text:
MINI REVIEW article
Sec. Pediatric Hematology and Hematological Malignancies
Volume 6 - 2018 | https://doi.org/10.3389/fped.2018.00142
The Role of Inflammation in Venous Thromboembolism
- 1University of Colorado Hemophilia and Thrombosis Center, Pediatric Hematology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States
- 2Kansas City Regional Hemophilia Treatment Center, Pediatric Hematology, UMKC School of Medicine and Children's Mercy Hospital, Kansas, CO, United States
Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT), and pulmonary embolism (PE), is becoming increasingly recognized as a cause of morbidity and mortality in pediatrics, particularly among hospitalized children. Furthermore, evidence is accumulating that suggests the inflammatory response may be a cause, as well as consequence, of VTE, but current anticoagulation treatment regimens are not designed to inhibit inflammation. In fact, many established clinical VTE risk factors such as surgery, obesity, cystic fibrosis, sepsis, systemic infection, cancer, inflammatory bowel disease, and lupus likely modulate thrombosis through inflammatory mediators. Unlike other traumatic mechanisms of thrombosis involving vascular transection and subsequent exposure of subendothelial collagen and other procoagulant extracellular matrix materials, inflammation of the vessel wall may initiate thrombosis on an intact vein. Activation of endothelial cells, platelets, and leukocytes with subsequent formation of microparticles can trigger the coagulation system through the induction of tissue factor (TF). Identification of biomarkers to evaluate VTE risk could be of great use to the clinician caring for a patient with inflammatory disease to guide decisions regarding the risk:benefit ratio of various types of potential thromboprophylaxis strategies, or suggest a role for anti-inflammatory therapy. Unfortunately, no such validated inflammatory scoring system yet exists, though research in this area is ongoing. Elevation of C-reactive protein, IL-6, IL-8, and TNF-alpha during a response to systemic inflammation have been associated with increased VTE risk. Consequent platelet activation enhances the prothrombotic state, leading to VTE development, particularly in patients with other risk factors, most notably central venous catheters.
Evidence is accumulating that the factors influencing VTE formation are not restricted to the coagulation system alone, but rather that the immune system is also closely involved with formation and resolution of thrombosis. It is important to consider the contributions of inflammation to VTE development in general, but also as it pertains to certain specific disease categories more commonly associated with development of hospital-acquired VTE (HA-VTE) in some patients. Surgery, (1–3) obesity, (4) cystic fibrosis, (5–7) sepsis, (8–10) systemic infection, (11, 12) cancer, (13–15) inflammatory bowel disease, (16–18), and lupus (19–22) are clinical VTE risk factors that may modulate thrombosis through inflammatory mediators. Understanding the role of inflammation in these particular clinical situations may not only help determine the optimal management but may also aid in the development of future preventative strategies, since current anticoagulation treatment regimens are not designed to inhibit inflammation (23).
Recently, inflammation has been accepted as a common pathway through which various risk factors trigger VTE formation. A feasible mechanism is that inflammation of the vessel wall initiates thrombus formation in an intact vein and that inflammation and coagulation systems are coupled by a common activation pathway. The first event in thrombus formation is probably activation of endothelial cells, platelets, and leukocytes, with initiation of inflammation and formation of microparticles that trigger the coagulation system through the induction of TF. Therefore, the key event in the initiation of VTE formation is most likely vein wall inflammation, but the contribution of specific immune modulators has not yet been elucidated. Recently, it was demonstrated that probable association between VTE and several other markers of inflammation such as C-reactive protein (CRP), IL-6, IL-8, and tumor necrosis factor-alpha exists (24–28). These pro-inflammatory cytokines play an important role in VTE by promoting a pro-coagulant state primarily by inducing the expression of tissue factor. Several immune system components (cytokines, chemokines, and various leukocyte subtypes) are involved in the underlying inflammatory process of VTE, as is very well-described in a recent review from Saghazadeh et al. (23). Additionally, it has been recently described that inflammatory mediators such as polyphosphates, bradykinin, and others may directly activate the contact system (the polyphosphate—Factor XII association is particularly notable) and initiate the extrinsic coagulation pathway (29–31).
The identification and elucidation of inflammatory markers relevant to VTE could provide targets for future therapy. That inflammation is the basic etiopathogenic process of VTE is also supported by the relation of some risk factors to both arterial and venous thrombosis: age, increased BMI, atherosclerotic disease, hypercholesterolemia, hypertension, antiphospholipid antibodies, and hyperhomocysteinemia (28).
Interaction Between Coagulation and Inflammation
For over a century, thrombosis formation has been attributed to three main groups of factors including alterations in blood flow, endothelial injury, and hypercoagulable state, collectively known as Virchow's Triad (32). A prime example is the frequent association of central venous catheter (CVC) with VTE. Blood flow is altered by the obstacle in the vein, creating turbulent flow in some areas, while promoting stasis in others, depending on local vascular architecture. Additionally, the endothelium is damaged at the catheter insertion site, and the body actively attempts to repair that site with primary and secondary hemostatic efforts. Finally, there is a high likelihood that the underlying disease process that necessitated the need for the CVC in the first place (volume resuscitation in trauma or distributive shock, chemotherapy administration for active cancer, long-term antibiotics for severe infection, etc.) increases the risk for thrombosis. There is also likely a reciprocal relationship between CVC infections leading to increasing risk for line thrombosis and infected clots within a line likely to adversely affect its function. Over the last decade, a growing body of evidence suggests a role for consideration of inflammation as a major contributor to the pathophysiology of VTE, (33) likely by enhancing the hypercoagulable state and increasing endothelial damage. Activation of endothelial cells, platelets, and leukocytes, with subsequent initiation of inflammation and microparticle formation, triggers the coagulation system through induction of TF, primarily that borne by microparticles, which may contribute to the hypercoagulable state in the Triad (28, 34, 35). Both formation and resolution of thrombosis have been associated with a series of inflammatory cascades (36, 37). Moderate to severe degrees of inflammation (inflammatory infiltrates throughout the thrombi, mostly composed of lymphocytes, with some mixing of other components including plasma cells, neutrophils, and eosinophils) (38) were found in approximately 15% of thrombus specimens from pulmonary thromboendarterectomy (23) and immunity/inflammatory genes constitute nearly 10% of those genes whose expressions are substantially altered under the influence of VTE (38, 39). A reciprocal relationship exists in which patients with VTE have an increased risk of myocardial infarction and stroke, and vice versa, while proven cardiovascular risk factors such as obesity, tobacco use, diabetes, stress, and diet increase the risk of both atherothrombotic events and VTE, likely due to the common pathophysiological mechanism of promoting cardiovascular inflammation (40).
Evidence of specific pathophysiologic links between the coagulation system and innate immunity continues to mount. Polyphosphate (polyP) is present in human platelet dense granules and is released upon platelet activation, assisting with coagulation by increasing activation of factor V, decreasing tissue factor pathway inhibitor (TFPI) activity, and delaying clot lysis by activating thrombin-activatable fibrinolysis inhibitor (TAFI) (41–44). PolyP is also a potent pro-inflammatory signal when released from mast cells during a hypersensitivity reaction, for example (42).
Additionally, histones have been shown to be increased in sepsis and other inflammatory conditions along with nucleosomes (DNA + histones), and are toxic to the endothelium. Activated protein C inactivates histones, protecting the endothelium in the process (45). Extracellular DNA fibers extruded from neutrophils (Neutrophil Extracellular Traps, NETs) are produced in response to infection to allow neutrophils to trap and destroy invading microorganisms. Fibrin formation and deposition has been shown to be stimulated by NETs, and fibrin formation is also important in trapping organisms and controlling infection (46). NETs also cause platelet adhesion and have been shown to be linked to deep vein thrombosis in experimental models (47). Moreover, platelets have been shown to stimulate NET production (46). There is also evidence that some bacteria interact with platelets, either directly or through antibody-mediated mechanisms, leading to platelet activation or contributing to thrombus development. Other interactions have been identified which are beyond the scope of this brief review and have been described excellently elsewhere (45, 48–50).
Inflammation can be both a cause and a consequence of VTE, but current anti-coagulation treatment regimens are not specifically designed to inhibit inflammation (though it is known that heparins have some anti-inflammatory effects). Selective pharmacologic targeting of immune/inflammatory mediators in VTE may result in more effective therapeutic or prophylactic strategies (23). It is important to note, however, that the role of anti-inflammatory therapies in VTE prevention efforts is still not well-established. One study demonstrated a 2-fold or more increased risk of VTE with the use of non-selective non-steroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2-selective (COX-2) inhibitors (51). These results were reflected in a recent systematic review and meta-analysis in which the pooled risk ratio among NSAID users was 1.8-fold for VTE (52). Adequate VTE mechanism data in this setting are not yet available, however, to determine whether the anti-inflammatory medication itself drives the VTE formation or whether inflammation drives the usage in patients who are being treated with anti-inflammatory drugs to manage their underlying medical condition. The same question may be considered in users of steroids, though it has been shown more specifically that glucocorticoids increase levels of clotting factors and fibrinogen, which may explain the elevated VTE risk (especially pulmonary embolism) demonstrated in a recent Danish study of glucocorticoid users that followed an associated temporal pattern, persisted after adjustment for underlying disease severity, and existed even in non-inflammatory conditions (53). A similar effect with 1.5-fold increased VTE risk was seen in subjects treated with glucocorticoids for at least 30 days prior to surgery (54).
Particular disease subgroup-specific relationships have been studied, as seen below and in Table 1.
Surgery and Trauma
Surgery and trauma are linked in terms of HA-VTE risk due to the tissue injury they have in common. The role of inflammation in driving HA-VTE risk in these clinical situations is primarily related to the process through which transected vessels and tissue undergo physiologic repair. The innate immune system is activated following tissue injury, platelets degranulate locally after recruitment from the circulation, and tissue macrophages and mast cells are activated with a combined effect of leukocyte chemoattraction (55). Neutrophils infiltrate the wound, followed by additional circulating monocytes that differentiate into mature tissue macrophages, (56) and later by additional infiltration of mast cells from adjacent tissue (57), and finally by T-lymphocytes (58). The collective result of these cellular activation processes is increased release of IL-1, IL-6, IL-12, and TNFα (59, 60). IL-6 has been demonstrated to play a critical role in inflammation-related thrombosis (61) increased concentrations of IL-6, along with TNFα and IL-8 are potent risk predictors for VTE, even after adjustment for covariates, including CRP (62). Additional neutrophil presence (following chemoattractant release from platelets and mast cells) and subsequent NET formation have been linked to venous thrombosis (47, 63). The interaction between endothelial E-selectin, leukocyte L-selectin, and platelet P-selectin also plays an important role in platelet-leukocyte aggregation and adherence to vessel walls at sites of surgical or traumatic injury. P-selectin inhibition has been shown to decrease venous thrombosis in murine (64) thrombosis models and enhance thrombus resolution in rat models (65). Similarly, E-selectin inhibition with a small molecule inhibitor has been shown to decrease inflammation (vein wall monocyte extravasation) and acute venous thrombosis in a surgical model of murine thrombosis induction (66) and is now being studied in early clinical trials in humans.
Inflammatory Bowel Disease
Among VTE-related hospitalizations, the presence of IBD was associated with a 2.5-fold increased risk of mortality in one population-based study (18). No studies have specifically evaluated the potential benefit of VTE prophylaxis in hospitalized or ambulatory IBD patients, but studies to date do not support an increased bleeding risk with moderate doses of anticoagulant medications in IBD patients with active disease (18). Recent large studies have quantified this risk showing that IBD patients run a 1.5 to 3.6 higher risk of developing VTE than healthy controls (16, 17). IBD has been demonstrated to represent an independent risk factor for the recurrence of VTE (17).
IBD has been previously associated with increased levels of TNFα (67) with upregulation of TNFα mRNA in colonic tissue in patients with Crohn's Disease (68) and Ulcerative Colitis (69) and many current therapeutic regimens involve a focus on blocking signaling through this molecule. Giannotta et al. (16) have recently reviewed the specific effects of TNFα on activation of intrinsic coagulation pathway by inducing tissue factor expression on leukocyte surfaces, down-regulation of natural anticoagulants (protein C and heparin-antithrombin pathways) in addition to thrombomodulin and the endothelial protein C receptor, increasing platelet production and enhancing thrombin formation in conjunction with IL-6, and triggering (in conjunction with IBD-associated elevation in homocysteine) expression of vascular cell adhesion protein-1 and monocyte chemoattractant protein 1 on endothelial surfaces leading to enhanced capacity to recruit T cells and monocytes.
Obesity is a known risk factor for arterial and venous thrombosis. Studies have shown that obesity conveys an odds ratio of 1.7–2.2 for VTE, similar to that of other known VTE risk factors (70). A recent cohort of 268 adults with incident VTE events over 4.6 years from the Reasons for Geographic And Racial Differences (REGARDS) cohort demonstrated that higher CRP levels and lower serum albumin levels were associated with increased VTE risk and statistically mediated part of the association of body mass index (BMI) with VTE, suggesting that inflammation may be a potential mechanism underlying the relationship between obesity and VTE risk. White blood cell (WBC) count and platelet count were not determined to have any relationship. Adipocytes secrete inflammatory cytokines leading to chronic, low-grade inflammation resulting from recruitment of macrophages to adipose tissues that progressively accumulate as fat mass increases, and drive a progression of anti-inflammatory M2 macrophages to proinflammatory M1 macrophages, leading to increased secretion of proinflammatory cytokines including TNFα, IL-6, and IL-1β, as well as impaired fibrinolysis due to marked increase in plasminogen activator inhibitor-1 expression (70). These proinflammatory cytokines, as well as adipokines such as leptin, stimulate vascular endothelium, platelets, and other circulating vascular cells, leading to upregulation of procoagulant factors including tissue factor and cellular adhesion molecules, downregulation of anticoagulant regulatory proteins, increased thrombin generation, and enhanced platelet activation (71). Finally, aberrant microRNA expression patterns likely contribute to thrombosis in obesity through decreased endothelial nitric oxide bioavailability, unregulated expression of endothelial adhesion molecules, and enhanced platelet activation and degranulation as reviewed by Blokhin and Lentz (72).
Cystic Fibrosis (CF)
CF is a multi-system inflammatory disease, complicated by excessive production of thick mucus secretions that lead to pulmonary infectious exacerbations resulting in hospitalization for IV antibiotics, frequently through a CVC. These patients have increased risk of thrombosis due to CVCs, as well as acquired thrombophilia secondary to inflammation [including both the elevation of pro-coagulant acute phase reactant proteins such as fibrinogen, factor VIII, and/or von Willebrand factor (VWF), as well as the suppression of protein S by inflammation-related C4B binding protein], or natural anticoagulant protein deficiencies due to vitamin K deficiency and/or liver dysfunction (6). Also, the incidence of antiphospholipid antibodies that may be associated with increased thrombotic risk ranges from about 5–10% in patients with CF, which is elevated compared to that reported in healthy children (1–3%) (73, 74). While platelets are generally thought to play a more significant role in the pathogenesis of arterial thrombosis (coronary heart disease and stroke), it has been postulated that activated platelets may contribute to pulmonary inflammation and tissue destruction in CF, specifically (75). Certain specific pulmonary infections, such as Burkholderia cepacia, may also increase VTE risk in CF patients (76).
VTE in children with cystic fibrosis was recently studied at a single center and the incidence rate was found to be 53 VTE cases per 10,000 children with CF. Several inflammatory-specific risk factors for VTE were reported, including sinus disease, positive respiratory cultures, and elevated inflammatory markers such as erythrocyte sedimentation rate and CRP (7). A recent retrospective study of 116 adults with CF hospitalized for pulmonary exacerbations using a CVC demonstrated a 2.5% incidence of catheter-related VTE (77). Elevated CRP was associated with the thrombosis group but did not reach statistical significance (p = 0.51) and the time to VTE development was shorter for peripherally-inserted central catheter (PICC) lines compared to Port-a-Cath, though the only two recurrent events occurred in subjects with Port-a-Caths (77). A prospective study of 90 adult and pediatric CF patients, on the other hand, demonstrated a CVC-related VTE frequency of 6.6% (combination of symptomatic clots and those detected by screening ultrasound) (5). This study did not identify biomarkers (CRP, D-dimer, fibrinogen) for inflammatory/hypercoagulable screening at the time of catheter insertion, but did emphasize the contribution of VTE history and raises the issue of prospective Doppler ultrasound for consideration in identifying asymptomatic CVC-VTEs, though the role of anticoagulant therapy in the management of these patients remains controversial. The utility of pharmacologic prophylaxis for the prevention of CVC-associated thrombosis, particularly in high risk CF individuals, deserves further study (6).
Sepsis and Systemic Infection
Bacterial sepsis is a classic example of inflammation-triggered coagulation induced by endothelial injury and tissue factor expression following an acute systemic inflammatory response, (78) leading to activation and consumption of coagulation factors and platelets, along with impaired fibrinolysis, disruption of endothelial barrier, and loss of physiologic antithrombotic factors such as thrombomodulin (79). Sepsis denotes progressively more severe host defense reactions to invading organisms with endothelial dysfunction and elevation of inflammatory markers triggering the activation of coagulation with concurrent down-regulation of anticoagulant systems and fibrinolysis (disseminated intravascular coagulation, DIC) which, in turn, contributes to increased inflammation. There is significant interplay between inflammation and coagulation in sepsis, highlighted by the procoagulant properties of the endothelium such as expression of tissue factor (TF) and VWF, activating interactions with platelets, release of procoagulant microparticles, and downregulation of TF pathway inhibitor (TFPI) and the protein C/S anticoagulant system, inhibiting fibrinolysis. The coagulation response serves to isolate the invasive organism, but some bacteria have adapted to this and can use the coagulation response to hide from immune attack (12, 46, 80).
As mentioned above regarding B. cepacia specifically imparting elevated VTE risk in CF patients, certain clinical variables and bacterial virulence factors are associated with VTE in Staphylococcus aureus bacteremia (Methicillin-resistance, CRP >20 mg/dL, and hemoglobin nadir </= 9 g/dL, though it may not always be clear whether anemia was an additional factor in the development of thrombus or is a marker of more severe disease) (11). These findings were comparable to those from another study of 70 children with osteomyelitis where in an elevated CRP was associated with increased VTE risk (81). Furthermore, a study of over 10,000 subjects in the Atherosclerosis Risk in Communities (ARIC) study, CRP above the 90th percentile was associated with a 76% increase in risk of VTE versus lower percentiles (24). A recent study of 39,831 patients who underwent colorectal surgery demonstrated a 2.4% incidence of VTE, associated with urinary tract infections, pneumonia, organ space surgical site infection, or deep surgical site infection (3).
Systemic Lupus Erythematosus
In general, inflammatory rheumatologic diseases (lupus, Sjogren's syndrome, inflammatory myositis, and systemic sclerosis) are associated with high VTE rates—more than three times higher than in the general population (22). In particular, patients with systemic lupus erythematosus (SLE) are at significantly increased risk for premature atherosclerosis and thrombosis not only due to direct effects of chronic systemic inflammation but also to the additional risk imparted by antiphospholipid antibodies (21). This acquired, multi-organ, autoimmune disease itself is an independent risk factor for both arterial and venous thrombotic events, particularly in those with the antiphospholipid syndrome. Myriad factors influence atherosclerosis and cardiovascular disease in SLE patients, including those related to the disease itself (INF-alpha, TNF-alpha, MCP-1, cystatin C, kidney disease, overexpression of ICAM/VCAM/VEGF/VWF, NETs, elevations of interleukins 6/12/17/18, and other acute phase reactants) and to the medications used to treat it (corticosteroids, antimalarials, mycophenolate mofetil, HMG-CoA reductase inhibitors, and non-steroidal anti-inflammatories) (20). Individuals with SLE have been shown to have decreased DNase1 activity in their serum, which decreases NET degradation, and may contribute to thrombus formation (47). Activation of the innate immune system as evidenced by the elevation of TNF-alpha and the interleukins described above increases the risk of VTE even after adjustment for CRP (62). Polymorphisms in genes encoding factor VIII, Interleukin-1β, and interleukin-10 have been shown to modulate the risk of idiopathic VTE (82).
The lupus nephritis and autoimmune thrombocytopenia found in some of these patients also complicate the anticoagulant strategies and their standardization, but consistent APLA screening, renal evaluation/management, and use of hydroxycholorquine may decrease thrombotic risk or at least disease-related morbidity/mortality (19).
Clinical observations and mounting laboratory evidence support a complex interplay between inflammation, innate immunity, and the coagulation system. As more is understood about these interactions, novel preventive and treatment modalities for thrombosis will likely become available.
BB and SC contributed equally to the preliminary literature review, as well as the writing and revision of the manuscript.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Keywords: pediatrics, venous thromboembolism, thrombosis, inflammation, cytokines, platelets, risk factors
Citation: Branchford BR and Carpenter SL (2018) The Role of Inflammation in Venous Thromboembolism. Front. Pediatr. 6:142. doi: 10.3389/fped.2018.00142
Received: 11 January 2017; Accepted: 27 April 2018;
Published: 23 May 2018.
Edited by:Birgit Knoechel, Dana–Farber Cancer Institute, United States
Reviewed by:Cameron C. Trenor, Boston Children's Hospital, Harvard University, United States
Leo D. Wang, City of Hope National Medical Center, United States
Copyright © 2018 Branchford and Carpenter. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Brian R. Branchford, email@example.com

domain: medical


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NO DIRECT THREAT FROM ACTIVE TROUGH: SIMS
The Solomon Islands Meteorological Services (SIMS) has said the country is no direct threat from the current winds over land areas due to the active trough which lies over the country.
Director of Meteorology, David Hiriasia told SIBC News there are no threats at the moment, but strong winds may occur at times.
He says the main warning now is for mariners and those living in coastal areas.
“The main threat or warning goes for mariners and those living in coastal areas where there would be rough seas. Also, the low-pressure systems can develop heavy swells which if added up with the wind waves can cause very rough seas and also the possibility of coastal flooding.”
SIBC News understands, the Met Service has issued ‘Heavy Rain Warnings’ and ‘What To Do Information’ messages for the whole country.

domain: news


Agricultural Land in Nata, Paphos
for sale in Paphos, Nata
Publish: 06 Apr 21, views: 17
|Size (m²)||2676 sqm|
Agricultural land in Nata, Paphos is available for sale.
The property has an area of 2,676sqm and benefits from c. 9m road frontage along a registered road on its northwest border.
The immediate area comprises of agricultural and undeveloped parcels of land.
It falls within agricultural planning zone Γ3 with 10% building density, 10% coverage, 2 floors and a maximum height of 8,3m.
Contact Name: G & P LAZAROU ESTATE AGENTS LTD (Επιχείρηση)
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Take an EXTRA 5% OFF Your Order With Code: YAY
I use these for bible Journaling and they are GREAT! They fit perfectly in the margins and the circle ones I tend to overlap a bit to get it some of those "long" words. Figured out pretty quick these are so much easier to use if you use tweezers to place them onto the page. If you gently lay them you can reposition if needed but once you stick them they stick real good!!! Haven't had any coming up at all.
The teensy type alphabet are great and can be used in so many different ways on cards and scrapbook pages. They are easy to remove from the card and very easy to place on the project. They do not come off. They can be rearranged if you do it within a few minutes of the original placements. I have every color that was available and would highly recommend this product.
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domain: hobby


Ho-hum. The Bruins went on the road to face the top team in the Eastern Conference tonight.
It was supposed to be a stiff test, but as usual the Bruins made short work of the Pittsburgh Penguins. They are now just one point back of the Pens for the conference lead.
The Bruins are now 14-0-1 in their last 15 games. Goaltender Tim Thomas, who made a season-high 43 saves, has won a career-best 10 games in a row. Since November 1, Thomas has a 1.70 goals-against average and .950 save percentage.
Now comes a true stiff test as the Bruins will have combat complacency when they visit Winnipeg Tuesday night.


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All the articles I've posted.
City of Heroes/Villains legally back (and playing on Linux)!Published: at 08:06 PM
It looks like NCSoft has officially granted Homecoming a license for CoH/CoV. Now let's play it on Linux!
New Year, New Game! Rose Cottage Hype!Published: at 10:10 AM
My favourite ARG peeps Alice and Smith are at it again. This time with the Rose Cottage.
AoC23 - Lessons Learned on Day 1Published: at 06:00 PM
No answers for this day, just a few things I learned that I want to remember.
Choice Paralysis - Advent of Code 2023Published: at 02:06 AM
Choice paralysis sucks.
Rainbow Filter Mod in Grim Dawn LinuxPublished: at 02:06 PM
How to install the Rainbow Filters for Grim Dawn when your OS is Linux


text:
ONLINE CATALOG SEARCH
Draft of Proposed Press Release
August 23, 1945 [Washington, D.C.]
An article in a Washington paper this morning indicated that the protests of some 3,000 men in the 29th Division in the European theater had resulted in their being given an earlier date for return to the United States. Such a report, if not based on fact, is merely an encouragement to hundreds of thousands of other soldiers to follow the same procedure which clearly would have a very serious effect on the morale and good order of the army. The actual facts in the case are indicated in the following message dispatched by the Chief of Staff to General Eisenhower and General McNarney on 10 August:1
Document Copy Text Source: George C. Marshall Papers, Pentagon Office Collection, General Materials, George C. Marshall Research Library, Lexington, Virginia.
Document Format: Typed draft.
1. At this point Marshall quoted his entire message. See Papers of George Catlett Marshall, #5-191 [5: 264]. The memo printed here was released to the press at 11:30 A.M. with additional comments by the Bureau of Public Relations regarding the return of high-point soldiers and MacArthur’s need for manpower. (Memorandum for the Press, August 23, 1945, GCMRL/G. C. Marshall Papers [Pentagon Office, General].)
Recommended Citation: ThePapers of George Catlett Marshall, ed.Larry I. Bland and Sharon Ritenour Stevens(Lexington, Va.: The George C. Marshall Foundation, 1981- ). Electronic version based on The Papers of George Catlett Marshall, vol. 5, “The Finest Soldier,” January 1, 1945-January 7, 1947 (Baltimore and London: The Johns Hopkins University Press, 2003), p. 287.

domain: library


iOS VPN App
Apple Pay could automatically select specific credentials depending on the location, with a future version potentially able to take advantage of an iPhone’s ultra-wideband technology to make sure the right card is used.
Apple has made the iPhone an almost indispensable item for everyday life, especially where payments are concerned. Users frequently perform Apple Pay transactions via their devices, registering multiple bank and credit cards for use in mobile payments.
The Wallet within iOS is also able to handle other types of cards, such as reward cards and boarding passes, which can be presented for their related purposes when required.
However, aside from the default payment card, users have to manually scroll through a list of stored cards to fish out the one they need for a situation, if it’s not the default card.
In a patent granted to Apple by the U.S. Patent and Trademark Office on Tuesday titled “Location-based credential selection for wireless transactions,” that search for the right card could be a thing of the past.
In essence, the patent suggests that a device like an iPhone could automatically present the correct credential or payment type for a nearby terminal. It does so by detecting a nearby terminal using radio technologies, such as ultra-wideband, to determine relative distance and to confirm the type of terminal being used.
The system consists of a secure transaction subsystem and a processor, with the former set up to store multiple credentials. The processor is set to receive encrypted radio polling messages from other devices, to respond, and to receive location data back from the nearby transmitter.
The distance is used to determine how far away the iPhone is from the terminal, to make sure that it is within a specific range before performing any further transactions.
If that distance is within range, the processor then uses the data gathered in polling to determine and select the appropriate credential to provide.
The selection could be made based on the specific type of terminal being used, such as one used by transit authorities for train payments, which could…


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NAG TIBBA TREK
A total of 12 people joined us on the Republic Day Weekend trek to Nag Tibba. Those were some awesome guys who had every bit of fun factor in them. We started from Akshardham Metro Station around 9 PM with everyone cozily tucked in their seats as it had gotten a bit cold when we started our journey.
We exchanged introductions with each other on the way inside our tempo traveler as we all kept singing songs throughout the journey until everyone fell asleep except for me and our driver Mr. Rahul. Our journey was delayed on occasion by the fog here and there. But, we still managed to move smoothly despite all that and got in time to Mussoorie the next morning for the sunrise.
The sunrise was incredibly beautiful and mesmerizing. It was cold so we all didn’t take much time to stay out and get the pictures and quickly got back into our vehicle and continued our journey to Pantwari.
We reached Pantwari amidst the celebrations of Republic Day with the locals singing the National Anthem under the National Flag outside the PNB bank right in front of the place where we were staying. After getting fresh, having breakfast, getting over the night’s tiring journey, everyone was looking full of energy by the time we started trekking for our Nag Tibba Base Camp.
It was around 10:30 when we started trekking and though the weather was beautiful, the sun played spoilsport to us. People had started feeling the uneasiness of trekking in warm clothes with the sun shining brightly over our heads. A few stayed behind, a few went ahead, some rested. That’s how everyone proceeded for the first few kilometers of the trek.
Most of the people who accompanied me had some experience of trekking before, so it didn’t really bother them much. But, some were trekking for the first time and the aftereffects of the inexperience started showing after the first one hour when they seemed exhausted with walking. We kept halting our pace as I kept on encouraging everyone to keep moving so that we could reach the base camp before sunset. All through the journey, I kept telling everyone why sunsets are one of the most important moments of a trek if you are a traveler. The stories of witnessing so many sunsets myself did help and people slowly and steadily kept on going without taking long halts to catch a breath. Instead, they only stopped at a few places to catch their breath and continued moving at a steady pace to reach the water source where we were about to have our lunch.
We sat there for a while and saw the first glimpse of snow that had everyone smile. They all had lunch and with a final push, everyone started the final ascent of the day. The final kilometer ascent was quite steep and hence it was creating a bit of problem for some of the people, so they needed more rest. We kept going as we were chasing a beautiful sunset after a tough and tiring day of walking. As our base camp drew closer, the ascent grew steeper, so everyone put in extra effort to reach the top and reach the Nag Tibba Campsite and everyone made it well in time to enjoy the beautiful sunset.
As it happens, everyone was waiting with their cell phones in their hands as the sunset kicked in. Everything had slowly started turning red and kept changing to different shades. We all had our evening tea while enjoying the sunset and that moment was perfect. With bonfire, hot served dinner, and a perfect company of fellow travelers, we enjoyed our night before we went to sleep.
The next morning, I woke up everyone who could for the Nag Tibba Summit. As it was going to be difficult, I wanted to make sure that whoever goes reaches the summit. We started early around 6 after having our breakfast. Everyone was glad that they found snow on their way to the summit. At a few places, we all stopped to play in the snow and have a snowball fight. It was just so fun. We kept moving ahead steadily, enjoying the gorgeous views and soft snow. It had now become easier for everyone to trek today as there was less sunlight and colder, so everyone was able to trek around snow. After trekking for a few hours, playing in the snow, we reached the Nag Tibba Summit with a lot of crowd present there.
We all sat at the summit peak to get some pictures before moving towards the areas with much snow and less crowd. Everyone enjoyed to the fullest with snow everywhere and wished they all had more time to stay there and enjoy the gorgeous beauty of the Nag Tibba Summit. After an hour or so, we began our return to the Camp Site. It didn’t take us long to come back as everyone was sliding wherever they could to reduce the walking time and save energy.
In around 90 minutes, we were back to our campsite where we had our lunch and departed for Patwari. Everyone was enjoying the descent as the sunset kept approaching and everything looked beautiful and people didn’t feel tired. On reaching Patwari, everyone thanked our organizer for having made the trip successful and then had snacks and tea as we left for Delhi around 8 PM from Pantwari and reached Akshardham Metro Station the next morning before sunrise.

domain: travel


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Department of Social Services
Department of Health
Medicaid Payments to Clinics Using Products of Ambulatory Surgery and Ambulatory Care Methodology
Under the Medicaid program, hospital-based clinics may be reimbursed for providing patients with preventive, diagnostic, rehabilitative or other types of services termed ambulatory care and ambulatory surgery. The reimbursements, which are processed by the Department of Social Services, should be based on rates established by the Department of Health. We examined these reimbursements over a 29-month period and found that clinics were overpaid as much as $4.5 million because services were billed at incorrect rates, the same service was billed more than once, and the prior approval of the Department of Health was not documented for certain types of services. The overpayments were made because controls were not established by the Department of Social Services to detect these billing errors. In a prior report, we recommended that some of these controls be established, but our recommendations were not fully implemented. We again recommended that the appropriate controls be established. We also recommended that the overpayments be recovered.


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Paige has shared her first social media message since it was reported that was not cleared to return to the WWE due to her neck injury.
The 25-year-old posted a black-and-white shot of herself standing in a wrestling ring with her arms raised to the crowd, with the audience enthusiastically cheering for her.
She did not caption the image, letting the photo speak for itself.
At a WWE Live event last month, Paige was performing in a match with Mandy Rose, Sonya Deville, Sasha Banks, Bayley and Mickie James when she suffered a neck injury. Paige was kicked in the back of the neck and suffered a stinger, attempting to get up before falling again.
Her injury was later determined to be more serious than initially suspected, and Paige was reportedly informed last week that she would not be cleared to return to an in-ring career with WWE. Prior to her return to WWE in November, she had missed 17 months of action due to neck surgery.
On Jan. 12, Paige posted a photo that indicated she would be attempting to return to the WWE, sharing a shot of herself in-ring and writing, "The comeback is always stronger than the setback."
Paige debuted on WWE's main roster in 2014 and has been named the NXT Women's Champion and a two-time Divas Champion.
Photo Credit: Instagram / @realpaigewwe


First post, by Siran
After I've recently found some of my old PCs while clearing out the attic I came across my very own first PC: An AMD 386 DX 40 on a 4386-VC-HD board with 8MB RAM, a "HighScreen Blaster 3.0" (Soundblaster 2.0 clone based on CPS' Soundblaster 2.5), 120MB Connor HDD and a Trident TVGA 9000B with a whopping 512KB VRAM.
I even got it to post, albeit the dreaded Dallas RTC reared its ugly head and greeted me with a CMOS battery error. I then opened the case and to my great surprise realised that not only did my late father who used it after I got a new PC upgrade it with a 387 FPU but the board could also house a 486 DX/2 66 instead of an FPU:
According to the manual (thank got I kept it) if you want to install a 486 DX/2 66 you'd have to switch two resistors, swap the oscillator to a 33MHz model (currently it has a 80MHz model installed due to the 386 DX 40) and set the jumpers accordingly:
Apart from the switching resistors, setting jumpers and swapping the oscillator do I need to do anything else before upgrading the board? For instance when I looked at the BIOS chip on the mainboard I got worried since it says "386DX". Does that mean I also need a new BIOS for a potential 486 DX/2 upgrade? I've found several pictures and a video by VSwitchZero that show that there are indeed BIOS chips that are labeled "486DX". See his video here (he also has a 386 installed): https://youtu.be/MV8nkl1Cjw0. Here's a picture of my BIOS chip:
If I need a new BIOS - can I flash it? The first time I flashed a BIOS was on a later Asus T2P4 board (that I also found in the attic) so I'm not sure if it is even possible and if it is what program to use. If it can't be flashed would I need someone with an eeprom flash tool? I've found several BIOS versions for the board here: https://theretroweb.com/motherboards/s/fic-4386-vc-hd.
I'm planning on tinkering a bit with the board. First, I'm getting the Dallas IC replaced so that I can properly use it, then I plan on upgrading the cache to a full 256K. I'll also need an HDD replacement since the trusty 120MB Connor HDD did not survive the almost 30 years in the attic. I'm torn between using an old 500MB IDE drive I have left, an IDE/SD-card adaptor and going all in with an old Compaq SCSI ISA controller that has a AIC-6260AL chipset since I still have a Seagate Cheetah 9GB with 10K RPM (that needs extra cooling and is loud so I guess I'll skip that) and an IBM Ultrastar with 18.2 GB. Even though these are U2W HDDs I recently got a working cable to attach them to a standard SCSI 50-pin controller.


It is hard enough developing a vaccine in record time to halt a global pandemic. But what if you need to print the instructions with every dose in Portuguese, Lithuanian and Greek?
An EU official said Brussels was considering having printed information in a limited set of languages. Other versions would be available online.
An industry official said even that might be too difficult: labels may not have enough space for more than two versions.
Consumer groups say leaving any languages off of packaging could hurt patients, particularly those less capable of looking up details online.
“The urgency of getting a vaccine should not be an excuse for companies to cut corners on consumer protection,” said Monique Goyens, the head of BEUC which represents major European consumer organizations.
The EU translates all its rules into all member languages. Commission staff use English, French and German as working languages.


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Nicki Minaj weighs in on Lil Wayne’s beef with Birdman and why Tyga wasn’t on “Truffle Butter,” Rihanna previews “American Oxygen,” Carly Rae Jepsen really likes teacup pigs, and more on First Dibs.
- Nicki Minaj called in to Charlie Sloth on BBC Radio 1Xtra and spoke about the Lil Wayne-Birdman beef, her relationship with Meek Mill, and the story behind why Tyga doesn’t appear on “Truffle Butter.” [Miss Info]
— March Madness TV (@MarchMadnessTV) March 6, 2015
- Rihanna gave a taste of “American Oxygen” in a commercial for March Madness after posting snippets of “Higher” to her Instagram.[Stereogum]
- Rick Ross premiered the visuals for “Movin’ Bass.”
- Carly Rae Jepsen talks about really liking teacup pigs, really disliking fast food, and more with host Ellie Lee.
- Paul McCartney recorded a new version of “Come And Get It” with The Hollywood Vampires, of which Johnny Depp, Alice Cooper, and Aerosmith’s Joe Perry are members. [CoS]
- Taylor Swift FaceTimed with a dying fan to fulfill her last wish.
- Raekwon of Wu-Tang Clan and Kanye West plan to collaborate in the future. [NME]
- Jack White sets vinyl aflame on the cover of Billboard.
[Photo Credit: Getty Images]

domain: entertainment


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CAIRO — Egypt’s powerful Muslim Brotherhood and the secular opposition banded together Sunday around a prominent government critic to negotiate for forces seeking the fall of President Hosni Mubarak, as the army struggled to hold a capital seized by fears of chaos and buoyed by euphoria that three decades of Mr. Mubarak’s rule may be coming to an end.
The announcement that the critic, Mohamed ElBaradei, would represent a loosely unified opposition reconfigured the struggle between Mr. Mubarak’s government and a six-day-old uprising bent on driving him and his party from power.
Though lacking deep support on his own, Dr. ElBaradei, a Nobel laureate and diplomat, could serve as a consensus figure for a movement that has struggled to articulate a program for a potential transition. It suggested, too, that the opposition was aware of the uprising’s image abroad, putting forth a candidate who might be more acceptable to the West than beloved in Egypt.
The Muslim Brotherhood just bought themselves a public secular face as a beard. And for those of you with little short term memory – let point out that it was during Dr. El Baradei’s watch at the International Atomic Energy Agency that the Iranians got away with creating a second parallel but ‘unmonitored’ nuclear program.
crossposted at the Last Exile

domain: politics


text:
Connect your Spotify account to your Last.fm account and scrobble everything you listen to, from any Spotify app on any device or platform.
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Hip-Hop producer from Moscow.
Anno Domini Beats (http://annodominination.com) is one of the most renowned underground Hip Hop production companies worldwide. As CEO of the…
Producer/Engineer from Portland, Oregon.
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Cold Legistics composes of two up and coming producers from the New England area. Teddy Roxpin residing from Boston, MA. and Chris Brassard from…
Алина Сиппс (also Alinah Sipps) is a musician from Tallinn, Estonia
The Jazzment is an instrumental piece created by a duo MARWZ + Nuno BC from The Netherlands. Jazzy, spacey sounds experimentally combined with…

domain: artistic


What is the Purpose of Heating, Ventilation, and Air Conditioning Repair and Why is it Considered Important?
A lot of things in this world are considered as complicated and that is a true fact. Temperature is one of the things out there that one can consider as complicated and for good reason. Temperature can be quite a touchy topic to think and talk about. This deals with something that is entirely out of our league before. One thing that you cannot deny is the fact that temperature is something that we cannot control and that holds true to scenarios where the places are wide and open. We have the ability to change the temperature of enclosed spaces but other than that then we might have an easier time getting to space than changing the ways that nature works. There are a lot of machines that are made out there that can directly contribute to the influence of temperature. The three main things that can directly influence temperature are air conditioning, heating, and ventilation. These three important things are the ones that directly influence the ability that we can dictate the temperature of a given area and space. These things are quite hard to install as there are different things that people have to think of when it comes to installing ventilation, air conditioning, and heating.
Each one of the three complement each other and you should take note of that. You can’t have a good air conditioning and heating system without the use of ventilation and you won’t find any purpose with ventilation if you don’t have heating and air conditioning. It is a well-known fact that these three help each other and it is important for people to realize that these three need to be with each other in order for everything to go according to plan. Heating and air conditioning are the two main things that can influence a certain area if they are going to be cold or hot and it is important to keep the balance between the two. The same goes for ventilation. Ventilation systems are the ones that move around the cold or hot air to different part of the area. Repairing these three things can take some time and professional skill as they were installed by professionals also. Services that have professionals in them in these systems are required in order for them to be repaired and maintained. Ventilation, air conditioning, and heating repairs are important as they will save money and cost for the owners rather than buying a new one.


Cape Leeuwin to Bremer Bay Marine Weather Overview
Tides for Albany
forecast windsWednesday: E/NE 30 kts
Thursday: SW 15/25 kts
Friday: E/NE 10/15 kts
East to northeasterly 15/20 knots, reaching up to 30 knots east of Albany in the evening. Seas: 1/1.5 metres, increasing to 1/2 metres during the afternoon. Swell: Southwesterly 2/2.5 metres. Outlook Thursday: Northeast to southeasterly 10/15 knots tending southwesterly 15/25 knots before dawn. Winds reaching up to 30 knots offshore east of Albany in the late morning. Seas: 1.5/2.5 metres. Swell: Southwesterly 1.5/2 metres, increasing to 2/3 metres during the afternoon. Outlook Friday: Variable about 10 knots becoming east to northeasterly 10/15 knots during the evening. Seas: Around 1 metre, decreasing below 1 metre during the morning. Swell: Southwesterly 2/3 metres.Issued Wed 04:00 WST
Seas: Up to 2.0m
Swell: Up to 2.5m, SW
most recent warnings
Strong Wind Warning for Gascoyne Coast, Geraldton Coast, Lancelin Coast, Albany Coast and Esperance Coast
View all current warnings
Sydney has endured another sweaty night during what could be shaping up to be the city's warmest January on record.
Prolonged heatwave conditions are helping elevate the bushfire threat in parts of New South Wales this week, after a slow start to the season.
A four-day heatwave that begins on Wednesday will bring the same kind of conditions that saw more than 200 Queenslanders treated for heat stroke and dehydration last week.


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Seed & Blossom Designs
⋒ Introducing beautiful Emily! ⋒
I'm Emily and I live with my 2 beautiful children and amazing husband in the rustic foothills of the Great Diving Range in the Southern Central Highlands in Central Queensland.
We are your typical country family; city girl, turned primary school teacher marries a local grazier and we spend our days living in a fibro weather beaten house loving all the things that rural life has to offer.
Creativity has always played a key role in my life growing up and sitting down to sketch, paint and create just makes my heart sing. After having both my children, I was stuck in the rut of trying to run a household and help in the paddock. I was sick of always saying to myself "I wish I was more organised for this person's upcoming birthday". So along came Seed & Blossom Designs, not only an outlet for my creative side but also a means to kick me into gear and become more organised!
I’ve always loved watching my family and friend’s faces when they open a card and gift I have given them; their smiles give me all the warm and fuzzy feels. All of our designs have been purposefully crafted to help you create that same feeling for both yourself and your lucky recipient. We stock a range of lovely gifts to make the whole process of selecting a gift and card simple and enjoyable.


text: Here's some sketches I did recently. The one above was just a quick little painting in my sketchbook. The later sketches were done at the natural history museum. I went into Ny and saw the museum, the met, and then went to the Society of Illustrators sequential show. Got to see great things, talk to great people, it was a great day.


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Who has a tough set of opening fixtures? Staying with Everton, Ronald Koeman's side follow their opening day home fixture against Stoke with games against Manchester City, Chelsea, Tottenham and the aforementioned trip to United. Stoke are not much better off, either. After visiting the.
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Like the crested tit this is a passerine bird also a member of the Paridae family.
See previous comments.
See my previous comments on Panoramio re. this lake where my brother has his holiday home where we all descend every September for much hilarity!!!
See my previous Panoramio comments re. these Portsmouth Landmarks.
This is the second ship of the Type-45 or Daring-class air-defence destroyers built for the Royal Navy. She was launched at Govan in 2007 and handed over to the Royal Navy on 3rd December 2009 being formally commissioned on 3rd June 2010.
This gun was designed for the battleships of the Royal Navy in the late 1930s. This gun armed the King George V-class battleships during the Second World War. It stands at the forefront of the Royal Armouries pointing towards sea!
Fort Nelson is one of five defensive forts built on the summit of Portsdown Hill in the 1860s overlooking the important neval base of Portsmouth. It is now part of the Royal Armouries housing their collection of artillery and is a Grade I listed building.
This was a British shell-firing mortar built for the Crimean War but never used in combat. It was constructed in sections so it could be transported. Eleven feet long it weighed 42,674 Kg. It could fire a 2,400 lb shell one and a half miles!
And now his birthplace is a chinky restaurant!!! The blue plaque reads, "Peter Sellers, 1925-1980, Actor & Comedian, was born here".


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[ad#Adsense Block Post Floats Right]There is so much information about the nutritional benefits of smoothies that sometimes it can be really difficult to know where to start with recipes and the right smoothie maker machine. We have reviewed and recommended many appliances on this site – in a wide range of price brackets, so I thought it was about time I brought you my favorite recipe books for making green smoothies so you can dive right in there and get started on your journey to better health!
1. The Green Smoothie Bible
This book is by Kristine Miles who lives in Australia and is a physiotherapist with more than fifteen years’ experience. She has a passion for sharing her mission in helping her readers and those who go to her cookery demonstrations to enjoy really delicious and nutritious food free from toxins and chemicals. You can enjoy a sample of her green smoothie recipes for free on her blog by visiting this page https://www.kristinemiles.com/green-smoothies.html
I love this book because it shows you that smoothies containing fruits and vegetables is one of the easiest (and most delicious) ways to really boost your intake of the health-giving benefits of fruits and vegetables.
Get the The Green Smoothie Bible with 300 Delicious Recipes at a discount from Amazon!
Whether you are wanting to shed some weight, protect yourself from illnesses, boost your energy and immune system, detox your body, fight off heart disease or whether you just want to reap the benefits of brighter, clearer skin, stronger, healthier nails and shinier, healthier hair, you will find more than 300 delicious recipes in this book to help you.
Each recipe shows you how to combine a variety of fruits rich in vital antioxidants with vitamin rich leafy greens into delicious drinks that can be made in minutes and which will have amazing benefits for your health.
2. Green Smoothie Revolution
This is the first of two books I am recommending by Victoria Boutenko. First published in 2009, this book addresses the problem common to many of us living in the fast-paced 21st century, that of finding life so hectic, that it is difficult to take the time to prepare and eat a balanced diet. It shows how this problem which causes so many health problems can be addressed by consuming healthy smoothies.
Many of us do not even realize that we are not functioning at optimum levels, we have gotten used to feeling tired, not sleeping well, finding it difficult to concentrate – and so on, the list goes on!
Green Smoothie Revolution: The Radical Leap Towards Natural Health – get your copy at a discount from Amazon!
In her book, Victoria calls this a ‘silent epidemic’ and sets about informing her readers in an interesting and very readable way about how to improve our nutrition with delicious recipes that are quick and easy to make.
There are 200 recipes in the book, each of them is simple to make, but there is such a huge variety of tastes that there is enough to keep everyone happy!
“This book is groundbreaking and needed by a population whose health is threatened by its own processed food supply. From a naturopathic perspective, the most important constituents of healing are here in these new recipes—enzymes, amino acids, fiber, minerals, antioxidants, and much more. Victoria Boutenko has an intense sense of curiosity combined with a brilliant mind… Join the Green Smoothie Revolution! You may not buy a more important book this year!”
—Ariel Policano, ND
3. Green for Life
This is the second book by Victoria Boutenko that I recommend and if possible, get both as this one, published in 2010, leads on from the Green Smoothie Revolution book listed above.
Whilst we all know and understand that we should be eating more of the health-giving fruits and vegetables in our diets, but with our modern lifestyles, it can be difficult to accommodate that.
Victoria advocates Green smoothies as a way to correct those deficiencies in our diet and to eliminate the build up of toxins in our bodies.
You can get your copy of Green for Life here!
This book goes into more detail about the nutritional science behind the benefits. But she does it all in an easy to read and interesting way. You will learn more about the benefits of the soluble and insoluble fiber and how the chlorophyll that makes plants green has tremendous healing powers in our bodies.
If you want more delicious recipes, combined with more in depth information about the health benefits, backed up by real testimonials of people who have experienced those benefits for themselves, this is a great choice.
“Green for Life is a classic tome on green smoothies, with lots of information on the health benefits and easy recipes to get started.”
4. Green Smoothies Diet
Author Robyn Openshaw has created a real winner here with a super book on how to stay younger longer and remain healthy with the Green Smoothies Diet. Her recipes focus on teaching her readers how to improve their health with delicious and inexpensive recipes. You can read more about Robyn and her work on her web site greensmoothiegirl.com.
I love this book because the recipes are not only amazingly healthy, but they are also really delicious. It takes only a few minutes to make one of her smoothies and get all the nutritional benefits of the ingredients she teaches you to use.
Green Smoothies Diet: The Natural Program for Extraordinary Health – get your copy at a great price from Amazon!
So whether you want to lose weight, detox, boost your immune system or just boost your energy, these recipes will help you and in addition provide long-term health benefits in helping to ward off heart disease, diabetes and some cancers if you use the smoothies regularly. In addition, these delicious recipes will not only make you feel great on the inside, you will soon start to notice that you are looking great on the outside too, with improvements in hair, nails and especially, your skin!
“I was engrossed from the first page of the introduction, which is funny
because you wouldn’t think a nutrition book would be so interesting. The
author has a nurturing voice and helps you feel YOU CAN DO THIS.”
I have loved sharing my roundup of my favorite four green smoothies recipe books with you – enjoy!
[ad#Adsense Block For Every Post]

domain: food


Tesla (NASDAQ: TSLA) is a name that’s on many investors’ watch lists, and it’s always been a volatile stock. The electric vehicle (EV) pioneer has hit the skids in recent weeks, but this morning, shareholders are seeing a reason for the hope that the worst of the recent pullback is behind them.
Musk has been selling stock in order to pay taxes on options that he’s exercising. He took to Twitter some time ago to ask his followers if he should sell 10% of his stock, though it seems he already had a plan in place to do so. Since then, Musk has been selling weekly, and Tesla’s share price has plummeted.
During the recent interview, Musk said he has sold enough stock. He didn’t say he’s done selling, and he didn’t reveal exactly how much he’s sold. But he did make it seem as though he won’t be selling more in the near term.
On Sunday, he said he would pay more than $11 billion in taxes this year. He has said his personal tax rate tops 50%, which would include federal and state income taxes. Musk said last year he had relocated from California to Texas where he faces no income tax.
In the interview with The Babylon Bee, Musk said:
“I sold enough stock to get to around 10% plus the option exercise stuff and I tried to be extremely literal here.”
Musk recently exercised 2 million more options, which add up to the tune of some $1.9 billion, and sold about 584,000 of the shares.
Musk, who moved the company’s headquarters from California to Texas earlier this month, in Tuesday’s interview also criticized California for “over-taxation” and “overregulation.”
Tesla stock’s gain today represents a bit of a rebound from a steep sell-off recently. Even including today’s gain, the stock has slid 25% from a high of more than $1,243 just a few months ago.
As the year wraps up, Tesla investors have the company’s fourth-quarter vehicle deliveries to look forward to. While the challenging global supply chain and logistics environment that Tesla is operating in make it difficult to forecast the quarter. Analysts are expecting record deliveries during the period. But a wide range of outcomes are possible.
Tesla delivered 241,391 vehicles in its third quarter, representing 73% year-over-year growth. For the current quarter, analysts generally expect 260,000 or more deliveries. This would put total deliveries for the year at over 887,000 — far higher than the 500,000 vehicles the company delivered in 2020.
The company usually posts its quarterly deliveries within three calendar days of each quarter’s end, or somewhere around Jan. 1 to Jan. 3 for Tesla’s Q4.


Eighteen of the Army's most sophisticated combat helicopters are one step closer to becoming part of the Utah National Guard arsenal after ceremonies Saturday in West Jordan.
Utah Adjutant General John L. Matthews activated the 211th Aviation Group and its subordinate battalion at the National Guard facility adjacent to Salt Lake Airport No. 2 in West Jordan. He said the upcoming delivery of the AH-64A "Apache" helicopters signifies a vote of confidence from the Department of Defense and the Army.Matthews said the aviation group's 85 pilots and support members face an intense training program before the new helicopters are delivered, probably next September. There will also be significant increases in facilities and staffing at the armory and maintenance facilities.
Guard members working out of West Jordan previously flew and provided support for Vietnam War-vintage AH-1F "Cobra" attack helicopters. Those helicopters will be transferred to another National Guard unit, possibly in Colorado, said Col. Robert D. Mabey, group commander.
The anti-tank Apaches are armed with Hellfire laser-guided missiles, a 30 millimeter cannon and 2.75-inch rockets.
The first official step toward transition to the new helicopters took place Nov. 20 when the Attack Troop, 163rd Armored Cavalry Regiment of the Utah Army National Guard, was dissolved. The same soldiers are now members of the upgraded 211th Aviation Group.
Matthews said changes in both the balance of power in the European theater and U.S. military policy are shifting additional responsibility from active duty soldiers to reserve components. The Utah National Guard is only the second guard unit to be assigned the new helicopters, promoted by the military as being the most sophisticated combat helicopters in the world.
The new unit will bring 32 new full-time federal jobs to the National Guard with an annual payroll of about $900,000. About $2.5 million will be spent retraining the pilots and ground crew, a process that will take several months. The attack group and its subordinate battalion are authorized by the army to have 346 soldiers compared to 243 in the old attack troop.
The group will eventually receive $250 million worth of aircraft and another $200 million in equipment.
Utah pilots and crew members will begin training at Fort Rucker, Ala., in February, Mabey said.


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Brussels was built on a swamp, and its name is the Frankish version of “Broekzele”, which means settlement in the swamp, and was the name of one of first settlements on an island in the Zenne river, where the city has its origins. Today only one tiny part of Brussels is still officially a swamp. It’s the swamp of Ganshoren, a municipality in the west of Brussels. The tiny swamp is ensnared between two railroad tracks. Just behind the tracks the city commences, with high-rise social housing, an industrial area, and just a bit further, the ring road highway that surrounds Brussels. The area is a mix of damp prairies and patches of bushes and trees, and is home to a lot of small wildlife such as birds, rodents, bats, amphibians and even ringed snakes. It’s a small green oasis, in the middle of a concrete landscape. The city completely engulfs it and acoustically permeates it, draping a continuous permeating bassy drone over the landscape.
Murmur is a collaboration between filmmaker Jan Locus and sound artist Stijn Demeulenaere. On two occasions they went to the swamp in the late hours of the night, just before first light, to record the dawn chorus. A dawn chorus is the awakening of the world, or the biotope. Just before dawn, the animals wake up, almost one species at the time, and start making their presence known, creating a lush symphony-like soundscape that lasts till the sun is well up in the sky. At the same time one hears the city awakening in the distance, the continuous bass drone gets louder, the traffic picks up, the overtones of people waking up and getting to work start to disturb the night’s calm.
The city drone permeates the sound of the swamp, and a strange mix enfolds between the sound of an awakening nature and a very human presence. It gives the place a very otherworldly atmosphere during the twilight hours of the morning.
MURMUR is a film by Jan Locus and Stijn Demeulenaere
Camera and EditSound RecordingSound design & CompostitionMixing and Mastering5.1 mixSound AssistanceCamera AssistanceAssistant editor and Title designJan LocusStijn DemeulenaereStijn DemeulenaereYves De MeyYves De MeyFan Yau WingJannes De KortDesirée De Winter


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- Collective ⇢ Glasgow, Scotland ⇢ June 2017
- We are a group of artists, designers and writers working at the intersection of art and ecology. We are leaning forward, staying with the trouble and taking notice of a climate in crisis.
Mental health and wellbeing in the Anthropocene, disrupting anthropocentric tunnelvision and aligning in solidarity with the more than human around us are the focus for our interdisciplinary work.
- Finn Arschavir + Marie Leguedois + Ane Lopez + Maria Sledmere + Lucy Watkins
- We are always seeking new ideas for projects and collaborations so please don't hesitate to reach out.


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Why Middlesbrough should complete a move for Deabeas Owusu-Sekyere
According to claims from reliable journalist Wayne Veysey, Middlesbrough are weighing up a move for Dutch teenager Deabeas Owusu-Sekyere, manager Jonathan Woodgate keen to add to his attacking options following a disappointing start to the campaign.
The same report suggests that the 19-year-old forward, who is currently on trial at the Riverside Stadium, has also attracted interest from fellow Championship outfit Barnsley.
The 19-year-old rose through the youth ranks of Ajax, playing in the same youth teams as Matthijs de Ligt and Justin Kluivert, but he failed to make the grade at the senior level and had stints at Portuguese clubs Freamunde and Leixoes before being released by the latter earlier in the summer.
The Dutchman is currently a free agent, meaning that Middlesbrough are unlikely to face any problems in registering him outside of the transfer window should they opt to offer him a professional contract.
Deabeas Owusu-Sekyere is set to be assessed at close quarters by the Boro coaching staff when he features for the club’s U-23s in the Premier League 2 Division 2 and any decision to get him on board is likely to depend on whether he manages to impress Woodgate.
Given his lack of exposure at the senior professional level, not much is known about the trialist apart from the fact that he is a right-footed centre-forward who also has the versatility to play out wide and through the centre in a supporting role.
Meanwhile, Middlesbrough have made a lacklustre start to their campaign in the Championship under Woodgate.
A change of fortunes was expected when Woodgate took over the reins from Tony Pulis in the summer.
While the change of philosophy to a more attacking and attractive one has been a notable difference, Boro haven’t really able to achieve the desired results, was with the club managing only 2 victories from their first 11 league fixtures.
A modest tally of 11 goals in 11 games certainly calls for attacking reinforcements in January and given that the likes of Marcus Browne, Marcus Tavernier and Marvin Johnson haven’t really contributed a lot in terms of goals and assists, Woodgate clearly has a lot to think about.
To that end, getting a talented youngster like Debeas Owusu-Sekyere on board wouldn’t be the worst idea and the 19-year-old’s availability on a free transfer certainly makes him a gamble worth taking for Middlesbrough.
Given Ajax’s scintillating track record in blooding top-quality young talents, Boro have enough reason to believe in the potential of Owusu-Sekyere even though he failed to make the grade in his homeland. Of course, they should be wise enough to assess the youngster at close quarters before offering him a new lease of life.
Keeping in mind the ongoing attacking crisis at the club, the door is pretty much open for a talented youngster to come in and make an instant impact on the first-team.
The 19-year-old is likely to initially ply his trade with the U-23s if a deal does materialize and then it will be up to prove his worth and eventually stake a claim for a senior call-up.
- More Middlesbrough News
- Why Stephen O’Donnell would be a real coup for Middlesbrough
- Why Middlesbrough should beat others for Cameron John
- Why Middlesbrough should arrange a loan move for Patrick Reading
All in all, there is no guarantee that Deabeas Owusu-Sekyere would be able to push on and cut the mustard in the Championship, given his lack of previous professional experience in English football, but the teenager is certainly worth a punt for the Teessiders on a free transfer.
The move could turn out to be a real masterstroke in the future if he does go on to fulfil his promise.


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Examples of Independent Appraiser in a sentence
In cases in which a majority of Independent Directors so determine, and in all cases in which the transaction is with the Advisor, the Sponsor, any Director or any Affiliate thereof, such appraisal of the underlying property must be obtained from an Independent Appraiser.
SB Advisors represents that it isindependent of, and unrelated to, any party in interest to the Plan and that its revenues for 2021 from parties in interest and affiliates in connection with its engagement as Independent Appraiser would be less than two percent (2%) of its projected revenues for 2021.
The Plan will not be responsible for any commissions, fees, or other expenses associated with the Sale and will not bear any costs associated with the exemption request, including the professional fees of outside counsel, the Independent Fiduciary, and the Independent Appraiser, which amount to at least $315,000.
If a majority of the Independent Directors on the Board of Directors or a duly authorized committee of the Board determines, or if the Real Property is acquired from the Advisor, a Director, the Sponsor or their Affiliates, such fair market value shall be determined by a qualified Independent Appraiser selected by such Independent Directors.
The Plan will receive cash for each Interest based on the fair market value of the Interests as of the date of the Sale based upon an appraisal report prepared by the Independent Appraiser.

domain: law