text:
Life on a Divided Island: The Urgency of Contemporary Art in Cyprus
Artists Peter Eramian and Stelios Kallinikou represent the new creative energy of Cyprus, Nicosia
Interviews > Life on a Divided Island: The Urgency of Con…
While some people mistake Cyprus for a Greek island, others romanticize its status as Europe's last divided country. But there is another Cyprus: it is young and vibrant and it doesn't shy away from putting the finger into the wound.
Born and raised in Nicosia and Limassol, artist Peter Eramian and photographer Stelios Kallinikou belong to the younger generation of Cypriot creatives who are reinvigorating their country's cultural scene. Together they run the cultural space Thkio Ppalies, whose slang name alone, a Cypriot expression meaning "chop chop." breaks with local expectations of an art space. Before translating their shared ideology into four walls, Peter was one of the publishers of The Cyprus Dossier, a free magazine that circulated an accessible and critical dialogue of the island's cultural and political issues. Stelios, meanwhile, just released a book, Flamingo Theatre, which showcases his long term photographic documentation of the dreamy but controversial Akrotiri peninsula in Limassol, that to this day is the site of a British RAF base.
While the majority of the island is still attuned to the slower, Cypriot mentality of "siga siga" ("slowly, slowly"), Peter and Stelios set their own pace, preferring to do things more rapidly.
"Cultural institutions in Cyprus tend to imitate things from outside Cyprus, but we wanted to do something that feels more local."
What is the idea behind Thkio Ppalies and what does its name mean?
Peter Eramian: Thkio Ppalies in Cypriot slang means something like, "Let's do something really quickly", or how they say in English, "chop chop." It actually translates almost directly, because Thkio Ppalies literally means to cut with a big knife. For us this communicates an energy that we want to give the art scene in Cyprus. We also picked the name because it is a slang term and breaks with people's expectations about a gallery space. Cultural institutions in Cyprus tend to imitate things from outside Cyprus, but we wanted to do something that feels more local.
Is there a story about how you found this place? Is it what you were looking for?
Stelios Kallinikou: It started with the idea of the two of us sharing an office, so we were looking for a place—not necessarily an art space. Then I came across a rent sign for this one and I couldn't even imagine how it would look from the inside. So we called the owner, he showed us the place and we knew we wanted to move in. Coming back to the name and its origin: when we moved in we found a sticker outside advertising some kind of plumbing service, it said "Thkio Ppalies" to advertise how quickly they offered their services, and we immediately knew this was our name.
Thkio Ppalies was also established as a space to connect like-minded people. How would you describe the local creative community?
P: I think the creative community in Cyprus is really powerful and talented. Most of the young creative people I know have studied abroad, so they are aware of what is happening outside of this island. At the same time, they are producing work that is uniquely local, independent and visionary.
Do you feel that being Cypriot plays a key role in the work you do? How do you see that in other artists' practices?
S: It definitely influences my personal work, but I don't want it to be the main theme. Because being an artist in Cyprus is not an easy choice, I think the work produced here has a very specific quality, it is quite raw in a way.
P: Within the circles of people we work with you find this sense of urgency. It is not a middle class lifestyle they pursue with making art. Their work is valuable on a social and personal level, because there is a necessity for it to be made. If you go to London or Berlin you can find a lot more institutional support, but then being an artist can become more of a lifestyle. Whereas here being an artist is a struggle, due to the lack of institutional support and lack of understanding within the Cypriot society about what an artist could or should do. It's a challenge, but one we welcome and make the most of.
A lot of Cypriots study abroad, as you yourselves did. Some return, some don't. You both came back—so was it ever a question for you either to return to Cyprus or live somewhere else?
S: It's not something that I can explain. Of course there's always the option of living somewhere else, but I just really like being here. That's also why my practice as an artist moves around themes connected to this place.
P: While I was in London, I could feel that the arts had become saturated and commodified and were being consumed without much thought. In Cyprus the scene is still so new and uncultivated, so you feel that every contribution you make has a value and that it's needed. It's not that I have a problem with places like London, of course you can find a lot of incredible work and ideas in such creative centers, but I think generally the value of art has a lot to do with the context in which it is being produced and in which it is being presented. Sometimes I like to give this—admittedly bad—example: If you're eating ten pizzas, however good the tenth pizza is, you're going to be sick of it. During my time in London so much was happening but somehow at some point I wasn't interested very much at all. In Cyprus a lot is happening as well, but many projects are completely self-initiated, artists feel the urgency to make things happen and are willing to struggle without any institutional support. Links and communities are being formed. And because Cyprus is so small, our actions feel much more significant and effective. I think that's amazing.
"People come here and say: Wow, Europe's last divided country. For us it's not about that. What makes this place special are the things that are here, not the narratives that are constructed around this place."
How does the political situation of living in a divided country influence your lives and work?
S: For my work the circumstances play a crucial role. All my practices are developed around the issues present here. I'd like to think that the whole island is my art studio. But don't get me wrong, this is not because I am Cypriot and I am living in a divided country. I'm not interested in my country in a nationalistic sense. It is more that I am trying to use the conflict here as a starting point to speak about something more general in my work, about the human condition, about how we as humans negotiate with the situations around us.
P: The political situation in Cyprus is—and has been for a while—a bit of a cliche and so is talking about the situation. It's always very easy to talk about things from a nationalistic perspective or a very simplified perspective. So what I think Stelios does in his photographic work is, instead of focusing on that core political narrative, he explores around it: What are the social effects? How can they be interpreted aesthetically instead of explicitly? How does this whole thing work outside this very dominant political narrative?
S: Our generation can look at the history of Cyprus' division from a distance. It's been over 40 years now and this distance gives us the opportunity to view it differently than our parents could. A lot of people from the previous generations were displaced, living the life of refugees in their own country and their trauma also shapes how they currently talk about the situation. I feel I can speak about the topic with more immediacy. I'm interested in the now and how the now is showing itself in really nuanced ways within our everyday lives. I'm not trying to educate anyone or use my work to raise awareness. I want to reach people on a rather personal level.
P: It's not just about shooting the Green Line or the barriers any longer. This has almost turned into a rather touristy thing. People come here and say, "Wow, Europe's last divided country!" For us it's not about that. What makes this place special are the things that are here, not the narratives that are constructed around this place.
At the apartment of Stelios
What was it like to live through the time of the financial crisis in 2012 and 2013?
S: Of course the crisis influenced our lives dramatically. Things have been more difficult but at the same time also new opportunities opened up for artists. It also taught people to appreciate and utilize the things around them.
P: It humbled down a lot of people—but in a good way. Cyprus was seeking this kind of European identity, a lot of money came in, real estate was flourishing, the island was booming. Then the crisis came and however much we should be critical of the source of the crisis, its effects made people rethink the value of that expensive car or third house they were thinking of buying, and realize that Cyprus after all isn't so bad, we can find pleasure in simpler things, in each other, we can work with what we have here—in our own way.
You once said that The Cyprus Dossier would receive cynical remarks stating that there isn't an audience in Cyprus for such a journal. Why would people say that?
P: In Cyprus people are sometimes afraid to analyze things too much. Which is okay—sometimes I'm afraid to analyze things too much as well! But people here often think of intellectual discourse as either intimidating or pretentious. But actually The Cyprus Dossier was always free because we wanted to make it as accessible as possible. You might think it's pretentious, but then it is free—so you might as well just pick up a copy and decide for yourself!
"We like the idea of moving, doing different things, changing paths. Also with this space: it's not about a bigger plan, we just go with the energy of the space, with the now."
Peter, you started The Cyprus Dossier in 2011 and by the end of 2015 you announced that the journal would not be continued after nine successful issues. How did you feel about The Cyprus Dossier coming to an end?
P: It didn't end for any specific reason other than the fact that it wasn't working practically anymore. We (Marios Menelaou, Entafianos A. Entafianos and I) had all sort of grown up and committed to other jobs and projects. Nine issues seemed like a good circle for us. Right now we're looking into the possibility of creating three hardback volumes with selected contributions from all issues of The Cyprus Dossier, an anthology of sorts. The content we collected and published over these four years is certainly very important historically as well as socially for this island, I think it will benefit greatly being published in a more durable and archivable format.
I'd like to believe that The Cyprus Dossier in fact made intellectual conversation more accessible and that it gave the Cyprus problem an angle that was different from the mainstream political narratives in the news everyday. Also in terms of graphic design, thanks to our designers Piero Di Biase and Alberto Moreu (of studio Think Work Observe), I think it introduced a style that was not present in Cyprus back then and inspired a lot of young graphic designers.
Is Thkio Ppalies a continuation of these efforts in a different way?
P: I think it definitely is. Not necessarily in a similar way, but with the same intensity. I personally wanted to transition to something more physical and direct. Finding a balance between the intellectual and physical state of my work, or rather translate the one into the other. Because this is what Thkio Ppalies is: an intellectual project translated into a physical space.
S: We like the idea of moving, doing different things, changing paths. Also with this space: it's not about a bigger plan, we just go with the energy of the space, with the now. People sometimes complain that our exhibitions change too fast, but it is almost out of our control, because people come to us with such interesting projects all the time. And helping others to realize these projects is also a healthy learning process for us as artists, almost like a second university.
Point Centre for Contemporary Art
Situated between the charming old city of Nicosia and its modern but worn down commercial centre, Point, directed by Andre Zivanari, showcases contemporary work by Cypriot and international artists and supports cultural production from various disciplines and practices.
Moufflon Bookshop
Moufflon has been around for longer than the country has been divided. Run by Ruth Keshishian, the bookshop offers a wide range of antiquarian and specialty publications relevant to Cypriot history and culture, in English and other languages.
Neoterismoi Toumazou – exhibition space
Since 2011 Neoterismoi Toumazou (Neo Toum) has been an evolving space for exhibitions in the heart of Nicosia's old city. It begun as Maria Toumazou's grandfather's old clothing store and in 2014 along with artists Marina Xenofontos and Orestis Lazouras was turned into a gallery space with a curated program of emerging local and international artists. Neo Toum also produce fashion stories, editions and multiples related to the shop's clothing stock. The products explore an alternative art funding model and are part of a larger concern that resonates with the obsolete local consumer industry which had once sustained the space.
A κχoffee Project
The third wave of coffee finally swapped over to Cyprus. Whoever likes to enjoy artisan coffee—whether hot or cold—will come to κχoffee Project just little outside of the old city.
Thank you, Peter and Stelios, for showing us around your hometown and giving us such an immediate insight into your work and lives. For everyone interested in their work, visit Peter's and Stelios' websites. All 9 issues of the Cyprus Dossier can still be read online, and to find out about the current exhibition schedule head to Thkio Ppalies' website.
Interview & Text: Vanessa Oberin
Photography: Panagiotis Mina
Dorothee Halbrock
Mercedes Hernáez & Alejandro Sticotti
Charleston, USA
Mary Edna Fraser


glominerals Sheer Tint Base gently conceals fine lines, blemishes and dark spots while hydrating your complexion and laying down a smooth, buildable cosmetic base. Vitamins A, E and C brighten, renew and protect your complexion by promoting cellular renewal and filtering damaging UV rays. Ideal for those who prefer light coverage makeup.


Ah, the high seas. Nothing around you but salt air, water for miles, and web connectivity from satellites. Peace and quiet. But researchers at the security consulting firm IOActive say that software bugs in the platforms ships use to access the internet could expose data at sea. And these vulnerabilities hint at larger threats to international maritime infrastructure.
A report published Thursday outlines two flaws in the AmosConnect 8 web platform, which ships use to monitor IT and navigation systems while also facilitating messaging, email, and web browsing for crewmembers. Compromising AmosConnect products, developed by the Inmarsat company Stratos Global, would expose extensive operational and personal data, and could even undermine other critical systems on a ship meant to be isolated.
The two vulnerabilities Ballano found in AmosConnect 8 aren't readily accessible, but would provide deep access into a ship's systems for an attacker with a gateway onto the ship's network—perhaps through a compromised mobile device brought on board, a tainted USB stick used to exchange documents at ports, or physical access. The first bug is in the platform's login form that would allow an attacker to access the database where credentials are stored for the software, revealing all the username and password sets. Even worse, AmosConnect 8 stores these credential pairs in plaintext, meaning an attacker wouldn't even need to crack an encryption scheme to use what they find.
The other flaw exploits a backdoor account built into every AmosConnect server that has full system privileges, and can use a tool called the AmosConnect Task Manager to execute remote commands. The backdoor is guarded by a ship's "Post Office ID" (used to coordinate wireless connectivity at sea, like satellite internet) and a password. But Ballano found that the password was derivable because it was generated off of the Post Office ID using a simple algorithm. This means an attacker could gain privileged remote access to the Task Manager's setup and configuration pages governing the whole platform.
Maritime networks are generally architected to isolate systems like navigation, industrial control, and general IT—an important security practice. But with administrative privileges on AmosConnect, an attacker would be in position to probe for flaws in this setup.
IOActive says it contacted Inmarsat about the AmosConnect 8 findings beginning in October 2016. Inmarsat promised fixes for the bugs, and also began notifying its customers in November 2016 that it would end support for AmosConnect 8 in June. The company encouraged customers to downgrade to an older platform, AmosConnect 7. It is unclear whether this was in reaction to IOActive's findings or unrelated. Inmarsat claims that it issued patches for AmosConnect 8 before retiring the entire platform and fully disabling it. IOActive disputes that Inmarsat patched the flaws.
"When IOActive brought the potential vulnerability to our attention, early in 2017, and despite the product reaching end of life, Inmarsat issued a security patch that was applied to AC8 to greatly reduce the risk potentially posed," Inmarsat says in a statement to WIRED. "Inmarsat's central server no longer accepts connections from AmosConnect 8 email clients, so customers cannot use this software even if they wished too."
A Computer Emergency Response Team vulnerability report about the bugs noted, "Successful exploitation of this vulnerability may allow a remote attacker to access or influence AmosConnect 8 email databases on computers that are installed onboard ships. AmosConnect 8 has been deemed End of Life, and no longer supported." Before AmosConnect 8 was disabled, the nonprofit Mitre Corporation listed both bugs' "Likelihood of Exploit" as "Very High."
Thousands of ships worldwide use the AmosConnect platform, and those that haven't migrated to the older version will remain exposed indefinitely. That potentially longstanding, widespread vulnerability only adds to what experts describe as a general lack of security in maritime connectivity. Much like other infrastructure and industrial control systems developed before the advent of the internet or before its widespread adoption, maritime industries are now scrambling to implement comprehensive cybersecurity protections.
In June, a dangerous spoofing attack—unrelated to the AmosConnect vulnerability—disrupted GPS service for about 20 ships in the Black Sea. Later that month, the largest terminal in the Port of Los Angeles was closed for days when its tenant, the Danish shipping company Maersk, was hobbled by the NotPetya ransomware attack. "The June cyberattack that impacted the Port of Los Angeles revealed serious vulnerabilities in our maritime security, and we must address these weaknesses before it is too late," Congresswoman Norma Torres said on Tuesday when a maritime cybersecurity bill she introduced passed the House of Representatives.
Legislation could certainly help keep networks at sea shipshape. But deeper structural changes will need to come soon if the industry is going to keep up with a rapidly evolving cyberthreat that it wasn't built to withstand.
October 26, 2017 10:45am: This article has been updated to include a statement from Inmarsat and clarification about AmosConnect 8's availability.


Providing effective legal counsel to companies requires more than knowing the law. A skilled corporate attorney thinks like a business person and fully understands all aspects of the business side of the equation. This depth of knowledge facilitates the precise advice needed to solve any legal challenge faced by companies.
Our corporate attorneys put themselves in clients' shoes to effectively blend vital legal and business counsel. This has been our unwavering approach for over 100 years in offering practical, useful advice in sophisticated corporate matters.
We have developed sub-specialties within corporate law. For example, several of our attorneys offer significant expertise in the hospitality and food service industries, both in franchised and independent operations. We routinely represent lenders and borrowers in private and institutional loan transactions, enabling us to counsel both lenders and borrowers in their corporate and business relationships. Our business lawyers understand the goals of lenders and borrowers, as well as the purposes of alternative capital structures. We are able to add significant value when assisting our clients with mergers and acquisitions, financing and sales.
Because of our substantial expertise in real estate law, employment law and litigation, we can assist our corporate and business clients with all their business and strategic planning needs. We offer Straight Talk without any disclaimers or hedges. Our business clients rely on us to provide a clear roadmap to solve their legal and business challenges.
A major Wall Street banking firm and its insurance company retained us as local counsel to advise them on the risks and upside in their bid to purchase an asset package exceeding $600 million. We also managed an integrated team conducting both legal and business due diligence.


There will be five shorts in total on Marvel HQ, along with a Disney XD compilation special.
The first "LEGO Marvel Super Heroes – Black Panther: Trouble in Wakanda" short is here and fans can watch now via Marvel HQ!
Watch the video above to see the story begin in "Speeches & Sandwiches," as Thanos descends on Earth to wreak havoc, interrupting both the Black Panther's diplomatic speech and the Avengers lunch hour.
There will be five shorts in total available via Marvel HQ and all five shorts will debut as a compilation special on Sunday, June 3 (11:00 a.m., EDT) on Disney XD.
In "LEGO Marvel Super Heroes – Black Panther: Trouble in Wakanda" we see that being the King of Wakanda is tough — especially when you're also the Black Panther! When Thanos arrives from outer space and threatens to destroy Earth, the Black Panther leaps into action and defeats him with the help of Earth's Mightiest Heroes. But the situation only gets worse when rogue villains Killmonger and Klaue team up with the Mad Titan to take the fight to Black Panther's homeland! Can the Panther pounce on their perilous plan before Wakanda is pulverized?
"LEGO Marvel Super Heroes – Black Panther: Trouble in Wakanda" stars James Mathis III ("Marvel's Avengers Assemble") as T'Challa/Black Panther, Keston John ("Bosch") as Killmonger, Daisy Lightfoot ("Horizon: Zero Dawn") as Shuri, Yvette Nicole Brown ("Community") as Okoye, Trevor Devall ("Marvel's Guardians of the Galaxy") as Klaue, Mick Wingert ("Kung Fu Panda" ) as Iron Man, Travis Willingham ("Sonic Boom") as Thor, Roger Craig Smith ("Marvel's Avengers Assemble" ) as Captain America, Laura Bailey ("Marvel's Spider-Man") as Black Widow, Fred Tatasciore ("Family Guy") as Hulk, Liam O'Brien ("Critical Role") as Doctor Strange, and Issac C. Singleton Jr. ("Marvel's Guardians of the Galaxy") as Thanos.
"Lego Marvel Super Heroes – Black Panther: Trouble in Wakanda" is directed by Michael Black; written by Mark Hoffmeier; executive produced by Jason Cosler, Robert May, Jill Wilfert, Dan Buckley, Joe Quesada and Cort Lane; co-executive produced by Stan Lee; and supervising produced by Kalia Cheng Ramirez. Animation services provided by Pure Imagination Studios.


A completed family home featuring an open plan entrance and kitchen offers space for entertaining and family life. A guest bathroom, laundry and access to the garden provide a thoughtful layout. The ground floor also features a large family or entertaining room with a private bath which could offer additional bedroom space if required. Beautiful finishes and custom cabinetry offer plenty of storage and windows allow for lots of natural light. The upper level of the home features two additional bedrooms both of which have bathrooms and small private verandas. The separate apartment is self contained and spacious and offers the opportunity for rental income. The home is air conditioned in the bedrooms and is offered unfurnished. The garden is fully fenced.


text:
using System.Collections.Generic;
using VKApiSchemaParser.Models;

namespace VKApiSchemaParser
{
    internal static class StringFormatMapper
    {
        private static readonly IDictionary<string, ApiStringFormat> _formatsMapping = new Dictionary<string, ApiStringFormat>
        {
            { JsonStringConstants.Uri, ApiStringFormat.Uri }
        };

        public static ApiStringFormat? Map(string formatName)
        {
            return formatName == null || !_formatsMapping.TryGetValue(formatName, out var stringFormat)
                ? null
                : (ApiStringFormat?)stringFormat;
        }
    }
}

redpajama_set_name: RedPajamaGithub


text:
Strategic PlanAnnual ReportsBrochuresPolicies & ProceduresJoin Our TeamBoard & Mgt
call 03 5021 6500 Just Redgum Store
NDIS & Disability Services
NDIS Eligibility
Support Co-ordination
Daily Living Support & Community Access
Day Program Just Redgum
Vidovic House Supported Accommodation
Social Squad and Holiday Program
Homelessness Support
Housing Access Vic Case Management
Assistance with Care & Housing for the Aged (ACHA)
Family Reconciliation
Intensive Case Management of Indigenous Tenancies (ICMIT)
Housing Access Vic Supporting Young Parents
Housing Access NSW
NSW Enhanced Domestic Violence Response
Family and Youth Services
The Orange Door
Becoming a Foster Carer
Carer Recruitment, Training and Support
MASP Youth Mentoring Program
Become a Kokoda Mentor
'Team DMG' – MASP Cycling Team
Just Redgum Sales
Board of Directors & Senior Leadership Group
Supporting children, youth, adults and families. MASP is a community-based organisation with a history of over 30 years of service provision to youth, adults and families. The overall aim of MASP is to deliver a coordinated range of services which facilitate the most appropriate, timely and cost-effective support to people in need. READ MORE Supporting children, youth, adults and families. MASP is a community-based organisation with a history of over 30 years of service provision to youth, adults and families. The overall aim of MASP is to deliver a coordinated range of services which facilitate the most appropriate, timely and cost-effective support to people in need. READ MORE
NDIS and Disability Services
MASP offers a wide range of NDIS & Disability Services that are flexible to suit each individual.
The Homelessness Support Program offers a number of housing-related services for adults, families and youth.
The Children, Youth and Families Program provides support to children, young people and families across a range of services.
The MASP Youth Mentoring Program is a community-based mentoring program delivered by Mallee Accommodation and Support Program (MASP). The 12-month program is designed to 'make a difference' to young people who have been subjected to multiple adverse childhood experiences.
Providing a safe and supportive home. Foster care placements can range from short-term to long-term
Thriving Mallee communities, with individuals and families equipped to lead safe, secure, healthy and fulfilling lives.
Donate to a good cause
Would you like to make a positive impact on your community?
MASP encourages the community to make a donation or in-kind support to help people in need across the Mallee region.
Get the support you need today
Here at MASP we exist to help alleviate the impacts of homelessness, abuse, suffering and disadvantage in our community.
If you are seeking support and would like to speak with someone about how our services might assist you or a loved one, we would love to hear from you.
Registered Housing Provider
MASP is a Registered Housing Provider, we aim to provide affordable community housing options for people on low incomes, experiencing homelessness or at risk of becoming homeless.
Referrals to Adults/Families program are required to access through Haven, Home Safe at 143A Lime Avenue Mildura.
Referrals to the Youth Homelessness program (15 – 25yo) can be made via MASP reception.
Christmas Cheer That Makes a Difference All Year
28 November 2022 News and Eventsinfo@creativekrew.com.au
MALLEE Accommodation and Support Program (MASP) is urging local businesses and benefactors to make a difference to Mallee families and communities all year when they lend a hand this Christmas. MASP Chief Executive Officer Vincent Wilson said the "Christmas spirit" drives enormous community benefit for MASP each year through donations of gifts and toys and…
Covid-19 Bring Unexpected Benefits For Foster Caring
28 September 2022 News and Events, Storiesinfo@creativekrew.com.au
The uncertainty of COVID-19 has had an unexpected up-side for the Mallee's out-of-home care agencies, with community members showing stronger interest in finding out more about being a Foster Carer. Mallee Accommodation and Support Program (MASP) and Mallee Family Care (MFC) have both noted increased inquiry in foster caring since the beginning of the pandemic…
Canned Food Drive To Help Feed 500
10 August 2022 News and Eventsinfo@creativekrew.com.au
IN excess of 1000 canned meals were donated to help feed Mildura's homeless community through Mallee Accommodation and Support Program's (MASP) canned food drive held during Homelessness Week last week. MASP housing access and support worker Celeste Smith hailed the drive a "huge success", estimating the meals including soups, spaghetti, baked beans, chili con carne…
Homelessness Week To Shine A Light On Mallee Housing Insecurity
4 August 2022 News and EventsJean Guillermo
MALLEE Accommodation and Support Program (MASP) says new census data has revealed homeless and housing insecurity will be a growing challenge for Mallee communities, and is hoping Homelessness Week will help focus attention on long-term solutions. ABS data from 2016 shows homelessness rates in some areas of the Mallee are comparable to the State average…
Community Urged To Join "Drive" To Ease The Burden Of Homelessness
Community support agency Mallee Accommodation and Support Program (MASP) is offering a practical and low-cost way for Mildura residents to do their bit to support vulnerable community members during Homelessness Week (August 1-7). "People always say 'what can I do?' – well our Food Can Drive is something really practical, affordable and easy, and we…
Masp Focussed On Mallee Housing Opportunities
A leading community services provider says there's an unprecedented opportunity to push the Mallee's case as governments sharpen their focus on addressing structural housing issues and building new housing infrastructure. With rental vacancy rates at an all-time low and cost of living pressures at an all-time high Mallee Accommodation and Support Program says conditions are…
Homelessness could rise in Victoria's north-west due to cost-of-living pressures, social service providers warn
18 July 2022 News and Eventsinfo@creativekrew.com.au
Social service providers fear the rising cost of living will push more people into homelessness in north-west Victoria. Reserve Bank Governor Phillip Lowe warned last month that inflation was likely to hit seven per cent by the end of the year. Fuel, food and education costs have been leading price rises across much of the economy, putting immense pressure…
Supporting mallee communities into the future – MASP launches community survey
8 June 2022 News and Eventsinfo@creativekrew.com.au
A key agency that's provided services and support to Mallee communities for almost 30 years is inviting community input into planning for the organisation's future role and programs. Mallee Accommodation and Support Program (MASP) is developing its next three-year Strategic Plan and Chief Executive Officer Vince Wilson said the organisation was looking for feedback on…
MASP welcomes new CEO
22 March 2022 News and Eventsinfo@creativekrew.com.au
After a national recruitment process, Mallee Accommodation and Support Program (MASP) has welcomed experienced leader Vincent Wilson to the positon of Chief Executive Officer (CEO). Mr Wilson brings more than 15 years' senior leadership experience in the public and private sectors with a strong track record of delivering organisational transformation and growth, most recently serving…
Community generosity bringing joy to children in need
Christmas will be a little brighter for children in the care of Mallee Accommodation and Support Program (MASP) thanks to generous gift donations from local businesses and community members. MASP Chief Executive Officer Vincent Wilson said the support and generosity from the community makes a big difference to clients at this time of year. "Christmas…
More News and Stories
We provide quality services and support that assist people to lead safe, secure, healthy and fulfilling lives.
MASP Acknowledges and respects the traditional owners of this country. We pay our respects to Elders past and present and celebrate and respect their continuing culture and acknowledge the members of their ancestors.
Just Redgum
Copyright All Rights Reserved © 2020 Web Design & Digital Marketing Agency Mildura - Build Digital Growth
We acknowledge the First People of the Millewa-Mallee, The Latji Latji, Ngintait, Nyeri Nyeri and Wergaia as the Traditional Owners and Custodians of the Country on which we are. We pay our respects to the Elders past and present of First People of Millewa-Mallee and the ancient connection they hold with their Country.
Aboriginal and Torres Strait Islander people are advised our website may contain the names, images and voices of people who are now deceased.

redpajama_set_name: RedPajamaCommonCrawl


Our history of high standards and quality service will become evident as we help make your experience with us first-rate. We strive to connect your vision with our expertise making your event the admirable one that you deserve. Our customers are top priority which is why we help meticulously plan and form your event as if it was our very own.
We look forward to hearing from you and discovering how we can help make your next event the best one yet!
Love of people; Outgoing; Charisma; Energetic; Professional………These are just a few words that people have used to describe Ryan Thetford. In 2005, Ryan began working for a local DJ company at the young age of 16. Although, the owner was very skeptical about hiring a 16 year old for this type of business, Ryan's love for music and people helped quickly establish himself as one of the top premier DJ's in the Northwest Arkansas area. He would go on and team up with a former colleague to start "One Way DJ Service," that would eventually be recognized as the top DJ company in Northwest Arkansas by the Wedding Wire. In 2015, "One Way" revamped their business to better serve their customers. Out of this, "Ryan T. Productions" was born.
Today, Ryan is the owner and operator of "Ryan T. Productions." He is a member of the American Disc Jockey Association (ADJA) and the United States Disc Jockey Association (USDJA). He attends multiple trainings, seminars, and tradeshows throughout the year all across the nation. He has had the privilege of performing at hundreds of events including Weddings, School Functions, Birthday Parties, Corporate Events, Private Parties, and much more. He is a fun and an outgoing DJ who will make sure all your guests have a great time!


Happy New Year! As some of you know, I'm starting the year out on a different path. No resolutions, no 'feel better' schemes, no diet plans. Just some good-old-fashion organization and inspiration. I'm spending the month of January helping you reset your pantry and be inspired to cook from all those grains, legumes, nuts, and seeds you might already have on hand. I'll be doing weekly recap emails you can sign-up for or you can follow along on YouTube or keep up on instagram. Don't worry though- I still have quite a few delicious recipes I'm sharing on the site.
So, if you're just looking to cook a few more plant-based meals or you're looking to overhaul your dinners, I have you covered. Hope you enjoy the series and happy cooking!
And to get started, a bit of inspiration for all those pantry items I'll be chatting about throughout the month!
The post The January Pantry Reset appeared first on Naturally Ella.
This black bean chili is a little bit naughty, but mostly nice as we round the corner into the new year. Quite honestly, I'm not sure the world needs another chili recipe, but this one checks a number of boxes that are sometimes tricky to check. It's vegan. It's flavor-forward. It's hearty, and feisty, and easy to tweak (more heat, less heat, etc). It's perfect for a slow cooker, and it has a wild card ingredient – Kahlua. But don't worry, the alcohol cooks off, and the liquor just leaves a nice bass note of sweet coffee-ness. Not too much sweet, just a kiss, and I think it gets balanced out by the cumin and cayenne in most chili powders, and the smokiness of the chipotle. Slow cooker black bean chili for the weeknight win. I've also include notes for a stovetop version, and Instant Pot (pressure cooker) version, so everyone can come along.
Shout out to my friend Chris at Bi-Rite Market, who always listens to me thinking out loud about what I'm working on. I was running through all the typical black bean chili wildcard ideas – pumpkin, orange juice, espresso, etc…We landed on Kahlua (before flirting with a whisky version)….and it turned out NICE!
Also, here's a shot of the Breville Fast Slow Pro. It was the multi-cooker I originally purchased. Unfortunately, it was damaged during shipping, and I replaced it with the Instant Pot DUO Plus 6 Qt 9-in-1. Then, Breville kindly sent me a new one to work with. Long way of saying, I've been testing, and experimenting with both now, and have a bit of a strengths/weaknesses chart going. I'm not going to do a product review at this point, just know, the recipes work in both.


Professor Chris Bone is leading a team of researchers from the Department of Geography, Computer and Information Science, the Institute for Sustainable Development, The University of Chicago and the University College London in a National Science Foundation-supported project. The $1.3 million grant will examine the effects of climate change on the mountain pine beetle. This insect is responsible for the killing of tens of millions of acres of trees just in the past twenty years.
The team will use computer modeling to identify patterns of forest change under different scenarios to increase the understanding of pine beetle infestations. The hope is that providing more information about possible responses by the beetles to climate change scenarios, agencies charged with dealing with these infestations can be more proactive that reactive, and able to use the information to prevent or reduce future outbreaks of this destructive insect.


text:
Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography
Sung Woo Ko1 , Tae Hyeon Kim2 , Tae Jun Song1 , Seong-Hun Kim3 , Dong-Wan Seo1 , Jai Hoon Yoon4 , Chang Min Cho5 , Jae Hee Cho6 , Jun-Ho Choi7 , Dong Wook Lee8 , Sang Hyub Lee9 , Seung Bae Yoon10 , Tae Hoon Lee11 , Gwang Ha Kim12 , Hoon Jai Chun13
1Department of Gastroenterology, Asan Medical Center, Seoul, 2Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, 3Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 4Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 5Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, 6Department of Internal Medicine, Gachon University College of Medicine, Incheon, 7Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 8Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, 9Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, 10Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, 11Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, 12Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, and 13Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
Correspondence to: Tae Hyeon Kim
E-mail kth@wku.ac.kr
Tae Jun Song
E-mail medi01@naver.com
*Current affiliation of Sung Woo Ko is Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
†Current affiliation of Dong Wook Lee is Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Received: March 18, 2021; Revised: July 1, 2021; Accepted: July 13, 2021
Corrigendum: Gut Liver 2022;16(5):806-806
Published online October 7, 2021, Published date May 15, 2022
Background/Aims: Endoscopic ultrasonography (EUS) provides high-resolution images and is superior to computed tomography (CT) scan in diagnosing small pancreatic ductal adenocarcinoma (PDAC). As a result, the use of EUS for early detection of PDAC has attracted attention. This study aimed to identify the clinical and radiological characteristics of patients with PDAC diagnosed by EUS but not found on CT scan.
Methods: The medical records of patients diagnosed with PDAC at 12 tertiary referral centers in Korea from January 2003 to April 2019 were reviewed. This study included patients with pancreatic masses not clearly observed on CT scan but identified on EUS. The clinical characteristics and radiological features of the patients were analyzed, and survival analysis was performed.
Results: A total of 83 patients were enrolled. The most common abnormal CT findings other than a definite mass was pancreatic duct dilatation, which was identified in 61 patients (73.5%). All but four patients underwent surgery. The final pathologic stages were as follows: IA (n=31, 39.2%), IB (n=8, 10.1%), IIA (n=20, 25.3%), IIB (n=17, 21.5%), III (n=2, 2.5%), and IV (n=1, 1.4%). The 5-year survival rate of these patients was 50.6% (95% confidence interval, 38.8% to 66.7%). Elevated liver function testing and R1 resection emerged as significant predictors of mortality in the multivariable Cox regression analysis.
Conclusions: This multicenter study demonstrated favorable long-term prognosis in patients with PDAC diagnosed by EUS but indeterminate on CT scan. EUS should be considered for patients with suspected PDAC but indeterminate on CT scan.
Keywords: Pancreatic neoplasms, Endosonography, Kaplan-Meier estimate
Despite recent advances in surgical techniques and chemotherapeutic agents, the prognosis of pancreatic ductal adenocarcinoma (PDAC) is still poor with a 5-year survival rate of 9.3% according to the National Cancer Institute of the United States.1 This poor prognosis may be attributed to difficulty in early detection as most patients are asymptomatic in the early stage, and there is no reliable biomarker for PDAC.2 As a result, only around 20% of patients are eligible for surgical resection at the time of diagnosis.3 Unlike gastric or colorectal cancer, the lack of an effective screening method for PDAC is one of the reasons that make early detection difficult. However, there are several reports indicating that a favorable prognosis can be expected when PDAC is detected in the early stage. In the case of PDAC confined to the pancreatic parenchyma, the 5-year survival rate has been reported to be 34.3%.1 The 5-year survival rate of patients with PDAC smaller than 1 cm is up to 80.4% according to the Japan Pancreatic Cancer Registry.4 Therefore, early detection of PDAC is crucial to improve prognosis.
Recently, endoscopic ultrasonography (EUS) has attracted attention with its high sensitivity for detecting tumors of the pancreas. In a review of 22 studies to compare imaging modalities for the detection of pancreatic tumors, the sensitivity of computed tomography (CT) was 74%, whereas the sensitivity of EUS was up to 98%.5 As EUS can provide high-resolution images, it can be useful particularly when the tumor is small.6 For pancreatic tumors smaller than 3 cm, the sensitivity of EUS, CT, and magnetic resonance imaging has been reported as 93%, 53%, and 67%, respectively.7 In clinical practice, it is not uncommon to detect small pancreatic tumors on EUS, which had not been identified on other imaging modalities (Fig. 1).
Figure 1.A 66-year-old male underwent an abdomen computed tomography (CT) scan for a medical checkup. (A) The CT scan showed diffuse pancreatic duct dilatation, but no mass-like lesions were identified in the pancreas (white arrow). (B) On endoscopic ultrasonography, an approximately 6-mm-sized hypoechoic mass was identified in the body of the pancreas (white arrowhead). Fine-needle aspiration confirmed it to be adenocarcinoma. Distal pancreatectomy was performed, and the pathological stage was IA. The patient was followed up over a period of 6 years without recurrence.
Thus far, the clinical characteristics, pathological stage after surgery, and long-term prognosis of patients with PDAC diagnosed by EUS but indeterminate on CT have not been well established. The purpose of this study was to identify the aforementioned parameters in patients with PDAC diagnosed by EUS but indeterminate on CT.
1. Patients
Between January 2003 and April 2019, the medical records of patients with PDAC diagnosed by EUS but indeterminate on CT from 12 tertiary referral hospitals in South Korea were reviewed retrospectively. The inclusion criteria were as follows: (1) age ≥18 years; (2) pancreatic mass identified on EUS but indeterminate on CT; or (3) histopathological diagnosis was established by EUS-guided fine-needle aspiration (EUS-FNA) or surgically resected specimens. The exclusion criteria were as follows: (1) patients with pancreatic mass clearly identified on CT; (2) patients whose histopathological diagnosis was not confirmed; or (3) patients with pancreatic neoplasms other than ductal adenocarcinoma, such as neuroendocrine tumor or lymphoma. Data including the patient's baseline demographics, laboratory findings, pathological stages after surgery, and follow-up monitoring were also recorded. The protocol was approved by the institutional review board of each hospital enrolled in the study (Asan Medical Center IRB approval number: S2019-1839-0004). The need for informed consent was waived.
2. EUS technique
EUS was performed using a radial (GF-UM2000, GF-UE260-AL5; Olympus Medical, Tokyo, Japan) or linear array echoendoscopes (GF-UCT240-AL5, GF-UCT260; Olympus Medical) for detecting the pancreatic mass. All EUS-FNA procedures were performed using a linear array echoendoscope connected to a processor featuring color Doppler function (ProSound Alpha 5 or Alpha 10; Hitachi Aloka Medical, Ltd., Tokyo, Japan or UM-ME1 or UM-ME2; Olympus Medical). Experienced endosonographers in each hospital performed all procedures with conscious sedation (with midazolam or propofol combined with pethidine). Once masses were identified on EUS, the largest diameter was measured. When EUS-FNA was performed, the type and size of EUS-FNA needles were determined according to the endosonographer's preference in each hospital. Contrast-enhanced EUS and rapid on-site evaluation were not used in all cases in the study cohort.
3. CT protocol and definition of CT findings
Before EUS, CT was performed using a 64- or 256-detector-row scanner. After the patients were given contrast media intravenously, 3 phases of abdominal images (unenhanced, arterial, portal) were acquired with a standard CT protocol in each hospital. Section thickness was 2.5 mm or 5 mm. Indeterminate CT findings was defined that there were ancillary findings but no definitive mass in the pancreas. The definition of each indeterminate CT finding was as follows: (1) focal alteration of pancreatic parenchymal attenuation: localized tissue enhancement that differs from the surrounding pancreatic parenchyma described by the radiologists; (2) bile duct dilatation: diameter of the common bile duct greater than 8 mm; (3) pancreatic duct dilatation: diameter of the main pancreatic duct greater than 3 mm, 2 mm, and 1 mm in the head, body, and tail of the pancreas, respectively; (4) double-duct sign: combined dilatation of the common bile duct and pancreatic duct; or (5) peripancreatic lymphadenopathy: enlarged lymph nodes around the pancreas by 1 cm or more.
4. Staging workup
To determine the extent of the disease, staging workup was performed for all patients. Positron emission tomography-CT was performed in all but one patient, and chest-CT was performed in 13 patients. All patients underwent at least one of positron emission tomography-CT or chest-CT for staging workup.
5. Outcomes
The baseline characteristics of the patient population, pancreatic tumors, and procedural details were analyzed. The primary outcome was overall survival (defined as the time from date of PDAC diagnosis to date of death from any cause) for all cohorts. The secondary outcomes were progression-free survival (defined as the time from date of PDAC diagnosis to earliest disease progression or death), pathological staging based on surgically resected specimen according to the American Joint Committee on Cancer staging manual 7th edition, abnormal findings detected by CT, and the findings of EUS and EUS-FNA for all enrolled patients.
6. Statistical analysis
Descriptive statistics such as the mean, median, standard deviation, and interquartile range were calculated to summarize continuous variables. The sensitivity of EUS-FNA for diagnosing PDAC was also quantified. Survival analysis was performed using the Kaplan-Meier method. Multivariable Cox regression was performed to identify factors associated with overall survival. Using a backward elimination, variables with p-value <0.2 on univariable regression were included as covariates for multivariable Cox regression. The results of the Cox regression were presented as a hazard ratio with corresponding 95% confidence interval (CI). Statistical significance was determined as p<0.05. All statistical analyses were performed using R software version 3.5.3 (R Foundation for Statistical Computing, Vienna, Austria; http://www.R-project.org).
1. Patients' characteristics
From January 2003 to April 2019, 83 patients who met the inclusion criteria were identified. The mean age was 64.2 years (±10.9), and 46 patients (55.4%) were male. In addition, 17 patients (20.5%) had a history of pancreatitis, and three patients (3.4%) had a family history of PDAC.
Indications for abdominal CT were as follows: abdominal pain (n=47, 56.7%), medical checkup (n=17, 20.5%), jaundice (n=11, 13.3%), weight loss (n=2, 2.4%), and fever (n=1, 1.2%). Another five patients (5.9%) showed abnormal CT findings during the surveillance of diseases in other organs. Elevated liver function (define as three or more positive parameters including bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, alanine transaminase, and aspartate transaminase) and carbohydrate antigen 19-9 (CA19-9) level (≥37 U/mL) were noted in 21 patients (25.3%) and 25 patients (30.1%), respectively.
Abnormal findings detected by CT are summarized in Table 1. The most common abnormal finding was pancreatic duct dilatation, which was identified in 61 patients (73.5%). Other findings were focal alteration of parenchymal attenuation in 14 patients, double-duct sign in 10 patients, bile duct dilatation in nine patients, metastatic lymphadenopathy in eight patients, and splenic infarction in one patient. All lymph nodes identified on CT were regional lymphadenopathy (e.g., lymph nodes in hepatoduodenal ligament) expected to be curatively resected. One patient underwent CT for workup for a pancreatic mass found by transabdominal ultrasonography during medical checkup; however, no abnormal findings were noted on the CT scan. The patient then underwent a EUS examination, and the mass was identified.
Table 1. Abnormal Findings on Abdominal Computed Tomography
Computed tomography findings
No. of patients (%)
Pancreatic duct dilatation 61 (73.5)
Focal alteration of parenchymal attenuation 14 (16.9)
Double-duct sign 10 (12.0)
Bile duct dilatation 9 (10.8)
Metastatic lymphadenopathy 8 (9.6)
Splenic infarction 1 (1.2)
Normal 1 (1.2)
2. EUS findings
In all patients who underwent EUS, the pancreatic mass was identified on EUS. The location of pancreatic mass on EUS was as follows: head/uncinate process in 45 patients (54.2%), body in 33 patients (39.8%), and tail in five patients (6%). The mean size of the masses was 15.3±4.6 mm in the greatest dimension, and most of the masses were smaller than 20 mm (n=75, 90.4%).
EUS-FNA was performed in 71 patients (85.5%). For EUS-FNA, 22-gauge needles were used in 47 patients (66.2%), and 25-gauge needles were used in 21 patients (29.6%), and a 19-gauge needle in one patient (4.2%). Among the 71 patients, EUS-FNA revealed definite ductal adenocarcinoma in 45 patients (63.4%) and atypical cells suspicious for adenocarcinoma in 15 patients (21.1%). The remaining 11 patients did not reveal malignancy. As a result, the pooled sensitivity of EUS-FNA for detecting PDAC in patients with indeterminate abdominal CT findings was 84.5%. The specificity, positive predictive value, and negative predictive value were not calculated because only patients confirmed as having PDAC were included in this study. The findings of EUS and EUS-FNA are summarized in Table 2. Magnetic resonance cholangiopancreatography was performed in 66 patients (79.5%). Among them, the mass was identified in 46 patients (69.7%) on magnetic resonance cholangiopancreatography.
Table 2. Findings of EUS, EUS-FNA
Mass location on EUS
Head/uncinate process 45 (54.2)
Body 33 (39.8)
Tail 5 (6.0)
Size of mass
Mean±SD, mm 15.3±4.6
≤20.0 mm 75 (90.4)
EUS-FNA 71 (85.5)
Adenocarcinoma 45 (63.3)
Atypical cells, suspicious for adenocarcinoma 15 (21.1)
Inflammation 4 (4.8)
Inadequate sample 7 (10.8)
EUS, endoscopic ultrasonography; EUS-FNA, EUS-guided fine-needle aspiration.
3. Pathological staging and survival analysis
Of the 83 patients, 79 patients underwent surgical resection for PDAC. The remaining four patients either refused surgery (n=2) or had a medical condition that was unfit for surgery (n=2). Two patients received neoadjuvant chemotherapy before surgery. Pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy was performed in 49 patients, and 30 patients underwent distal pancreatectomy. R0 resection was achieved in 63 patients (79.7%). The pathological staging of surgically resected specimens was performed according to the American Joint Committee on Cancer staging manual 7th edition.6 Sixty patients (75.9%) showed no lymph node metastasis. The postoperative pathological stages were as follows: IA (n=31, 39.2%), IB (n=8, 10.1%), IIA (n=20, 25.3%), IIB (n=17, 21.5%), III (n=2, 2.5%), and IV (n=1, 1.4%) (Table 3). In addition, 41 patients received adjuvant chemotherapy after surgery.
Table 3. pTNM Staging According to the American Joint Committee on Cancer 7th Edition
T stage
T1 33 (41.7)
T2 9 (11.4)
T4 1 (1.4)
N stage
N0 60 (75.9)
M stage
M0 78 (98.3)
M1 1 (1.4)
TNM stage
IA 31 (39.2)
IB 8 (10.1)
IIA 20 (25.3)
IIB 17 (21.5)
III 2 (2.5)
IV 1 (1.4)
The median duration of follow-up was 22.7 months (interquartile range, 13.7 to 52.8) in the study cohort. The overall 1-year and 5-year survival rate was 93.4% (95% CI, 88% to 99.2%) and 50.6% (95% CI, 38.8% to 66.7%), respectively (Fig. 2A). The overall 1-year and 5-year recurrence-free survival rate was 70.3% (95% CI, 60.6% to 81.6%) and 36.6% (95% CI, 23.6% to 48.2%), respectively. We also performed a multivariate Cox regression analysis to identity variables relevant to survival. Age, sex, elevated liver function test (LFT), elevated CA19-9, tumor location, tumor size, pathologic staging, R1 resection, and lymph node metastasis assessed as potential variables. On univariable Cox regression, elevated LFT, elevated CA19-9, tumor location, pathological staging and R1 resection were found to be eligible for further analysis. Application of multivariate Cox regression analysis using backward elimination demonstrated elevated LFT (hazard ratio, 2.25; 95% CI, 1.07 to 4.47, p=0.031) and R1 resection (hazard ratio, 2.68; 95% CI, 1.24 to 5.76, p=0.01) were significant predictors of poorer survival in the final model. The results of the Cox regression analysis are summarized in Table 4. Subgroup analysis of overall survival by LFT was performed by the Kaplan-Meier curve. The patients with elevated LFT had a 5-year survival rate of 15.4% (95% CI, 4.41% to 54.1%), whereas the patient with normal had a rate of 60.6% (95% CI, 46.8% to 78.5%). The difference in overall survival between two groups was significant by log-rank test (p=0.005) (Fig. 2B).
Table 4. Univariable and Multivariable Cox Regression Model for Overall Survival
Sex (male) 1.15 0.56–2.35 0.702
Age (≥65 yr) 0.81 0.62–2.48 0.549
Elevated liver function test 2.70 1.32–5.53 0.006 2.25 1.07–4.47 0.031
Elevated CA19-9 2.31 1.06–5.01 0.034
Tumor location
Head, uncinated process 2.06 0.96–4.41 0.063
Tumor size (≥2 cm) 1.39 0.63–3.11 0.417
Pathological staging
Stage IB, II, III, IV vs IA 2.11 0.95–4.71 0.068
R1 resection 3.15 1.50–6.61 0.002 2.68 1.24–5.76 0.01
Positive lymph node metastasis 1.60 0.74–3.48 0.234
CI, confidence interval; CA19-9, carbohydrate antigen 19-9.
Figure 2.(A) The Kaplan-Meier curve of patients with pancreatic ductal adenocarcinoma diagnosed by endoscopic ultrasonography but indeterminate on computed tomography. Over a median follow-up of 22.7 months (interquartile range, 13.7 to 52.8 months), the overall 5-year survival rate was 50.6% (95% confidence interval, 38.8 to 66.7). (B) The Kaplan-Meier curve of patients according to liver function test (LFT). An elevated LFT result was associated with a lower 5-year survival rate (15.4% vs 60.6%, log-rank p=0.005).
Our study examined the pathological stage and prognosis of patients with PDAC detected by EUS but indeterminate on CT as well as their clinical characteristics.
CT provides wide anatomic coverage, allowing the local assessment of tumors (such as vascular involvement) and the evaluation of distant metastasis in a single session.8 Due to these advantages, CT is the most widely used imaging modality for diagnosing PDAC,9 and the National Comprehensive Cancer Network guidelines recommend CT as the first choice of imaging modality for patients with clinically suspected PDAC.10 However, some tumors are not detected by CT, especially when the size of the tumors is smaller than 2 cm.11,12 In a review of 19 comparative studies covering 895 patients, the sensitivity of CT for the detection of pancreatic masses was 53% to 92% (pooled sensitivity, 74%), and the sensitivity of EUS was 87% to 100% (pooled sensitivity, 98%).5 As EUS provides high-resolution images, it can be more advantageous when the tumor is small. For the detection of pancreatic tumors smaller than 2 cm, EUS has been reported to have superior sensitivity compared with CT (94.4% and 50%, respectively).13 Furthermore, given that EUS has a high negative predictive value for PDAC, if masses are not detected by EUS, the possibility of PDAC may be excluded.14 Accordingly, the Japan Pancreas Society has recommended EUS as one of the diagnostic tools for patients with suspected PDAC.15
The superior sensitivity of EUS in the detection of pancreatic tumors has been demonstrated consistently.16-18 All these studies were single-center studies, and most studies included patients with pancreatic tumors other than PDAC and did not define indeterminate CT findings suggesting PDAC. Therefore, it would be clinically significant to identify the characteristics of PDAC detected by EUS but indeterminate on CT. Moreover, the pathological stage after surgery and long-term prognosis and predictors of survival in those patients was not established by previous studies.
In our study, we enrolled only patients with confirmed PDAC from 12 tertiary referral centers in Korea. Pancreatic duct dilatation was most common finding on CT when no definite mass was identified but other abnormal findings were present, which was observed in 71 patients (85.5%) (including double-duct sign). Studies have been conducted to compare the diagnostic performance of CT and EUS in detecting pancreatic tumors; however, few have reported CT findings suggesting pancreatic tumors. In the study by Wang et al.,18 multivariate analysis identified pancreatic duct dilatation as an independent risk factor in the detection of PDAC by EUS (odds ratio, 7.24; 95% CI, 1.97 to 26.7). Several studies have demonstrated that dilatation of pancreatic duct has a high probability of being PDAC.19-21 Recently, Fujisawa et al.22 investigated the incidence of pancreatic duct dilatation and its relationship with PDAC for healthy population who underwent medical checkups. Dilatation of pancreatic duct was predictive factor for PDAC with odds ratio of 12.684 (95% CI, 1.70 to 94.48) in the logistic regression. This finding is in agreement with the result of our study. Therefore, EUS must be considered for patients suspected to have PDAC but with indeterminate CT findings, especially for those who show pancreatic duct dilatation.
Data regarding the distribution of pathological stages after surgery and long-term prognosis of patients with PDAC diagnosed by EUS but indeterminate on CT are limited. All but four patients in our study underwent pancreatic resection. The pathological stages of the surgically resected specimens from 79 patients was determined; around half of them were classified as stage IA or IB (n=39, 49.3%). More notably, around 75% of the enrolled patients had negative peripancreatic lymph nodes. Over a median follow-up of 22.7 months, the 5-year survival rate was 50.6% (95% CI, 38.8 to 66.7), which was superior to the survival rate of PDAC recently reported by the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute (9.3%).1 Around half of our patients were classified as stage I, and many of them did not have lymph node metastasis. Lymph node metastasis is a well-established negative predictor of survival in patients with PDAC who underwent surgery. In comparison with patients without metastasis, patients with lymph node metastasis after surgery have been found to have a worse survival outcome.23,24 Therefore, in the present study, early detection of tumors by EUS may have contributed to a favorable clinical outcome.
In this study cohort, elevated LFT and R1 resection were identified as significant prognostic factors of survival on a multivariable Cox regression. R1 resection is a well-established poor prognostic factor after PDAC surgery;25 however, the role of elevated LFT as a prognostic factor in patients with PDAC is rarely investigated yet. In the present study, the locations of the masses in the patients with elevated LFT were pancreatic head or uncinate process, the proportion corresponding to stage IA was significantly lower than that of patients with normal LFT (11.01% vs 56.9%, p=0.013). However, elevated LFT was still a significant predictor of survival after adjusting potential confounding factors by multivariable Cox regression. Darnell et al.26 reported preoperative cholangitis was a risk factor for mortality after pancreaticoduodenectomy. While all patients in the study by Darnell et al. were borderline resectable PDAC who received neoadjuvant chemotherapy, most of the patient in this study, except for two, were resectable without requiring preceding anticancer treatment. The impact of elevated LFT in such patients is unclear. To the best of our knowledge, there is no study that has systematically investigated the impact of elevated LFT in patients with early PDAC eligible for surgery. Given that the elevated LFT in pancreatic head cancer is a marker of bile duct invasion,27 it is assumed extent of cancer beyond the pathological staging affects the prognosis. Further studies with a larger number of patients are warranted to validate this result.
This study has some limitations. First, the design of the study was retrospective. Retrospective studies are more susceptible to selection bias.28 However, our study involved 12 referral hospitals in Korea, which should limit biases in the patients' characteristics. Second, CT protocols such as slice thickness were not standardized due to the multicenter study design. As the spatial resolution of CT is influenced by slice thickness,29 the patient's characteristics may be different if the CT protocols of the enrolled hospitals were standardized. Third, diagnostic accuracy of EUS for vascular invasion could not be evaluated due to retrospective study design. Finally, our study only included patients with masses detected by EUS. As EUS remains largely operator-dependent30 and the likelihood of a false-negative may increase in patients with chronic pancreatitis, diffuse-type carcinoma, or a recent episode of acute pancreatitis,31 the characteristics and prognosis of patients with PDAC whose masses were not found on both CT and EUS were not compared. Therefore, further studies will be necessary to investigate the role of EUS in diagnosing PDAC in patients with the aforementioned diseases.
To the best of our knowledge, this is the first study to establish the pathological stages, long-term prognosis and predictors of survival in patients with PDAC diagnosed by EUS but indeterminate on CT. The patients in the study demonstrated a favorable prognosis compared with the previously reported prognosis of patients with PDAC, which may be attributed to the detection of tumors by EUS in the early stage. EUS should be considered for patients with suspected PDAC but with indeterminate CT findings, as early detection of PDAC by EUS is associated with favorable survival.
This study was supported by a grant from the Korean Gastrointestinal Endoscopy Research Foundation (2020 Investigation Grant).
C.M.C. and G.H.K. are editorial board members of the journal but were not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.
Study concept and design: T.H.K., T.J.S. Acquisition of data, analysis, and interpretation of data: S.W.K., T.J.S., D.W.S., J.H.Y., C.M.C., J.H. Cho, J.H. Choi, D.W.L., S.H.L., S.B.Y., S.H.K., H.J.C., G.H.K., T.H.L. Drafting of manuscript: S.W.K. Critical revision of the manuscript for important intellectual content: T.H.K., T.J.S. Statistical analysis: S.W.K., T.J.S. Supervision: T.H.K., T.J.S. All authors read and approved the final manuscript.
National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer stat facts: pancreatic cancer, cancer statistics [Internet]. Bethesda: National Cancer Institute [cited 2019 Oct 1].
Available from: https://seer.cancer.gov/statfacts/html/pancreas.html.
Hart PA. Early detection of pancreatic cancer in high-risk individuals: where do we go from here? Am J Gastroenterol 2019;114:560-561.
Wray CJ, Ahmad SA, Matthews JB, Lowy AM. Surgery for pancreatic cancer: recent controversies and current practice. Gastroenterology 2005;128:1626-1641.
Hanada K, Okazaki A, Hirano N, et al. Diagnostic strategies for early pancreatic cancer. J Gastroenterol 2015;50:147-154.
Kitano M, Yoshida T, Itonaga M, Tamura T, Hatamaru K, Yamashita Y. Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer. J Gastroenterol 2019;54:19-32.
Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471-1474.
Müller MF, Meyenberger C, Bertschinger P, Schaer R, Marincek B. Pancreatic tumors: evaluation with endoscopic US, CT, and MR imaging. Radiology 1994;190:745-751.
Lee ES, Lee JM. Imaging diagnosis of pancreatic cancer: a state-of-the-art review. World J Gastroenterol 2014;20:7864-7877.
Pietryga JA, Morgan DE. Imaging preoperatively for pancreatic adenocarcinoma. J Gastrointest Oncol 2015;6:343-357.
Natinal Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Pancreatic adenocarcinoma version2.2019 [Internet]. Plymouth Meeting: NCCN; c2019 [cited 2019 Oct 1].
Available from: https://www.nccn.org/guidelines/category_1.
Prokesch RW, Chow LC, Beaulieu CF, Bammer R, Jeffrey RB Jr. Isoattenuating pancreatic adenocarcinoma at multi-detector row CT: secondary signs. Radiology 2002;224:764-768.
Yoon SH, Lee JM, Cho JY, et al. Small (≤ 20 mm) pancreatic adenocarcinomas: analysis of enhancement patterns and secondary signs with multiphasic multidetector CT. Radiology 2011;259:442-452.
Sakamoto H, Kitano M, Suetomi Y, Maekawa K, Takeyama Y, Kudo M. Utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas. Ultrasound Med Biol 2008;34:525-532.
Klapman JB, Chang KJ, Lee JG, Nguyen P. Negative predictive value of endoscopic ultrasound in a large series of patients with a clinical suspicion of pancreatic cancer. Am J Gastroenterol 2005;100:2658-2661.
Yamaguchi K, Okusaka T, Shimizu K, et al. Clinical Practice Guidelines for Pancreatic Cancer 2016 from the Japan Pancreas Society: a synopsis. Pancreas 2017;46:595-604.
Deerenberg EB, Poley JW, Hermans JJ, Ganesh S, van der Harst E, van Eijck CH. Role of endoscopic ultrasonography in patients suspected of pancreatic cancer with negative helical MDCT scan. Dig Surg 2011;28:398-403.
Meijer OL, Weersma RK, van der Jagt EJ, van Dullemen HM. Endoscopic ultrasonography in suspected pancreatic malignancy and indecisive CT. Neth J Med 2010;68:360-364.
Wang W, Shpaner A, Krishna SG, et al. Use of EUS-FNA in diagnosing pancreatic neoplasm without a definitive mass on CT. Gastrointest Endosc 2013;78:73-80.
isajjakul S Sr, Prapaisilp P, Bangchokdee S. CT and MR features that can help to differentiate between focal chronic pancreatitis and pancreatic cancer. Radiol Med 2020;125:356-364.
Tanaka S, Nakaizumi A, Ioka T, et al. Main pancreatic duct dilatation: a sign of high risk for pancreatic cancer. Jpn J Clin Oncol 2002;32:407-411.
Tanaka S, Nakao M, Ioka T, et al. Slight dilatation of the main pancreatic duct and presence of pancreatic cysts as predictive signs of pancreatic cancer: a prospective study. Radiology 2010;254:965-972.
Fujisawa T, Isayama H, Gunji T, Sato H, Matsuhashi N. Prevalence rate and predictive factors of pancreatic diseases in cases with pancreatic duct dilatation: a cross-sectional study of a large, healthy Japanese population. Intern Med 2020;59:769-777.
Yamamoto Y, Ikoma H, Morimura R, et al. The clinical impact of the lymph node ratio as a prognostic factor after resection of pancreatic cancer. Anticancer Res 2014;34:2389-2394.
Pawlik TM, Gleisner AL, Cameron JL, et al. Prognostic relevance of lymph node ratio following pancreaticoduodenectomy for pancreatic cancer. Surgery 2007;141:610-618.
Rau BM, Moritz K, Schuschan S, Alsfasser G, Prall F, Klar E. R1 resection in pancreatic cancer has significant impact on long-term outcome in standardized pathology modified for routine use. Surgery 2012;152(3 Suppl 1):S103-S111.
Darnell EP, Wang TJ, Lumish MA, et al. Preoperative cholangitis is an independent risk factor for mortality in patients after pancreatoduodenectomy for pancreatic cancer. Am J Surg 2021;221:134-140.
Decker C, Christein JD, Phadnis MA, Wilcox CM, Varadarajulu S. Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer. Surg Endosc 2011;25:2364-2367.
Geneletti S, Richardson S, Best N. Adjusting for selection bias in retrospective, case-control studies. Biostatistics 2009;10:17-31.
Monnin P, Sfameni N, Gianoli A, Ding S. Optimal slice thickness for object detection with longitudinal partial volume effects in computed tomography. J Appl Clin Med Phys 2017;18:251-259.
Hewitt MJ, McPhail MJ, Possamai L, Dhar A, Vlavianos P, Monahan KJ. EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis. Gastrointest Endosc 2012;75:319-331.
Bhutani MS, Gress FG, Giovannini M, et al. The no endosonographic detection of tumor (NEST) study: a case series of pancreatic cancers missed on endoscopic ultrasonography. Endoscopy 2004;36:385-389.
Published online May 15, 2022 https://doi.org/10.5009/gnl210123
Correspondence to:Tae Hyeon Kim
Figure 1. A 66-year-old male underwent an abdomen computed tomography (CT) scan for a medical checkup. (A) The CT scan showed diffuse pancreatic duct dilatation, but no mass-like lesions were identified in the pancreas (white arrow). (B) On endoscopic ultrasonography, an approximately 6-mm-sized hypoechoic mass was identified in the body of the pancreas (white arrowhead). Fine-needle aspiration confirmed it to be adenocarcinoma. Distal pancreatectomy was performed, and the pathological stage was IA. The patient was followed up over a period of 6 years without recurrence.
Table 1 . Abnormal Findings on Abdominal Computed Tomography.
Table 2 . Findings of EUS, EUS-FNA.
EUS, endoscopic ultrasonography; EUS-FNA, EUS-guided fine-needle aspiration..
Table 3 . pTNM Staging According to the American Joint Committee on Cancer 7th Edition.
Table 4 . Univariable and Multivariable Cox Regression Model for Overall Survival.
CI, confidence interval; CA19-9, carbohydrate antigen 19-9..
Figure 2. (A) The Kaplan-Meier curve of patients with pancreatic ductal adenocarcinoma diagnosed by endoscopic ultrasonography but indeterminate on computed tomography. Over a median follow-up of 22.7 months (interquartile range, 13.7 to 52.8 months), the overall 5-year survival rate was 50.6% (95% confidence interval, 38.8 to 66.7). (B) The Kaplan-Meier curve of patients according to liver function test (LFT). An elevated LFT result was associated with a lower 5-year survival rate (15.4% vs 60.6%, log-rank p=0.005).
Table 1 Abnormal Findings on Abdominal Computed Tomography
Table 2 Findings of EUS, EUS-FNA
Table 3 pTNM Staging According to the American Joint Committee on Cancer 7th Edition
Table 4 Univariable and Multivariable Cox Regression Model for Overall Survival
National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer stat facts: pancreatic cancer, cancer statistics [Internet]. Bethesda: National Cancer Institute [cited 2019 Oct 1]. Available from: https://seer.cancer.gov/statfacts/html/pancreas.html.
Natinal Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Pancreatic adenocarcinoma version2.2019 [Internet]. Plymouth Meeting: NCCN; c2019 [cited 2019 Oct 1]. Available from: https://www.nccn.org/guidelines/category_1.
CrossRef [1]
Ko SW, Kim TH, Song TJ, Kim S, Seo D, Yoon JH, Cho CM, Cho JH, Choi J, Lee DW, Lee SH, Yoon SB, Lee TH, Kim GH, Chun HJ. Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography. Gut and Liver 2022;16:474-482. https://doi.org/10.5009/gnl210123
Ko SW, Kim TH, Song TJ, Kim SH, Seo DW, Yoon JH, Cho CM, Cho JH, Choi JH, Lee DW, Lee SH, Yoon SB, Lee TH, Kim GH, , Chun HJ. Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography. Gut and Liver 2022;16:474-482. https://doi.org/10.5009/gnl210123
A 66-year-old male underwent an abdomen computed tomography (CT) scan for a medical checkup. (A) The CT scan showed diffuse pancreatic duct dilatation, but no mass-like lesions were identified in the pancreas (white arrow). (B) On endoscopic ultrasonography, an approximately 6-mm-sized hypoechoic mass was identified in the body of the pancreas (white arrowhead). Fine-needle aspiration confirmed it to be adenocarcinoma. Distal pancreatectomy was performed, and the pathological stage was IA. The patient was followed up over a period of 6 years without recurrence.|@|~(^,^)~|@|(A) The Kaplan-Meier curve of patients with pancreatic ductal adenocarcinoma diagnosed by endoscopic ultrasonography but indeterminate on computed tomography. Over a median follow-up of 22.7 months (interquartile range, 13.7 to 52.8 months), the overall 5-year survival rate was 50.6% (95% confidence interval, 38.8 to 66.7). (B) The Kaplan-Meier curve of patients according to liver function test (LFT). An elevated LFT result was associated with a lower 5-year survival rate (15.4% vs 60.6%, log-rank p=0.005).


Expansion of your business holdings through the acquisition of an existing business or merger with another company can increase your revenue base and allow you to tap new and diverse markets. I work with owners of medium and large companies to expand their businesses through mergers and acquisitions, and, with the assistance of my associates, am able to provide the same services to businesses of any size.
Florida Mergers / Acquisitions - The purchase of a business valued at $1.5 million or less may qualify for financing through the Small Business Administration. You will also have access to information about the performance of a business in its targeted markets as you seek to gain access to those markets through acquisition.
A Florida merger acquisition may also create opportunities for you to diversify your services, expand your customer base and add new streams of revenue. Mergers can also reduce overall operating costs through synergy and consolidation of operations between two or more companies.
The success of an acquisition or merger will hinge upon the selection of the right business to buy or the right company with which to combine. I will provide you with access to a vast database of businesses available for sale or merger, as well as my analysis of the listings and pertinent data about each business. You can be assured that I accept only quality listings that pass a thorough qualification inspection.
I will guide you through the valuation process to help you establish an understanding of the value of all elements of the business and its earning potential, and what it has to offer to your company. As a transaction broker, I will work with you through all phases of an acquisition or merger, handling any obstacles as they arise and serving as a conduit of timely information between all parties involved.
As the deal is closed, I will ensure that all of the necessary documentation is assembled and properly prepared to complete the transaction. And I will be there to provide support through the transitional period following the completion of the deal.
Contact me for more information about business acquisitions and mergers, or if you are interested in the purchase of or a merger with another company.


text:
Buy Cephalexin On Line
Tizanidine Order Online
Cialis Co Drug Eli Impotence Lilly
S. Home » Erectile dysfunction » Cialis Online » Eli Lilly, the company which produces Cialis Cialis has always been made and sold by Eli Lilly Laboratories. CIALIS- tadalafil tablet, film coated 1. Eli Lilly currently produces, markets or distributes over 43 drugs in the US, with 6 drugs in the top 100. , Detrol La Capsules 4 Mg the maker of Cialis. This week, claiming they later suffered from skin cancer that was related to the. Food and Drug Administration in 20013 indicated for the treatment of erectile dysfunction and Cialis On Line Us benign prostatic hyperplasia, also known as enlarged prostate Eli Lilly and Company announced that a pivotal phase III study of Cialis (tadalafil) tablets 5 mg for once daily use met its co-primary endpoints, significantly improving measures of both erectile dysfunction (ED) and signs and symptoms of benign prostatic hyperplasia (BPH) in …. 5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. The recommended starting dose of CIALIS for once daily use is 2. Cialis (tadalafil) is a drug prescribed for the treatment of male impotence (erectile dysfunction). Cialis 30 day free trial coupon – review of Eli Lilly Savings Card offer! 2. It was first approved for use by the U. Although pharmacies in our program sell Cialis distributed by Eli Lilly, but we cannot guarantee that Eli Lilly made it Lupin Ltd. In 2015, Eli Lilly's patent for Cialis expired in South Korea and immediately, 60 pharmaceutical companies released more than 150 generic version of the erectile dysfunction drug. The drug works by relaxing muscles and boosting the flow of blood to certain areas of the body 2. Although pharmacies in our program sell Cialis distributed by Eli Lilly, but we cannot guarantee that Eli Lilly made it Cialis is a signature product of Eli Lilly and Company, a US-based pharmaceutical company. Wants to see its erectile dysfunction drug Cialis become the first of its kind to be sold to men without a prescription. Erectile dysfunction in the United States. The study also received funding …. Like South Korea, erectile dysfunction drugs are a big business Lilly, Eli and Company. Lilly, Eli and Company. Cialis is the brand name for the generic drug tadalfil, developed by Eli Lilly, the Indiana-based pharmaceutical company. It is supplied by Lilly, Eli and Company. It was produced to compete with Viagra, the famous ED medicine in the early 2000s Eli Lilly and Company announced that a pivotal phase III study of Cialis (tadalafil) tablets 5 mg for once daily use met its co-primary endpoints, significantly improving measures of both erectile dysfunction (ED) and signs and symptoms of benign prostatic hyperplasia (BPH) in …. Eli Lilly and Co (NYSE:LLY) in its defense says it might opt to overhaul health insurers from its payment system if the same would go a long way in ensuring much lower costs for Cialis Eli Lilly and Co. 3 billion last. Cialis is used in the treatment of erectile dysfunction ; benign prostatic hyperplasia and belongs to the drug class impotence agents Cialis is indicated for the treatment of men with erectile dysfunction (ED), men with the signs and symptoms of benign prostatic hyperplasia (BPH), and men with both ED …. The recommended starting dose of CIALIS for once daily use is 2. Just Cialis Co Drug Eli Impotence Lilly a year after launching their generic version of Pfizer's erectile dysfunction (ED) drug Viagra (sildenafil), Teva is taking on another blockbuster as they prepare to debut generic Cialis …. However, some male persons are frightened by the extremely high price of the medication, offered by regular pharmacies.. Fibromyalgia MS Drug Linked to Cases of Stroke, Blood Vessel Wall. Cialis, a popular drug that treats erectile dysfunction, is distributed by Eli Lilly in Australia, Canada, New Zealand, the United Kingdom, the United States — and other countries. Finasteride 5mg Tablet Northstar 2 CIALIS for Once Daily Use for Erectile Dysfunction. Under the …. Sanofi and Eli Lilly and Company announced an agreement to pursue regulatory approval of nonprescription Cialis (tadalafil). Lilly Corporate Center Indianapolis, IN 46285 Tel: (800) 545-5979 Erectile dysfunction CYMBALTA. Prescription Drug Information: Cialis. Pill with imprint C 20 is Yellow, Elliptical / Oval and has been identified as Cialis 20 mg. Eli Lilly will still be Cialis Co Drug Eli Impotence Lilly in charge of manufacturing and exporting the drug to India Eli Lilly and Company: CIALIS. 2 CIALIS for Once Daily Use for Erectile Dysfunction. Told a federal jury that a German company is trying to take credit Arcoxia 90 Mg Para Que Serve for centuries-old Chinese medicine in seeking royalties on the use of its erectile-dysfunction drug Cialis to. Cialis is currently available by prescription only worldwide for the treatment of men with erectile dysfunction (ED). The report was published April 2 in the Journal of the American Medical Association and partially funded by Eli Lilly & Co. 3 Erectile Dysfunction and Benign Prostatic Hyperplasia CIALIS is indicated for the treatment of ED and the signs and symptoms of BPH (ED/BPH) Under a new patent settlement with multiple generics makers, Eli Lilly's storied erectile dysfunction med Cialis will keep exclusive protections a little while longer. As Eli Lilly are the only people qualified to produce authentic Cialis , you should always check the box to make sure it is sold by them Look out, Eli Lilly: Teva is launching its generic version of the erectile dysfunction drug Cialis in the U. Cialis is the first drug men think about when they face the problem of erectile dysfunction. The CIALIS dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability Seven men who took Cialis pills to treat erectile dysfunction sued Indianapolis drugmaker Eli Lilly and Co. Fibromyalgia MS Drug Linked to Cases of Stroke, Blood Vessel Wall. The plan involves a licensing Cialis Co Drug Eli Impotence Lilly Aldara Online Medicine Purchase Irelnad deal between Lilly and. Cialis has generated more. The CIALIS dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.. Eli Lilly and Company 15 February 2018. S. "Cialis should be reserved for the treatment of erectile dysfunction if and when it occurs," he added. Apr 17, 2017 · Eli Lilly & Co. 5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. Lilly Corporate Center Indianapolis, IN 46285 Tel: (800) 545-5979 Erectile dysfunction CYMBALTA. It was introduced in 2003 and comes with Tadalafil as its active ingredient. The top selling drug, Cymbalta (duloxetine) a serotonin-norepinephrine reuptake inhibitor for depression, had US sales of over $5 billion in 2013 and has brought over $24 billion in …. Sales of the heavily advertised branded version, which brought in $2. It is supplied by Lilly, Eli and Company. It can also be used to treat the symptoms of benign prostatic hypertrophy (enlarged prostate). Of India acquired the rights to market and sell Cialis, Eli Lilly's erectile dysfunction (ED) drug. Cialis, a popular drug that treats erectile dysfunction, is distributed by Eli Lilly in Australia, Canada, New Zealand, the United Kingdom, the United States Buy Lithium Stock — and other countries.
Canadian Online Pharmacy Accutane
Best Herbal Erectile Dysfunction Pill
Cialis Malaysia Price
Cialis Peru Venta
Seroquel Online Order
Can You Buy Vimax Over Counter
Lithium Element For Sale
Buy Viagra Xanax
Clomid Online Buy
Online Pharmacy Hgh Steriod


[johnearledogtraining.com] Measurement Made. Simple with Arduino 21 different. measurements covers all physical and. electrical parameter with code and. circuit By Manoj. Editorial Reviews. About the Author. Matthew Scarpino is an engineer with more than 12 years .. Hacking Electronics: Learning Electronics with Arduino and Raspberry Pi, Second Edition Measurement Made Simple with Arduino: 21 different measurements covers all physical and electrical parameter with code and. Measurement Made Simple with Arduino: 21 different measurements covers all physical and electrical . P. Fulmer · out of 5 starsNot Quite Up to Par. December 31, The home automation section is somewhat interesting, but does require the user to have some basic knowledge of AC circuits and electrical safety.
Editorial Reviews. About the Author. Simon Monk has a bachelor's degree in cybernetics and See all 2 versions are just like the physical edition; Length: pages; Enhanced Typesetting: Enabled . Measurement Made Simple with Arduino: 21 different measurements covers all physical and electrical parameter with. 9 Dec P. Hardware/Programming. Make: Getting Started with Arduino. In Getting Started examples in this guide, all you need is an Arduino Uno or. 9 Jun Physics Project with a Research Connection 5 hp, 1FA • June Measuring ways to measure mechanical vibrations and in this study.
for you to start some simple experiments, for US$ arduino. An Arduino UNO 6x Analog INPUT pins (A0 to A5): By default, each pin can measure between 0V to 5V . The objective is to turn ON and OFF an LED repeatedly every second. . are not made from silicon (it is hard to get silicon to emit light), but from other. 4 days ago #Download, and other source Isaiah 1 39 Interpretation A Bible Stationary And Related Stochastic Processes Sample Function Properties And Their Measurement Made Simple With Arduino 21 Different Measurements Covers All Physical Standard Method Of Measurement Civil Engineers Cesmm. Some common units used in electronics include voltage for electrical the metric prefixes that help describe all of these base units in quantities ranging from We' ve been measuring stuff for millennia, and our units used for those There are now dozens of units to describe physical quantities. pico (p), , 1 trillionth. These topics cover the hardware and software setup required to connect an . Works with all cameras that are compatible with the Canon RC-1 remote. Arduino powered simple LANC remote Circuit and sketch with rec, zoom and focus buttons johnearledogtraining.com - Analog IR distance sensor. 9 Nov A simple, low-cost groundwater detection system could open up The field is based on detecting physical properties, then using those or move the entire array to take measurements at the same depth in different to measure voltage, building our own voltmeter out of an Arduino .. 11/10/14 pm.


text:
#import <IDEKit/IDEAssistant.h>

@interface IDEARCConversionAssistant : IDEAssistant
{
}

@end


text:
Someone is having a birthday this month!
Spring has Sprung, Happy Easter!
New Services available from the Food Bank of Monmouth and Ocean Counties, www.foodbankmoc.org
Health Insurance Special Enrollment Period: April 16th through April 30th, Tuesdays, Wednesdays, Thursdays 10:00 - 7:00 & Saturdays 10:00 - 4:00
We wanted to notify potentially eligible people in Monmouth County that there is a special enrollment period for people that missed the open enrollment period for health insurance.
The FoodBank Benefits team can help them apply. Appointments can be made by calling 732-414-6745.
Culinary Training Program: for low-income people that want to get jobs in the food service industry. The next class starts on May 18th and there are limited spaces available. For more information and application contact Debbie Palacios at dpalacios@foodbankmoc.org or by calling her at 732-904-9254.
We continue to be blessed with such great supporters in the community.
On March 26th, a group of Volunteers from Columbia Bank in Middletown (blue shirts) paid a visit to lend a helping hand. Their help was greatly appreciated by the 'regulars'.
Far Left: Ruth Poletis, Far Right: Michael Campbell
Photo credit: Daniel Hedden Photography, LLC, (973) 951 5628
Thank you and God Bless you!
A closing note: Please feel free to wish Mr. Cooper a HAPPY BIRTHDAY on Thursday, April 9th!


New York Times bestselling author, John R Maxim can often be spotted at the bar during Happy Hour.
Local author Kathryn Wall of the Bay Tanner Mysteries usually dines here Mondays at 6:00pm.
Our cat's name is Stripey. He lives with Lauren, Lawrence and Lola. During his work shifts at Jump and Phil's, he charges $5 a pet.
Jump and Phil's is a dog friendly restaurant. Stop by and bring your four legged family member too!
Jump and Phil's is Green Bay Packer's Headquarters on Hilton Head Island. Join us for grilled brats on the Patio for every Packer's game.


Today I want to talk about the strategic layer of the game - the campaign.
This game is a survival adventure RPG, and most of the time you will fight in big encounters. Your followers can be injured, or die if not treated with bandages!
When Urtuk and his followers escape the Underworld to search for the Cure, the player begins his journey on the world's surface - in an old, destroyed, grim, low-fantasy landscape. The final goal is to travel to the Ancient City, far in the East, where Urtuk hopes to find the Cure.
The campaign takes place on a big world map, consisting of many zones. Player begins in the first zone, named 'Badlands', think of desolated savanna land. In each zone, we have implemented a traveling system like in FTL, where you move your party across random generated places interconnected with routes. Normally when party approaches a given place, an encounter event is executed - most often, the battle begins! There are also other kinds of places, like shops or secret entrances to new zones or environments..
The rewards after a successful battle can be various - from Trilium (game's currency for trade) to unique items or new party members or a combination of these.
Player can move only in one direction within the routes in map, from left to right, so normally he cannot travel back, only forward. The reasoning behind this design is that we don't want the player to visit all places within a zone and level up too quickly and get best gear - simply said, we need some balance and game pace.
Also, in a battle, if the odds are against the player, he can retreat. When done so, the party travels to the last place visited in the zone.
Each zone has its final boss node, where he poses a really challenging encounter for the player. Bosses have their own mechanics, strengths and weaknesses. They can be extracted for unique traits and abilities after successful battle!
Note that in this game there isn't any enemy level scaling, so everything you see in the world has been already generated in the beginning and will not change with player's progress. The whole world is always procedurally generated, you get a new game experience with each run!
We want to create 4-5 zones (two zones are already created at the time of writing), where each zone has its own biom, visuals, enemy types and overall feeling. After the zones has been cleared, player moves to the very last node of given zone - Shop. In here, bandages, items or new mercs can be bought with Trilium. Remember, this game is about survival, so when all party members are dead, it's game over! Bandages are the most important items - they heal injured members, so make sure you buy them in plenty!
An important feature of the game is the Extraction of traits. In a battle, Urtuk (or maybe other character) has the ability to inject into enemies a fluid called Aldehyde. With that, when that enemy dies, he can be extracted (butchered) to gain his traits or abilities! These extracted traits are wrapped into special items named Mutators. Any character can equip up to 3 mutators just like a weapon or armour. Some enemies like bosses might have multiple valuable extractables, so it is up to player to take note about what enemies are top priorities. Once in battle, Urtuk does not have an unlimited amount of Aldehyde, so choose wisely!
If you have any suggestions or tips, please give us your feedback!