against Ferencvaros in a pre-season friendly
VIDEO Costa a key signing - Mourinho
The club's Brazilian contingent will be hoping to put their national heartache behind them - after being humiliated 7-1 by Germany in the semi-finals of their home World Cup.
Jose Mourinho's side are favourites to win the title after some astute business in the transfer market that has included the arrivals of Diego Costa, Cesc Fabregas and the return of Stamford Bridge legend Didier Drogba.
In their 10 pre-season fixtures, Chelsea have won seven, drawn one and lost to Werder Bremen and Besiktas ahead of their opening league game against Burnley on Monday 18 August.
Despite being handed an extended break following the World Cup, Ramires returned to score an impressive goal against Ferencvaros on Sunday (see below).
Will any Chelsea players make the cut for your Fantasy Football team?
CLICK HERE to start picking your Fantasy Football team NOW! There’s £60,000 in prizes including £1,000 up for grabs EVERY WEEK…
Boys from Brazil: Luis Felipe and Willian celebrates their birthdays on route to a friendly in Hungary
The pain! Oscar reacts after Brazil were beaten 7-1 by Germany in the World Cup semi-finals
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domain: medical


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If you’ve been around long enough (like you know who) you’ve occasionally seen these metal and glass illuminated boxes mounted on utility poles, like the one in the title card, saying: “Telephone to call police.” As a rule they were lit by two light bulbs. Not too many of them remain around town, but they used to be more frequently found.
Here’s one I found around 1999 or 2000 in the Manhattan Beach area.
This one was formerly at Woodside Avenue and 54th Street.
The remnants of one of the indicators is still found at Hollis Court Blvd. and 192nd Street in Auburndale.
In the days before 911, telephones to local police precincts were mounted on lampposts or utility poles around town, and were usually signified by the illuminated signs. These were the equivalents of fire alarms, which until recently were marked by lit cylindrical orange cylinders mounted on lampposts (now, they are marked by small red lights mounted on top of luminaires).
Here’s another marker, at East Tremont Avenue and Bronx Street, long since removed.
In the 1970s, the phones were mounted in tandem with fire call boxes. I remember Walt Frazier filmed a PSA commercial on how to use these when they first appeared.
Of course, the universality of wireless telephony now makes many of the fire call boxes redundant, and the police phones had mostly disappeared by the late 1960s.
Turns out the Gamewell box seen above is a rarity. I’ve only seen three in the city, and this one was one such. ForgottenFan Al Trojanowicz:
Most alarm boxes in New York are of their own custom designs, and where a mechanical box was converted to ERS, special adapters were made to allow the more modern voice box innards to replace the former inner electro-mechanical box. Of all boxes, finding a Gamewell box on the street was indeed a rarity. In my time I only saw 2 (both in Queens). Like all other box housings, FDNY was able to adapt a Gamewell shell to accept ERS innards.
The odd thing about this hybrid is that atop the box is a noise-making device to call attention when the mechanical box is pulled. I believe these were mechanically linked and tripped when the box was pulled. Also note a sliding cover to allow a key to be inserted to rewind the device. I remember the Newark NJ Fire Dept had these on some boxes, and the local term was “growler”. I don’t know what Gamewell called them.
The really odd thing is that I think it is impossible for the push-button electronic ERS box to trigger this device, thus it is one of the rarest boxes I ever saw in the City. Last time I walked by, it was still there, though its paint badly faded.


text:
Koppers Leslie S. Hyde Named 2020 STEP Ahead Honoree by The Manufacturing Institute
Award Celebrates Women Demonstrating Leadership Excellence
PITTSBURGH, Sept. 24, 2020 /PRNewswire/ -- Koppers (NYSE: KOP) today announced that Leslie S. Hyde, Senior Vice President and Chief Sustainability Officer, is being recognized by The Manufacturing Institute with the 2020 STEP Ahead Award. The annual award celebrates women from across all levels of the manufacturing industry who have demonstrated excellence and leadership in their careers. Leslie joins other honorees from around the country who will be recognized in a virtual ceremony today.
Leslie S. Hyde
"A longtime champion of sustainability, Leslie has spent her career at Koppers fulfilling our company's shared purpose of 'Protecting What Matters and Preserving The Future,'" said Koppers President and CEO Leroy Ball. "She has played an integral role in transforming the company's environmental, health and safety practices while also working to create a more inclusive and community minded culture – all of which will have a lasting impact. We are fortunate to have Leslie as part of the Koppers team and congratulate her on this well-earned recognition."
"I am honored and humbled to receive the STEP Ahead Award alongside a group of incredibly accomplished women from around the country," said Ms. Hyde. "My hope is that this recognition helps our next generation of female leaders see manufacturing as an industry that values excellence, innovation and a willingness to create positive change in our world."
"The women being honored demonstrate what modern manufacturing careers are all about: making an impact in their communities with meaningful careers that offer significant opportunities for growth," said Manufacturing Institute Executive Director Carolyn Lee.
The STEP Women's Initiative is the nation's marquee program to close the gender gap in manufacturing. STEP works to foster a 21st-century manufacturing workforce by empowering and inspiring women in the manufacturing industry through recognition, research and leadership, as well as by motivating alumnae to mentor the next generation. The biggest challenge facing manufacturers continues to be the growing workforce crisis—the shortage of skilled talent to fill open positions. Manufacturers can close the skills gap by 50% simply by bringing 10% more women into the industry. STEP Ahead builds networks for women to have support in their industry and to elevate the role models that can motivate and mentor the next generation.
Koppers, with corporate headquarters in Pittsburgh, Pennsylvania, is an integrated global provider of treated wood products, wood treatment chemicals and carbon compounds. Our products and services are used in a variety of niche applications in a diverse range of end markets, including the railroad, specialty chemical, utility, residential lumber, agriculture, aluminum, steel, rubber, and construction industries. Including our joint ventures, we serve our customers through a comprehensive global manufacturing and distribution network, with facilities located in North America, South America, Australasia, China and Europe. The stock of Koppers Holdings Inc. is publicly traded on the New York Stock Exchange under the symbol "KOP." For more information, visit us at: www.koppers.com.
About The Manufacturing Institute
The Manufacturing Institute grows and supports the manufacturing industry's skilled workers for the advancement of modern manufacturing. The Manufacturing Institute's diverse initiatives support all American workers, including women, veterans and students, through skills training programs, community building and the advancement of their career in manufacturing. As the workforce development and education partner of the National Association of Manufacturers, The Manufacturing Institute is a trusted adviser to manufacturers, equipping them with resources necessary to solve the industry's toughest challenges. For more information, please visit www.themanufacturinginstitute.org.
Jessica Franklin, Manager, Corporate Communications, Brand and Giving


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'20 October 2020 — As the small Pacific Island nation celebrated World Statistics Day, the Government of Tonga released results of the Tonga Multiple Indicator Cluster Survey (MICS) 2019, the country’s first-ever MICS.
Led by the Tonga Statistics Department, the survey has collected data on health, nutrition, child protection, education, water, sanitation and hygiene as well as domestic violence amongst other topics. The survey also collected data on many other indicators including drinking water quality, learning skills of children and child functioning, at the population level.
“I believe that World Statistics Day has the greatest opportunity to mark the valuable contribution of statistics towards development in Tonga. The fact that MICS contains high quality and reliable statistics that are essential for measuring progress in reaching development goals as well as provide essential information on the effectiveness of policies and programmes, its official launching on the Statistics Day marks its significant contribution to the Kingdom of Tonga,” said Tonga Government Statistician, Dr. Viliami Konifelenisi Fifita.'
Download Tonga 2019 MICS Survey Findings Report.

domain: sociology


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After months of private negotiations, tenants of the Harvard-owned Craigie Arms apartment building and representatives of the developer that Harvard has chosen to make major structural repairs on the building may be hearing a settlement.
Harvard had previously offered a $1500 relocation fee to the residents of the 122 Mt. Auburn St. building, and Housing Associates, the developer that is now representing the University, was reported in January to have increased Harvard's original offer.
The terms of the latest proposal to tenants have not been disclosed, due to what a Harvard spokesman called a "gentleman's agreement" between the University and the tenants.
Craigie Arms tenants say that the original relocation offer was "way off."
Tenants said Sunday that they are united in their fight against Harvard and are not merely holding out for higher relocation fees. The Craigie apartments should remain low-to-moderate-income housing after a $205 million renovation is completed, "especially" because of "what will be built next door." one tenant said. The Craigie building is located adjacent to the site of University Place, a majority Harvard office and luxury housing complex scheduled for construction this spring.


text:
The Lincoln Plawg - the blog with footnotes
Thursday, May 06, 2004
Michael Moore: by any chance, are we being spun?
Perhaps journos should use smileys, just to tip off the plebs.
For instance, in the New York Times today, it says that
[Disney e]xecutives said it was made clear to Miramax last May, when it became the principal investor in the film, that Disney would not let it be the distributor.
Yet, according to the Big Fat Liar himself, Miramax
was listed as producer and distributor in his contract.
Now, I know nothing about the movie business; but a controversial guy like Moore doing business (indirectly) with Mousewitz would surely have anticipated the need to get a little detail like Will my distributor distribute? nailed down.
Unless he was looking to ape Mel Gibson's Passion. Or it was all a set-up with Weinstein.
For the Oscar for Crassest PR Stunt, he's surely rivalling Jackson: two tits together...
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Arms race, competition between more nations to have best armed forces
Arms Race: Area QB's Compete At Combine In Stockton
The Tinder Arms Race - Why You Don't Get Matches (2019)
Inside the Streaming Media Arms Race
An arms race, in its original usage, is a competition between two or more states to have the best armed forces. Each party competes to produce more weapons, larger military, superior military technology, etc. in a technological escalation.


text:
The humdrum, simple moments of life are what I want so badly I can taste it. I fantasize about it. I have dreams flushed with the radiance of life’s simple pleasures, the everyday trials and rewards that routine brings. I also have exasperating dreams where I use copiously and can’t get high, and mind-blowingly satisfying dreams where I use and it feels sooo good, like it did the first time.
I wake up every morning with the hope that my high today will be better than it was yesterday, that maybe it will feel good again. The ecstasy of using disappeared a while ago. For the most part, all it does now is help me maintain and keep feelings of sickness at bay. My greatest wish is to wake up, go to a dull job, come home, eat dinner, spend a few hours in the evening winding down, and repeat it the next day. I would find so much satisfaction in that. I fear losing everything, including drugs, which are my final and failsafe lifeline. I am fucking up so badly with my obligations at work and home that I anticipate encountering something drastic every time I step outside my door. Even so, drugs create this invisible shield that buffers me from all of it. It’s a mental partition that keeps me from being too concerned over the reality of my situation, which is that I’m hanging on by less than a thread. My goal is to make people think I’m hanging on by at least a thread, but that veneer is beginning to wear extremely thin. Every day I screw up and blow things for myself and people around me, and I think, tomorrow; I’ll get it right tomorrow. Every night I go to bed with the best of intentions to get up at 5AM, crank out a week’s worth of work by 9AM, another week’s worth by noon, tend to everything I’ve been neglecting for months, and achieve some damage control by patching up a bit of the harm I’ve caused. Realistically, I usually stay up using until 5AM, but this thought process carries over from Monday to Tuesday, then to Wednesday and so on, until another Friday has come and gone. Then I think, I’ll catch up this weekend. I anticipate each weekend as a chance to make up some extra credit points. It never happens. Pretty soon weeks start bleeding into each other, then months, and it starts to sink in that I’ve lost control. Still, every morning I wake up hoping that today will be a better day than yesterday, and that I can make things up a little to the people in my life.
I used to have this fantasy as a kid that I could freeze time and still move around in the world. For instance, I would freeze time and spend a week doing whatever the hell I wanted, and I could clean my room too. When time started up again, my room would be clean and I wouldn’t be in trouble anymore. I wish I could do that now, and just take some time to myself to rest and recharge. I would keep time frozen as long as it takes to finally get a restful sleep and wake up feeling refreshed and restored. I wish I could actually ask people for an opportunity like that, to just take a week to rest. I hit a wall a long time ago, and I just need to back up for a short while and catch my breath. I can’t bring myself to talk about it with anyone though.

domain: psychology


"New rockers should be made to follow a Springsteen tour. It’s instructive to point out that in the latest Entertainment Weekly, the top 30 contemporary performers are listed. Springsteen, at number 23, is the only one included from a prior generation. There’s a reason for his longevity. To paraphrase one of his songs, he’s alive."
“Lean”, “angry” and “relentless” are the words Springsteen now uses to describe the feelings and sounds he was trying to capture in the follow-up to Born to Run, the hit album that landed him on the cover of Time and Newsweek and led some to write him off as just another victim of record-company excess. Delayed by a bitter legal battle over his management contract, he finally presented the public with a version of Darkness from which all traces of joy and release had been purged, replaced by a sense of desperation. The claustrophobia of ordinary lives trapped by work and family ties provided his metaphor.
“Looking more at the man behind the music than the man behind the myth, The Promise may be one that’s more for the fans, who will undoubtedly gush over all the never-before-seen footage and unreleased songs performed by a 27-year-old Bruce. Fans will also be green to learn that, having detached his microphone from its stand at the end of friday night’s Q&A, Bruce jokingly invited anyone in the audience to come up to the stage for a ‘spanking’.”