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Ultrasound-guided penile block for circumcision instead of anatomical landmark method in newborn babies
Serap Aktas Yildirim ORCID: orcid.org/0000-0002-4889-66491,
Hamiyet Ozcan2 &
Ayda Turkoz3
The primary objective of this study is to compare the effectiveness of the newborn's penile block performed by the surgeon using the classical landmark method and the penile block performed by the anesthesiologist with ultrasound guidance.
This prospective, single-blinded, randomized clinical study included a total of forty newborn babies scheduled to undergo elective circumcision. The babies were randomized into two treatment groups of ultrasound (US)-guided penile block (group I; n = 20) and classical landmark method dorsal penile nerve block (DPNB) (group II; n = 20) group. Face, Legs, Activity, Cry, Consolability (FLACC) score was used to determine the block efficacy and postoperative pain and analgesic requirements. Intraoperative and postoperative FLACC scores, intraoperative analgesic needs, discharge time, complications, first oral intake time, and parent's satisfaction were also recorded.
FLACC scores were higher in group II than in group I during the intraoperative periods. Heart rate was higher in group II than in group I, at the incision, and during the procedure (P < 0.05). The number of patients requiring fentanyl was higher in group II than in group I (P < 0.01). FLACC scores were statistically higher in the landmark group at arrival in the PACU (P < 0.01) and after 30 min up to 2 h (P < 0.01). Parent's satisfaction was significantly higher in US group (P < 0.01)
Intraoperative analgesic needs and pain scores are lower in newborn babies who performed penile block with ultrasound-guided compared to the landmark method.
Circumcision is a painful surgery and it is a very wrong belief that anesthesia and postoperative analgesia are not required in newborn babies. When we look at the place of circumcision in history, we see that it was generally performed for religious and hygienic reasons. Traditionally, newborn babies were circumcised without using general anesthesia. The most frequently used method is the injection of local anesthetics into the base of the penis to block the dorsal penile nerve (DPNB) by surgeons (Dalens et al. 1989). This block was first described by Bateman in the 1970s and since then several variations of this method have been described (Bateman 1975).
With the widespread use of ultrasound, it has become popular to perform bilateral subpubic injections with ultrasound guidance. This method was first described in 2007 by Sandeman and Dilley (Sandeman and Dilley 2007). Although the dorsal penile nerve is very difficult to see directly with ultrasound, the spreading of the local anesthetic solution can be seen on both sides.
It is important to know whether the block is performed effectively during circumcision in newborn babies. For this reason, it is necessary to see the effective spread of local anesthesia with the block performed with ultrasound and follow-up of the newborn during circumcision. Regardless of whether the circumcision is performed locally or regionally, the newborn should be followed by an anesthesiologist and intervened in case of insufficient anesthesia.
For this reason, in our study, we wanted to compare the ultrasound (US)-guided block, in which local anesthetic spread is made by seeing it, and the classical landmark method, which was made by not seeing local anesthetic spread.
The primary objective of this study is to compare the effectiveness of the penile block performed by the surgeon using the landmark method and the penile block performed by the anesthesiologist with ultrasound guidance. The secondary objective is the comparison of parent's satisfaction of blocks made by the landmark method and blocks made by the ultrasound guidance.
The study protocol was approved by the institutional Ethics Committee and written informed consent was obtained from each parent. The study was conducted in accordance with the principles of the Declaration of Helsinki.
This prospective, single-blinded, randomized clinical study included a total of 40 newborn babies scheduled to undergo elective circumcision surgery who had an American Society of Anesthesiologists (ASA) grade I, between May 2018 and January 2019. The babies were randomized into two treatment groups of ultrasound (US)-guided penile block group (group I; n = 20) and classical landmark method DPNB group (group II; n = 20). Randomization was performed with a closed envelope method. Premature and low-birth weight babies and the babies with an allergy to an aminoamide local anesthetics or a general contraindication for penile nerve block were excluded from the study. All blocks were performed by the same anesthesiologist and surgeon.
Forty-five minutes before the block, topical anesthesia with lignocaine-prilocaine cream was administered to the block area in both groups. The penis and scrotum area were prepared with 0.5% chlorhexidine in 70% alcohol. Pulse oximetry, electrocardiography, and noninvasive blood pressure were monitored in the operating room. Intravenous access was performed before the block.
In US-guided group I, a linear ultrasound probe with 5 to 10 MHz (LogiQ P5, GE, Milwaukee, USA) was placed transversely along the base of the penis (Fig. 1). By using real-time ultrasound with the in-plane method, after determining the corpora cavernosa, dorsal artery and vein, and superficial and deep Buck's fascia, the needle was advanced through Buck's fascia laterally to the dorsal artery. After negative aspiration, plain 0.25% bupivacaine solution was injected 0.1 ml/kg under direct vision, while being careful to prevent neurovascular injury or intravascular injection. After the injection, the spread of the local anesthetic solution was seen as a black hypoechoic area (Fig. 2), and the same procedure was performed on the other side. Finally, 0.05 mg local anesthetic solution was injected at the scrotal penis basis to block the scrotal branches of the pudendal nerve. In group II, surgeons used the landmark method to block the dorsal penis and scrotal penis nerve with the same local anesthetic solution. The needle was inserted on either side of the midline just distal to the inferior ramus of the pubic bone then advanced slowly, in a slightly medial and caudal direction, until a "pop" was felt as it passed through Scarpa's fascia, and local anesthetic was injected. In both groups, 26-gauge needles were used.
Anesthesiologist approach: ultrasound-guided (in-plane method) penile block
Ultrasound-guided in-plane needle placement for dorsal penile nerve block. CC, corpus cavernosum; CS, corpus spongiosum; DA, dorsal artery; DPN, dorsal penile nerve; red arrow, 22-G needle
The skin incision was started 10 min after the block performed. Face, Legs, Activity, Cry, Consolability (FLACC) (Voepel-Lewis et al. 1997) (Table 1) score was used to determine the block efficacy and postoperative pain and analgesic requirement. FLACC score was recorded at the beginning, 10 min later, and every 30 min until day 1 at home. If the FLACC score was higher than 4, determined an increase in heart rate, and mean arterial pressure of more than 20% above the baseline, an ineffective block was defined. In case of failure fentanyl, 1 mcg kg was administered intravenously.
Table 1 FLACC score
On arrival post-anesthesia care unit (PACU) and then every 30 min up to 3 h, FLACC score was recorded by the same trained nurse. When the FLACC score was higher than 4, paracetamol 15 mg kg iv was given as a first choice of rescue analgesic. One day after circumcision, the family was questioned for satisfaction. Answers were recorded as yes and no. Discharge time, complications, first oral intake time, and parent's satisfaction was recorded also.
Statistical analysis was performed with the Statistical Package for Social Sciences version 10 software (SPSS Inc., Chicago, IL, USA). Data were analyzed by using the Student's t-test, Mann-Whitney U test, and logistic regression tests. The results were assessed in the 95% safety interval and statistical significance was assumed when p < 0.05.
Sample size estimation
Assuming a 50% reduction in the number of patients receiving fentanyl and paracetamol to be clinically significant, it was estimated that a minimum of 20 patients would be required in each group to achieve a power of 80% at the 0.05 level of significance.
The demographic characteristics of the babies were similar in both groups. No patients were excluded from the study. Group I median age is 6.5 (29) days, and weight 3.1 (2.9) kg. Group II median age is 4 (29) days, median weight 3.1 (1.3) kg. The number of patients requiring fentanyl was higher in group II than in group I (P < 0.01) (Table 2). We used fentanyl intraoperative for one patient in the US group and eight patients in the landmark group (P < 0.01). Only one patient received the paracetamol during the hospital stay (5%) in the US group and 8 (%40) in the landmark group during the postoperative periods (P < 0.01). FLACC scores were higher in group II than in group I during the intraoperative periods (P < 0.05) (Table 2). FLACC scores during the postoperative periods were shown in Table 3. FLACC scores were statistically higher in the landmark group at arrival in the PACU (P < 0.01) and after 30 min up to 2 h (P < 0.01). No significant differences were found in the FLACC score at the third hour of the hospital stay (P > 0.05). Heart rate was higher in group II than in group I at the incision and during the procedure (P < 0.05). The ultrasound method took longer to perform in group II than in group I (P < 0.01). There was a significant difference in first oral intake time between the groups (P < 0.01) but no significant differences were found in discharge time in the groups (P > 0.05). While the families of all babies in the US group answered yes to the questioning of satisfaction, 16 families in the landmark group answered yes.
Table 2 Main result
Table 3 FLACC score versus time
Circumcision is a routine procedure in neonate babies for religious or cultural reasons. Caudal anesthesia, topical anesthesia, and dorsal penile nerve block are the most common methods for pain relief (McGowan et al. 1998). Dorsal penile nerve block (DPNB), which is applied by injecting local anesthetic drugs close to the dorsal nerves of the penis, was first described in the 1970s (Dalens et al. 1989). The complication rates of the penile block are low. Reports of complications include swelling, hematoma, or edema; bruising at the injection site; and drug-related complications (Snellman and Stang 1995).
Since 1978, ultrasound-guided nerve block has been reported in the literature (Peterson et al. 2002). With the use of ultrasound in regional anesthesia, significant improvements have been made in pediatric regional anesthesia. Rubin et al. showed with their clinical studies that block made with ultrasound guidance provide some advantages over blocks made by traditional methods in children (Rubin et al. 2009). In DPNB performed with ultrasound guidance, it provides a two-dimensional evaluation of the subpubic space and penile structures, allowing the needle to be advanced directly into the subpubic area in real-time and to see the effective spread of the local anesthetic solution.
In this study, the US-guided method was compared with the classical landmark method. FLACC score was used to evaluate the pain and rescue analgesic needs. We wanted to show whether the block performed with the use of ultrasound in newborn babies provides more effective analgesia.
Serious complications, like gangrene of the glans, intravascular local anesthetic injection, have been described in the literature. We found only one baby in group I and two babies in groups II that had swelling and edema on his penis during and after the surgery. In Soh and colleague's retrospective study, DPNB complication rate was 0.23% in 3909 boys (Sara and Lowry 1985). In Faraoni's study, they have a small group, compare the US and classical landmark methods, and found no minor or major complications (Faraoni et al. 2010).
O'Sullivan et al. compared the DPNB by anatomical landmark method with the ultrasound-guided method (O'Sullivan et al. 2011). The findings of this study do not support the routine use of ultrasound for the performance of DPNB in male pediatric circumcision compared with the anatomical landmark method. They found there is no significant difference in the fentanyl usage or in the initial pain scores between the "anatomical landmark" group and the "ultrasound" group. Unlike this study, in our study, our patients were newborn babies and intraoperative analgesic needs and postoperative pain scores were higher in the landmark group. Time to first need a rescue analgesic was also shorter in the landmark group. Parent's satisfaction rates were higher in the US group due to improved postoperative analgesia.
Faraoni et al. also compared the subpubic DPNB by anatomical landmark method with the ultrasound-guided method. Like our study, they concluded that ultrasound guidance does improve the efficacy of the procedure (Faraoni et al. 2010).
In Sandeman's study, they compared three different regional methods (landmark-based DPNB, US-guided DPNB, and caudal anesthesia) in pediatric circumcision (Sandeman and Dilley 2007). The authors found the landmark method needs more rescue analgesics in the recovery room but no other differences between other groups including hospital discharge time. Caudal analgesia was compared with DPNB in several trials, and no differences were found in the need for rescue analgesia or the incidence of postoperative nausea and vomiting (Gauntlett 2003; White et al. 1983). However, the caudal group showed a higher incidence rate of motor block or leg weakness (Cyna and Middleton 2008). In our study, we found that the US-guided block in newborn babies provides better intraoperative and postoperative analgesia than the landmark method. Most anesthesiologists prefer penile block performed by the surgeon with the landmark method instead of the caudal block and general anesthesia in newborn babies because they are afraid of the technical difficulties and complications of the procedure. These studies are important to encourage the US-guided DPNB instead of caudal block.
In recent years, the use of ultrasound has become popular in the performance of regional anesthesia, and several studies have shown the benefit of ultrasound over the landmark method mostly in pediatric anesthesia. However, there are studies supporting the use of ultrasound not only in pediatric circumcision surgery but also in adult penile surgery. In Gurkan's study, they demonstrate the analgesic effect of US-guided DPNB in adult penile surgery (Gurkan et al. 2016). They showed that US-guided penile block improved postoperative analgesia and decreased morphine consumption in adults like our study.
Newborns have a special importance among pediatric circumcised patients. They are a difficult group of patients due to their fragility, immature systems, and different responses to pain. In these patients, postoperative and intraoperative pain can only be evaluated subjectively. It is not known whether the pain has a long-term effect on newborns. Therefore, we think that knowing that the use of ultrasound in neonatal circumcision provides a better postoperative and intraoperative analgesia is important for the routine use of ultrasound during the newborn penile block.
Our study has some limitations. The low number of patients decreases the statistical power, and this is an important limiting factor of our study. Therefore, multicentric studies with a much higher number of patients are needed. All pain scores used in neonates may not be able to make an objective pain assessment, so we may not be able to determine effectively which patient's block is effective or not.
Ultrasound use improved the efficacy of the penile block compared to the classical landmark method in newborn circumcision.
The datasets during the current study are available from the corresponding author on reasonable request.
FLACC:
Face, Legs, Activity, Cry, Consolability
PACU:
Post-anesthesia care unit
DPNB:
Dorsal penile nerve block
Bateman DV (1975) An alternative block for the relief of pain of circumcision. Anaesthesia 30:1
Cyna AM, Middleton P (2008) Caudal epidural block versus other methods of postoperative pain relief for circumcision in boys. Cochrane Database Syst Rev CD003005. https://doi.org/10.1002/14651858.CD003005.pub2
Dalens B, Vanneuville G, Dechelotte P (1989) Penile block via the subpubic space in 100 children. Anesth Analg 69(1):41–45
Faraoni D et al (2010) Does ultrasound guidance improve the efficacy of dorsal penile nerve block in children? Pediatr Anesth 20(10):931–936. https://doi.org/10.1111/j.1460-9592.2010.03405.x
Gauntlett I (2003) A comparison between local anaesthetic dorsal nerve block and caudal bupivacaine with ketamine for paediatric circumcision. Paediatr Anaesth 13(1):38–42. https://doi.org/10.1046/j.1460-9592.2003.00926.x
Gurkan Y et al (2016) Ultrasonography-guided penile block for adult penile surgery. Can J Anesth/Can J Anesth 63(6):780–781. https://doi.org/10.1007/s12630-016-0596-z
McGowan PR, May H, Molnar Z et al (1998) A comparison of three methods of analgesia in children having day case circumcision. Paediatr Anaesth 8(5):403–407. https://doi.org/10.1046/j.1460-9592.1998.00270.x
O'Sullivan MJ, Mislovic B, Alexander E (2011) Dorsal penile nerve block for male pediatric circumcision–randomized comparison of ultrasound-guided vs anatomical landmark method. Pediatr Anesth 21(12):1214–1218. https://doi.org/10.1111/j.1460-9592.2011.03722.x
Peterson MK, Millar FA, Sheppard DG (2002) Ultrasound-guided nerve blocks. Br J Anaesth 88(5):621–624. https://doi.org/10.1093/bja/88.5.621
Rubin K, Sullivan D, Sadhasivam S (2009) Are peripheral and neuraxial blocks with ultrasound guidance more effective and safe in children? Pediatr Anesth 19(2):92–96. https://doi.org/10.1111/j.1460-9592.2008.02918.x
Sandeman DJ, Dilley AV (2007) Ultrasound guided dorsal penile nerve block in children. Anaesth Intensive Care 35(2):266–269. https://doi.org/10.1177/0310057X0703500217
Sara CA, Lowry CJ (1985) A complication of circumcision and dorsal penile block of the penis. Anaesth Intensive Care 13(1):79–82. https://doi.org/10.1177/0310057X8501300111
Snellman LW, Stang HJ (1995) Prospective evaluation of complications of dorsal penile nerve block for newborn circumcision. Pediatrics 95(5):705–708
Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 23:293–297
White J, Harrison B, Richmond P et al (1983) Postoperative analgesia for circumcision. BMJ 286:934
There was no funding and financial support for this study.
Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University School of Medicine, Kerem Aydınlar Kampüsü, Kayışdağı Cad. No. 32 Ataşehir, 34752, Istanbul, Turkey
Serap Aktas Yildirim
Department of Anesthesiology, Private Emsey Hospital, Istanbul, Turkey
Hamiyet Ozcan
Department of Anesthesiology Bezmialem University Dragos Hospital, Istanbul, Turkey
Ayda Turkoz
SAY, HO, and AT designed the study. SAY drafted and modified the manuscript. SAY performed the study and collected data. AT performed the statistical analysis. All authors read and approved the final manuscript.
Correspondence to Serap Aktas Yildirim.
Ethical approval was obtained from the Regional Ethical Committee of Emsey Hospital Ethical Committee (protocol no. 2014/08) and therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The written informed consent was obtained from all parents.
Yildirim, S.A., Ozcan, H. & Turkoz, A. Ultrasound-guided penile block for circumcision instead of anatomical landmark method in newborn babies. Ain-Shams J Anesthesiol 13, 39 (2021). https://doi.org/10.1186/s42077-021-00158-2
Received: 14 December 2020
Newborn circumcision
Ultrasound-guided penile block
Landmark method penile block
Intraoperative analgesic need
Parent's satisfaction

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Category: Ethics Morality
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Q: discory.py BeautifulSoup get a class behind many div classes I have the following html code:

         My link

How can i get the href link?

A: This will get you all links in the html page.
soup = BeautifulSoup(html)

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Renfrewshire residents are being asked for their views on a new plan promoting the Gaelic language in the area.
Consultation begins this week on Renfrewshire Council's Gaelic Language Plan.
Every local authority must prepare a plan explaining how it will promote and support the Gaelic language within its boundaries.
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"There is a small but vibrant Gaelic community in Renfrewshire and, after the outstanding success of Paisley's staging of the Royal National Mod in 2013, local interest has never been higher – our three weekly Gaelic learning classes for adults have a waiting list of over 30 people.


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Guillaume de Melun (1087-1102), vizconde de Melun, apodado el carpintero,  fue un noble francés que participó en la reconquista en España, además de participar en la Primera Cruzada. Llamó la atención por desertar del ejército, tanto en España, como en la cruzada, aunque también se le conocía por su fuerza en batalla, donde se ganó su apodo de el carpintero. Regresó de suelo sagrado tras la cruzada y se desconoce nada más sobre su vida o muerte.

Vida

Sucesión
Su origen específico no está claro, de acuerdo con el genealogista del siglo XVII Père Anselme, era el hijo de Ursio I, vizconde de Melun, un pueblo a unos 50 kilómetros de París, en la región de Brie del Vexin francés, que más tarde se conocería como Île-de-France. Anselme creyó que William sucedió a su padre en 1084, y más tarde fue sucedido por su propio hijo, Ursio II. Sin embargo, en el siglo diecinueve, Adolphe Duchalais demostró que Anselme malinterpretó las cartas que estaba usando; todo lo que se sabe con certeza es que Ursio era vizconde en 1085 y William era vizconde en 1094. No hay un registro definitivo de un Ursio II, y después de William no hay vizconde conocido hasta que Adán, que se casó con la hija del anterior, vizconde sin nombre en 1138. William estaba supuestamente relacionado con Ursio, pero se desconoce su relación específica con él y los otros vizcondes.
Según el cronista del siglo XII, Roberto el Monje, William era "de estirpe real" y estaba emparentado con Hugh I, conde de Vermandois, y el hermano de Hugh, el rey Felipe I de Francia.

Hazañas militares
Según el monje del siglo XII, Guibert de Nogent, William fue "poderoso en palabras, pero menos en acción ... un hombre que se propuso hacer cosas demasiado grandes para él". William era un miembro del contingente francés que marchó a España en 1087 para ayudar a Alfonso VI de Castilla con el asedio de Tudela contra los almorávides. Pudo haber sido uno de los líderes, junto con Eudes I, duque de Borgoña, que era sobrino de Constance, la esposa de Alfonso. El ejército francés nunca llegó a Tudela y se retiró con poco éxito. Guibert dice que William "se retiró como un miserable, dejando a innumerables hombres varados por su huida". Las acciones de William en España pueden haber sido la inspiración para el personaje de Ganelon en la Chanson de Roland, posiblemente escrita a principios del siglo XII, basado en eventos similares que habían ocurrido durante el reinado de Carlomagno siglos antes.
En Francia, Guibert dice que se enfrentó a pequeñas guerras contra otros nobles y al "saqueo criminal" del campo, en contravención de la Paz y la Tregua de Dios. En 1096 se unió a la Primera Cruzada, y "tomó de sus vecinos pobres lo poco que tenían para proporcionarse vergonzosamente con provisiones para el viaje". Participó en los ataques contra los judíos en Maguncia, dirigidos por Emich de Flonheim. El ejército de Emich luchó más tarde contra los húngaros, durante el cual William "decapitó al jefe del ejército húngaro, que era miembro del consejo [del rey Coloman], un hombre distinguido con deslumbrante cabello blanco como la nieve". Después de la dispersión de El ejército de Emich después de esta batalla, William y los otros líderes franceses se unieron al ejército de su pariente Hugh of Vermandois. El ejército de Hugh marchó hacia el sur en Italia, y en Bari, Hugo envió a William a través del mar a Dyrrhachium como embajador ante el gobernador bizantino de la ciudad. William luego viajó a Constantinopla con Hugh, y fue uno de los hombres que vino a conocer a Godofredo de Bouillon cuando Godfrey llegó a la ciudad más adelante en el año.

No se menciona más a William hasta el Asedio de Antioquía en 1098. Los cruzados habían tomado con éxito la ciudad, pero luego fueron sitiados por un gran ejército musulmán liderado por Kerbogha de Mosul. Los cruzados sufrieron por la falta de suministros, y hubo muchas deserciones; Guillermo huyó de Antioquía en enero de 1098, junto con el monje francés Pedro el Ermitaño, que había llevado a su propio ejército a Constantinopla antes de que los principales cruzados llegaran allí. William era probablemente un miembro del ejército de Bohemundo de Taranto en este punto, porque Bohemundo envió a su sobrino Tancredo a buscarlos, y los trajeron de vuelta al campamento de Bohemundo. Roberto el monje supone que William huyó porque "nunca antes había experimentado tales sufrimientos por hambre". William "pasó toda la noche ... en la tienda de Bohemond, tirado en el suelo como un pedazo de basura". Bohemond lo reprendió como una "deshonra miserable para todo el ejército franco", y mencionó su deserción del ejército francés en España en 1087. Los otros líderes le pidieron a Bohemundo que le perdonara y William no sufrió más castigo. Sin embargo, William estaba tan avergonzado que abandonó el ejército de nuevo. Alberto de Aquisgrán dice que la segunda deserción de Guillermo ocurrió en junio de 1098, junto con Guillermo de Grand-Mesnil, un pariente de Bohemundo. En el camino lejos de Antioquía, se unieron a Esteban de Blois, otro líder de la cruzada que también había huido del asedio. Regresaron a Constantinopla, pero en el camino se encontraron con el emperador Alejo I Comneno, que avanzaba hacia Antioquía con un ejército de socorro. Lo convencieron de la inutilidad del asedio de los cruzados y el emperador regresó a Constantinopla. William aparentemente regresó a Tierra Santa en la Cruzada de 1101. La Primera Cruzada había conquistado Jerusalén con éxito, y aquellos que habían regresado a casa antes de completar el viaje fueron a menudo avergonzados de ir a una cruzada por segunda vez; algunos de ellos, como Esteban de Blois, fueron asesinados en su segundo viaje. William, sin embargo, sobrevivió para participar en la política del recién descubierto Reino de Jerusalén; él estaba entre los hombres que le pidieron al rey Balduino I que restaurara a Daimberto de Pisa como patriarca latino de Jerusalén. También estuvo presente en el asedio de Ascalon de Balduino I en 1102. William pudo haberse establecido en el norte, en el cruzado Principado de Antioquía como un vasallo de Bohemundo, porque aparece como testigo en una carta de Antioquía en 1101.

Apodo

Las acciones de William en el Asedio de Antioquía son conocidas por la Gesta Francorum, una crónica anónima escrita por un testigo italo-normando. La Gesta fue muy popular en Europa después de la cruzada, pero fue considerada crudamente escrita por lectores más refinados. Posteriormente fue reescrito y expandido por escritores más educados, incluidos los monjes franceses Robert y Guibert, quienes deseaban agregar información acerca de cruzados franceses como William. Según Robert, William "adquirió el nombre de 'Carpenter' porque nadie quería enfrentarlo en la batalla: no había coraza, casco o escudo que pudiera soportar el impacto demoledor de su lanza o espada". Guibert dice que "se lo llamó el Carpintero, no porque fuera un artesano en madera, sino porque prevaleció en la batalla como un carpintero, cortando hombres", y Bohemond pregunta: ¿Qué tipo de carpintero teníamos, el cual, como un obrero con su pico, dando hachazos, con lanzas y espadas, en las espaldas de los gentiles? Christopher Tyerman interpreta esto como las" habilidades de William como carnicero en el campo de batalla ". Edward Gibbon, aparentemente malentendiendo a Guibert, pensó que el apodo provenía "de los pesados golpes de su hacha".

Referencias

 Anselme de Sainte-Marie, Histoire Généalogique et Chronologique de la Maison Royale de France, des Pairs, Grands Officiers de la Couronne et de la Maison du Roy et des anciens Barons du Royaume (Reproduction de l'éd. de Paris: chez Estienne Loyson), 1674: Num. BNF de l'éd. de Paris: Bibliothèque Nationale de France, 1987. 1 microfilm Reproduction de l'éd. de Paris: Compagnie des libraires associés, 1730); vol. 5, "Généalogie de la Maison de Melun.", p. 221.
 Duchalais, Adolphe "Charte inedité de l'an 1138, relative à l'histoire des vicomtes de Melun" (Bibliothèque de l'école des chartes; vol. 6 no. 6, 1845), pp. 253–255.
 Sweetenham, Carol (tr.) (2005) Robert the Monk's History of the First Crusade = Historia Iherosolimitana. Aldershot: Ashgate; iv.XII, p. 128.
 Guibert of Nogent; Levine, Robert (tr.) (1997) The Deeds of God Through the Franks. Woodbridge: Boydell Press; bk. iv, p. 79.
 Reilly, Bernard F. (1988) The Kingdom of León-Castilla under King Alfonso VI, 1065-1109. Princeton University Press; p. 191.
 Riley-Smith, Jonathan (1997) The First Crusaders, 1095-1131. Cambridge University Press; p. 43.
 Guibert of Nogent (1997), p. 79.
 Defourneaux, Marcelin (1949) Les Français en Espagne aux XIe et XIIe siècles. Paris: Presses universitaires de France; p. 269.
  Riley-Smith, Jonathan (2005) The Crusades: a history, 2nd ed. New Haven: Yale University Press, p. 28.
 Albert of Aachen; Edgington, Susan B. (ed. & tr.) (2007) Historia Ierosolimitana. Oxford University Press; I.29, p. 55.
 Riley-Smith, The Crusades, p. 28.
 Runciman, Steven (1951) A History of the Crusades, vol. I: The First Crusade. London: Folio Society, 1994, p. 120 (originally published: Cambridge U. P., 1951). Runciman's account is derived from Anna Comnena, who calls William "Tzerpentarios", a Greek rendering of his French nickname. Anna Comnena; Sewter, E.R.A (tr.) (1969), Alexiad. Penguin, p. 314.
 Albert of Aachen (2007), II.9, p. 75.
 Asbridge, Thomas (2004) The First Crusade: A New History. Oxford University Press; pp. 178–179.
 Robert the Monk (2005), p. 128.
 Hill, Rosalind T. (ed. and trans.) (1967) Gesta Francorum: the Deeds of the Franks and the Other Pilgrims to Jerusalem. London: Oxford University Press; pp. 33–34. August C. Krey's translation of the passage in The First Crusade: the accounts of eyewitnesses and participants (Princeton, 1921, pp. 136–139) can be found at the Internet Medieval Sourcebook, "The Sufferings of the Crusaders - 3. The Gesta Version". Guibert was not as forgiving as Robert, but he also gives hunger as the excuse for William's second flight (Guibert of Nogent (1997), pg. 81).
 Albert of Aachen (2007), iv.39–40, pp. 311–313.
 Riley-Smith, Jonathan (1986) The First Crusade and the Idea of Crusading. Philadelphia: University of Pennsylvania Press; p. 120.
 Albert of Aachen, ix.14-15, p. 655.
 Riley-Smith (1986), p. 72. The charter is in Reinhold Röhricht, Regesta Regni Hierosolimitani; no. 35, p. 5.
 Robert the Monk, pp. 127–128.
 Guibert of Nogent, pg. 80.
 Tyerman, Christopher (2006) God's War: a new history of the Crusades. London: Penguin Books; p. 87.
 Gibbon, Edward; David Womersley (ed.) (1996) The History of the Decline and Fall of the Roman Empire, vol. 3, Chapter LVIII, p. 598.
Participantes cristianos en la primera cruzada
Nobles de Francia del siglo XI

redpajama_set_name: RedPajamaWikipedia


text:
Q: Count the number of results I have a homework where I have to print the number of results (range(1,36), 7) where are no numbers consecutive. I have already wrote the python script for that, but no idea how to count the lines of the results what is something like this:

(1, 2, 5, 6, 8, 16, 34)
(1, 2, 5, 6, 8, 16, 35)
(1, 2, 5, 6, 8, 17, 18)
...

What I expecting for result is: 6711905
And here is my little script:
from itertools import combinations

def count_consecutive(l):
    counts = [1]
    counts_index = 0
    for i in range(1, len(l)):
        if l[i] == l[i-1] + 1:
            counts[counts_index] = counts[counts_index] + 1
        else:
            counts.append(1)
            counts_index += 1
    return max(counts)

for comb in combinations(range(1,36), 7):
    if count_consecutive(comb) not in [5, 6, 7]:
        #print (comb)

A: counting=0
for comb in combinations(range(1,36), 7):
    if count_consecutive(comb) not in [5, 6, 7]:
        print (comb)
        counting+=1
print (counting)

This will give you the number that you want, after each print adding 1 to counting variable. when for loop is end, it will print the last value of counting variable.

Example:

counting=0
for comb in combinations(range(1,10),3):
    print (comb)
    counting+=1
print ("The number of counts is:",counting)

Output:
(1, 2, 3)
(1, 2, 4)
(1, 2, 5)
(1, 2, 6)
(1, 2, 7)
(1, 2, 8)
(1, 2, 9)
(1, 3, 4)
(1, 3, 5)
(1, 3, 6)
....
....
....
(6, 8, 9)
(7, 8, 9)
The number of counts is: 84

Edit: Here is more pythonic:

list1=[comb for comb in combinations(range(1,10),3)]
print (len(list1))

Output:
>>>
84
>>>


The gospel is about grace, not law, and we as leaders in the church have as our main purpose the proclamation and celebration of that gospel.
So why a customary? The first reason is that, as I Corinthians tells us, our God is a God of order. Secondly, we want to make sure that our ministry has no scandal or impediment. Thirdly, I Timothy tells us that 'the laborer is worthy of his wages,' in other words, fairness and thriving are goals for our common life as the ordained.


Ca&Lou's yellow gold-plated Adeline Pearl earrings have the right amount of vintage. Expertly made in Italy, this elegant pair is embellished with pink pearls and Swarovski crystals in a silver shade.
This lovely design hugs your ear from your ear lobe and finishes with a sparkly hoop.
Measurements: total length 3cm (1.2in), hoop diameter 1.7cm (0.7in). Sold in pairs. For pierced ears.
We love how they make for a candied look courtesy of pink pearls and silver Swarovski crystals. Make an insinuated statement with these earrings from Ca&Lou.
Finish outfits off on a fanciful note courtesy of Ca&Lou's Adeline Pearl earrings. Team them with an updo for a classy look.


text:
Canceling the Littoral Combat Ship Was the Right Call for the Navy | US News
February 12, 2014 - Op-Ed - Tagged: LCS
No one will miss the Littoral Combat Ship. This ship doesn't really work.
By Benjamin Freeman
The Navy's Littoral Combat Ship, or LCS, program was dealt a death blow last month when the Pentagon advised the Navy to purchase only 32 of the small, fast and much maligned ships that were originally designed to combat three distinct threats — submarines, mines and groups of small boats.
This was absolutely the right move for at least three reasons.
The first, and most glaring, deficiency of the LCS is that, as a recent Pentagon's Director of Operational Test and Evaluation report states, the "LCS is not expected to be survivable in high-intensity combat." While the Pentagon has used similar language in previous reports, the level of detail explaining why the boat wouldn't survive a real fight is unprecedented.
The report indicates the ship's vulnerability is inherent in its design. In dry Pentagonese, the LCS does "not require the inclusion of survivability features necessary to conduct sustained combat operations in a major conflict as expected for the Navy's other surface combatants." Thus, despite having "combat" in its name, the LCS is pretty lousy at fighting enemies.
A second problem is the LCS can focus only on a single threat at a time, even though it might have to fight surface enemies, submarines or mines at the same time. This leaves the LCS highly vulnerable to whichever two threats it isn't specifically focused on. For example, without the "surface warfare package," LCS ships are "lightly armed for ships of this size and possess no significant offensive capability," and when outfitted to combat surface threats, LCS ships "have no systems designed to detect torpedo attacks or mines," according to the report. Regardless of how the LCS is outfitted, then, it will be highly vulnerable to attack by at least two different threats.
Third, the LCS is a "one-size-fits all" weapons platform which, like the F-35 Joint Strike Fighter, has a tendency to become "one-size-fits-none." Having a single weapons platform perform multiple, radically distinct missions means the weapon will have to compromise its ability to do one job well in order to do multiple jobs poorly. This "Swiss Army knife" approach provides weapons that will be mediocre at a lot of things; and while mediocrity is not typically a mortal sin, it can be fatal in 21st century warfare.
But while the LCS's many problems meant axing the program, the trouble for America is that the missions the LCS was intended to perform won't disappear with it. Curtailing the LCS program did, however, free up money to purchase ships that can effectively perform these missions.
One possibility is the Navy's new DDG-1000. These Zumwalt destroyers are an oddity in Navy acquisitions — and not just because the first ship was delivered on time and on budget. The Zumwalt has serious firepower, is bigger and better-equipped than older destroyers, is designed to operate in the littorals, and can do many of the jobs the LCS was supposed to do.
There's one little problem, however: The DDG-1000 program was cancelled after just three ships because of cost concerns (each ship costs roughly $2.5 billion to build). But with the truncation of the LCS program and the budgetary room it frees up, America should seriously reconsider opening up the Zumwalt line.
The LCS was certainly created with good intentions. But we should never compromise on whether Navy "combat" ship will survive combat. We owe our men and women in uniform the best we have, and the LCS, unfortunately, fell far short of that mark. Hopefully the Zumwalt can do better.
via Canceling the Littoral Combat Ship Was the Right Call for the Navy | US News.


text:
Mirotic is the fourth Korean studio album (seventh overall) by South Korean pop group TVXQ, released on September 26, 2008, by S.M. Entertainment. This is the group's last Korean album to feature members Jaejoong, Yoochun and Junsu.

The album was a major commercial breakthrough and is TVXQ's most critically successful album to date. The best-selling album of 2008, Mirotic debuted atop the Hanteo charts and sold 110,000 albums in one week, setting the record for one-week sales in South Korea on that chart. Version A of the album sold over 208,000 copies in a month, and cumulative sales surpassed 500,000 copies 109 days after its release. Mirotic was the first Korean album in four years, since Seo Taiji's 2004 album 7th Issue, to break 500,000 sales. Mirotic sold over 541,000 copies by 2014.

Background
The album had been in production since 2007, but the title was not decided upon until January 2008. TVXQ members Xiah Junsu and Max Changmin participated directly in the making of the album, penning the lyrics for "노을.. 바라보다 (Picture of You)" and "Love in the Ice", respectively. In addition, members  Hero Jaejoong and Micky Yoochun composed and wrote the lyrics to "사랑아 울지마 (Don't Cry My Lover)" and "사랑 안녕 사랑 (Love Bye Love)", respectively, for version C of the album.

TVXQ had two promotional singles from the album. The title single "Mirotic" won a total of nine number-one trophies on Korean music programs The Music Trend, Music Bank, and M! Countdown, and is touted by critics as a staple song of K-pop. Though succeeding single "Wrong Number" was unable to meet the success of its predecessor, it was an acclaimed K-pop hit.

Mirotic won the Disk Daesang (equivalent to Album of the Year) at the 23rd Golden Disk Awards and Album of the Year at the 2008 Mnet KM Music Festival (MKMF). It is currently the best-selling album among Korea's second-generation idols, earning the name "Album of the Decade."

The choreography of "주문-Mirotic," the title track of the album, was done in a collaboration between Korean choreographers and Kenny Wormald, who had also worked with pop stars Justin Timberlake, Chris Brown and Christina Aguilera. The song features a "reverse beat" track, meaning that the bass beat is either a half beat or a whole beat late in coming into a new phrase. While in most genres of music, the bass note comes in directly on the first beat of the measure in setting the chord of the phrase, reverse beat songs alter this usual method. In doing so, the reverse beat genre is said to have an effect of "growing on" the listener, having an addictive sound.

"Mirotic" is a newly coined term, created by member Hero Jaejoong, that combines the Korean miro (미로), meaning "maze", and the English suffix "-tic".

The title song was composed by the Danish producers, Remee, Lucas Secon and Thomas Troelsen. The German singer, Sarah Connor, also bought the copyright to the song (not specified when). Despite the fact that the two original songs were the same composed piece, they have musical differences (TVXQ's version has a rap and multi-layered harmonies while Connor's has a bridge; the melodies in the chorus also differ). "Mirotic" is one of the most successful singles ever in South Korea, in 2008 the song was downloaded 2,337,864 times. By the end of 2011 the song was officially downloaded 4,173,225 times.

Reception

Mirotic has received positive acclaim from music critics. Hwang Seon-eop of online magazine IZM rated the album 3.5 out of 5 stars, putting Mirotic as TVXQ's most critically successful album to date.

Accolades

Lyrics controversy

In November 2008, the Korean Commission of Youth Protection ruled that the lyrics of "Mirotic" were provocative and overly sexual. As a result, the album was labeled with stickers indicating that it was unsuitable for people under 19 years old and any performances of the song would have to be broadcast after 10pm. In response to the ruling, SM Entertainment agreed to make a clean version but also had filed an injunction to overrule the commission's decision, asserting that the lyrics are "entirely different and miles away from the erotic or sexual that the association is making it to be."

TVXQ performed the clean version at the 23rd Annual Golden Disk Awards. The lyrics were changed from "I got you" to "I chose you" and "I got you under my skin" to "I got you under my sky." In March 2009, the Seoul Administrative Court ruled in favor of SM Entertainment, stating that the concerned lyrics "neither encouraged youth to have sex or described women as object for sex". The following month, the Commission of Youth Protection announced they would appeal the ruling to a high court after having an emergency meeting and deeming that the phrase, "I got you under my skin", was inappropriate for minors.

Track listing

Notes
 Track 5 is stylized in all caps as HEY!
 Version B of the album does not include Tracks 11 & 12 ("Forgotten Season" & "Love in the Ice (Korean version)").

Charts and sales

Weekly charts

Monthly charts

Sales

Release history

References

2008 albums
Dance-pop albums by South Korean artists
TVXQ albums
Grand Prize Golden Disc Award-winning albums
SM Entertainment albums
Korean-language albums


Metro 2033 and Metro: Last Night are among the most acclaimed first-person shooters to emerge last generation. After several years since the last game and a current-gen remastering, a third entry in the post-apocalyptic series was unveiled today on Microsoft's stage: Metro Exodus.
A gameplay demo began with the protagonist exploring the familiar network of dingy underground tunnels. As the player explores the dank caverns, he encounters the mutated, rat-like beasts from the previous games. The monsters relentlessly pursue him until he's able to barely escape their jaws by fleeing to the surface.
After a serene yet eerie trek through a ruined village, a larger behemoth appears and suddenly charges the player. The protagonist quickly uses his crossbow to shoot an explosive arrow to stun the beast, followed by other shots to send it over the edge of a cliff. The demo concludes with the player ziplining across a large crater and hitching a ride aboard a steam train with a female companion in wait.
Metro Exodus seems to retain the bleak mood of the previous series though I'm curious to see if the survival elements continue to play a large role. We'll find out when the game ships to Xbox One and PC (other platforms are currently unknown) sometime next year.
Never been a fan of the Metro serious but this game was gorgeous!!!!!


text:
NEBRASKA FOOTBALL RECRUITING: The Big Board (3/22/12)
By Huskerlocker @huskerlocker
By Brandon Cavanaugh
1. OLB Josh Banderas, Lincoln, NE – A flip happens at the top spot after Banderas somewhat surprisingly received a new offer from Iowa.
While the Hawkeyes give him plenty of opportunity to do his thing as an interior linebacker, if he's going to commit to a Big Ten school, it'll likely be Nebraska. The Cornhuskers' biggest competitor in this race may very well be Iowa State.
While it's been assumed for some time now that Banderas will be a Husker, underestimating Paul Rhodes hasn't ended well for Nebraska.
Banderas still wants to get his decision out of the way before his senior year. At this stage, the wait seems to be about offer-padding and enjoying the spotlight. There's nothing wrong with that.
2. S Tahaan Goodman, Rancho Cucamonga, CA – While Goodman continues his slow and steady pace, his teammate and former Big Board member Chris Hawkins recently visited Oklahoma and things are apparently narrowing down for him.
It wouldn't be a shock to see Hawkins commit by mid-season. This will truly test just how badly Goodman and Hawkins want to remain teammates.
3. ILB/HB Chans Cox, Lakeside, AZ – Arizona, Arizona State and Oregon all want Cox's verbal commitment, but it doesn't appear that they're going to be getting it any time soon.
With Cox still nursing his shoulder, expect the love to keep coming from Nebraska as the opportunity for versatility as a Husker appears tempting.
4. TE Keith Towbridge, Toledo, OH – Towbridge is now scheduled to attend Nebraska's Spring Game. He'll also be taking in Louisville's in mid-April as those two events are during his spring break.
It would do Tim Beck well to feature tight end Kyler Reed as much as we've heard early this spring. Ben Cotton is arguably Nebraska's best run blocker, so being pitched as a tight end that can contribute in multiple ways wouldn't hurt Nebraska's pitch at a position of need.
*NEW* 5. DE Christian Lacouture, College Station, TX – Deon Hollins leaves the Big Board by way of commitment to UCLA, but his replacement should raise some eyebrows. You'll note that Christian Lacouture's from College Station, Texas a.k.a. home the SEC-bound Aggies.
He was their first commitment of the cycle, but decommitted after staff turnover. Nebraska has some stiff competition, but they're far from out of this fight.
LSU, Michigan, Missouri will also also be fighting for his commitment and A&M wants to regain it. He's familiar with what the Aggies have to offer. Now it's time for another school to wow him and likely split his eventual choices down the middle.
Unless a school shows him an amazing time and checks every possibly desire off his list, this could be a tight race between A&M and one or two other schools. There's enough love going both ways to indicate that Nebraska could get the Big 12 back for a few bad calls.
6. DB Priest Willis, Tempe, AZ – Willis has a full dance card for the near future. He'll be participating with B2G Sports in Las Vegas this weekend before headed to Southern Cal's campus to participate in a Nike event.
Scheduled visits over the next several weeks include Virginia, Oklahoma, Oklahoma State, Florida, Florida State and Miami (FL). Will some time open up for the Huskers in April? We'll find out soon.
7. QB JT Barrett, Wichita Falls, TX – This is a critical juncture in Barrett's recruitment. He'll be returning from his unofficial visit to Baylor where the RG3 wooing was no doubt in effect. If the Bears soar up the charts, it's not an impossible mission for Nebraska to snag him, but it's going to be difficult.
Fortunately for the Huskers, they also had a Heisman trophy winner who was a dual-threat quarterback that can be touted. Unfortunately, it's been a while since he's been on television. Patience is the name of the game with Barrett.
8. OT Kenny Lacy, Phoeniz, AZ – Lacy's starting to lay out his visit plan with trips to Cal and UCLA in the near future. While he plans to take things slow, UCLA was tenacious with Deon Hollins, and he's now a member of their class.
While that may happen with Lacy, expect a press to be put on him if the Bruins truly want him. Nebraska still remains in the conversation and badly need a player of Lacy's size and caliber. The Huskers are also the only Big Ten team he appears to be giving much consideration right now.
9. QB Malik Zaire, Kettering, OH – With Zaire pushing back his announcement due to Alabama and Ohio State's presence, the air seems almost gone from the Big Red balloon. While things could turn on a dime (as evidenced by Zaire's own recruitment), this battle appears to be coming to a head with the Buckeyes and Crimson Tide as the two leaders.
The good news is that if that's the case, we'll know by mid-summer as that's when Zaire is slated to make his announcement. Should he commit elsewhere, expect Nebraska to start looking for JUCO quarterbacks in addition to keeping up with other current offers.
10. ILB Nick Ramirez, Lee's Summit, MO – While Nebraska has had Ramirez on their radar for a while now, other schools are gunning for the Missouri native just as hard. We've covered Arkansas' exploits, but don't count the home state Tigers out.
With Pinkel's crew headed to the SEC, they know they'll have to step up their recruiting game if they want to be more than a middle-of-the-pack team. We'll see how things develop over the next week to determine whether or not Ramirez drops from the Big Board.
Mike Minter Watch: Nothing to see here, folks. That's a good thing.
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Becoming an LVN isn't easy. You want to learn from the best and CDI's nursing program in Los Angeles is an accredited program in southern California. We continue to look around the web for interesting articles that further the education of students here on the west coast and across the globe.
Once graduating, your everyday practice is filled with assessments, documentation, planning, interventions, and evaluations. Then there's patient and family education, medication reconciliation, communication with other healthcare professionals, and transferring and discharging patients. The list goes on and on. The point is that as nurses, our days are full!
The clinical team at Lippincott NursingCenter.com has assembled a list of nursing tips to help make our days run a little smoother, improve your practice, and optimize patient care. Here you'll find handy mnemonics, definitions, practice pointers, and more.
2. Nursing is a 24/7 operation that requires teamwork – do your best to prioritize and work safely & pass on the rest.
6. Take the lead to inspire teamwork – pitch in and help your colleagues. Perhaps others will follow your lead!
8. When caring for an abuse victim – establish trusting relationship, treat immediate injuries, record factual account, & refer.
22. Think "CURVES" to evaluate decision making ability: Choose & Communicate, Understand, Reason, Value, Emergency, Surrogate.
24. When documenting a patient's behavior, include only the facts – not your opinion on why the patient is behaving a certain way.
25. When documenting the reason for seeking care, record the information in the patient's own words.
30. Don't forget common courtesy – introduce yourself to patients and identify yourself as a nurse.
32. Consider asking, "Does anyone have any ethical concerns with this patient's care?" to open dialogue during rounding.
37. Closed questions elicit yes/no or 1-2 word answers; can help you zoom in on specific points, but don't allow patient to elaborate.
Thank you clinical team at Lippincott NursingCenter.com for putting together such an awesome list. Learn more tips here!


Last year I got asked to style my first Wedding Shoot for Uptown Planning. Owner and Creative, Ashley Kidder organized the most elegant list of artists and vendors including Denver's downtown Castle Marne as our backdrop. Talented photographer, Kyla Fear, captured the delicate charm of this styled photoshoot while showcasing the darkly vivid details including the unconventional Tarot Reader.
The gothic-lace inspired Emma + Grace gown set the tone for the rest of the wardrobing and I played with vintage fur, textures, and patterned suiting to create depth amongst the wedding party members. The Tarot Card Reader was a fun addition and I designed a feathered cloak that sat at the top of her shoulders while layering jewelry and adding gold and silver flash tattoos to her arms for a mystical feature. Shanon Faber fabricated delicate black 'lace' paper masks for the bridesmaids, and the accordion black and gold party dresses from the Denver Street Boutique provided the perfect opportunity for custom feather accented belts.
And then Caleb Kohl put together the most beautiful video ever. Happy Wedding Season!


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Die Abkürzung IBCS steht für:

 Intel Binary Compatibility Specification
 International Business Communication Standards

IBCS


Fabulous Dolphin Massage Chair with Pisces Dolphin Massage Chair – If you intend to buy furniture for your home, it's good to see some reference pictures of Fabulous Dolphin Massage Chair with Pisces Dolphin Massage Chair below, the dimensions of the image above is 500×645 pixels. Whatever type of furniture you choose, it is recommended to adjust the budget you have. Though not necessarily absolute, avoid buying cheap furniture, because usually these things – will have an impact on the quality of a given. Currently, this short article is going to supply some details regarding Dolphin Massage Chair. So, just take a look at the following details below.
There will be many considerations that accompany the selection of Chair and Furniture Design; either based on tastes or needs. In fact, choosing furniture is easy. As long as it is with the concept of the space will be constructed, budget, and needs. All of them can even do it yourself, without having to consult or use the services of interior design. Buying the right furniture for your home is indeed rather difficult. However, that does not mean impossible, Yes. Some of the following images of Fabulous Dolphin Massage Chair with Pisces Dolphin Massage Chair could be an idea for you when you want to buy furniture to complement the interior; the renovation; or as a gift to someone. Good luck!
Popular of Dolphin Massage Chair with Pisces Dolphin Ii Portable Massage Chair Massage Chairs And. Inspiring Dolphin Massage Chair with Pisces Dolphin Ii Portable Massage Chair Massage Chairs And. Fabulous Dolphin Massage Chair with Pisces Dolphin Massage Chair.


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Home Karachi Media freedom gone worse compared to previous 2 years: CPNE
Media freedom gone worse compared to previous 2 years: CPNE
The Council of Pakistan Newspaper Editors (CPNE) has released "Pakistan Media Freedom Report – 2021", according to which the situation of media freedom has gone worse compared to the previous two years.
The report has been compiled under the supervision of CPNE's Press Freedom and Monitoring Committee in the light of information acquired directly as well as material collected from various media outlets and websites.
Noting that conditions related to media in Pakistan which further deteriorated in 2021, the report expressed concerns over increasing tactics aimed at stifling the freedom of media, freedom of expression and the right to access to information.
In 2021 alone, the report revealed, at least five journalists lost their lives in the line of duty in the country, including Karachi-based young social media activist and community journalist Nazim Jokhio, who was abducted and killed mercilessly.
At least nine journalists lost their lives due to the coronavirus pandemic, whereas two newsmen committed suicide due to the lingering unemployment.Following 2020, the year 2021 has also been an extremely difficult year for journalists, media workers, and media organizations in Pakistan in different ways.
Freedom of the press and freedom of expression remained under severe pressure and faced a myriad of challenges during the previous year, the report stated.
Moreover, it went on to say, due to the COVID-19 pandemic, not only several journalists lost their lives, but it also plunged the media houses into deep financial crises.
Different governmental institutions, non-governmental organizations and state organizations, have reportedly, continuously attempted to keep Journalist community under pressure through their direct and indirect, and intolerant behavior and tactics.The report feared that the number of journalists, who were harassed, tortured and killed in the line of duty last year, could be higher.
It especially highlighted the gruesome murder of Nazim Jokhio, who shared a video of alleged Arab hunters engaged in illegal hunting on the northern outskirt of Karachi on November 3rd, 2021.
The hunters' local feudal hosts, demanded the removal of the video from social media; on refusal, Jokhio was abducted and brutally murdered and his body was dumped in the bushes, the report states.
A number of Journalists had to face life attempts, threats, lawsuits, and telephone calls from "unknown numbers", in addition to online harassment on various occasions.
Family members of the effected journalists were also subjected to physical and mental torture, it added.
While performing their assigned tasks, Ajay Lalwani, Abdul Wahid Raseeni, Shahid Zehri, Nazim Jokhio and Mohammad Zada Agarwal lost their lives. The police and other state institutions, including the FIA, registered cases against several journalists during 2021.
In a desire to control media "by hook or by crook", the government continued to pursue its policy of enforcing the "most" controversial Pakistan Media Development Authority (PDMA) law, taking several shows and hosts off air, getting them expelled from their organizations, and removing a significant number of genuine and authentic newspapers from the state media list.
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Monday 1st August 2016
Canvas helps St Helens artist reach online audience
Prototype Project artist Drunk Wolf is taking his work to a new audience.
Canvas, funded by Arts Council England, came to St Helens to meet the artist to showcase his recent solo exhibition at The World of Glass.
St Helens Goes Pop, which draws on his experiences growing up in the town. His pop-art style work reimagines some of St Helens' most famous characters and landmarks, from Johnny Vegas and Rick Astley to St Helens RFC, alongside lesser-known local characters that he has immortalised in portraits and Star Wars figurines.
The exhibition was made possible by Heart of Glass. The film was produced by Carl Davies of FACT Liverpool and funded by the Arts Council's Sky Amplify initiative
Canvas is the home of the UK Arts scene on Youtube. Their aim is to inspire younger audiences to explore the wonderful world of art, showcasing videos from some of the UK's leading arts organisations as well as producing our own series.


Gashora Girls Academy of Science and Technology (GGAST) is a model school of innovative student-centered learning. Students and teachers work in a collaborative fashion to ensure that students acquire the knowledge and skills they must have to succeed on the Rwandan National Exams and to succeed in life. Students are expected to become "masters of their own fate" by working hard and to work effectively in groups. They learn how to ask good questions in class and to take advantage of the teachers' willingness to offer extra help. Our students develop "meta cognition"—to know how they learn best and to use their strengths to help overcome weaknesses.
Each student is assigned a staff advisor in groups of 12-15 students, and the advisory groups gather every other week. The main purpose of advisory is to provide each student with an adult on campus who pays particular attention to each student's progress and needs, and to help each girl realize her full potential.


Years ago my family stopped being nuclear and evolved into an extended and very eclectic family of friends. My Thanksgiving dinners have evolved too, from the traditional menu of my childhood to the wondrous offerings of many cooks who come together yearly, each bringing a different dish, to form a collective feast.
In this way Thanksgiving has become the ultimate pot luck dinner, a fabulous array of the "best of" each cook. We enjoy innovations of the traditional themes – stuffing, cranberry sauce, side dishes, pies – that always seem to embody the originality and generosity of the makers. Favorite dishes are requested the following Thanksgiving, to become a newly time-honored custom.
Purees using the season's produce – chestnuts, winter squashes, and root vegetables like celery root and turnips – make appealing plays on the classic Thanksgiving mashed potatoes. Their velvety texture and rich, spicy flavors seems to unify the other elements of the feast. These purees are also unexpectedly virtuous – requiring minimal enrichment of cream or butter due to their naturally creamy textures.
Throughout the cooler months, these purees are also great accompaniments to simple roasted meats and poultry such as pork, lamb, venison and chicken, and game birds like duck and quail. All can be doubled or tripled to serve more, and can be made up to 2 days in advance. Reheat them in a double boiler, adding a little chicken broth, water or cream to thin them if necessary.
To roast the squash for pureeing: Preheat the oven to 350′. Cut the squash in half and scoop out the seeds. Brush lightly with olive oil and place cut-side-down on a heavy baking sheet. Sprinkle 2 tablespoons of water onto the pan. Pull the loose papery skin off the garlic, keeping the head intact, and wrap it in a sheet of foil. Place the baking sheet and the foil packet in the oven and bake 40 to 50 minutes, until the squash is puree tender and the garlic gives when the package is pressed. Set aside until cool enough to handle, about 20 minutes.
To make the Tunisian Spice Mix, combine the spices in a small bowl. Add half the spice mix to the puree, then taste, adding more spice if desired and fresh lemon juice to lift the flavors. Adjust the seasoning. Keep the puree warm in a bain marie until ready to serve.
Reminds me of a lima bean puree I made to prove to my sister that she could like lima beans.


© Andy Perez Benzo. All rights reserved.
It's become very popular to enter the gardens of Seoul's imperial palaces while wearing "hanbok," or the traditional dress of South Korea. If you're properly attired, admission is free and you have the privilege of enjoying the magnificent scenery of the country in an oasis of natural beauty within a bustling city.
Date Uploaded: Nov. 14, 2016, 8:30 p.m.


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Welcome Home to Aspire Fillmore
Finding a quality apartment home in Colorado Springs, Colorado has never been easier. Our community is situated west of Interstate 25 in a quaint neighborhood just north of downtown Colorado Springs. Aspire Fillmore is conveniently located in close proximity to freeways and local destinations, including restaurants, shopping, and entertainment venues in Colorado Springs, Colorado. At Aspire Fillmore, there is something for everyone.
We are proud to offer five spacious studio, one, two, and three bedroom apartments for rent in Colorado Springs, CO. Designed with your comfort in mind, you will feel right at home in our designer and updated layouts. Apartment features include a deluxe kitchen complete with modern appliances, A/C units and central heating, and carpeted bedrooms. Select floor plans include brick accent walls, vinyl wood flooring, and walk-in closets. Aspire Fillmore is a pet-friendly community so please bring your furry friends to enjoy your new home with you.
Our amenities extend beyond your front door. Dive into our shimmering swimming pool or simply lounge poolside and soak up the sun. Enjoy a stroll in our beautiful courtyard, visit our on-site business center, take advantage of the laundry facility, or make new memories with friends and family at our barbecue picnic area. Call us today and schedule your tour of Aspire Fillmore in Colorado Springs, Colorado!
Aspire Fillmore
3210 N. Chestnut St.
Colorado Springs, CO 80907 (719) 473-0322
© 2023 Clear Capital, LLC. All Rights Reserved. | Website Design by RentCafe (© 2023 Yardi Systems, Inc. All Rights Reserved.)


Hair donuts and hair padding will help you create updos, chignons and bridal hairstyle. These innovative shapes create easy upstyles and updos that you can do in minutes. Don't wait for a special occasion or upstyle, the hair donut is great for everyday when you want to put your hair up. Create almost any shape imaginable!


Address and Phone of Brian Baker, Carmel & Naccasha LLP in San Luis Obispo, CA.
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The jury in the trial of former police authority chief Dave McLuckie have been urged not to let sympathy for a dead man influence their judgement.
Maurice Ward, who was terminally ill with cancer, wrote a letter on his deathbed allegedly exposing McLuckie as a law-breaker who persuaded him to take three speeding points on his behalf, a court has heard.
But the former Cleveland Police Authority chairman, who is accused of perverting the course of justice, denies the allegation.
The alleged incident in April 2005 only came to light in January 2012 when Mr Ward died, and after his relationship with McLuckie "soured".
Defence barrister, Julian Smith, told the jury at Newcastle Crown Court the defendant, who works at Cleveland Potash, was a busy man who worked 15 hour days and kept three diaries to run his working life.
It was "not far fetched, not nonsense, not absurd," to suggest Mr McLuckie did not know who was driving the car.
The 51-year-old Redcar and Cleveland councillor let his friend, Mr Ward, use his car "very frequently" the court heard.
Earlier the jury was told by prosecutor Nick Dry it was not credible that Mr Ward's family had got together to concoct the story against McLuckie out of malice and vindictiveness.
Instead the court was told that McLuckie had interfered with the law to his own advantage.
McLuckie, from Great Ayton, has said it was possible that it was him who was driving the black Peugeot that was clocked doing 36mph in a 30mph speed limit area in Carlin How. But at the time he said he "believed it was Maurice".
McLuckie, who was vice-chairman of the police authority at the time and on the verge of taking the senior role, had nine penalty points on his licence.
The case returns today when the jury are expected to be sent out to consider their verdict.


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小毒龍 (1972)
The Young Avenger
Reviewed by: Sydneyguy
Summary: Hmmm.....
i was a little bored with this!!
The story doesnt help either, with the young avenger coming back to town to kill a bad guy who killed her father (by hitting him in the back when he wasnt defending himself, but her father thoroughly defeated him)
So a bad guy who was not her fathers match comes back to seek revenge in 10 years, now how well do you think this bad guy will fair when she is sent to one of her powerful uncles, along with her cousin being sent to another powerful uncle??
What i didnt like is a monk going KILL KILL at the end.
IT starts off well enough but it becomes predictable to routine.
Reviewer Score: 5
Reviewed by: bmwracer
Summary: Little Poisonous Dragon
"The Young Avenger" is a 1972 Shaw Brothers Studios wuxia action film starring Shih Szu, who for most of the 1970's was the reigning queen of the Shaw Brothers kung fu/wuxia films, having inherited the title from Cheng Pei Pei, who had retired to raise a family.
First off, "The Young Avenger" is an odd title for the film, since it's not even close to the literal translation. From my recollection (I saw this movie when I was a kid--had a thing for Shih Szu, but that's another story) the translated title is "Little Poisonous Dragon," and a quick check using Babel Fish confirms this. Why the studio changed this name so dramatically is beyond me, but it's not the first time an Asian film has its title hacked to pieces (no pun intended) upon translation to English.
Like many wuxia films that came before and would follow, "The Young Avenger" is a revenge film, with Shih Szu in the title role as Bao Zhu. Her father, Li Kui (Tung Lin), master of the Poisonous Dragon Sword style, is wounded in a battle with Liu Tou (Fan Mei Sheng), a revenge-minded swordsman with a hunchback. Though beaten, Liu Tou swears to return in ten years to avenge his defeat at the hands of Li Kui. Unfortunately, Li would eventually die from his injuries, but not before sending Bao Zhu off to a monastery to learn the Poisonous Dragon Sword style. After ten years, Bao Zhu returns, now a master of the Poisonous Dragon Sword style, and wielding her father's deadly cane sword. But now she is also an assassin/bounty hunter, heading back to town seeking to face off with Liu Tou and avenge her father's death during the Mid-Autumn Festival. Her return also allows her to reunite with her cousin, Chen Shi Lun (Yueh Hua), a master of the Iron Fan style. Together, they plan on how to deal with Liu Tou and his thugs.
The quality and quantity of swordplay in this film is first rate with minimal wirework. Shih Szu appears to be very comfortable and adept with a sword as she slices up the thugs with confidence and aplomb. And after she routs them, she has this knack of carefully wiping off the blood on her sword on her sleeve before re-sheathing it, an interesting detail. Bao Zhu's final battle with Liu Tou is pretty well done, although I was really disappointed that the story required her needing outside assistance to defeat Mr. Hunchback. Major demerit here. Was it because she's a woman? I think so. That might also explain why the male lead (Yueh Hua) is shown more prominently on the DVD cover than she is, though Shih Szu is more prominent on the original poster art. Strange.
Speaking of women, I found it extremely hard to believe that a number the characters mistook Bao Zhu as a boy and even referring to her as such. Early on in the movie, she was disheveled and appeared to be a beggar, but come on, she's no boy. I guess the need for glasses in medieval China was considerably more severe than anyone could have imagined. LOL.
Like all of the remastered Shaw Brothers films (from IVL - Intercontinental Video Limited) on DVD (Region 3) that I've seen, the picture and audio are very good with good color saturation and detail. I didn't see any flaws in the film aside from some the typical lack of focus in a few shots (the cinematographer needed glasses too, I suppose). The extras are thin as usual: just trailers, selected bios, and some brief movie info.
All told, "Little Poisonous Dragon," er, "The Young Avenger" gets an 8 out of 10.
Reviewed by: MrBooth
Summary: 7/10 - a bit muddled, but entertaining
Shih Szu's father is mortally wounded by a hump-backed villain, who promises to return 10 years later for a rematch. She is promptly sent off to train in swordplay, and becomes "The Young Avenger". The story is actually rather muddled, and would probably have benefited from some streamlining - in particular, Yueh Hua's character wasn't necessary, and Chan Shen's character should probably have stayed off screen.
Despite the story problems, the film is definitely entertaining. I'd say this is one of Shih Szu's best roles in fact - she acts (relatively) well, fights well and looks quite lovely. The action is one of the film's main draws, featuring some excellent choreography from the under-rated Hsu Er Niu. Although Shih Szu isn't a talented martial artist by any measure, she does swing her sword with steely-eyed ferocity at least.
Reviewed by: pjshimmer
Summary: Classic
This is a good effort that took 3 years to complete. The King's Video trailer advertized it as "a new form of swordplay." While that's a 100% overstatement, the swordplay does look nice in this one. Unexpectedly, there are a lot of running and sterning, clearly resemblance of King Hu's trademarks.
I have to say, I wasn't expecting much from this movie that only grossed 1/3 of a million HK$, so it was a propos that this is not a perfect movie. The story sounded great, but it wasn't executed well at all. More could have been thrown in, as this movie really didn't give much of anything. Plus, no female lead has annoyed me as much as Si Si here since Hsu Qi in The Blacksheep Affair. So it definitely could have been better.


Suspension Package, Autoride, bi-state variable shock dampening and rear air-assisted load-leveling includes (G69) automatic air level control.
GVWR, 7300 lbs. (3311 kg) (Standard on 4WD models.).
Transfer case, active, single-speed, electronic Autotrac with rotary controls, does not include neutral. Cannot be dinghy towed. (Requires (GU4) 3.08 rear axle ratio. Not available on 2WD models or with (K5L) heavyduty trailering package.).
Wheels, 4 - 20" x 8.5" (50.8 cm x 21.6 cm) polished aluminum.
Recovery hooks, front, frame-mounted (Standard on 4WD models. Not available on 2WD models.).
Luggage rack center rails, roof-mounted, Black.
Fascia, rear color-keyed with chrome strip and integrated trailer hitch cover.
Moldings, color-keyed bodyside (Unique design with chrome strip included on LTZ.).
Mirrors, outside heated power-adjustable, power-folding and driver-side auto-dimming with integrated turn signal indicators, ground illumination and curb-tilt (Mirror caps are bright chrome. Includes memory function with (AN3) front bucket seats.).
Liftgate with liftglass rear door system with rear-window wiper/washer.
Audio system with Navigation, AM/FM stereo with MP3 compatible CD player and navigation, auxiliary jack input, seek-and-scan, digital clock, auto-tone control, Radio Data System (RDS), speed-compensated volume, TheftLock, USB Port, and voice recognition (Not available with (PCJ) Sun, Entertainment and Destinations Package.).
Audio system feature, Bose Centerpoint Surround Sound 10-speaker system.
Audio system controls, rear with 2 headphone jacks (headphones not included), power outlet and controls for volume, station selection and media).
XM Radio is standard on more than 50 2010 GM models, including three trial months of service. XM turns your world on with commercial-free music channels for virtually every music genre, all in amazing digital quality sound. Turn on your favorite sports, the biggest names in News, Talk and Comedy, family programming, exclusive concerts and original music series, wherever you go from coast to coast. Everything worth listening to is now on XM. (Not available with (UUL) AM/FM stereo with CD player and MP3 playback, navigation, voice recognition or (UUK) AM/FM stereo with MP3 compatible CD/DVD player and DVD-based navigation. XM service available only in the 48 contiguous United States and the District of Columbia. XM Radio subscription required and sold separately after trial period. Fees, taxes, and a one-time re-activation fee, may apply. Subscriptions governed by XM Customer Agreement available at xmradio.com. All fees and programming subject to change. Family programming Packages are available.).
XM NavTraffic enhances your vehicle's GPS navigation system by showing realtime traffic data when it's needed most - while you're driving. Available in over 80 markets, XM NavTraffic displays construction, road closures and accidents so you can get to your destination faster. Available in select models (Required XM Radio and NavTraffic monthly subscriptions sold separately after trial period. XM NavTraffic only available in select markets. For more information, see www.xmradio.com/navtraffic .).
Seats, front bucket with Perforated leather-appointed seating (AG1) 12-way power driver and (AG2) front passenger seat adjusters, power lumbar control, heated and cooled seats, 2-position driver memory (including lumbar), adjustable head restraints, storage pockets and floor console.
Seats, heated and cooled driver and front passenger.
Seat adjuster, front passenger 6-way power.
Seat release, second row, power release only.
Console, floor with storage area, cup holders and integrated second row audio controls (Includes woodgrain covered forward storage.).
Pedals, power-adjustable for accelerator and brake (Includes memory function with (AN3) front bucket seats.).
Universal Home Remote includes garage door opener, programmable.
Air conditioning, tri-zone automatic climate control with individual climate settings for driver and right front passenger.
Rear Parking Assist, Ultrasonic with audible warning.
Rearview camera system (Included and only available with (UUL) AM/FM stereo with CD player and MP3 playback, navigation, voice recognition or (UUK) AM/FM stereo with MP3 compatible CD/DVD player and DVD-based navigation.).
Safety belts, 3-point, driver and front passenger in all seating positions.


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Jenny Wecker, founder and CEO of Fawn Design, has always embodied an entrepreneurial spirit. When Jenny was five years old, her mom—a talented seamstress—taught her how to sew and gave Jenny her first sewing machine. At that young age, Jenny would spend hours designing and sewing clothes for herself, her dolls, and even the family dog. Little did Jenny know that her love of sewing would one day lead to a woman's lifestyle brand and a booming bag business.
In her early 20s, Jenny was working as a dental hygienist, living in a one-bedroom apartment with her husband, Cole, and pregnant with their first daughter. After a friend mentioned that she couldn't find a diaper bag she liked, a light bulb went off for Jenny and she got the idea to make a different kind of diaper bag—one that was as fashionable as it was functional. She designed the bag with a minimal, modern shape, an easy-to-open half-round zipper top, and comfortable backpack straps. She chose premium faux leather, which offers a luxe look but is animal-friendly and easy to clean, and added stylish gold hardware details. When Jenny sat down at her sewing machine and made the first stitches on that bag, she was stitching together the beginning of the brand's signature style: the Fawn Design Original Bag. The bag was a huge hit with Jenny's friends, and she was bombarded with requests for more. And with that, Fawn Design was born.
Flash forward a few years, and the lineup of signature Fawn Design bags now includes the Original, Mini, Tote, Weekender, Drawstring Bag, Circle Bag, Fawny Pack, and an array of accessories from keychains to stroller hooks. The Fawn Design brand continues to grow: New products are always in the works and new colors are released twice a year as limited-edition Fall/Winter and Spring/Summer collections.
Jenny no longer sews each bag by hand—as she did late into the night, every night, during her first year of business—but her original designs and her focus on quality and attention to detail remain. Today, all Fawn Design bags are ethically produced in China by a team of women and mothers, much like ourselves. Fawn Design bags are made of high-quality polyurethane faux leather with no BPA, PVC, or lead.
Between raising her two young daughters and running Fawn Design, Jenny's days are full of love, gratitude, and hard work as she balances her role as a mom and a business owner. She pours her heart into every aspect of Fawn Design, from customer service to new product launches. She continues to focus on making innovative products that are accessible to women all over the world. Her mission with Fawn Design is to empower women from every walk of life and to create products that embrace and celebrate every stage of womanhood.
Our customer is a modern, effortless woman who embodies a sense of personal style, a passionate spirit, and a curiosity for travel and adventure. She wants to live life to the fullest and embrace every moment. She spends her days juggling many different roles—mom, wife, boss, friend—but she isn't defined by any of them. Maintaining her unique identity and style are important to her. She spends a lot of time caring for her loved ones and the people around her, but she knows how important it is to also take care of herself. To her, Fawn Design is a bright spot in her day and a place where she can shine—a place where she can be herself, feel her best, get inspired, and feel supported. Fawn Design offers her a sense of belonging and a sense of self-worth.