text:
Comparative analysis of US real-world dosing patterns and direct infusion-related costs for matched cohorts of rheumatoid arthritis patients treated with infliximab or intravenous golimumab
Received 28 August 2018
Accepted for publication 20 November 2018
Published 15 January 2019 Volume 2019:11 Pages 99—110
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Samer Hamidi
Lorie A Ellis,1 Elisabetta Malangone-Monaco,2 Helen Varker,3 Diana Stetsovsky,3 Maureen Kubacki,1 Raphael J DeHoratius,1,4 Shelly Kafka1
1Real World Value and Evidence, Janssen Scientific Affairs, LLC, Horsham, PA, USA; 2Life Sciences, IBM Watson Health, Armonk, NY, USA; 3Life Sciences, IBM Watson Health, Cambridge, MA, USA; 4Janssen Immunology, Medical Affairs, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
Purpose: The objectives of this study were to evaluate and compare treatment patterns and infusion-related health care resource expenditures for rheumatoid arthritis (RA) patients initiating golimumab for intravenous use (GLM-IV) and infliximab (IFX) therapy and to assess cost implications from the commercial perspective.
Methods: Adult RA patients with a new episode of GLM-IV or IFX treatment between January 1, 2014 and March 31, 2016 were identified from MarketScan databases and evaluated for maintenance infusion intervals and related costs of treatment. IFX and GLM-IV patients were matched 1:1 on index medication treatment duration, gender, payer type, prior biologic use, and post-index methotrexate use. Paid amounts for drugs and associated administration costs were applied to treatment group dosing patterns.
Results: Final matched treatment groups included 547 GLM-IV and 547 IFX patients (mean age = 55–56 years). Mean (SD) follow-up was 609 (161) days for GLM-IV and 613 (163) days for IFX. Treatment duration was 396 (240) days for GLM-IV and 397 (239) days for IFX. Overall, 80% of GLM-IV and 39% of IFX maintenance infusions were given approximately every 8 weeks; and 6% of GLM-IV and 53% of IFX maintenance infusions occurred more frequently than every 8 weeks (P<0.001). When weighting of the maintenance infusion interval was applied, the mean number of induction plus maintenance infusions during the first year of treatment was estimated at 7.03 for GLM-IV and 9.48 for IFX. From the commercial perspective, drug plus administration costs per infusion were $5,846 for GLM-IV and $5,444 for IFX with total annual cost of therapy for GLM-IV patients costing $10,507 less than that for IFX patients in the first year and $6,774 less than that for IFX patients in subsequent years.
Conclusion: Annual GLM-IV drug plus administration costs for commercial health plans were significantly less than IFX in RA patients due to differences in real-world dosing and administration.
Keywords: rheumatoid arthritis, infliximab, golimumab, dosing, treatment patterns
Rheumatoid arthritis (RA) is the most common adult chronic inflammatory arthritis condition, affecting ~0.5% to 1% of the world population, including an estimated 1.3–1.8 million Americans.1,2 This autoimmune disease appears to stem from genetic susceptibility and environmental triggers in which B-cell and T-cell activation, autoantibody production, tumor necrosis factor alpha (TNF-α), and IL-6 play central roles. The characteristic joint synovium inflammation and degenerative articular changes are often accompanied by systemic complications of the underlying disease, such as those affecting cardiovascular, pulmonary, and gastrointestinal systems; cancers; and psychiatric diseases.1,3 Annual economic costs for RA in the USA were estimated at $8.4 billion (2,005 dollars) in direct health care expenditures and $10.9 billion in indirect costs resulting from the disease and comorbid conditions, along with psychosocial effects of the disease and impacts on health-related quality of life.4
Treatment guidelines focus on managing inflammation, preventing structural damage, controlling pain, and managing comorbid conditions with the goal of optimizing patients’ participation in activities of daily living by using a treat-to-target strategy that adjusts therapy to meet treatment goals.5–7 Early intervention with disease-modifying antirheumatic drugs (DMARDs) has become the backbone of the treat-to-target approach, in which therapy is regularly reassessed based on progress toward relieving signs and symptoms and minimizing disease activity.3,8 Initial therapy typically involves conventional DMARDs, such as methotrexate, leflunomide, or sulfasalazine. For patients with moderate or high disease activity, the guidelines from the American College of Rheumatology recommend use of conventional DMARD combinations with or without a biologic targeted immune therapy or biologic therapy alone, such as abatacept, adalimumab, etanercept, golimumab, and infliximab (IFX).9 The most prevalent biologics used for RA are the TNF inhibitors (anti-TNF agents); however, US guidelines do not provide recommendations for prioritizing between agents of the same class, leaving this decision solely in the hands of individual providers.2,5,9
Golimumab (GLM) for intravenous use (GLM-IV) and IFX are currently the only anti-TNF agents approved in the USA for IV administration in treating patients with RA. Despite having similar mechanisms of action, there are significant differences in dosing and administration recommendations between GLM-IV and IFX. GLM is a fully human monoclonal antibody specific for human TNF-α, approved for IV administration in July 2013 for moderate-to-severe active RA in combination with methotrexate. The 2 mg/kg dose is administered by IV infusion over 30 minutes at weeks 0 and 4 for induction and then as a maintenance regimen every 8 weeks.10,11 Under this dosing schedule, patients can receive seven GLM-IV infusions in their first year of therapy. IFX is a chimeric IgG1κ monoclonal antibody specific for human TNF-α. The recommended 3 mg/kg dose is given by IV infusion over a minimum of 2 hours at weeks 0, 2, and 6 for induction, followed by a maintenance regimen every 8 weeks in combination with methotrexate. Patients with insufficient response may have the dose increased up to 10 mg/kg or may have the frequency increased up to every 4 weeks.12 Under this dosing schedule, patients can receive between 8 and 14 IFX infusions in their first year of therapy.
The differences in dosing and administration recommendations, as well as the subtle differences in protein structure between GLM-IV and IFX, can affect the use of health care resources and costs. However, no studies to date have directly compared the dosing and administration regimens and associated resource use and costs for these two IV anti-TNF RA medications in real-world populations. The comparison of these agents is complicated by noted differences in the populations treated with each agent since early studies have shown that a higher proportion of patients receiving GLM-IV tended to be older, with longer-standing active disease and had failed more prior biologic therapies compared with the population receiving IFX.13,14 Therefore, studies in matched patient cohorts are important to ensure that confounding factors are controlled in any analysis.
The objectives of this study were to evaluate and compare the treatment patterns and infusion-related health care resource expenditures for matched RA patient cohorts initiating GLM-IV and IFX therapy identified in real-world health care claims data sets and to assess cost implications from the commercial perspective
This retrospective, observational cohort study used administrative health care claims data from a large geographically distributed US data source to examine the real-world dosing and administration patterns and direct infusion-related health care expenditures for matched patients during the first year after initiating RA treatment with either GLM-IV or IFX.
A de-identified US administrative health care claims database for years 2013–2016 was used for this study (MarketScan® Commercial Claims and Encounters Database and Medicare Supplemental and Coordination of Benefit Database [Truven Health Analytics, Ann Arbor, MI, USA]). The data consist of complete longitudinal records of inpatient services, outpatient services, and prescription drug claims for commercially insured and Medicare-eligible patients covered under a variety of health plans, including dates of service, places of service, and all payments. All database records are de-identified and fully compliant with US patient confidentiality requirements set forth in Sections 164.514 (a)-(b)1ii of the Health Insurance Portability and Accountability Act regarding the determination and documentation of statistically de-identified data; therefore, Institutional Review Board approval to conduct this study was not necessary.
The measurement of study variables was based on inpatient medical, outpatient medical, and outpatient pharmaceutical claims data using ICD, Ninth Revision, Clinical Modification (ICD-9-CM) codes, ICD, Tenth Revision (ICD-10) codes, Current Procedural Terminology® (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes, and US National Drug Codes (NDCs), as appropriate.
Adult patients (at least 18 years of age on the index date) were selected if they had an ICD-CM diagnosis code for RA (ICD-9: 714.xx; ICD-10 diagnosis codes: M05, M06) in the 12 months before or within 30 days following the first medical claim for GLM-IV (HCPCS code J1604) or IFX (HCPCS code J1745) during the study identification period (January 1, 2014 and March 31, 2016). The study index date was defined as the first observed claim for GLM-IV or IFX during the study identification period. No evidence of prior index medication use in the 12 months prior to index was permitted. All patients had continuous medical and pharmacy benefit enrollment for at least 12 months before index (baseline period) and for at least 12 months following the index date (follow-up period). Patients were excluded if they had a diagnosis code for pregnancy observed in the data at any time.
Patient demographic, clinical, and post-index characteristics were assessed for the GLM-IV and IFX index cohorts to assess the need for matching. Demographic variables measured on the index date included age, sex, payer (Commercial or Medicare), health plan type, and geographic region of residence (Northeast, North Central, South, West). Clinical characteristics found in medical claims over the entire 12-month pre-index period included indices for RA severity and comorbidity burden. The claims-based index for RA severity (CIRAS) uses claims data for a medical records-based index of RA severity.15 The Deyo–Charlson Comorbidity Index (DCI) is an aggregate measure of comorbidity based on weighted values for select diagnoses, which was adjusted to eliminate RA from its computation since all patients will have that diagnosis.16 The number of unique diagnoses is based on counts of the unique diagnoses at the 3-digit ICD-9-CM and ICD-10 level, and the number of unique prescription drugs counts the total number of unique NDCs in outpatient prescription claims.17 The presence of specific comorbidities of interest included essential hypertension, disorders of lipid metabolism, respiratory symptoms, diabetes mellitus, depression, osteoporosis, interstitial lung disease, ischemic heart disease, psoriatic arthritis, and psoriasis. Pre-index usage of RA-indicated biologics and non-biologic DMARDs, including methotrexate, corticosteroids, hydroxychloroquine, leflunomide, sulfasalazine, and azathioprine, was summarized from prescription claims.
After assessment of the baseline and follow-up variables, patients in the GLM-IV cohort were matched 1:1 with IFX patients on the following variables: gender, payer type, prior biologic use, index medication treatment duration, and post-index methotrexate use.
Key outcome variables included dosing and administration, treatment patterns, and costs.
Dosing and administration outcomes consisted of the number of infusions, the number of vials per infusion of the index drug, and the infusion interval for induction and maintenance infusions of the index drug. The number of index drug infusions was calculated for outpatient medical claims of the study drug occurring at the physician’s office, in a clinic, or other outpatient facility. Vials of study drug per infusion were computed by dividing the paid amount of the drug claim by the published wholesale acquisition cost (Analysource) for the applicable time period of the paid claim. Infusions were designated as either induction or maintenance according to the administration schedules in each drug’s prescribing information, with the first two GLM-IV infusions and the first three IFX infusions identified as induction doses and all subsequent doses considered maintenance.12 The infusion interval between administrations was calculated as the number of days between claims for a study drug.
Treatment pattern outcomes included index medication persistence (treatment duration and proportion of patients with an index discontinuation), administration billing time and procedures, and concomitant use of methotrexate or corticosteroids during index medication use in the follow-up period. Treatment duration was calculated as the number of days from the index date until the date of the last drug administration claim in the dataset plus a clinical benefit period equal to 56 days. Discontinuation was assessed as the proportion of patients who discontinued index medication over the follow-up period and as the total index treatment duration. Discontinuation was determined by a switch to a non-index biologic or the absence of a claim for the study index medication for at least 168 days (three times the clinical benefit of 56 days) after the last observed claim. Concomitant usage of methotrexate and/or corticosteroids was based on the respective days of supply in outpatient prescription claims on or after the index date through the duration of index drug therapy.
Drug and infusion costs were computed from total paid amounts on adjudicated claims, including health plan payments, patient copayments, deductibles, and coinsurance. Inflation was adjusted to 2,017 US dollars using the Medical Care component of the US Bureau of Labor Statistics Consumer Price Index.18 Infusion-related costs were obtained for claims on the same day as the drug claim with the following CPT codes: first hour 96365, 96413; additional hour 96366, 96415; IV push 96372, 96374, 96375; additional sequential infusion 96367. Average drug and administration costs per IFX infusion or GLM-IV infusion were derived from all observed GLM-IV and IFX infusions provided there was a valid cost value. Claims with $0 cost were excluded. The drug and administration costs of the first year following GLM-IV or IFX initiation were computed in two ways by multiplying the average drug plus administration cost per infusion by a) the expected number of infusions based on the approved dosage and administration in the prescribing information, and b) the weighted number of infusions in a given year from this study’s results. The weighted number of infusions per year was computed from the proportion of maintenance infusion intervals occurring plus the addition of the indicated number of induction intervals.
Bivariate analyses of all dependent and independent variables were summarized descriptively, with categorical variables presented as the count and percentage of patients, and continuous variables providing the number of observations, the mean, SD, and median. Statistical tests of significance for observed differences between treatment groups were conducted using chi-squared tests for categorical variables and t-tests for continuous variables. The threshold of statistical significance for all analyses was set a priori at 0.05. All analyses were conducted using SAS software, version 9.4 (SAS Institute Inc, Cary, NC).
The initial unmatched study samples consisted of 647 GLM-IV and 881 IFX patients (Figure 1, Table). After matching 1:1 for gender, payer type, prior biologic use, index medication treatment duration, and post-index methotrexate use, the final study sample consisted of 547 GLM-IV and 547 IFX patients adequately matched for baseline demographics and clinical characteristics and index medication treatment duration in the follow-up period (Tables 1–4). The matched populations were predominantly female (82%) with mean age 55–56 years (Table 3). Indices of RA severity and comorbidity burden were not statistically different between matched treatment groups (Table 4). Common comorbidities included hypertension, disorders of lipid metabolism, respiratory symptoms, and diabetes (Table 4). Prior to initiating GLM-IV or IFX treatment, over half of the patients had treatment with methotrexate (55.0% of GLM-IV and 60.0% of IFX patients) and 38.2% of all patients had no prior biologic use. Pre-index corticosteroid use was found in 47.7% of GLM-IV and 44.6% of IFX patients (Table 4).
Table 1 Demographic characteristics of patients prior to matching
Abbreviations: GLM-IV, golimumab intravenous; IFX, infliximab.
Table 3 Demographic characteristics of matched patients
Abbreviations: GLM-IV, golimumab intravenous; IFX, infliximab.
Post-index treatment patterns
The mean (SD) post-index follow-up was 609 (161) days for GLM-IV patients and 613 (163) days for IFX patients (Table 3), during which the mean treatment duration was 396 (240) days for GLM-IV and 397 (239) days for IFX therapy (Table 5). Discontinuation occurred for 53.7% of patients in both cohorts at a mean of 241 (165) days for GLM-IV and 244 (171) days for IFX patients.
Post-index concomitant methotrexate use was observed in 51.7% of patients in both GLM-IV and IFX treatment cohorts for approximately one-third of total treatment days. Post-index concomitant corticosteroid use was observed in 38% and 49% of GLM-IV- and IFX-treated patients, respectively, although use was limited, occurring in only 2.2% and 3.9% of GLM and IFX treatment days, respectively (Table 5).
Dosing and administration outcomes
A total of 3,961 GLM-IV and 4,716 IFX infusions were administered during the study period. GLM-IV patients received significantly fewer infusions per patient during follow-up compared with IFX patients. The mean (SD) number of induction plus maintenance infusions per patient observed during follow-up was 7.2 (4.3) for GLM-IV vs 8.6 (5.6) for IFX (P=0.018, Table 5). Likewise, on average, GLM-IV patients in this study required fewer vials per infusion (4.1) than did IFX patients (4.7; Table 5). All GLM-IV and IFX infusions were associated with a claim for at least 1 hour of billed infusion time; however, fewer than 1% of GLM-IV infusions vs 96% of IFX infusions had claims for more than 1 hour of billed infusion time.
The proportion of maintenance infusions administered approximately every 8 weeks (>7 weeks and ≤9 weeks) was 80.2% for GLM-IV vs 38.6% for IFX (P<0.001, Figure 2). The proportion of infusions that occurred more frequently than every 8 weeks was 5.9% for GLM-IV infusions compared to 52.8% for IFX infusions (P<0.001, Table 5). The proportion of infusion intervals exceeding 9 weeks was 13.9% for GLM-IV and 8.6% for IFX with the average infusion interval in this category being 12 weeks.
When weighting of the maintenance infusion interval was applied, the annual number of maintenance infusions was estimated as 5.05 for GLM-IV and 6.48 for IFX infusions and the number of total induction plus maintenance infusions per the first year of therapy was estimated at 7.03 for GLM-IV and 9.48 for IFX.
Total mean drug cost per infusion for commercially insured patients receiving GLM-IV therapy was $5,622 ($3,641) and $5,083 ($4,339) for IFX (Table 6). Mean administration cost per infusion for commercially insured GLM-IV infusions was $224 ($151) and $360 ($281) for IFX infusions.
Table 6 Drug and infusion expenditures
Note: aExcludes claims with zero dollar costs.
Abbreviations: GLM-IV, golimumab intravenous; IFX, infliximab.
Estimation of annual cost of therapy from the commercial perspective
The annual drug plus administration costs for the first year of GLM-IV therapy was estimated based on the recommended dosing in the GLM-IV and IFX prescribing information. Based on a total of seven infusions in the first year (two induction infusions occurring at weeks 0 and 4 and five maintenance infusions occurring at an infusion interval of every 8 weeks) and the commercial cost per infusion (Table 6), the expected GLM-IV drug plus administration cost in the first year was estimated at $40,922 (Figure 3). Based on a total of eight infusions for IFX recommended in the prescribing information (three induction infusions occurring at weeks 0, 2, and 6 and five maintenance infusions occurring at an infusion interval of every 8 weeks), and the commercial cost per infusion (Table 6), the expected IFX drug plus administration cost in the first year was estimated at $43,552 (Figure 3).
Figure 3 First-year costs of GLM-IV and IFX therapy comparing recommended dosing intervals and real-world dosing intervals in commercially insured patients.
Abbreviations: GLM-IV, golimumab intravenous; IFX, infliximab.
When real-world dosing and administration data, weighted maintenance infusion intervals, and commercial costs were used, the first year of GLM-IV therapy (7.03 infusions/year) was estimated at $41,104 while IFX therapy (9.48 infusions/year) was estimated at $51,611 in the first year of therapy (Figure 3).
This study, conducted on a large database population of US self-insured RA patients from diverse practice settings across the USA, found significant differences in treatment patterns between GLM-IV and IFX-treated patients; notably a significantly greater proportion of GLM-IV maintenance infusions were provided every 8 weeks with reduction of billed administration time that resulted in lower annual treatment cost per patient for commercial insurers. Taken together, these findings suggest that GLM-IV provides a more efficient treatment option for infused anti-TNF therapy.
Consideration of efficiency in the delivery of health care is growing in importance. The Institute of Medicine (IOM) has defined high quality of care as consisting of six important domains: safe, effective, timely, efficient, equitable, and patient-centered.19,20 Phase III studies of IFX and GLM-IV have demonstrated the safety and effectiveness, two of the six domains of high-quality health care, of both agents in patients with RA. Head-to-head studies of these agents have not been conducted to differentiate the clinical or safety profiles of these agents in RA patients, although differences in the protein structures of these agents could translate into differences in tolerability among patients treated with fully human vs chimeric murine/human proteins. To address this possibility, a real-world pragmatic trial is underway to assess whether the higher occurrence of infusion reactions for IFX than for GLM noted in Phase III trials is observed in the real-world setting.21
The findings from the present study, however, suggest that under the IOM framework, GLM-IV may achieve higher quality than IFX through impacting domains of timeliness and efficiency. Timeliness, as defined by Agency for Health care Research and Quality (AHRQ), is care that reduces wait times and harmful delays for both those who receive and those who give care.20 In this study, GLM-IV reduced billed infusion time for RA patients significantly compared with IFX. Logically, this reduction in billed administration time should be derived from reduced time in the clinic for patients, and possibly from fewer demands on infusion monitoring by staff. A recent time and motion study showed that nearly three GLM-IV patients could be treated in the same time required for one IFX infusion and that both patients and staff were more satisfied with the shorter in-clinic time associated with GLM-IV.22 Efficiency is defined by AHRQ as care that avoids waste, including waste of equipment, supplies, ideas, and energy. Under this construct, GLM-IV was associated with the expected number of infusions per year and fewer vials per infusion than IFX while nearly half of IFX infusions occurred more frequently than every 8 weeks. Taken together, these differences were estimated to equate to nearly $10,500 per patient per year reduction in commercial payer costs.
The differences in real-world infusion patterns also impact other domains of health care quality, including providing patient-centered care. Fewer number of infusions and shorter infusion times may be important for patients who prefer an infusion but have greater life demands related to work or family. In this study, patients treated with GLM-IV required fewer infusion visits with each visit requiring less time as shown by billing records than that observed for IFX patients. Likewise, a more predictable, shorter infusion may translate into a greater patient capacity for physician offices, which are known to be the least costly sites of care for biologic infusion.14
Finally, this study demonstrated that efficiency and predictable dosing of GLM-IV could translate into cost savings, at least by the commercial payer over IFX. We were unable to assess whether treatment patterns of GLM-IV differed from those of biosimilar IFX because it was not present in the dataset during the time of this study. However, given the assumption that biosimilar IFX would likely demonstrate similar dosing and administration patterns to originator IFX, we were able to confirm that GLM-IV treatment patterns observed in this study would be cost saving over biosimilar IFX under commercial reimbursement scenarios. Further real-world studies will be needed to confirm these findings and further investigate how infused anti-TNF agents perform on various domains of health care quality and cost.
Use of administrative health care claims, which were intended to support reimbursement, may impose limits on the data available for analyzing therapies and their outcomes. Misclassifications or errors affecting covariates and study outcomes resulting from data coding limitations, data entry error, and missing or inaccurate codes are possible when relying on administrative claims. Medication dosing and treatment patterns were based on data from medical and prescription claims in the absence of patient charts or physician attestations. It was, therefore, not possible to ascertain reasons for deviations from recommended dosing or confirm how patients actually took or reacted to their medications. Patients’ medical and prescription history was limited to health care claims during the reporting years in this study, such that patients’ other comorbidities, pharmacotherapy, or sociodemographic factors affecting the outcomes were unavailable. In addition, disease severity is not directly reported in claims data and must be inferred from claims-based scores, such as CIRAS and DCI along with prior use of biologics and post-index use of methotrexate. This analysis focused on RA patient populations found in MarketScan commercial and Medicare databases that are representative of US payers and reimbursed paid costs in the time frame studied. Findings should not be interpreted outside of RA-labeled indications and may not be generalizable to other US or international patient populations or reflective of current treatment cost dynamics.
Patients treated with GLM-IV therapy had more consistent dosing patterns than IFX-treated patients; this resulted in significantly lower drug plus administration costs for commercially insured RA patients than IFX in the first year of care. These findings have important implications for population health decision makers in understanding health care quality, variations in health care utilization, or cost-saving measures.
Editorial/medical writing support for this manuscript was provided by Jay Margolis, PharmD (IBM Watson Health).
Lorie A Ellis, Maureen Kubacki, and Shelly Kafka are employees of Janssen Scientific Affairs. Raphael J DeHoratius was an employee at Janssen Scientific Affairs at the time this work was conducted, however, has since retired. Elisabetta Malangone-Monaco, Helen Varker, and Diana Stetsovsky are employees of IBM Watson Health, which received compensation from Janssen Scientific Affairs for the overall conduct of the study and preparation of the manuscript. This study was sponsored by Janssen Scientific Affairs, LLC, Horsham, PA, USA. The authors report no other conflicts of interest in this work.
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Henry Holland scored a massive win with his House of Holland show this weekend with a fabulously starry collection of young fashionistas. From the left we have co-presenter of E!'s Fashion Police Kelly Osbourne, Pixie Geldof, model and style icon Alexa Chung, supermodel Poppy Delevingne, DJ Leigh Lezark, and Henry's fellow Styled To Rock mentor Nicola Roberts.
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Is Writing a Book Right for You?
A year or so ago, when podcasting was just starting to get big, I set about finding out what it would take to start my own podcast.
It was THE thing to do at the time and it looked like a great marketing strategy – everybody loves podcasts! (Don’t they?)
I imagined it would be relatively easy to do (it’s just recording audio, right?) and wouldn’t take up too much of my time. Also, I’d done a bit of radio when I was at the BBC and loved it, so I thought having a podcast would be fab.
How to Find the Right Idea for Your Book
How do you decide what to write about in your book? If you have some ideas already, how do you know if any of them are any good? Choosing a book idea can lead to a lot of soul-searching and procrastination. This can really keep you stuck. But remember, there’s no such thing as a perfect idea, it develops as you work on it. So, begin with the mindset of an explorer and you’re far more likely to hit upon the perfect idea.
What if you haven’t got any ideas?
Starting a book can be hard, especial…


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Fill your pot up with water
Place on stove and turn on high to boil the water
Get your eggs, cling wrap and cup
Place the wrap in the cup.
Crack the egg into the wrap
Place cracked egg and yoke inside the wrap
Fold all corners up and remove from cup
Fold any flaps in, and then twist to create a water tight seal
If you like, put 2 eggs in to save the wrap.
Allow to boil for 4 - 6 minutes depending on how you like your eggs, the size of eggs, or quantity inside the wrap
Pull out of boiling water using, tongs, spoon or hands if your are daring. It will be hot.
Test the egg by squeezing it lightly, to see if it's ready. Should feel slightly firm
Dry the wrap so no water is on it.
Unwrap the egg carefully. If you think your eggs are not cooked enough. Then place back in boiling water. If your wrap is not sticking together wrap some more wrap around so it's water tight.
Unwrapped. Egg. If its hard to get the egg out, next time pre grease the inside of the wrap. Or cook eggs for longer
The perfect runny gooey egg. If you don't like as runny, cook for longer. This egg took 4 minutes to cook.
For fitness tips, more food ideas you can follow me on twitter at @HighDegreeFit

domain: food


KUALA LUMPUR, Feb 24 ― Voting PKR and PAS will divide the Muslim community and destroy their aqidah (faith), Barisan Nasional (BN) chairman and Prime Minister Datuk Seri Najib Razak has said, in a warning to Malay voters against supporting the opposition in Election 2013.
Najib (picture) also added that supporting DAP would see “Islam oppressed” if the Chinese-dominated component of Pakatan Rakyat (PR) were to be voted into power, according to Sunday Star.
“A vote for PKR will destroy the aqidah (faith) while a vote for PAS will only result in disunity among Muslims,” the Umno president was quoted as saying at the launch of his administration’s “Jelajah Janji Ditepati (Promises Fulfilled Tour)” in Terengganu yesterday.
“As for DAP, a vote for them will see Islam being oppressed”.
The BN chairman’s statement comes amid rising tension between the country’s majority Muslims and minority Christians over the tussle on “Allah”, an Arabic word for god that Muslims insist was exclusive to them.
Malaysian Christians, however, said it was their right to use the term to describe their god, especially for those in Sabah and Sarawak where “Allah” has been used in religious texts and sermons purportedly for centuries.
The term is also used by the Sikhs in their religious scriptures.
The “Allah” storm was reignited recently when DAP secretary-general Lim Guan Eng urged Putrajaya in a Christmas message to lift its ban on the word published in Malay-language bibles shipped to East Malaysia, where the bulk of Malaysia’s 9.2 per cent Christian population reside.
This led to the Sultan of Selangor issuing a blanket ban against non-Muslims using “Allah” in the state, a move that sparked legal confusion in light of the December 2009 High Court ruling that the term was not restricted to Muslims and the Catholic Church had the constitutional right to publish the word in the Malay section of its weekly newspaper, The Herald.
PR also differed with the Selangor Sultan’s decree, insisting that Islam does not prohibit others from using the word.
Explaining the federal opposition’s position, PAS president Datuk Seri Abdul Hadi Awang told a joint press conference with PR leaders that Christians and other non-Muslim communities should not abuse the word to spread confusion among Muslims but this did not mean they were not allowed to use the word.
The Islamist party, however, was seen backtracking on its position when some members from the party’s highest decision-making body, the Syura Council, said “Allah” can be used orally but not translated in religious texts.
The move drew criticism from DAP chairman Karpal Singh who felt PAS was politicking on the issue to placate its conservative powerbase.
Najib saw this as PAS’s failure to defend Islam, according to a report in New Sunday Times today.
“When DAP belittled Islam, made statements that offended Muslims, what did PAS do? They did nothing and bowed down to DAP leaders,” the English language newspaper quoted the prime minister as saying.
The BN chairman added that voters were beginning to reject the Islamist party as “mengarut (nonsense)”, saying that Muslim voters now look to Barisan Nasional as the only safeguard to the sanctity of Islam.
However, observers noted the Najib administration was unresponsive to calls for intervention by minority groups who felt a concrete policy on the issue could have easily contained the tension and end the controversy.
Najib’s statement also came after he made a rare Vatican visit in mid-2012, in what appeared to be an attempt to repair frayed Muslim-Christian ties.
Political analysts pointed out that communal politicking had escalated in recent months in the run up to Election 2013, which must be held by June.


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They Only Eat Their Husbands
The Last Frontier
Thirty-one Years Old
The day after Scott left, Chance called. My heart started beating with the same silly eagerness as a puppy's tail thumping the floor. He invited me for a hike up Flattop, a popular mountain just half an hour outside town. Without asking why he hadn't called in two weeks, without stopping to think about his last words to me, I leapt at the chance to see him again.
Flattop was always the handiest place to remind myself that, although I lived in a city, I still lived in Alaska. It only took forty-five minutes to hike to the top of the 3500-foot mountain, and it was a relatively easy trail for anyone in decent shape. Yet it was also an easy place to achieve a sense of accomplishment, with steep rises and a hand-over-foot scrabble up craggy rock, leading to an incredible view. The top looked as if someone had chopped the peak off with a cleaver, giving Flattop its name. The flat surface seemed to confuse the ever-shifting, swirling air, leaving the top invariably cold and windy.
Just in case the winds might be in his favor, Chance packed his paraglider on his back. But as we rose above the twisted hemlock of the lower slopes, the wind was already whipping us. So he hid his paraglider in some bushes on Blueberry Hill, to retrieve on our way down. Now that he was empty-handed, he offered to carry my daypack. "I'm okay for now," I said. "But I may take you up on that later."
A short way up the trail, he said his throat was sore. "I put some cough drops in the top of your pack, can I grab them?" I waited as he stepped behind me and unzipped my pack to rummage around for a lozenge. Later, when we reached the steepest section of the hike, I said, "Okay, I'll take you up on that offer—you can take my pack now." His face twitched in a mischievous grin as he took my pack, put it on the ground, and unzipped it. "Okay. But first...I won't be needing this anymore." He reached into the pack, pulled out a huge rock, and tossed it to the ground, where it landed with a thud. It weighed at least five pounds. Then he innocently tossed the pack onto his shoulders. Chance had never needed that cough drop. I stared at the rock, slack-jawed, then pummeled him. As we stood there giggling, I realized I was in love with him. That damned rock seemed to seal it.
A short time later, when we pulled ourselves over the final crag and onto the abbreviated peak, the wind nearly knocked us over.
"Isn't this great!" Chance shouted over the shrieking air. "I love extreme weather."
"Yeah, it's great, but my ears are freezing!"
We ran for cover behind a cairn, where Chance huddled behind me, cupped his hands over my ears and blew on them. His breath felt hot, in exciting contrast to the cold. When we felt warm enough to stand, we took in the 360-degree view: graceful saddles led in several directions to the severe alpine beauty of the Chugach Mountains, while below us Alaska's largest city looked like a toy model and Cook Inlet gleamed in the sun. No one else was on the mountain and we ran around like children, giddy with the freedom of having this windswept view to ourselves.
When we were too cold to stand it anymore, we scurried down the mountain and back to his place. We curled up together on his futon while Chance talked, his soothing voice buzzing in my ear. I relaxed into a feeling of warm contentment and, in characteristic fashion, spoke my thoughts aloud without stopping to consider them: "Chance, from now on I don't want to be with anyone but you."
The comment came from my desire to completely attach myself to Chance. Yet that comment severed me from him in a way I didn't expect, because this guy who'd told me he was lousy at commitment had assumed I'd already made one. His body stiffened with anger.
"What do you mean? Have you been with someone else? Did you see your old boyfriend again?"
"Well, yes. You stopped calling and I thought I wasn't going to hear from you again. So I thought I'd give him another chance. But that's my point: when I saw him, I realized I didn't want to be with him, I wanted to be with you. So I told him it was over."
He sat up and pushed me away. "When exactly did you tell him this?"
There was no getting out of this situation. I have a profound aversion to lying, based less on merit than on ingrained defensiveness over being wrongly and regularly accused of lying as a child. I could refrain from speaking, but he would know the answer by my silence.
As my mind raced for a reply, he repeated, "When was the last time you saw him?"
"Did you sleep with him?"
I sat in embarrassed silence.
"Damn it!" He jumped off the couch as if I'd burned him. "You have no idea what a turn-off that is for me. So you broke up with him, but you sent him away with a big smile on his face, didn't you? And I was starting to think I'd met someone who was so different. I thought this was special."
I'd thought so, too, and I could feel it irretrievably slipping away. I babbled, "Don't you see? I tried to give my old boyfriend a second chance, but it didn't work because I realized I was falling for you."
"Then how could you do that with him?"
"I'm sorry. I just want you to know . . . I really did have a wonderful time today. And . . . I'm so sorry. Goodbye." I started to leave.
"So now I don't even get a hug?"
Puzzled, I turned back and gave him a hug. He held me tightly. I felt confused by his mixed signals. I remembered him telling me he wasn't good at commitment. What had he expected? Then again, what had I expected? I pulled away and left.
© Cara Lopez Lee
Return to the They Only Eat Their Husbands page

domain: literature


Microsoft has confirmed that they will be allowing Plex Client development for the Xbox One. The makers of Plex are given a membership of the ID@Xbox, so that they can develop and release the software for the Xbox One as soon as possible.
In case some people are unfamiliar with Plex, must know that it is a software that will help you in organizing all your personal media, which will become accessible on your mobile phones, tablets and laptops anywhere you want.
Plex also provides access to number of streaming channels such as Vimeo, YouTube, CNN and TED talks etc. It also provides integrated cloud services that include Google Drive, Copy & Bitcasa, Box and Dropbox.
The developers have not given the exact release date but have assured the fans that they will start working on the project right now and make it available for the Xbox One very soon.
In their Xbox One reveal show, Microsoft promised that they will make their next-gen console a single device for all the entertainment. With Plex and other important softwares coming to the console in the upcoming updates, Microsoft looks right on track on keeping their word.
Plex is currently available for Microsoft Windows, Mac OS X, iOS, Android, Linux and Windows Phone and soon will be available to you at the Xbox One.
What is Plex Media Center


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The Stanford Prison Experiment [Celluloid Hero]
I've been fascinated with the Stanford Prison Experiment since the first time I heard about it. For a quick summation, in 1971 a psychology professor at Stanford University took 18 students and split them into two groups, 9 prisoners and 9 guards. He built a replica jail in the basement of one of the academic buildings during summer break, and let the students act out in order to observe the effects of prison life. What was meant to be a two-week study was terminated after six days due to brutal conditions forced upon the prisoners by the guards.
I've read and re-read the true accounts of the Experiment many times. Every time, I'm shaken at how quickly the situation devolved into madness. Half of me is shocked that the 'guards' would turn so sadistic, but the other half of me always thinks "well, what did you expect when one group is given total authority over another?" I have a pessimistic view of humanity in general. It might be a "me problem", but I just feel like a majority of people would take advantage of a situation if they were presented with one. When these students were told they would be guards, told they would be the absolute authority, told to dehumanize the prisoners, it should have been no surprise that they took it to an extreme.
The movie was a pretty good depiction of what went on. Obviously it fell short of an actual documentary, but I've seen some of the study footage and the similarities are definitely there. When watching any movie "based on a true story" you expect embellishment and dramatic license, but when you're basing a movie on a scientific study, you expect a bit more realism. The behind-the-scenes parts that were shown weren't part of the experiment, so they have to be taken as hear-say and memory, but even if they were mostly fabricated they did a nice job of tying the prison scenes together. It's close enough to a documentary that I kept rooting for a prisoner riot, hoping to see one of the guards take a kick to the gut.
Billy Crudup is great at playing a guy who seems nice but also has a smug punchable face. He made a nice turn from the "I'm smart, you just don't understand what I'm trying to do here" to a somewhat sinister authority, to the realization that he had lost all control and needed to shut things down. The rest of the cast is mostly unknowns, along with a few recognizable faces. The anonymity of the cast is a solid choice, as it helps to keep things feeling more real. Using lesser-known actors leant itself to being able to identify with the characters.
The events of the Experiment were so shocking, you can almost forget it really happened and just fall into the narrative of a fictional movie. Things go so crazy you almost feel it had to come from the mind of a screenwriter. It's an intense look into human psychology, the idea that "power corrupts and absolute power corrupts absolutely."
On the [Celluloid Hero] scale, "The Stanford Prison Experiment" gets an 8 out of 10.

domain: psychology


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It’s time to think outside of the pot and get creative on your front porch! See how to create a trash can planter that will be the talk of the neighborhood!
What do wine, plants, vintage and thrifted finds have in common? They’re all things you’ll find on my spruced up my front porch! I got creative with a trash can, an old basket as a wreath plus I have a great tip for adding real plants and flowers to your planters that takes only seconds!
This doormat has my name written all over it so if you plan to drop by, make sure you’ve got wine (or vodka or tequila … I’m not picky)! Speaking of wine, don’t miss my favorite sangria recipe here.
This post contains affiliate links which means if you make a purchase, I may earn a small commission at no extra cost to you.
Curb appeal matters and plants make a great first impression on any front porch.
Can you believe these black and white striped planters at my entrance are actually plastic waste cans?! Not your normal dinky waste cans either. These are larger than normal (5 gallons) which makes them perfect to be repurposed into outdoor planters.
I actually found one at the thrift store and immediately knew its days of holding trash were over. As luck would have it, I found another one at the same thrift store a few days later. Luckily, I found them for you and the best part is they cost less than $6 each!
Click Here for Black & White Striped Waste Cans
If you don’t love the stripes, click here for the same waste can in other colors and patterns.
I have a planting secret! I bought these hanging baskets filled with geraniums and trailing vines (also known as “the spiller”), removed the hanging hook, then just plopped them into the planters!
If you look at the top of the planters, you can see the coco liner from the hanging basket peeking out. I added a heavy rock on the bottom of the pot to weigh them down.
If you plan to put dirt and plants directly into your waste can, make sure to drill a few holes in the bottom for drainage.
My vintage Adirondack basket makes the cutest front door wreath with an easy care pothos plant cascading down the front.
I love the graphic black and white stripe on these garbage cans turned decorative planters and am so happy I found them while thrifting.
What is a good plant for the front porch?
Covered porches offer some shade and ferns in hanging baskets are an easy care solution. A trailing pothos plant spilling out of an old basket is another shade loving plant.
Most annual geraniums need full sun and these pretty pink flowers and the perfect pop of color to the black and white pots.
These plants will last well into late summer and even into fall. I treat the ferns as annuals and toss them when they get crispy and turn brown.
Want more creative planter ideas …
Love to garden? …

domain: hobby


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Have you ever wondered why we give Easter baskets? The holiday just wouldn’t be the same without them! Parents have been giving their children baskets in the spring for centuries. How did they become linked to Easter?
If you’re looking for something different to serve your guests this Easter, you might want to give popcorn a second look. Popcorn is a lot more versatile than people think and gourmet popcorn is even better! Sure, you can pop some popcorn and let your guests munch on it as they wait for Easter dinner,… Read More >
When you’re putting together an Easter basket for an adult, keep these helpful basket components in mind as they’re sure to be a hit! Kids aren’t the only ones who love Easter baskets! Adults do, too.
Today is National Pumpkin Day and what better way to celebrate than making a delicious Pumpkin dessert (or purchase our pumpkin cake, pumpkin pie or pumpkin cheesecake)! This pumpkin mousse recipe offers a simple way to eat this delicious seasonal food. This mousse is light and fluffy and tastes great with gingersnaps! If you don’t want to… Read More >
Do you love bacon, lettuce, and tomato? Most people do, which is why the classic BLT is such a popular sandwich. Strips of bacon, slices of tomato, and lettuce are jammed into mayonnaise-smeared rolls to make this classic sandwich. However, there are also a ton of delicious variations you can try! Here are… Read More >
Apparently 770,000,000 cupcakes were eaten in the US in 2012. That same year, Sprinkles Bakery, the world’s first cupcake-only bakery from Beverly Hills, developed a hole in a wall ATM that dispenses cupcakes 24 hours a day. It holds up to 600 fresh cupcakes at a time! Cupcakes have swept the culinary world in the… Read More >
Are you looking for a way to jazz up your next cup of tea? These fruit infused tea recipes will hit the spot! The general idea is to steep pieces of aromatic fruit with your regular tea. From there, you can either drink it hot or pour it over ice for a delicious… Read More >
Father’s Day is almost here! Are you looking for the perfect way to make your dad feel special? If your dad loves popcorn, these Father’s Day gifts will be a definite hit! The nice thing about popcorn is that there’s a flavor to satisfy every palate. It’s also a great gift if your dad… Read More >


Intel has wheeled out an asset management system along with flight planning software at a US drone conference.
Chipzilla, fresh from its drone light show at the Olympics, is keen to punt its line of Falcon 8 drones to industry, mounting a small but growing threat to the market dominance of Chinese manufacturer DJI.
At Xponential, the American Association for Unmanned Vehicle Systems' (AUVSI) annual shindig taking place in Colorado, US, Intel declared it had updated its still-in-beta flight planning software suite, Mission Control.
The suite is "designed to increase workflow efficiency and enhance automation of drone flights for commercial missions" including 2D and 3D visualisations of drone flight routes.
"Multiple layers of airspace information are integrated to support flight safety and compliance. Automatic pre-flight safety and system checks help validate the flight plan before the mission is executed," Intel told us, which, if true, puts the system on a level, albeit user-centred rather than air traffic control-centric, with Britain's own Altitude Angel.
The firm's Falcon 8 drones can also be fitted with 42MP Sony RX1R II cameras, which Intel described as its "High Resolution Imaging Payload". The octocopters' onboard software is also said to be capable of collision avoidance, which is increasingly becoming an essential feature of commercial-grade drones.
While the Olympics light shows were undoubtedly eye-catching, Intel has not yet made any notable breakthroughs in terms of market share or penetration, at least on this side of the Atlantic. One to watch though. ®


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Very experienced and charismatic teachers of Jive, Lindyhop, Balboa and Shag
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Also have Film credits to their name
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text:
What do you consider of to be a typical Vegas slot participant?
The odds are, unless you’ve been to Vegas recently, the image you have in your own personal mind, may be the one which is trapped in moment.
slot online terpercaya , if an individual had wandered right into a Vegas on line casino then you may well have observed a floor jam-packed with serious slot machine game participants. A mix of folks through many different qualification, but all of them sitting motionless, transfixed by way of the fishing reels in hope of reaching a big jackpot.
Once again in days past, gambling seriously was just about the particular gambling. The main explanation to play was to consider to get rich very simple, instead of being a new interesting and enjoyable pass-time. Back again then, the thought regarding a good slot machine like being a prime cause of entertainment was, to get honest, laughable
However, items have changed.
The new generation of online players happen to be different. They are applied to moving into a earth that stimulates the particular smells on every turn. Video lessons, computer system graphics, vivid soundtracks and cartoon-style leisure are among the things that a good typical slot person would like to see.
However, of which doesn’t mean the port floor is actually the distinctive domain associated with young gamers. Indeed, not even close to it. Several of the more ‘experienced’ folk have also used on the electronic lifestyle and even appreciate all of typically the ‘Bells and Whistles’ the fact that come with.
So precisely what has changed?
Very well, when you visit a on line casino currently, the first matter that may hit an individual is the intensity plus the atmosphere created by the particular high-tech images and looks on the slot ground. Games now feature arcade-style design, videos, active bonus units and a full variety of various other formerly amazing features
Try Lucky Larry’s Lobstermania and sign up for in this entertaining and games since he or she fishes for the fantastically delicious crustaceans. Go on the oil discovery trail with Texas Ted, in often the ever-popular Texas Teas slot machine game. Have fun slots based about popular board games, like Monopoly or Cluedo, or match show themed slots like Wheel involving Fortune or maybe Jeopardy. The choice and range of Vegas video slot machines appears almost endless.
Probably the most amazing thing to find out is that people are usually playing to get real interesting. Yes, an individual did study that right – they will are playing for entertainment! You will see people having a laugh and joking with each and every other as they play the slot bonus attribute rounds. Some will even be singing along to be able to the style tunes!
Having been entertained from the pai gow poker, some sort of modern gamer could very well leave a actively playing period acquiring spent $50 or maybe so feeling completely contented they own had some interesting, been amused and inside no way feeling downbeat and dejected in having ‘lost’ on the slots. This is the big difference. Online players are now looking for price in the form of leisure.
That value idea is not exceptional to the Vegas Casino gambler, nevertheless, it has also strike the online position world.
The top example of this new focus on benefit would be the popularity of online slot machine tournaments. Online slot competitions allow slot players to help compete against real men and women, rather than against the online casino. This means there isn’t any ‘house edge’. Plus, there is certainly some sort of social aspect into the event play that is brand-new and adds to typically the enjoyment.
So , where is the value throughout enjoying a slot competition?
Most certainly, for a new begin, just about every player starting the tournament has the same probability of winning one of the particular top gifts that anyone else has. You are free to perform longer, for less dollars, yet still have the particular chance to earn large. Many casinos at this point possibly have free online port tournaments, so you can win big income with out having to wager anything at all. In point, if anyone know where you can look, anyone will find regular position tourneys out there that have $100, 000 throughout prize income pools together with a good top prizes of $50, 500!
Just like the way that holdem poker events revolutionised online poker participate in, slot tournaments currently have the potential to become the number one way involving getting the fact that type involving value from on-line slots”
So, whether you usually are traveling to Vegas or taking a break up from your own daily activities to enjoy online, remember that the aim should be to help have a great time, know your restricts together with treat the idea like an entertainment.

domain: entertainment


text: Bursting the Bubble Tulips were the first, but they won’t be the last. What forms a “bubble” and what causes them to burst? Share | Have A Question About This Topic? Name Email Address Message Thank you! Oops! Related Content The Real Cost of a Vacation Home What if instead of buying that vacation home, you invested the money? Pullbacks, Corrections, and Bear Markets Clearing up confusion from the economic downturn following COVID-19 and how it might affect your financial strategy. What Is the Dividend Yield? This calculator helps determine your pre-tax and after-tax dividend yield on a particular stock.

domain: finance


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Anywhere, preferably in the metrowest area, where I could buy chestnut flour? It's for pasta, not a cake, so I can't use the cake mix that Whole Foods sells. Thank you!
I know they have it at Dairy Fresh in the North End, but that sounds out of your way. Try the little health-food place in West Concord?
thanks--it's a haul out there, but if the turnover's good there it would be a nice excuse to eat out in the North End...
Not sure, but you could check Russo's. Otherwise, I think Christina's spice shop in Inman Square has it.
Definitely have it in Chinatown (try 88), but I don't know how easy it will be to identify it as Chestnut flour if you don't read Chinese.
Whole Foods should have just plain chestnut flour - ours in Swampscott does.
Whole Foods in Bedford has regular plain chestnut flour.
Thanks, all--haven't checked in here in a while. Yes, last time I was at WF in Framingham I saw that they, too, have some.
20th Century Cafe's Russian Honey Cake, in Animated GIFs!
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text:
Nepali Malpuwa Recipe
Malpuas with Shahi Rabadi recipe | Malpuas with Shahi Rabri | by Tarla Dalal | Tarladalal.com | #5011
Rabri Malpuva - veganize it!
Mawa Malpua is a traditional Indian sweet from Rajasthan. It is basically a fried pancake dunked in sugar syrup. Serve it with rabdi or just as is, and it tastes absolutely delicious. #whiskaffair #mawamalpua #IndianDessert #IndianSweet
Find step by step Instant malpua recipe with rabri prepared under 30 minutes. No sugar syrup is required. Less calories and less time consuming malpuarecipe
Delicate and lacy malpuas made with fresh paneer.
Malpua (Indian Pancake Dessert) | Manjula's Kitchen | Indian Vegetarian Recipes
MAWA MALPUA - KNOWLEDGE MORE
'Malpua' ~ Indian Pancake Drenched in Sugar Syrup


A Tasmanian economist has argued a decrease in rental prices due to a land tax slash is a "myth propagated by the property industry".
Tax relief is hoped to ease the cost of living for owners of rental properties, shacks, vacant land and commercial property.
But there are concerns Tasmanians are still paying double in comparison to mainland counterparts for the same property value.
The Tasmanian government has revealed plans to double the tax-free threshold for land tax to $100,000, less than a year after initially doubling it to $50,000
The upper threshold for land tax will also be raised to $500,000.
The state government says the latest changes will mean 70,000 Tasmanians save an average of $800 each year.
While Premier Peter Gutwein said he would not speculate on future reductions to land tax, he believed "we've broadly landed in the right level for the Tasmanian context".
"There will be around 12,000 Tasmanians now in total, as a result of the changes that we made last year, and the changes that we're making now, that will no longer pay land tax," he said.
"Many of them are not what you would consider to be property moguls.
"This is a sensible way of ensuring that we can put downward pressure on rents, and ensure that we maintain an attractive proposition for investment."
What is land tax?
Land tax is an annual tax payable by the owner of land that is not the owner's primary home and is calculated on the assessed land value shown on land tax assessment notices.
The Office of the Valuer-General determines assessed land value annually on July 1.
Properties that are taxable include vacant land, commercial properties, rental properties and shacks.
It is not payable on a property which is the owner's principal place of residence or if the land is classified as primary production land.
Are the changes enough?
The Tasmanian Residential Rental Property Owners Association's Louise Elliot said the state government's planned changes to land tax do not go far enough.
"It's still really quite underwhelming given our threshold is $100,000 where elsewhere around Australia you won't start paying land tax until at least $250,000 and in some cases up to $500,000 or higher," she said.
"What we've seen here are some small changes and desperately needed changes, but Tasmanians will still pay around double what our mainland counterparts will for the same property value, and before that was triple."
Independent Tasmanian economist Saul Eslake said Tasmania's top land tax rate is "by no means the highest in the country".
"Tasmanians with comparatively modest land holdings, which are not exempt because they're not the principle place of residence, tend to be subject to higher amounts of tax than people holding similarly valued land in other parts of the country," he said.
"And that reflects the fact that historically land values in Tasmania have been much lower than in other parts of the country.
"But now that the average land value in Hobart is higher than in Brisbane, Adelaide or Perth, for example, and not that far short of Melbourne, that comparison no longer applies."
Will it have an impact on renters?
Ms Elliot, who represents landlords, said a cut to land tax could be beneficial to rental tenants.
"It can help because human nature goes to show that when you open a land tax bill that is dramatically higher, like double or triple what you have been paying in the past, that's a shock to the system," she said.
"That makes owners much more inclined to say yes to increasing the rent on the property.
"It will prevent a lot of people's rent from going up, which it would have done in the next few months.
"But excessively high land tax that's completely out of the ballpark of the national picture, it's another barrier to new homes in Tasmania, it's another deterrent to rental ownership, and it's more pressure on rental prices."
However, Mr Eslake does not expect reductions in land tax to be passed on in the form of lower rents.
"It's a myth propagated by the property industry, that land taxes affect rents, they don't," he said.
"Rents are determined by the interaction of demand and supply in the land market, in the rental housing market.
"I'd be very surprised if many landlords, having received a lower land tax bill, decide to reduce the rents they charge their tenants."


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In the morning Dusha is a perfect place to enjoy you healthy sumptuous breakfast, later the place evolves into atmospheric trattoria-restaurant to have a delicious lunch or dinner with evening transforming the space into a cozy bar with subtle lights, relaxing music tunes and exceptionally well mixed cocktails.
Read: Places to Enjoy a Glass of Wine in Kyiv
The interior design of the place is an interesting take on boho chic mixed with authentic Renaissance Italian interiors. Here guests will see intriguing wall frescos imitating Sandro Botticelli «Spring» and «The Birth of Aphrodite» art pieces. The Italian renaissance details collide with ultra-modern furniture and the rest of the interior items offering a complex fusion of styles and textures. Despite all the contrast layering the place makes a perfect setting for dining and enjoying cocktails.
The food at Dusha is simple yet delicious and it represents European cuisine. The Chef offers an interesting Italian touch to all the dishes. Many visitors will be pleasantly surprised with the special food combinations and popular dish interpretations. Breakfasts are served from 8 AM till noon and Saturday and Sunday are all-day-breakfast days.
The bar offers 12 signature cocktails specially created and mixed for Dusha by Kyiv expert mixologist. Dusha also boasts the collection of fine rums. Barmen will eagerly tell you all about drinks they mix and serve will help to make the right choice when ordering a drink.
Read:Best Desserts in Kyiv
Address: 39, Lva Tolstoho street, Kyiv.
Photo source: Dusha Facebook Page. All photos belong to their rightful owners.


Estimated $2.4M Sub-contract Expected to Improve ITS Maintenance Statewide
- Iteris, as part of the Digital Traffic Systems, Inc. team, will deploy an enhanced ITS Asset Management System to improve statewide ITS maintenance
- Iteris was selected following its successful deployment of ITS asset management system in Virginia
SANTA ANA, Calif. – June 16, 2020 – Iteris, Inc. (NASDAQ: ITI), the global leader in smart mobility infrastructure management, today announced that it is one of the core members of the Digital Traffic Systems, Inc. (DTS) team that has been awarded an indefinite delivery/indefinite quantity (IDIQ) contract for statewide intelligent transportation system (ITS) maintenance by the Georgia Department of Transportation (GDOT).
Under the terms of the five-year sub-contract, Iteris will implement a portion of the ITS Asset Management System (IAMS) for the GDOT project, with an estimated budget of approximately $2.4 million over the next five years.
GDOT will be able to utilize a suite of workflow improvement tools designed to reduce initial and ongoing costs to the program, including: a data collection and validation tool, an expedited service portal and an IAMS feedback tool.
Iteris’ deployment of the software solution to support the ITS Maintenance Program follows the prior successful delivery of the Iteris asset management services, part of the ClearMobility™ Platform, for city and state agencies nationwide.
“Having successfully deployed a SaaS-based asset management system in Virginia, Iteris is thrilled to be a core member of the DTS team that will deliver improved functionality and flexibility for ITS maintenance throughout Georgia,” said Moe Zarean, vice president and assistant general manager at Iteris. “We are committed to continuing to deliver the highest level of service to our state and county partners and look forward to providing full user training and support to the GDOT project for the term of the contract.”
Iteris and DTS have created an expedited service portal application that allows network operations center (NOC) and traffic management center (TMC) personnel to quickly detect and report field device outages while ensuring they are not issuing multiple service requests for the same device. Using drop-down menus and quick-view device status information from the network monitoring system, NOC and TMC staff can report down devices in as few as three mouse clicks.
Work on the new IAMS and NOC support, as well as the initial inventory of field assets, will commence immediately.
The ClearMobility Platform is the most complete solution for continuously monitoring, visualizing and optimizing mobility infrastructure around the world to help ensure that roads are safe, travel is efficient, and communities thrive. The ClearMobility Platform applies cloud computing, artificial intelligence, advanced sensors, advisory services and managed services to achieve safe, efficient and sustainable mobility.
About Iteris, Inc.
Iteris is the global leader in smart mobility infrastructure management – the foundation for a new era of mobility. We apply cloud computing, artificial intelligence, advanced sensors, advisory services and managed services to achieve safe, efficient and sustainable mobility. Our end-to-end solutions monitor, visualize and optimize mobility infrastructure around the world to help ensure that roads are safe, travel is efficient, and communities thrive. Visit www.iteris.com for more information and join the conversation on Twitter, LinkedIn and Facebook.
Iteris Forward-Looking Statements
This release may contain forward-looking statements, which speak only as of the date hereof and are based upon our current expectations and the information available to us at this time. Words such as "believes," "anticipates," “feels,” “anticipates,” "expects," "intends," "plans," "seeks," "estimates," "may," “should,” "will," "can," and variations of these words or similar expressions are intended to identify forward-looking statements. These statements include, but are not limited to, statements about the success, impact, and benefits of the awarded contract. Such statements are not guarantees of future performance and are subject to certain risks, uncertainties, and assumptions that are difficult to predict, and actual results could differ materially and adversely from those expressed in any forward-looking statements as a result of various factors.
Important factors that may cause such a difference include, but are not limited to, our ability to successfully perform each project and contract on a cost-effective basis; government funding and budgetary delays, constraints and issues; adverse impacts related to performance timing and cancellation of an awarded contract; and adverse impacts of general economic, political, and other conditions in the markets we address. Further information on Iteris, Inc., including additional risk factors that may affect our forward-looking statements, is contained in our Annual Report on Form 10-K, our Quarterly Reports on Form 10-Q, our Current Reports on Form 8-K, and our other SEC filings that are available through the SEC’s website (www.sec.gov).
Tel: (949) 270-9523
MKR Investor Relations, Inc.
Tel: (323) 468-2300


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Ensure you don’t overlook this captivating novel titled, CEO Leo’s Baby Mama Is Back by Ebunoluwa Ademide.
CEO Leo’s Baby Mama Is Back Novel Summary.
CEO LEO’S BABY MAMA IS BACK! (Mommy, please forgive daddy) “Why would I accept the claim of a child that I am sure you don’t even know who the father is.
That child ain’t mine.” ~ Darby Miller, labeled a jinx and not loved by her parents. She tried to find love in the arms of any one who cared to see her pain.
Until a truth and dare game resulted into a night of passion and that changed her life forever. After ending up pregnant and left on her own,
Darby Miller swore to never have anything to do with Leo Robin ever again. He denied their child which means he has lost every right as a father. Years later, she became a charming single mother as well as a successful business woman.
Unexpectedly, he is back into her life again. And this time, Leo would do everything to prove that he deserves her forgiveness.
Will he be able to untangle the misunderstanding from years ago? Does he stand a chance to prove with actions that he can be a loyal husband and a loving dad?
Read CEO Leo’s Baby Mama Is Back Free Online Novel.
To read this lovely novel, CEO Leo’s Baby Mama Is Back, by Ebunoluwa Ademide click on the link below!


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Bookmark and share the address of UKRAINE ENGLISH NEWS on your social bookmarking website
Most users ever online was 229 on Sat Aug 08, 2015 11:03 pm
Local police reported that shortly before the shooting took place in a cemetery burial ceremony.
Currently, the cemetery there are a large number of police. The whole area is cordoned off and interviewed witnesses of the incident.
glavcom.ua In Russian

domain: news


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North Dakota broke ground Friday afternoon on a state-of-the-art agricultural complex at North Dakota State University.
The Peltier Complex will be the new name for the Agricultural Products Development Center, which is to serve as an international learning center for the development, promotion, and marketing of crops grown in North Dakota and its neighbors, Montana, Minnesota and South Dakota.
North Dakota lawmakers approved $40 million in state funding for the Peltier complex in 2019, and approved $30 more million for it earlier this year.
The complex will house both NDSU’s food, meat and cereal science laboratories and the Northern Crops institute.
“I can’t think of a name more fitting for a state-of-the-art complex,” North Dakota Gov. Doug Burgum said.
The governor shares grandparents with the late Joe Peltier and grew up with Joe and Norma Peltier’s children Keith, Jeff, Suzette and Betty-Jo in Arthur.
“The Peltier family’s history of philanthropy at NDSU didn’t start today or with this project; it’s been going on really since the time that Joe (Peltier) graduated in 1951. … This philanthropy that the Peltier family and others have combined with the state support has really provided cutting-edge research that’s led to major advances in farming, and has contributed to the agricultural success and really touched every corner of our state,” Burgum added. state.
“It’s really historic to be putting together the Ag Products Development Center, Northern Crops Institute, federal programs, Trade Office and others into an unrivaled, world-class hub of research and development.”
Sen. John Hoeven also participated in the ceremony.
“Thanks to our hard-working farmers and ranchers, Americans benefit every single day from having the highest quality, lowest cost food supply in the world,” said Hoeven “The research done at NDSU and the Northern Crops Institute helps our producers to improve their yields, reduce their costs and market their products, helping to strengthen their competitive edge in the global economy. It is fitting that this new facility be named for the Peltier family, who has had an enormous impact on North Dakota agriculture.”
Hoeven is the lead Republican on the Senate Agriculture Appropriations Committee and is a senior member of the Senate Agriculture Committee. In that role, Hoeven helped secure $9 million in funding for continued maintenance and repair of the Edward T. Schafer Agricultural Research Center at NDSU, as well as $1 million for new cooperative agreements with land grant universities, non-profits, and other entities to support the research, development and acceleration of agriculture technology. He also helped procure an additional $292 million for agricultural research conducted under the U.S. Department of Agricultural through both ARS and the National Institute fo Food and Agriculture.
Research that benefitted from Hoevens effort ranges from Sugarbeet and barley to canola, pulse crops, oats, wheat, and more.

domain: agronomy


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“Unvaccinated COVID patients do not deserve ICU beds.”
“I have no empathy left for the willfully unvaccinated. Let them die.”
In the no-holds barred world of Twitter, comments like these, where the vaccinated say the unvaccinated deserve what they get, are becoming increasingly common. But even in the minds of people on the street, these sentiments are swirling in collective thoughts as the fourth wave of infections intensifies and vaccination rates plateau.
According to a recent Angus Reid poll most vaccinated Canadians are indifferent to the unvaccinated getting sick with the virus, with 83 per cent saying they have no sympathy for those who choose not to get the COVID-19 vaccine and then fall ill. Anecdotally, patience is even wearing thin among health-care professionals.
“There’s certainly health-care workers who have said they’re out of sympathy,” said Amir Imani, a clinical pharmacist serving neurological rehabilitation patients, including those recovering from COVID-19, adding that sometimes he feels it, too. “Many of them, frankly, have had it much worse than I do working in COVID ICUs.”
Dr. Anita Sircar, an infectious-disease physician, wrote in the Los Angeles Times about recently treating an unvaccinated patient who was critically ill with COVID-19. “Last year, a case like this would have flattened me. I would have wrestled with the sadness and how unfair life was. Battled with the angst of how unlucky he was,” Sircar wrote. “This year, I struggled to find sympathy.”
The lack of sympathy is apparent as the debate around mandatory vaccinations to attend public spaces heats up politically, and as ICU capacity and case numbers climb again. Over 80 per cent of eligible Canadians already have their first dose, and many are eager to return to a life free of COVID threats after 18 months. With vaccines free and available in Canada, patience and understanding for those who still choose not to get vaccinated is in short supply.
The rise of the more contagious Delta variant is also increasing the pressure. Dr. Kieran Moore, Ontario’s chief medical officer of health, stressed to reporters on Tuesday the urgency of getting more people vaccinated, especially those in the 18-29 age group, where only 62.6 per cent are fully vaccinated in Ontario.
For Imani and other health professionals, empathy for the unvaccinated remains key to having open conversations about their decision, and ideally convincing more people to get the shot once their fears about the vaccine are addressed.
But for most of the public, empathy is becoming harder to practise, and the divide between those who are vaccinated and those who are not is widening. On social media, quotes like “If an unvaccinated person catches it from someone who is vaccinated, boohoo, too bad,” and “If you chose to be unvaccinated I don’t care about you,” have become common, as news reports emerge of more people getting hospitalized with COVID-19 before receiving a vaccine.
Among all Canadians surveyed by Angus Reid regardless of vaccination status, 75 per cent said they’re unsympathetic to the unvaccinated getting sick. For the much smaller number of the unvaccinated, 82 per cent of them showed higher rates of sympathy for those who, like them, are unvaccinated and may become ill.
The divide between the two groups, while stark, is not entirely surprising. Empathy — the act of relating to and understanding someone who shares a different set of beliefs than our own — can sometimes be hard to practise in general, said Sara Konrath, a Canadian social psychologist. Konrath directs the Interdisciplinary Program on Empathy and Altruism Research at the Indiana University Lilly Family School of Philanthropy.
Empathy is different from sympathy, which means developing feelings of pity and sadness for someone else’s unfortunate situation.
Research shows that empathy takes effort, Konrath said, and it could be harder to extend when we ourselves feel worn out and psychologically tired. A 2019 study on empathy, published in the American Journal of Psychology, concluded that empathy is not easy to extend, and “in many cases, particularly with strangers, it may require cognitive work.” Work that, Konrath said, is tough to do when we ourselves aren’t feeling great because of pandemic trauma.
“People are exhausted at this point,” Konrath said. “At the best times, empathy takes effort … It’s been a year and a half of very challenging stress, financial stress, homeschooling, worries about jobs, worries about health, social isolation.”
“People don’t have the psychological resources that we would have had otherwise to invest in people different from us.”
Konrath said she finds herself feeling empathetic for people who aren’t able to extend empathy now. “I would assume that people who answered the (Angus Reid) survey don’t feel really great when they say they don’t care about the unvaccinated … I think if they were in a better state in their life, they probably wouldn’t feel that way.”
But the topic of vaccination has also become especially polarizing, said Imani, the clinical pharmacist. Developing lung cancer after a lifetime of smoking, or dying in a car accident after dangerous speeding, are understood as consequences of unhealthy behaviour, though the tragic outcomes are typically met with more empathy.
Responses to COVID, on the other hand, have become tied to our sense of identity, Imani said, making understanding between the vaccinated and unvaccinated even more difficult. The spread of the virus also impacts communities as a whole, and not just the individual who chooses to be unvaccinated.
While a percentage of people remain unvaccinated because of barriers to access or information, Imani said, some have capitalized on it as a political movement, tied to freedom of choice and anti-vaccine sentiments. “People smoke, but there isn’t a pro-smoking political group, or pro-smoking conspiracy theories,” he said.
The rise of conspiracies tied to the vaccine is one of many reasons why Imani said he maintains empathy through his role in health care, especially as a bulk of his time is spent educating those who are hesitant about the safety and efficacy of the vaccines.
“You can’t help people if you don’t really understand what they’re thinking or what they’re coming from,” Imani said. He added most of the people he ends up interacting with aren’t staunch anti-vaxxers, but rather victims of misinformation or systemic barriers, like not having access to a family doctor to answer questions about the safety of the vaccine.
“What I try to focus on is the systemic barriers that got them into that position, which I think are a lot more common than people think,” Imani said. Ultimately, he added, bridging the gap with the unvaccinated is important for society.
“No man is an island, and we are not separate from people who choose to not get vaccinated,” he said, adding those who survive illness with post-COVID health complications will likely put a strain on health care and social services, with ramifications on broader society and the economy.
Both Konrath and Imani said the lack of empathy for the unvaccinated after 18 months of a pandemic riddled with loss, isolation and despair are understandable. But for those who want to build on their empathy, Konrath said the work starts with healing from within.
“This is a time where people need recovery, they need to restore and rebuild both emotionally and socially, and give themselves time where they feel like they’re themselves again.”
She added that because exercising empathy is a choice and takes effort, a person needs to be willing and ready to do it. It’s also important to note that while empathy is a pillar of health-care workers’ job to help patients make informed decisions, empathy in general should be exercised without an agenda and without an expectation that someone will change their mind or behaviour.
“Our lack of empathy is not going to be very effective,” she said. “And if we do have empathy, the purpose of it is not to change them, it’s to understand them.”

domain: sociology


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Oingo Boingo Tribute Albums & Cover Songs
Oingo Boingo was an American new wave band. They are best known for their influence on other musicians, their soundtrack contributions and their high energy Halloween concerts. The band was founded in 1972 as a performance art group called The Mystic Knights of the Oingo Boingo, and from 1976 it was led by songwriter/vocalist Danny Elfman, who has since achieved substantial renown as a composer for film and television.
Cover versions and tribute albums in honor of songs and music by Oingo Boingo.


China Entertainment Group Partners With The QYOU Network
By Scott Green
October, 14, 2016
Agreement Will Bring New Video Trends to China’s Youth Audience
China Entertainment Group http://www.chinaentertainment.us/ and The QYOU Network http://theqyou.com/ have reached an agreement where China Entertainment Group will officially distribute The QYOU video packages to China’s main online video platforms, YouKu, LeTV, Weibo, Tencent and others.
China Entertainment Group is the first company in China cooperating with The QYOU, connecting it with a massive Chinese market. China Entertainment Group will curate trending sports, drama and comedy videos from The QYOU’s deep library, translate them to Chinese, and release them on Chinese video platforms. With this collaboration, Chinese millennial audiences can:
Gain access to content created by artists outside of China
Interact with Internet celebrities worldwide
Keep up with global media trends
Stream the latest viral content
And watch the hottest videos online!
Current audiences, especially young Internet viewers, are not satisfied with traditional TV services any more, preferring shorter videos with creative content instead. They also tend to be more open towards streaming on mobile devices. This is exactly what The QYOU delivers. The QYOU enables viewers to watch videos at any time and by any device they want.
Bob Reid, VP of Business Development and Sales at The QYOU, added:
“Launching a ‘best of YouTube’ channel in China with China Entertainment’s cooperation is a win-win for everyone involved, from the distribution platforms (YouKu, Tencent, LeTV, Weiboand others) to Chinese consumers. As the world’s leading curator and packager of internet video for millennial audiences, The QYOU expects to grow our audience from 10+ million users to over 60 million users by the end of 2016 and beyond, with reach from Africa to Europe, to the Middle East and North & South America. We are thrilled at expanding into Asia and starting with China!”
China Entertainment Group is a young company whose goal is to understand their audience’s content preferences. This is why The QYOU chose them as its partner. Sharing the same idea and goal, The QYOU and China Entertainment Group will create video content for young viewers, bringing new trends to online video in China. While the internet continues to connect the entire world, the entertainment marketplace specifically continues to see growth at an incredible rate. This makes the collaboration between QYOU and China Entertainment Group advantageous for both sides.
– Based in Los Angeles, The QYOU was founded in 2014 and is the world’s first company focusing primarily on curating and programming short videos for a range of digital entertainment platforms. Their strategy includes cultivating licensed short video content and distribution to linear and on-demand channels, mobile apps, custom shows and influencer marketing campaigns. Their video library showcases thousands of creators and boasts more than two billion views of original content.
– China Entertainment Group is a Sino-US media production and marketing company with regional headquarters in Los Angeles and Beijing. Founder Coca Xie, at 25 years old, has years of experience working in both Hollywood and Chinese entertainment markets.
SOURCE China Entertainment LLC


This excerpt from Class Notes: Discipline problems take a toll relays, rather succinctly, a nationwide concern in the classroom.
...while parents echo many of the solutions expressed by teachers, sometimes parents themselves are a big part of the problem.
Teachers and parents overwhelmingly agree that failure to teach children discipline at home is the top cause of behavior problems in schools. However almost 80 percent of teachers say students are quick to remind them that they have rights, or that their parents can sue.
Nearly half of the teachers say they have been accused of unfairly disciplining a student, and 52 percent say behavior problems often result from teachers who are soft on discipline "because they can't count on parents or schools to support them"
Not surprisingly student discipline problems take a toll on teachers. More than one third report having seriously considered leaving the profession because of intolerable student behavior, an many know colleagues who have done just that.
Percent of teachers who say item is a "very" or "somewhat" serious problem
- Talking out loud and horseplay. 69%
- Students treating teachers with lack of respect. 60%
- Cheating. 55%
- Students showing up late to class. 57%
- Rowdiness in hallways, lunchrooms. 51%
- Truancy and cutting class. 45%
- Illegal drugs. 45%
- Physical fighting. 36%
As the November election draws near, I anticipate the public admonitions of the teacher bashers this coming month when discussion of the school levy begins in the media. I would like to get a little jumpstart on the faultfinders and extend an invitation. Come and visit...see what we really do all day.


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Japanese Prefectures and Cities
Online information contained in City and Prefecture websites is usually in Japanese. While English information is available in many websites, it is very limited, and sometimes focussed only on foreign residents. If available, please click on the "English" button, in each website to obtain further info. Note that some city/prefecture websites contain info in Japanese only.
In most cases, the following formula can be used to get a city's or prefecture's URL:
This formula does not, of course, apply to all prefectures and cities. Some of them have unofficial, citizen's group-based homepages too.
- For Cities: In the URL, "www.city.cityname.jp" replace 'cityname' with the name of the city you are searching. For example, Sapporo City's URL would become: http://www.city.sapporo.jp/. Some cities require the name of the prefecture to be also included. So, Hekinan City in Aichi Prefecture would have the URL: http://www.city.hekinan.aichi.jp/
- For Prefectures: In the URL, "www.pref.prefecturename.jp" replace 'prefecturename' with the name of the prefecture you are searching. For example, Hokkaido Prefecture in the northenmost island, where Sapporo City is located, would have the URL: http://www.pref.hokkaido.jp/. Some of the smaller prefectures add a ".lg.jp" to their URL format.
A list of "Ordinance-designated cities" - cities that have been delegated most of the administrative powers and responsibilities thatwould normally be assigned to a nprefectural government:
The above links take you to the top/main page in Japanese, and most have further links/buttons to their English version websites

domain: geography


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Gummy Bear Invaders
The Gummy Bears have invaded!!
Fly through the depths of space as Commander SweetTooth. Pilot your trusty ship, Stardust, and defend the galaxies near and far from the Gummy Bear invaders! Their hunger for anything and everything has caused whole star systems to vanish into nothingness so it's up to you to defeat their gummy sweetness!
Battle multiple enemy types, utilize power ups, and battle bosses as you put your skills to the test in chapter one of Commander SweetTooth's adventure.
A new twist on a game that's withstood the test of time, Gummy Bear Invaders has more in store and more to come!

domain: game


text: The fact of the matter is that photoshop was not initially designed for screen design. It's a damn good tool for photo manipulation and compositing. It's nice that they're trying to work with it, but it simply wasn't built for screen design. Sketch has been built from the ground up for screen design. I'll use photoshop for photo manip and Sketch for UI designs.