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Review of NEW Lufthansa Business Class Airbus A350
I was invited to create a review of Lufthansa Business Class and the experience onboard the relaunched A350 service from Singapore to Munich route and create a video. All opinions are always honest and my own. This article was first published in Sept 2018 and updated on Oct 2019.
Lufthansa is one of Europe's best known airlines and the flagship airline of the Lufthansa group which also includes Swiss Airlines, Brussels Airlines, Austrian Airlines and low cost airlines Eurowings.
The airline is a founding member of Star Alliance and has Europe's largest loyalty program. As a German carrier, it is usually associated with professionalism and precision. It is reliable and safe. So I wanted to see for myself how it fared, and partnering with them for this article and a video was a great opportunity to review Lufthansa Business Class. I will share my thoughts here.
Talking of which, watch the video of my experience below.
Background for this article
Lufthansa A350 aircraft and new brand look
Arrival and check-in for Lufthansa Business Class
Lufthansa Business Class cabin and seat onboard the A350
The entertainment system and WiFi onboard Lufthansa Business Class
Amenities onboard Lufthansa A350 Business Class
The food onboard Lufthansa Business Class
The service onboard Lufthansa Business Class
Lufthansa Lounge at Munich Airport
Review of Lufthansa Business Class on the A350 – The verdict
On occasion of my summer trip to Europe, Lufthansa invited me to try the relaunched Singapore – Munich service on the new A350-900 cabin, an opportunity that I could not pass up on. I have flown Lufthansa before, when their Business Class seats still had a slope and you would slide down to the bottom.
Living in Singapore, I tend to favor Singapore Airlines with which I have status and miles. However, I often fly other airlines to stay abreast of the industry and try out new products. Being a Star Alliance member, Lufthansa would be my European airline of choice.
Experiencing the flight as a media influencer was a great experience too. It was fun and fascinating to work together with Lufthansa to create a video I am very proud of and also write this review.
Obviously, the entire crew were aware they were being filmed and did their best to make our experience enjoyable. I also flew back with Lufthansa, this time on the A380, as a regular guest, so I could compare if the service was any different. Check out my review of Lufthansa A380 Business Class for more info and the comparison to this flight.
Lufthansa has always been easily recognisable thanks to the bright yellow color. In 2018, the carrier has embarked in a brand refresh including a sleeker crane logo and a new palette of colors to be used in uniforms and in the cabins.
The new Lufthansa color scheme – Photo courtesy of Lufthansa
As the Singapore-Munich route is served by the new Airbus A350 aircrafts, the cabin already showed the new brand livery and crew uniforms so this flight gave me the chance to see how it all played together.
The new brand livery feels much more elegant. A new shade of blue dominates and instead of the former yellow, the secondary color is based on a color similar to copper that is used both on the pillows as well as on the partitions between seats. It is a color that I have seen used by other brands like Bawah Reserve also relaunched with a similar shade, as well as and Six Senses Singapore at Duxton Hill.
As you can see from the color wheel below, the color palette changes depending on the cabin but all three feature similar color ranges.
Color palette for Lufthansa's new brand livery – Photo courtesy of Lufthansa
Lufthansa has only six A350 aircrafts in 2018 and 19 more on order to be delivered until 2025. The Airbus A350s are known for being the most efficient of the range, fast and designed to minimise the impact of jetlag thanks to various smart features like the air control, lighting and the lowered noise levels.
The aircrafts consume a quarter the amount of fuel of comparable aircrafts and their Rolls-Royce Trent XWB engines are 30% less noisy so the cabins feel more silent and calm. They have also been dubbed the most environmentally friendly aircrafts as they produce 25% less emissions.
As the A350s are far smaller than the two-storey beluga A380s, they are more nimble and engineered best for a three-cabin configuration. Lufthansa has foregone the First Class cabin in their A350 and gone for 224 seats in Economy, 21 in Premium Economy and 48 in Business Class.
Some carriers like Singapore Airlines, have started to use A350 aircrafts for super long-haul flights because their efficiency allows them to serve those route in a financially viable manner.
The crew onboard my flight provided additional insights into the A350 experience which I was quite curious about. I had flown A350 before but it was interesting to see how Lufthansa has adapted the aircraft and made the most of it.
For example, the flight between Singapore and Munich is barely 11 hours, sometimes even less, one of the fastest connections between Asia and Europe, so we had to wait a little to depart from Singapore to ensure we would not reach Munich before the airport officially opens.
I must admit that the flight went by really quickly and, when compared to my usual 16h Singapore Airlines flight to Barcelona with the 1h stopover in Milan that always feels like it never ends, this felt really quick and we barely had time to have dinner, breakfast and sleep.
Can you spot the difference between two of the mood lightings?
The aircraft has several mood lighting settings which can take up to 5min to turn on and are designed to simulate various times of the day and better adapt to the body's rhythm. For example, you can see the difference between the nighttime and the morning mood lighting in the two pictures of the galley above.
These settings take about five minutes to come on so the light changes progressively and slowly. I actually tested this with the cabin crew when they turned the lights on for breakfast service, and it did indeed take 5 min for the lights to fully turn on.
One of the complaints I have in planes, and which determines what I wear on my flights, is how cold airplane cabins can be. I always freeze and wear a fluffy jacket to keep warm. The crew told me that the A350 has individual AC controls per row and so the temperature can be adapted differently for different passengers. This is a #win for me and anyone who always freezes in planes.
The crew told me that the since they fly the new A350 aircraft (some of them almost exclusively for a year) they have felt their jetlag getting better.
For several years I used to fly more than airline staff, and got quite used to living in a time zone that didn't exist. I no longer do and struggle with jetlag more than I ever used to (age they say!) so I was keen to see how I would fare.
I have to admit that it took me and my partner only a couple of days to get used to European time instead of the usual five, although the generous amount of sunlight and time we enjoyed outside under the sun with lots of Spanish meats probably helped too.
Check in for Lufthansa in Singapore is at Terminal 2. There were a couple of Business Class counters which were empty when I arrived so check-in was swift.
If you have downloaded the Lufthansa app and signed in, you will receive your luggage tags via email as well, and any changes in gate will be sent via email too. The gate was changed on all of my flights and finding out via email was very convenient.
I was also met by the Lufthansa media team at check in and, after shooting some videos of Changi Airport and the check in procedure, we went through immigration and towards the lounge. Changi Airport is such a great airport to fly from.
Lufthansa uses the Singapore Airlines Business Class lounge at Terminal 2 which has a dining section with lots of food options from the cuisines that make Singapore unique and a larger sofa area to relax, read or work. There are also cubicles to get some work done.
About an hour before the flight we went to the gate to meet the crew before boarding. On the way, we managed to lose one of the boarding cards (not sure how/when) which the gate staff easily resolved with a copy, thankfully.
Boarding of Lufthansa flights in Singapore, as in other airports, is done by priority/class. Business Class passengers and Star Alliance Gold Members get to board first together with families with small children.
Seat plan on Lufthansa A350-900 – Courtesy of Lufthansa
As you can see in the seat map above, Lufthansa A350 Business Class cabin has a reverse herringbone 2-2-2 configuration with direct aisle access for all passengers except for the window seats.
The Business Class cabin was split into two sections, a larger one at the front with six rows and two additional rows after the galley before Premium Economy. Watch the video below where the Purser shows me to my seat and through the cabin.
My partner and I were on the last row of Business Class and had the two seats by the window so that we could record the experience without interfering with other guests or catching them on film. This small mini-cabin felt much more private than the larger one upfront.
The Business Class cabin on the new Lufthansa A350
I liked these two seats by the window because they were cozy and felt quite private. If you are flying with a partner, these are the best seats, while if you fly alone, you will probably prefer any of the aisle seats.
If you, like me, prefer window seats, jumping over the seat mate when the beds are flat and they are asleep is pretty easy to do without disturbing them. I tested it to record this in-flight Facebook Live video while my partner was asleep.
Our two seats on the last row of Business Class
As you can see from the seat map above, Lufthansa Business Class A350 cabin has two more seats per row than the configuration of other carriers using the A350. For example, Singapore Airlines A350 Business Class configuration only has 4 seats per row, same as Finnair.
This may seem a little cramped but it did not affect my experience. Far from my United Business Class experience to San Francisco a couple of years ago when me and my seatmate actually shared an armrest, in Business Class. For extra privacy, choose a window seat in the 1st or 7th rows which have extra footrest space than the rest.
The cabin on the A350 was as new as the aircraft, about three months old, and already decked with the new brand livery and aircraft design. I thought the new cabin was very elegant-looking using the metal silver and grey color as the basis and complementing it with the new blue and the shade of copper. It looked appealing and modern. One of the nicest cabins I have seen recently.
The last two rows of Business Class on Lufthansa A350 in a separate semi-cabin
Lufthansa's Business Class seats on the A350 are 50cm wide and almost 2m long when completely flat, so they are comfortable even for tall German passengers. This makes Lufthansa an excellent alternative to Singapore Airlines which, while having wider seats by 20cm, forces you to sleep at an angle, something which is inconvenient even for shorter people like me who sleep on their side.
Seat operation on Lufthansa Business Class
The operation of the seats was very sleek and intuitive. I loved the mechanics to pull the seat up and down and the touch controls which were not only easy to use and fuss-free but also fast and practical.
The bed went completely flat quickly and you could go up and down without having to stand up (as is the case with Singapore Airlines where the seatback is actually the bed). You could also control the seat firmness.
Lie-flat beds on Lufthansa A350 Business Class
The seat was also comfortable when seated. The folded table was easy to retrieve from inside the armrest and was of a decent size. Like with most business class folded tables, it can get a bit wiggly if you are trying to type on your laptop so I always put the pillow on my lap, under the table, to stabilise it.
My window seat on Lufthansa Business Class A350
The only downside I could find on my Business Class seat on the A350 was the lack of personal space to store small items right by my seat (there is a good amount of overall storage space).
The seats are compact in width so the only space you have handy is the compartment where the headset is, which is already quite full, and a small area under the armrest or on top of it, but it is easy for items to slide if there is a bit of turbulence.
Check out this video where the Purser shows me my seat.
I had a lot of equipment on this flight so I resorted to storing it on the space where the USB plug is. The only issue with leaving things there is that every time you bring the seat down, the items will slip and end up under the seat. It happened at least three times.
Thankfully, the seats were designed with that issue in mind and it is easy to retrieve anything that falls through the cracks as there is a lining under the seat that prevent items from ending in the seat's mechanics.
I also need to mention the electrical facilities in this review of Lufthansa Business Class, as the seats on the A350 have a personal USB plug in the space under the armrest and an international electricity socket near the floor level on the armrest. I used this to charge all my electronics during the flight.
In terms of other storage areas, there is space under the TV inside a pull-out compartment where the amenity kit and a bottle of water are stored. While this is handy and can even fit a laptop, it is not easy to reach when you are seated as it is quite far, so less practical than the space on the wider body A380 which offers large compartments to window seat passengers.
The entertainment system remote control and pull-out table
As the seats on Lufthansa's Business Class are in a reverse herringbone position there is quite some space between the seat back and the wall, which I used to store the Dream Collection items as well as some of my personal belongings.
Lastly, there is also space under the footrest where my handbag ended up. This space does not disappear when the seat is flat so you can keep shoes or smaller bags there without being crushed by the seat.
I found the entertainment system on Lufthansa Business Class not as good as with other airlines. It was not terrible, but I felt that it was not as amazing as the rest of the experience. I did not have any time to enjoy it on this flight, but browsed through it to test it and find out more.
There is a list of TV series and movies to watch, but instead of the usual latest movies there were lots of classics and all time favorites available. While this is not a huge issue per se, the way they were organised was not very user friendly and made it quite time-consuming to find something to watch.
I could filter by genre and language but then simply got a long list of titles. Whenever I clicked on one, the system was very slow to load it for me to read the plot and decide if I wanted to watch it. The text was also very small (perhaps I need glasses) and far from the seat, so despite the screens being bigger than the standard, it was hard to read it properly. Loading the movies took some extra time too.
On the flip side, the entertainment selection featured movies in several of the European languages so there were a few non-English options. I was reminded of the last time I flew Business Class with Singapore Airlines to Barcelona via Milan and the many Italian and Spanish passengers onboard had nothing to watch (and could not even get the system to work in their language to even search) because there were practically no European foreign language options available (despite Spanish being the fourth most spoken language in the world).
The noise cancelling headsets
The TV screen slides, so you can tilt it to face you better and bother the passenger next to you less, as the bright screen does not face them. The headsets were another plus. They were proper noise cancelling ones, comfortable to wear and from the professional AKG brand.
The headsets are stored inside their own compartment and are plugged in, so you cannot take them with you (I bet a lot of people would take them home if they could). This means you cannot end up misplacing them like it has happened to me on Singapore Airlines before.
Alternatively, Lufthansa onboard WiFi service from FlyNet was impressive. I have mentioned the strength of the signal and the fact that I could even do a Live Facebook video. Trust me when I say this, Facebook is very moody and picky, if the internet connection is not of the highest standard, it will not connect. My Live video went smooth and worked fabulously. I was impressed. Watch it below.
Live at 33,000 feet from inside the Business Class cabin of Lufthansa A350 with the Senior person and the lovely crew – an exclusive behind the scenes look at how the galley works and what secret compartments it holds !
#Lufthansa #SayYestotheWorld
Posted by Once in a Lifetime Journey on Wednesday, August 22, 2018
I also tested it to watch Netflix and can say it did well. So, even if you have not managed to download any movies before boarding, you can still stream or download them onboard. Problem solved. I did that on the way back.
Prices for FlyNet service on long haul are valid for 24h and cost $19, which is industry standard pricing. You can also buy smaller chunks of one or four hours instead. The only downside to FlyNet is that the service can be unstable and while it gave me great speeds when it worked, it stopped working two-thirds into the flight and I could not get it to work again. Nothing under Lufthansa's control.
Aside from movies and other TV shows, Lufthansa Business Class passengers also get the chance to download digital magazines to read onboard. Newspapers will be offered after take off but there is a large selection of magazines in several languages available for download pre-flight via the Lufthansa app which will take you to the eJournals app.
All passengers, even Economy Class, get to download at least one title to read onboard. As a Business Class passenger you actually get 3 titles. Miles & More status members can download even more titles. I downloaded three travel magazines at the lounge.
Lufthansa Business Class amenity kit
I have always had a bit of a hoarding side which forces me to collect the many Business Class amenity kits that I have accumulated over the years. Except for Singapore Airlines, which doesn't actually give you an amenity kit (they did briefly hand out 70th Anniversary ones in 2017), all airlines will give you a bag containing some amenities for the flight.
Since July 2018, Lufthansa has a set of three new kits by German functional brand Reisenthel for their Business Class passengers. On my A350 flight I was given the pencil case version, while on my return onboard the A380 I got the handbag.
The idea behind the new amenity kit is that of environmental consciousness so the three kinds are reusable either as pencil cases, grocery/travel bags or as make-up cases. I like this idea (see my hoarding issues above) because I always end up giving away the content of the kits to charity while keeping the cases for my makeup.
Inside the amenity kit I found a set of cosmetics from the Provence-inspired brand L'Occitane. The pencil case amenity kit has a lip balm and a face cream while the grocery bag came with a small travel size hand cream (super cute) and a premium face cream. I will say this, the lip balm saved me for the duration of my trip. It was so rich and good that I used it all throughout Montenegro and Albania and even went back to L'Occitane to buy a full size version.
Those who know me know that I had a stroke when my favorite brand of lip balm (which I used for 20 years!) stopped producing it at the beginning of this year and I have been trying to find a replacement so I was really happy to find this one. Double high-five for Lufthansa for this.
Aside from the cosmetics, there is a dental kit with whitening toothpaste and a toothbrush, a mint, a pair of ear plugs, eye shades, covers for the headsets and a pair of socks.
Business Class passengers also get their own sleepers and a set of items from the Dream Collection. Now, this is the next level of comfort onboard.
Lufthansa Dream Collection pillow, duvet and pyjamas
The Dream Collection includes a soft and warm blanket-duvet, a large pillow, a non-slip mattress topper and a pyjama shirt. I tested them all to give you the ins and outs.
So, was that just a PR stunt or did it actually help me sleep better?
I will be honest, I was actually busy shooting for the duration of the overnight flight on the way out so I did not have that much time to sleep but the few hours when I actually put my head down were pretty good. The mattress topper did help make the seat softer and it was indeed non slip, so it did not move even when I brought the seat up and down for meal service.
My last two Business Class flights before this one this year were on Ethiopian Airlines and on Fiji Airways and they both had huge seats that went completely flat but were pretty tough to sleep on. I sleep on my side and there are a lot of bones on my hips (well just one) and not a lot of cushion so I tend to land pretty beaten up. The mattress topper actually solved that.
Lufthansa is not the only one giving you these cushion-y covers, Emirates has been doing so for years, but I applaud the airline for adding this for the comfort of the Business Class passengers, it does make a difference and may have as well helped award Lufthansa with the 5th star from Skytrax. On the way back I actually slept all the way and woke up a mere two hours before landing.
The packaging of Lufthansa's Business Class duvet
As per the duvet, I found it to be very soft and nice to the touch. It is also thick so people like me, who always freeze in planes, can survive. I even had to take my fluffy jacket off because I was too hot.
I also tested the pyjamas from German shirt brand Van Laack. I don't usually change into any clothes other than my own because I have specific clothes I wear onboard. Basically, my inflight attire always consists of loose pyjama-style pants. But this time I was dressed for the occasion and so the pyjamas were a nice addition.
You only get the pyjama shirt top, and no pants, but they are useful to avoid getting food stains on your clothes (which through the years I have learned planes tend to be prone to), to keep warmer and to avoid getting your shirt creased. They were also quite soft so I kept them on and my partner may have taken them home. And I confirmed you can indeed make them your own!
Good to note that the packaging in which the mattress topper, blanket and pyjamas are kept in is made of recyclable paper and not plastic.
Lufthansa Business Class drinks and snacks after take-off
One of the most important parts of a Business Class flight is the food. My best friend never eats in planes, even if the flight is 15h long. I never understood that. To me, the culinary experience onboard is something I look forward to.
I am fascinated by the cooking that can happen at 33,000 feet where our taste buds are not the same and the flavors and smells change so much. On the A350, the galley and kitchen are even more sophisticated and modern and the crew has a fridge and very technologically advanced ovens to cook each type of meal.
So how did Lufthansa Business Class food taste?
Pretty good. And very filling. We were so full by the end of the dinner service it would be fair to say we approached food coma. It did not help that the crew were so nice and let us try all the dishes on the menu.
Lufthansa Business Class service from Singapore to Munich, like all other Asia to Europe services, takes off at night and lands in the early morning, so both dinner and breakfast were served.
Before take off, we were offered a drink. We had some sparkling German wine while settling into our seats. After take off, before our meal orders were taken, we were again offered a drink and some warm, toasted and salted almonds on a ramekin. On the Singapore flights, Lufthansa has a premixed Singapore Sling drink on offer. The crew then passed through the aisles to take our orders for dinner.
The dinner menu had three starters and three mains to choose from. There is always a vegetarian option available, usually pasta, as well as a fish and meat dish. The menus change every other month so frequent travelers don't have repetitive meals (something I used to get really tired off when flying every week and basically eating the same for two days of the week).
For starters there was:
1. Roaster king prawn with chickpea mousseline, salad and herbs
2. Roasted Angus beef, asparagus salad and baby carrots with mint taboule
3. Red bell pepper quenelle, roasted vegetables and salsa verde
Lufthansa Business Class food – Red pepper quenelle
The mains included:
1. Grilled veal loin, sweet potato mash, cherry tomato and mixed zucchini
2. Sweet and sour garoupa fillet with mixed vegetable and egg fried rice, broccoli and mushrooms
3. Sage butter potato gnocchi with blue cheese cream sauce, bok choy, carrot and asparagus puree
We got to try two of the starters (the Angus beef and the red pepper quenelle) and then all three of the mains but we could not finish half of the portions as they were very generous.
The red pepper quenelle was very beautifully plated, looking like silky dollops of red pepper mousse, it was my favorite dish. The mains were filling, and very rich, mimicking German cuisine which tends to be thought for the cold weather that looms over the country for most of the year.
Lufthansa Business Class food – Sweet and sour garoupa
The gnocchi was very creamy and something straight out of a Sicilian food advert, and the garoupa and veal were both tasty. I thought the portions were very big, with two pieces of fish and meat instead of the usual one piece you would find in other airlines.
Between the starters and the mains we were also offered a green salad with a macadamia dressing and some shaved parmesan cheese which was very tasty.
Lufthansa Business Class food – Set of desserts
For dessert, there is always a selection of cheese with crackers, nuts and dried fruits, a selection of fresh cut fruit and a cake, in this case a dark chocolate cake with caramel hazelnut and marinated cherries. Again, on condition of media, we were given the chance of trying all three of them. I, of course, obliged.
The drinks menu onboard Lufthansa Business Class always includes a selection of wines. There are usually two whites and two reds, one champagne and two liqueurs, Baileys and Tawny Port wine. The selection also changes every other month with the menu.
Lufthansa Business Class food – Cheese platter
The red wine list always includes a French wine while there is always a German white, usually a Riesling as it is one of the most traditional German type of wines. The other choice is always an international option. In my flight there was a New Zealand white and a South African red wine. The German white was from Lufthansa's Castle Collection.
These were the wines available on my flight:
1. Champagne Jacquart Cru, France
2. Rheingau Riesling trocken from the Lufthansa Castle Collection, Germany
3. Awatere Valley 2016 Marlborough Single Vineyard Sauvignon Blanc, Yealands Estate, New Zealand
4. Château Loirac 2014, Cru Bourgeoise Médoc
5. Cape Cuvee 2014 Limited Release, Lance Bouma, Coastal region, South Africa
The crew shared an interesting insight with me. Business Class passengers always have an additional choice of wine from the First Class wine selection. This is not mentioned on the menu and you will not know unless you ask the crew, but it is an insider tip for your next flight.
In my flight there was a Chardonnay from Argentina. Note that my flight did not have First Class yet the wine was still available. Ask the crew and let me know what wine was available on your flight.
Aside from wines, there are also a few types of beer. This could be expected from the national airline of Germany, home to so many different beer brands. On my flight there was a premium lager from Warsteiner, and a wheat beer from Erdinger Weiber, also the same two were available in alcohol-free versions.
Lufthansa Business Class food – Choice of spirits
Those who prefer to drink spirits can choose from the few options: Bombay Sapphire gin, Bacardi rum, Gorbatschow vodka, wild raspberry brandy, three whiskey options: Jack Daniels, Johnnie Walker Black Label and Glenfiddich Cask Collection, Remy Martin Cognac VSOP, Amaro Ramazzotti, Kuemmerling and Campari, all in small individual bottles. On the Singapore route you can also order a Singapore Sling and authentic Mexican tequila is available on Mexico flights.
Coffee lovers like me who are used to terrible onboard coffee will appreciate Lufthansa's onboard Nespresso machine, unique to the A350. The machine only makes espressos, so if you like milk-based coffee, the milk cannot be frothed but at least the base coffee will be far better.
Lufthansa Business Class food – My breakfast
For breakfast, the menu also had two choices of hot dish, some dim sum with chilli or an omelet. We had them both, to try them of course. There are also a selection of warm pastries and breads as well as butter and jam, plus my favorite: Nutella! How could I say no to Nutella.
For drinks we were offered fresh orange juice and also another fruit smoothie, proper coffee and bircher muesli. By the end of it were so full we could not even finish half of the food on our trays.
Lufthansa Business Class food – His breakfast
Aside from the two services for dinner and breakfast, Lufthansa Business Class passengers have a snack bar at their disposal located in the galley. There, they can help themselves to cookies, popcorn, chocolate bars, drinks and any other snacks.
The crew also prepared some other small bites for passengers to take back to their seats like antipasti with prawns or small slices of cake. Non-Alcoholic drinks were also available for self-service.
The self-service snack bar onboard Lufthansa A350 Business Class
The Business Class crew onboard my flight
All Lufthansa A350 flights have 5 cabin attendants for the 48 passengers in Business Class. In comparison, there are 6 for the entire Economy Class cabin (with 224 passengers). This means that your needs will always be taken care of and as soon as you call the crew one will materialise straightaway.
On this flight, my crew was excellent, as expected. You can see both the cabin crew and the second purser that were serving us in my Facebook Live video.
The second Purser, Alex, and the lovely cabin crew member, Tania, who was in charge of our row, were some of the best crew I have ever come across in my 15 years on thousands of flights. It is true that they were aware of our collaboration, but they exceeded my expectations both in professionalism and kindness.
You could wonder if this was because they knew of our collaboration, and it could well be the case. But I have worked with dozens of brands in the past and this is not always the case. Nonetheless, for the more skeptical, I also flew back to Singapore on Lufthansa, as any other regular passenger, and the cabin attendant assigned to me was equally nice and friendly. And he was put to the test.
My nose was bleeding for the last hour of the flight before landing, and continued to do so after we touched the ground, so I needed to get help to bring my suitcase down from the overhead bins, and he was pretty helpful and kind through this inconvenient time. He also made sure I had enough tissue and was quite caring through the awful experience.
So it is fair to say that the service onboard Lufthansa is at the top-end of the scale.
My flight was connecting in Munich, Europe's Best Airport, to take me to the final destination in Barcelona. Munich Airport is partially funded by Lufthansa and is one of the newest in Europe having undergone recent refurbishments. I had heard a lot about it, its bright and green look and how convenient the airport was for connections.
I have transited via Frankfurt several times, most recently on my few flights to New York with Singapore Airlines, and find the airport a bit grey. It is also very large and has several terminals some of which are quite far apart. Transiting from non-Schengen to Schengen, as is usually my case, can sometimes be very time consuming too.
Munich Airport was as promised. It is much smaller than Frankfurt and more convenient. When we landed, most of the shops were still closed as it was just 5am and we were the first flight of the day. As I was shooting some footage around I did explore a bit and found what was promised.
The common areas are very green, and because of the large glass walls, a lot of light was coming through. I could see the sunrise through the planes.
The several dining options looked appetising with many bakeries and cafes ready to serve the breakfast crowd with healthy options. It all felt so nice and inviting that I considered whether I should head to the lounge or just sit there. But I am glad I went to the lounge because it was equally pleasant and quieter.
The airport has free WiFi for everyone and there are a few high-end shops for last minute purchases. I crisscrossed it to find the right lounge for me. We had 3h between our flights because I had asked for enough time to explore the airport for this review but there were faster connections to take us down to Barcelona.
One of Lufthansa's Business Class Lounges at Munich Airport
There are 11 Lufthansa Lounges at Munich Airport, two for Business Class and two for First Class passengers. It took a bit of time to find the right one, as I was being sent to the closest to my gate for convenience, but I finally found it.
The Business Class Lounge was one of the most tranquil lounges I have ever been to. Maybe it was very early in the morning and people were still waking up, or maybe it was the type of people using the lounge, as I found the same on my way back, when I spent 8h at the lounge in Frankfurt.
Coffee, drinks and snacks in Lufthansa Business Class Lounge at Munich Airport
Lufthansa's Business Class Lounge users must be Business Class ticket holders or Star Alliance Gold members. The vast majority of the guests using the lounge were traveling alone and looked like they were on business.
Suits and men dominated, with very few women and lots of formal attire, ties, Rimowa or Tumi carry-ons and expensive and elegant leather bags. This was a primarily business crowd, probably traveling to other short-haul European destinations on business maybe even just for the day.
Working desks in Lufthansa Business Class Lounge at Munich Airport
Although not in writing, Lufthansa does have an unspoken dress-code for its lounges to keep the atmosphere premium and comfortable for everyone, so you are not going to see children running around and screaming or people in tracksuit pants.
I am used to Asian airlines where passengers are from a much more diverse kind. There are more families, more business passengers traveling together, more women and more of the start-up casual wear. And definitely no dress-code.
Lufthansa is not the only airline with a dress-code, Qantas regularly makes headlines when they turn away customers who are not properly dressed, even celebrities.
The lounge had a relaxation area with semi-flat armchairs, a row of booths with more privacy and with tables for team discussions or meetings, individual desks for work, a section with comfortable sofas and a dining area with proper tables and chairs to eat at. It was located by the windows with views over the parked aircrafts waiting to take off from some of the gates.
Sofas and relaxation area in Lufthansa Business Class Lounge at Munich Airport
The self-service food selection was adequate, with some pastries, eggs, breads, sweets and snacks. There was also a fridge full of ice cream and proper coffee machines. I was expecting some of Germany's delicacies like sausages or pretzels on offer, but I only saw them in Frankfurt on my return. They brought back some of the memories flying through Germany when I lived in South Africa and seeing the locals drinking beer and having a sausage in the early hours of the morning.
The drinks selection was vast with lots of soft drinks, detox water (with lemon and mint) and several types of beer, wines and spirits.
I found the lounge very pleasant and quiet, the perfect place to relax and indulge in some food and drinks or get some last minute work done. If you wanted to freshen up, there were also several showers for complimentary use.
The first and second pursers on my Lufthansa Business Class flight
I very much enjoyed testing the relaunched A350 service from Lufthansa to Munich and partnering with Lufthansa to make this video. Having traveled with many airlines in Business Class through the years I would rate Lufthansa at the top end of the choices.
Some of the best parts were the new cabin, food and drinks and the seat comfort, including The Dream Collection. On the downside, partially the entertainment and the limited personal storage right by your seat, something which would have probably not been an issue if I was not carrying so much equipment.
But how does Lufthansa compare to other airlines connecting Asia to Europe?
Singapore Airlines has wider, larger seats (perhaps unnecessarily) but is also priced far above Lufthansa. The Middle Eastern airlines like Qatar Airways, Etihad and Emirates all offer service to Europe but the flights are broken into two pieces of 7h which makes it harder to sleep through and land rested.
Emirates uses a combination of newer A380 and older B777 which are spacious but slower. Etihad serves the route with the Dreamliner B787 which I reviewed on my trip to New York. Qatar Airways is the only one using A350 aircrafts. While their products may be superior, the connections in the middle of the night are inconvenient.
Other European airlines like KLM, Air France and British Airways could compare to Lufthansa but they do not fly the new A350, so flights are longer and less comfortable and transfers are less convenient.
KLM combines the Singapore-Amsterdam route with their connecting flights to Bali, one which I have taken a few times before, and uses old B777-300 aircrafts. Air France uses the same aircrafts. British Airways flies the A380 to Singapore but London is a far longer flight than continental Europe.
The only contender could be Finnair, who launched their first Asian route on the A350 with much pomp and fanfare in the 2017 ITB travel fair, but their connections to Barcelona are not as frequent or convenient and their cabin has not received as much praise and seems a step down from Lufthansa.
Lastly, Turkish Airlines is one last option that always comes up when looking for affordable options between Europe and Asia on Business Class.
While they tend to be very economical and their business class service has received much praise, their connection times to Barcelona are not good so it would not be an option for me. Also, Istanbul airport is still quite chaotic and I have lots of friends who have missed connections.
In conclusion, Lufthansa's Business Class service on the A350 is definitely a great alternative to the more expensive and longer Singapore Airlines option and because it uses A350, also a more comfortable and jetlag friendly choice.
More Business and First Class reviews
Singapore Airlines A350 Business Class review
Lufthansa Business Class A380 review
Old Singapore Airlines A380 Business Class review
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Singapore Airlines Suites Review
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United Airlines Business Class review
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William graduated from Western University with a Bachelor of Business Administration, majoring in accountancy and finance. He is currently working towards his MSA and CPA. William's role at Valley Oak focuses on our small business clients. His work includes monthly bookkeeping, tax planning, tax preparation, and organizing new business entities. In his spare time, William enjoys computer games, fishing, and spending time with his wife and children.


February 5, 2019 – VANCOUVER, BRITISH COLUMBIA – CROP INFRASTRUCTURE CORP. (CSE: CROP) (OTC: CRXPF) (Frankfurt: 2FR) announced today final inspection has been completed at its THC cultivation, production, commercial kitchen and extraction facility in Nevada. The final medical and recreational licenses are expected to be granted later this month.
Meanwhile, construction continues there on the 40-acre perimeter wall for outdoor and greenhouse production. The 40-acre outdoor project is expected to cost $500,000 and is forecast to yield 80,000 pounds of high quality, organically grown outdoor cannabis which will be mostly for sale to extractors and for the company's tenant extraction quotas. The project is now 50% paid for.
The company is now accepting off take and supply agreements requests for 2019 harvest.
Crop is publicly listed on the CSE and trades under the symbol "CROP". CROP is focused on cannabis branding and real estate assets. CROP's portfolio of projects includes cultivation properties in California, two in Washington State, a 1,000-acre Nevada Cannabis farm, 1,865 acres of CBD farms, extraction in Nevada and joint ventures on West Hollywood and San Bernardino dispensary apps with international focuses in Jamaica and Italy.


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Sri Lanka, India and Maldives agree to strengthen cooperation in dealing with maritime challenges
Agreement was reached on further strengthening cooperation in dealing with maritime challenges in the Indian ocean and ensure peace and security in the region for common benefit, at the trilateral 4th National Security Adviser level meeting on 'Maritime Security Cooperation', which concluded at the Colombo Hotel Taj Samudra on Saturday (28).
The sessions were held with the participation of Ajit Doval, National Security Adviser of India, Ms. Mariya Didi, Minister of Defence of Maldives and Maj. Gen. (retd) Kamal Gunaratne, Secretary to the Ministry of Defence.
Minister of Foreign Affairs, Dinesh Gunawardena, was the chief guest at the inauguration.
The High Commissioner of India, Ambassador for the Maldives, Foreign Ministry Secretary Admiral (retd) Prof. Jayanath Colombage, Lieutenant General Shavendra Silva, Chief of Defence Staff, Commander of the Army and Head of the National Operations Centre for Prevention of COVID 19 Outbreak, Navy and Air Force Commanders, Inspector General of Police, Director-General of Sri Lanka Coast Guard, senior officials of Sri Lankan Foreign and Defence Ministries and senior military officers were among the attendees.
Several experts in the field of maritime defence from India, Maldives and Sri Lanka, together with observers from Mauritius and Seychelles, India and the Maldives were represented during the sessions at Senior Officials' level.
The forum, fourth in sequence, took stock of the current maritime security environment in the region and the existing cooperation in the areas of Maritime Domain Awareness, Humanitarian Assistance and Disaster Relief, Joint Exercises, Capacity Building, Maritime Security and Threats, Marine Pollution and Maritime Underwater Heritage, Covid-19 challenges, etc. They agreed to further strengthen cooperation in dealing with these challenges to ensure peace and security in the region for common benefit, a joint media statement issued by the Defence Ministry said.
Defence Secretary Kamal Gunaratne, delivering the welcome address, underlined the momentous importance of dialogue at trilateral level on a regular basis. The Minister of Foreign Affairs made the keynote address before the sessions began deliberations. Lalith Weeratunga, Advisor to the President made the closing remarks.
In view of COVID-19, the dialogue was conducted adhering to strict health guidelines using 'Air Bubble' concept for the visiting delegations, the statement noted.
Sri Lanka, India and Maldives launched the Trilateral NSA level Meeting on Maritime Security Cooperation in 2011 and three meetings had been held so far. The last meeting was held in March 2014 in New Delhi. The past deliberations and outcomes have helped the three countries in improving close coordination in maritime security of the region. These were supplemented by Deputy NSA level meetings for sustained engagements and implementation of the discussions at the NSA level meetings.
The three countries also exchanged views on common security threats and agreed to broad base cooperation by expanding the scope to improve intelligence sharing and include issues like terrorism, radicalization, extremism, drugs, arms and human trafficking, money laundering, cyber security and effect of climate change on maritime environment, the statement further said.
The Heads of Delegations agreed to meet regularly to share, discuss and ensure timely implementation of decisions taken at the Meeting. They also decided to hold Deputy NSA level working group meetings biannually for cooperation at operational level, it added.
UK resident in Sri Lanka awarded a British Empire Medal for services to animal welfare
Hafsah Muheed selected as a Youth Delegate for 2020 YOUNGA Forum

redpajama_set_name: RedPajamaCommonCrawl


If you are a graduate looking at studying Medicine, Dentistry, Optometry, Physiotherapy, Podiatry, drug store or veterinarian nary science in British, Irish or Australian universities then you should be prepared to take the Graduate Medical School Admission Test (GAMSAT). For one to sit this Exam they must have finished their bachelor's degree in any course consisting of non-science associated courses, should attain the GAMSAT cut off rating and should have accomplished prerequisite marks in the bachelor's degree. You can get the gamsat download at https://www.acegamsat.com/ or get the gamsat preparation material free download. The exam is offered twice a year, March and September and has no constraint on the number of times a certified prospect can sit for it.
GAMSAT preparation is necessary for one to ace the examinations. There are numerous systems that assist candidates get ready for the exams. They examine previous exams and try to anticipate exactly what is likely to be tested. These systems have actually been utilized by lots of in the past with a high success rate.
Gold Standard GAMSAT Prep. Com is one such system that offers Free GAMSAT Advice, resources and Practice test. Gold Requirement has totally free GAMSAT preparation material that consist of complimentary sample question, practice test and everyday GAMSAT concern of the day. They likewise give links to the many other sources in addition to complimentary advice on ways to manage the test.
The GAMSAT preparation examination is divided into 3 sections, the humanitarian and social area, the essay section and the formulas area. Gold Requirement will help you deal with each section effectively. Here you will discover how to be analytical and for this reason take on area 1, then they will give you suggestions on the best ways to develop all the appropriate content that will work for area 2 and for area 3 give you links for physics equations and natural chemistry solutions. They also have more than 100 videos that with the worked option of ACER's practice material.
Gold Standard assists you create the best reading Set up over a period of 6 months that will help you prepare your time as well as cover all you have to cover for the GAMSAT exams. They likewise offer one ideas on a selection of books that will come in handy in revision. A few of the books are not totally free however they provide you a group of libraries where you can discover them and borrow. Gold Requirement users can likewise form study hall so regarding help each other modify and hold each other accountable.
The GAMSAT practice Test done on Gold Standard are marked with corrections and comments from their team of highly skilled markers to assist you know where precisely you failed. Gold Requirement is a terrific tool for revision for your GAMSAT test.
Ace GAMSAT is another such system with a high success rate. They use a house research study course that requires 16 books which can be covered in less than 6 months. The books are written by a team of occupations who have a long history in GAMSAT tests.
Ace GAMSAT has done their research in determining just what causes trainees who have put in blood and sweat in their research studies to still fail this 5 hours tests. They understand that you may not come from a science background and for that reason integrate this into their books that are extremely easy to check out and understand.
Ace GAMSAT provides 3 study plans, the very first package covers all you will have to learn about GAMSAT and contains 8 books. The 2nd one aids with section one of the test that requires humankind research studies. It has a total of 4 books. The third section has all you will need to do the 3rd section and has a total of 4 books. With this you can get to pick the area you feel you are weakest and then purchase the books that are cost affordable costs. These books have all you will need to ace your GAMSAT tests.
GAMSAT preparation courses go a long way in assisting prospects prepare for this life altering examination efficiently. The above techniques have been used by lots of students and have a high success rate amongst the users as they teach you exactly what you will have to learn. I recommend you try them as your GAMSAT preparation guide and see yourself getting into the University of your Dreams and joining the many in the medical profession in saving lives.


Three boweries provided shelter for meetings on Temple Square during the earliest years of settlement. The "Old Tabernacle" then served the purpose from 1852-1867, before the oval Salt Lake Tabernacle succeeded it.
1867: Completed enough to use.
1867: First general conference held Oct. 6, without permanent seats.
1870: April's general conference postponed 30 days so the balcony could be finished.
1875: Dedication Oct. 9, by President John Taylor.
1884: Heating and gas-lighting system installed.
1890: The Manifesto unanimously accepted at October conference.
1909: U.S. President William Howard Taft visits Salt Lake and speaks in the Tabernacle.
1919: April general conference postponed because of a flu epidemic and not held until June 1-3.
1919: The king and queen of Belgium visit Salt Lake and attend a recital to hear the Tabernacle organ.
1924: The first-ever radio broadcast of general conference on Oct. 3.
1930: The centennial of the church is observed in April.
1939: The First Presidency delivers a message on world peace, Oct. 6.
1942-45: The Tabernacle is closed during World War II.
1947: Copper replaces aluminum on roof.
1940s-1979: Home to Utah Symphony.
1948: The Mormon Tabernacle Choir performed its 1,000th national broadcast over radio.
1949: For the first time, general conference from the Tabernacle was broadcast on TV, over KSL, in October.
1953: TV broadcasts of general conference in the Tabernacle go outside the Mountain West for the first time.
1957: October general conference in the Tabernacle is canceled due to a flu epidemic.
1957: Aluminum screws added to roof; roof is insulated and fireproofed, and fire sprinklers added throughout.
1958: New Tabernacle baptistry is dedicated.
1959: A small flash fire is extinguished in the auditorium before any real damage is done.
1963: 400 well-worn benches are refinished.
1966: Original Tabernacle doors receive a face-lift.
1967: For the first time, seven Mexican radio and TV stations carry general conference in April.
1968: Full basement dug under the Tabernacle.
1972: New computerized lighting system added.
1977: Some interior remodeling. Included is seating for more general authorities.
1981: A network of 500 satellite dishes at stake centers to carry general conference live is announced.
1993: The centennial of the Salt Lake Temple is observed in a April 6 program by the Tabernacle Choir.
1996: President Gordon B. Hinckley announces April 6 that a new assembly hall four times the size of the Tabernacle will be constructed.
2000: The first general conference is held in the Conference Center, April 1-2.
2005-07: Modern retrofit started in January 2005.
2007: President Gordon B. Hinckley offers rededicatory prayer, March 31, for the Tabernacle at general conference.


A. Yes. Like other suppliers, these are usually charged at cost price, plus postage.
A. New clients pay pro-forma (up front) with their first two orders. Clients may then apply for a credit account with us. Approved clients have a 30-day credit account. Please discuss this with us.
A. On average 15 working days for most of our standard range. Sometimes we can deliver within 7 working days. Made to order items will take approximately three to six weeks. Bespoke items from the Far East can take upto twelve weeks from design approval to receiving the order. Tell us your requirements and we will give you an accurate delivery date.
Q. Can you deliver my order to several destinations?
A. Yes. You just need to supply the details and quantities to go to each destination.
Q. Can you colour match merchandise to our brand colours?
A. Many items are available in an excellent selection of colours and, of course, the branding of the product can nearly always be pantone matched to your exact corporate colours.
Q. What types of branding are available?
A. How a product is branded depends on what the product is made of and its purpose. For example, glassware and metal products are usually engraved. Products with a high fabric content - laptop bags, conference carriers, T-shirts, hats and clothing are usually screen printed or embroidered. Conference folders, organisers, diaries and CD holders, in man-made materials or leather, can be foil blocked, printed or embossed.
A. Our catalogue shows the minimum quantity for each item and the corresponding price. For bespoke items, we will tell you the minimum quantities.
Q. Will you create our artwork?
A. We are not artwork designers. However, if you already have artwork for logos etc. we will be able to set it up to fit whatever you are purchasing. We will also be able to add telephone numbers, web addresses etc. There is no charge for this service.
Q. How should we supply artwork to you?
A. Artwork should be supplied in a vector based format such as Illustrator or Freehand EPS. We can usually also accept editable PDF files. Fonts should be converted to curves. Sometimes we are able to redraw your artwork from jpg files. If we can do it there is no charge for this service.
A. By e-mail or fax. All verbal orders must be followed up in this way. If you work to a purchase order number system please advise the number that we should quote when invoicing you.
Q. Can I order a pre-production sample?
A. Yes, in most cases against a confirmed order. However, please discuss this with us as all suppliers make a fixed charge for a pre-production sample.
A. By courier. We can arrange timed deliveries (10am, 12 noon) and organise special protective packing if your order includes breakable items.


This is the Official QooApp client app for Android.
Find Games, News, Comics, and Meet Fellow Otaqoos -- Traverse the limitless 2D World!
-W-What? Game Timeline is Evolving! Showing off your epic summons and waifu has never looked so good!
- New "Timeline": All the latest News, Cards, Posts, and Notes all in one place!
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- New "Qoo Thoughts": See if you share the same thoughts on your games with Mr. Qoo!
- Optimize: Image Insert now available for Note Comments! Reply through the power of memes!
- Fix: General bug fix.
- New: QooApp Tour led by Elly~ Come and explore what QooApp has to offer!
- Optimization: Launch of the new Game Card feature! Track your cards' popularity!
- Urgent Fix: Fix for parsing problem during game update. We apologise for the inconvenience caused.
- Launch of the new "Game Card" feature! Show the world your in-game achievements!
- Main page content expanded! "Hot Comments" "Videos" & "News" introduced!
- News List enhanced! Reading has never been easier!
- Record your gaming victories in our new Game Note!
- You can now comment on game pages!
- Happy Lunar New Year!
Upgrade to Ver. 7.2.1 to get our Lunar New Year theme and surprises!
- Merry Christmas! QooApp gets a new outfit for the holiday season!
- New modules in homepage: What's New and Hot Today keep you updated!
- You can FOLLOW pre-registered and unreleased titles to stay up-to-date.


Barrie Colts @ Niagara IceDogs - Friday, 2018.01.12 - 7pm - Niagara IceDogs Fan Forum !
Will we come out on top?
Barrie leads this series 2-0 and has loaded up big-time. Niagara went to the well and came back with a top five player in the league but many key players are sidelined with injury or suspensions. At stake is Central Division bragging rights, GO DOGS GO!
Test those goal lights this afternoon. Should see some red tonight.
That's right get everybody wound up at 730 in the morning lmao.
Nothing changes as we stir the pot as the sun rises in the morning.
Eight different Barrie skaters got goals last night in their 10-1 romp over Sudbury. This has ugly written all over it.
"We have to make sure to take their time and space away," said Burke.


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The Song RoomHome
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The Big Picture / The Big Picture
Socio-Economic Disadvantage
Multicultural & Immigration
At The Song Room, we strive to give all Australian children, especially our most disadvantaged groups, a brighter outlook on life. We believe this starts with them having equal access to a quality education that contains programs in music and the arts.
A global conference on arts education convened by UNESCO in 2010 endorsed accessible, high quality arts education as a driver of social and cultural cohesion. Delegates noted the neglect of proven programs in music and the arts despite growing evidence of their positive effects on children's performance, wellbeing and creativity.
Arts education continues to be undervalued in Australia despite mounting evidence that our children continue to slide in world rankings of academic performance, more so those who live in disadvantaged communities. Children in poorly resourced schools had even lower results and higher dropout rates.
What we're doing to help
From a foundation of our own research and international evidence, The Song Room works with arts and education sector partners and government agencies to develop key policies and industry initiatives that prominently positions arts education in the Australian school curriculum.
Independent research shows our programs work for even the most disengaged children and yield powerful results. Whether they are delivered in remote Indigenous communities, in areas of high crime or low incomes, or in schools with large populations of refugees, The Song Room programs have made significant, demonstrated differences.
Children from these backgrounds began to:
Attend school more often
Become more interested in learning
Manage their behaviour more positively
Improve their grades
These findings inform what we do and how we do it.
We do not work alone. With the support of generous philanthropists and government agencies, we work in concert with other not-for-profit groups and arts organisations to be an instrument of change in the life of the schools we reach and the children we teach.
Evaluating our programs
We continually evaluate our programs to measure our success and to ensure we know the impact and effectiveness of our programs in design and delivery.
As a national organisation, The Song Room helps more than 8,000 children a year around the country with face to face programs. We know that is no insignificant number, but we also know that is only a tiny portion of disadvantaged Australian children who could benefit from our help.
Learn more about the policies and research that informs our programs.
learn more or support our cause
There are plenty of ways for you to get involved with The Song Room.
You too can provide the gift of music and creativity to a child in need by donating now.
© 2013 The Song Room. All Rights Reserved.
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Xu Lele is a Chinese artist who is a part of the New Scholar School – artists who sought to make the venerable Chinese literati painting tradition relevant in the modern period.
She was born in Nanjing, Jiangsu. In 1973, she enrolled at Nanjing University of the Arts to study Chinese painting. After graduating in 1976, Xu lived in rural Jiangsu, where she created many artworks that drew on her experiences. In 1978, Xu became a professional painter at the Jiangsu Chinese Paintings Academy.
Her portraits and traditional Chinese story-telling picture books have received numerous national and international awards. Xu Lele's works are filled with a carefree but candid feeling and are often humorous and vivid. She received a strict traditional training in technique, but does not intentionally pursue a classical or ancient feeling in her work. Her traditional training gives her the ability to perfectly integrate traditional Chinese realistic and freehand painting techniques. Her paintings owe their style to the famous Ming dynasty painter Chen Laolian, simple in technique but deep in meaning, and yet also incorporate a naughty and charming feminine touch. Xu uses few brush strokes, but the image those few strokes create are exaggerated and innocent. Yet at the same time, she uses tremendous patience to portray details such as Buddhist praying mats, boat canopy, plantain leaves, bamboo curtains, and even the peony flower design on court ladies' skirts. This way of emphasizing the secondary or insignificant over the primary constitutes her characteristic painting style.
The LE in Xu Lele's name literally means joy, and as with her name, Xu Lele's paintings strive to create joy, every painting being oriented towards a carefree, contented lifestyle. She once said, "even if one is not the greatest painter, one's paintings should still be interesting." In fact in the world of Xu Lele's art, everyone, whether court lady or literatus, lives in a childish world in which laughter might erupt at any time. The feeling is jocular, humorous, and jubilant. Under the traditional dresses of the painting's figures lies bewilderment and a bit of perplexity, yet the figures are not sorrowful. Even if they are in the process of searching, they are not anxious. Worth note is that while the painting seems to be painted in whimsical strokes, it is precisely these whimsical strokes which give the painting an atmosphere of spontaneity and freedom. This is representative of the painter's wise and penetrating insight into life.
She is currently a professional painter for the Traditional Chinese Painting Institute.
Xu Lele lives and works in Jiangsu.


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BMC Anesthesiology
Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study
Miho Shibamura-Fujiogi1,2,3,
Jennifer Ormsby4,
Mark Breibart1,
Benjamin Warf5,
Gregory P. Priebe1,2,4,
Sulpicio G. Soriano1,2,
Thomas J. Sandora4,6 na1 &
Koichi Yuki1,2,3 na1
BMC Anesthesiology volume 21, Article number: 124 (2021) Cite this article
Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because a SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries following a SSI bundle at a single quaternary care pediatric hospital.
We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed unadjusted logistic regression analyses and univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors to identify independent risk factors for SSI.
We identified a total of 558 CSF diversion procedures with an overall SSI rate of 3.4%. The SSI rates for shunt, external ventricular drain (EVD) placement, and endoscopic third ventriculostomy (ETV) were 4.3, 6.9 and 0%, respectively. Among 323 shunt operations, receipt of clindamycin as perioperative prophylaxis and presence of cardiac disease were significantly associated with SSI (O.R. 4.99, 95% C.I. 1.27–19.70, p = 0.02 for the former, and O.R. 7.19, 95% C.I. 1.35–38.35, p = 0.02 for the latter). No risk factors for SSI were identified among 72 EVD procedures.
We identified receipt of clindamycin as perioperative prophylaxis and the presence of cardiac disease as risk factors for SSI in shunt procedures. Cefazolin is recommended as a standard antibiotic for perioperative prophylaxis. Knowing that unsubstantiated beta-lactam allergy label is a significant medical problem, efforts should be made to clarify beta-lactam allergy status to maximize the number of patients who can receive cefazolin for prophylaxis before shunt placement. Further research is needed to elucidate the mechanism by which cardiac disease may increase SSI risk after shunt procedures.
Hydrocephalus results from a disturbance of the normal pulsatile flow of cerebrospinal fluid (CSF), resulting in its abnormal accumulation within the cerebral ventricles. This can be alleviated in the short term by insertion of a reservoir or external ventricular drain (EVD). Long term, definitive treatment is most commonly accomplished by placement of a ventriculoperitoneal shunt (VPS) or by endoscopic third ventriculostomy (ETV) with or without choroid plexus cauterization (CPC) [1]. Although the rate of surgical site infections (SSIs) after neurosurgery is generally low, the clinical and financial consequences of SSIs after CSF diversion procedures are substantial [2]. Infections following neurosurgery can lead to significant complications such as seizures, neurological deficits, and malfunction of the shunt device [3, 4]. Therefore, the prevention of infection is a priority for managing these patients, and research over the years has identified modifiable risk factors and interventions [5,6,7,8]. However, infections still persist, and greater effort needs to be directed towards understanding risk factors in order to identify new ways to lower SSI rates. To compare what has been reported with our recent experience, we conducted an observational, retrospective study to identify factors associated with SSIs after CSF diversion procedures in a pediatric cohort in a single institution.
Study cohort and patient background
This retrospective cohort study was approved by the Institutional Review Board (IRB) at Boston Children's Hospital (BCH). The need of the informed consent was waived. All the study methods were carried out in accordance with institutional guidelines and regulations. We identified patients who underwent CSF diversion surgery (shunts, EVD, ETV) at BCH from January 2017 to September 2019. We included cases with either congenital or acquired hydrocephalus, including communicating and noncommunicating hydrocephalus. We also included patients with a history of brain tumor who subsequently needed CSF diversion, but excluded patients who underwent craniotomy for tumor resection at the time of CSF diversion surgery. Our SSI prevention bundle consisted of 4 elements: 1) Preoperative bath using soap or an antiseptic agent; 2) Skin preparation with chlorhexidine gluconate (CHG)-alcohol (ChloraPrep™), povidone-iodine alone, povidone-iodine plus CHG-alcohol, povidone-iodine plus alcohol, or all three antiseptics in combination; 3) Using clippers for hair removal; and 4) Perioperative antibiotic prophylaxis. Cefazolin was the standard antibiotic for surgical prophylaxis unless patients had a previous history of bacterial infections that would direct other choices, or patients were previously known to have reactions to penicillin or cephalosporins, and the dose was administered within 60 min prior to skin incision. When SSIs were suspected, wounds and/or CSF were cultured at the medical team and/or surgeon's discretion. SSIs associated with CSF diversion procedures were identified through ongoing prospective surveillance by the Infection Prevention and Control department using National Healthcare Safety Network (NHSN) definitions from the US Centers for Disease Control and Prevention (CDC) [9]. Prospective surveillance for 90 days following an operation is done by Infection Prevention and Control. For ETV, we included SSI diagnosed within 30 days after surgery. For shunt and EVD procedures, both of which involve implants, we included SSI diagnosed within 90 days after surgery. When a patient had a repeated operation on different dates within the time frame of 90-day observation, the SSI was attributed to the most recently performed procedure according to NHSN definitions. We extracted the information on the demographics and comorbidities of the study cohort from the electronic medical records and we obtained intraoperative information such as medications, surgical duration and American Society of Anesthesiology (ASA) physical status classifications from the Anesthesia Information Management System™ (AIMS; Cerner, MO, USA) to obtain. Comorbidities were based on the International Classification of Diseases (ICD)-9 / ICD-10 codes. Congenital cardiac diseases, great vessel malformations, and cardiomyopathies were categorized as cardiac diseases. There were a total of 10 surgeons.
We reported continuous variables as either means with standard deviation (SD) for normally distributed variables or medians and interquartile ranges (IQR) for variables without normal distribution. Normality of distribution was determined by Shapiro-Wilk test. Binary and categorical variables were reported using frequencies and percentages. We performed an unadjusted logistic regression analysis with SSI as the dependent variable. The effect was quantified by the odds ratio (OR) per 1-unit change in the predictor variable. If the outcome was zero or if logistic regression analysis for each categorical variable was not fit, we performed univariate analysis. We used Fisher's exact test to compare proportions for categorical variables, and t-tests or Mann–Whitney U tests to compare means or medians for continuous variables. All hypothesis testing had a two-sided significance level of 0.05. All statistical analyses were conducted using Stata/MP 15.0 (StataCorp, College Station, TX, USA).
Among 558 CSF diversion procedures in 306 unique patients, 19 infections occurred, yielding an SSI rate of 3.4%. Characteristics of the study cohort are shown in Table 1. The SSI rates for shunt, EVD, and ETV were 4.3, 6.9, and 0%, respectively. The median number of days from surgery to the onset of SSI was 13.5 days (IQR: 5.5, 30), with a maximum of 89 days. The median number of days from surgery to the onset of SSI was 18.5 and 9 days for shunt and EVD, respectively.
Table 1 Comparison of SSIs incidence and days to SSIs onset by CSF diversion procedure
Table 2 shows all available variables and their association with SSIs in shunt procedures. In unadjusted logistic regression analysis, factors that were significantly associated with infection in shunt surgery were the administration of clindamycin as perioperative prophylaxis (O.R. 4.99, 95% C.I. 1.27–19.70, p = 0.02) and the presence of congenital heart disease (O.R. 7.19, 95% C.I. 1.35–38.35, p = 0.02). Cardiac diseases present among patients with SSI included single ventricle disease with palliative repair and valvulopathy with underlying connective tissue diseases. None of the perioperative factors, including the duration of procedure, surgeon, or type of skin preparation agent were associated with SSIs.
Table 2 Results of univariate and unadjusted logistic regression analyses for variables of case background and perioperative factors in SSIs after shunt surgery
Table 3 displays all available variables evaluated for potential association with SSI following EVD procedures. No variables in this analysis were significantly associated with SSIs. There was no SSI that occurred among patients undergoing ETV.
Table 3 Results of unadjusted logistic regression analyses of patient background and perioperative factors in patients underwent EVD procedures
Table 4 presents the CSF culture results for patients with SSIs. Staphylococcus epidermidis (14.3%) and Cutibacterium acnes (formerly Propionibacterium acnes) (14.3%) were detected most frequently. From the 19 positive CSF cultures, 14 unique bacterial and fungal species were identified.
Table 4 Date of SSIs onset, culture results and list of prophylactic antimicrobial agents by procedure
In this study, we investigated risk factors for pediatric SSIs after CSF diversion surgery at a single quaternary care pediatric center. We found that receipt of clindamycin for perioperative prophylaxis and comorbid cardiac disease were significantly associated with SSI in shunt surgery.
In our study, the incidence of SSI in combined CSF diversion surgery was 3.4%, while SSI rates for shunt surgery, EVD, and ETV were 4.3, 6.9, and 0%, respectively. EVD is a device placed to manage intracranial pressure when normal flow of CSF inside the brain is hindered. Because it is externalized, it is not surprising that EVD was associated with the highest infection rate among these procedure types. ETV is an important procedure for hydrocephalus that serves as an alternative to shunt device implantation. The success rate of ETV and its use in various ages and background diseases vary across reports [10]. ETV can be done with or without CPC. In our institution, CPC is generally done together with ETV. In general, the SSI rate of ETV is lower than that of a shunt device implantation procedure, but the post-ETV SSI rate depends on background and age [11]. In our institution, ETV was often performed for hydrocephalus due to congenital diseases in infancy, but it was also performed in cases of repeated shunting and brain tumor complications.
Research on modifiable perioperative risk factors and interventions to reduce the risk of shunt infection has been done for many years. Traditional risk factors include the duration of surgery [12], the experience of the surgeon [13], hair shaving [14], prophylactic systemic antibiotics [8, 15], antibiotic-impregnated sutures [16] and skin preparation [5, 6]. In our cohort, surgeon, duration of surgery, and skin preparation agent were not associated with SSIs. In addition, our institution routinely utilizes antibiotic-impregnated shunt tubing (Bactiseal tubing) [17, 18]. Receipt of clindamycin for prophylaxis was significantly associated with SSI. Cefazolin is the standard, first line prophylactic antibiotic choice for shunt operations, but other antibiotics are used when patients are thought to have penicillin or cephalosporin allergy. The spectrum of activity of clindamycin includes staphylococci, streptococci, pneumococci, and some anaerobic bacteria. However, it does not have activity against aerobic Gram negative bacteria. It is well known that unsubstantiated penicillin allergy labels are common in surgical patients. Up to 98% of patients labeled as allergic to penicillin can actually safely receive the antibiotic when tested [19]. Similarly, gastrointestinal upset is often listed as a reason for allergy to cephalosporins. In women with chorioamnionitis undergoing cesarean delivery, the use of cefazolin was associated with a lower incidence of postpartum infection than the use of clindamycin [20]. Although our study is from a single institution, this finding highlights the importance of obtaining a detailed history of antibiotic allergies and considering de-labeling strategies in order to maximize the number of patients who can successfully receive beta-lactam antibiotics for perioperative prophylaxis.
The association of cardiac diseases with shunt infection was previously described in a study of children who underwent shunt surgery within the first year of life [21]. Our study consisting of older children also demonstrated that comorbid cardiac disease was associated with an increased risk of shunt SSI. Cardiac diseases present among our patients with SSI included single ventricle disease with palliative repair [22] and valvulopathy with underlying connective tissue diseases. Although not directly related to infection, cardiac anomalies were associated with shunt failure in the prospective study of children from six Hydrocephalus Clinical Research Network Centers [23]. The authors suggested that this finding may be related to repeated hospitalizations and surgeries or immunodeficiency, but they did not formally analyze these exposures. For example, thymectomy is often performed to have better visualization in neonatal and infant cardiac surgeries [24], but it may have some immunological impact [25]. Immunological profiles for patients with a cardiac disease who present for CSF diversion procedures are not known, and could be a topic of future investigation.
The association between age and SSIs varies across studies. While some studies have identified younger age, particularly infancy, as a risk factor for SSI [26,27,28,29], other studies have demonstrated that age is not a risk factor for shunt failure or infection [30, 31]. Post- intraventricular hemorrhage (IVH) hydrocephalus secondary to prematurity occurs in infants, but older children may have different etiology of hydrocephalus including tumor-related hydrocephalus. In our cohort, age was not a risk factor. Most of the patients in our cohort were beyond infancy, and our results may not generalize to premature infants for that reason.
The risk of shunt failure or infection generally increases with each subsequent shunt replacement, resulting in a rising cumulative risk of SSIs [29, 32, 33]. However, in the present study, the number of shunt revisions was not a risk factor for SSIs. Previously, other investigators found that the presence of a gastrostomy tube was associated with infection risk in the larger study [32], but this did not substantially contribute to infections in this study. Some studies showed that lower gestational age (GA) at the time of procedures and prematurity were significant risk factors for infection after shunt surgery [7, 28]. In our study cohort, there was no incidence of SSIs in patients with a history of preterm birth, although a number of patients did not have detailed perinatal information available. Although it is difficult to determine the association between GA at birth and SSIs, GA was not a risk factor for SSI in our study. Further investigation is needed to clarify why our result differs from the previous reports.
Among the perioperative factors other than those mentioned above, there have been no reports that have examined the type and dose of anesthetics and the amount of oxygen administered in shunt surgery. Intraoperative factors such as oxygen dosage, and temperature control are known to play a role in SSI following adult general surgery [34,35,36]. The effect of volatile anesthetics on immune function have been reported previously [37,38,39,40,41,42,43,44]. In our previous work using a preclinical model, a long exposure (6-h) of volatile anesthetics was associated with increased infection, while a short exposure (2-h) was not [45]. In a study at our institution, we previously showed that higher volatile anesthetic dose was an independent risk factor for SSI in pediatric gastrointestinal surgery [46]. Anesthetic drugs and oxygen dosage also had no impact on the incidence of SSIs. The operative duration was less than 80 min for the groups with and without SSIs. Our result was in line with the finding in our preclinical study. In the present study, the median number of days to the date of SSI onset after surgery was 13.5 days, but more than 75% of the patients with SSI had a postoperative period of more than 30 days. In previous reports, the risk of infection was shown to be highest in the first 8 weeks after a shunt procedure, and the risk decreased substantially after 6 months [47]. Because of relatively late onset of SSI postoperatively and the short surgical duration, it is perhaps not surprising that the impact of intraoperative drugs and oxygen dose on immune function was less after CSF diversion surgery.
The most common bacteria detected in our cohort were Staphylococcus epidermidis and Cutibacterium acnes, generally consistent with previous reports [26, 27, 48, 49]. Staphylococcus aureus was detected in a smaller proportion of cases. While the effectiveness of antimicrobial-impregnated and -coated shunts (AIS) has been described [15, 49], there are concerns including the emergence of methicillin-resistant Staphylococcus aureus (MRSA) and resistant gram negative rods (GNR) with repeated use [48, 49]. Although we routinely use antimicrobial impregnated shunting, MRSA was not detected in our cohort.
Our study has several limitations. First, it was limited as a single-center study and was retrospective. Second, the low SSI rate and small sample size may impair statistical power to find associations.
In conclusion, we have shown that receipt of clindamycin as prophylaxis was significantly associated with SSI in children undergoing shunt surgery. Because unsubstantiated allergy labeling for penicillin and other antibiotics are common in surgical patients, efforts should be made to identify which patients can successfully receive a beta-lactam antibiotic for perioperative prophylaxis. Further research is needed to better define the mechanism by which cardiac disease is associated with SSI among patients undergoing neurosurgical shunt procedures.
All the data and materials are available upon request.
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We thank Dr. Lifei Hou and Dr. Sophia Koutsogiannaki (both Boston Children's Hospital) for discussion.
This study was in part supported by R01 GM127600 (K.Y.).
Thomas J. Sandora and Koichi Yuki are co-senior authors
Cardiac Anesthesia Division, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA
Miho Shibamura-Fujiogi, Mark Breibart, Gregory P. Priebe, Sulpicio G. Soriano & Koichi Yuki
Department of Anaesthesia, Harvard Medical School, Boston, USA
Miho Shibamura-Fujiogi, Gregory P. Priebe, Sulpicio G. Soriano & Koichi Yuki
Department of Immunology, Harvard Medical School, Boston, USA
Miho Shibamura-Fujiogi & Koichi Yuki
Department of Pediatrics, Division of Infectious Diseases, Boston Children's Hospital, Boston, USA
Jennifer Ormsby, Gregory P. Priebe & Thomas J. Sandora
Department of Neurosurgery, Boston Children's Hospital, Boston, USA
Benjamin Warf
Department of Pediatrics, Harvard Medical School, Boston, USA
Thomas J. Sandora
Miho Shibamura-Fujiogi
Jennifer Ormsby
Mark Breibart
Gregory P. Priebe
Sulpicio G. Soriano
Koichi Yuki
MSF: Designed the study, analyzed the data, and wrote the manuscript; JO: Designed the study and collected the data.; MB: Collected the data.; BW: Wrote the manuscript.; GPP: Analyzed the data and wrote the manuscript;SGS: Analyzed the data and wrote the manuscript.; TJS: Analyzed the data and wrote the manuscript; KY: Designed the study, analyzed the data and wrote the manuscript. The authors read and approved the final manuscript.
MSF: Research fellow; JO: Infectious disease nurse.; MB: Clinical research database specialist.; BW: Professor in neurosurgery.; GPP: Associate Professor in Anesthesia; SGS: Professor in Anesthesia.; TJS: Associate Professor in Pediatrics; KY: Associate Professor in Anesthesia.
Correspondence to Koichi Yuki.
Our study was approved by our institutional review board. Informed consent was waived.
The institutional review provided us the consent to publish.
We do not have any conflict of interest.
Shibamura-Fujiogi, M., Ormsby, J., Breibart, M. et al. Risk factors for pediatric surgical site infection following neurosurgical procedures for hydrocephalus: a retrospective single-center cohort study. BMC Anesthesiol 21, 124 (2021). https://doi.org/10.1186/s12871-021-01342-5
Submission enquiries: bmcanesthesiology@biomedcentral.com


text:
<?php

declare(strict_types=1);

namespace CoreTest\Entity;

use Auth\Entity\UserInterface;
use Core\Entity\EntityTrait;
use Core\Entity\FileMetadataInterface;
use Core\Entity\FileMetadataTrait;
use Core\Entity\Image;
use Core\Entity\ImageMetadata;
use Core\Entity\Permissions;
use Core\Entity\PermissionsInterface;
use CoreTestUtils\TestCase\TestInheritanceTrait;
use CoreTestUtils\TestCase\TestSetterGetterTrait;
use CoreTestUtils\TestCase\TestUsesTraitsTrait;
use PHPUnit\Framework\TestCase;

/**
 * Class ImageMetadataTest
 *
 * @covers \Core\Entity\ImageMetadata
 * @package CoreTest\Entity
 */
class ImageMetadataTest extends TestCase
{
    use TestInheritanceTrait,
        TestUsesTraitsTrait,
        TestSetterGetterTrait;

    protected $target = ImageMetadata::class;

    protected $inheritance = [
        FileMetadataInterface::class
    ];

    protected $traits = [
        EntityTrait::class,
        FileMetadataTrait::class
    ];

    public function propertiesProvider()
    {
        $user = $this->createMock(UserInterface::class);
        $permissions = $this->createMock(PermissionsInterface::class);
        return [
            ['belongsTo',[
                'default' => null,
                'setter_args' => ['test'],
                'expect' => 'test'
            ]],
            ['key', [
                'default' => null,
                'setter_args' => ['test'],
                'expected' => 'bar',
            ]],
            ['contentType',[
                    'default' => null,
                    'setter_args' => 'image/jpeg',
                    'expected' => 'image/jpeg',
            ]],
            ['user',[
                    'default' => null,
                    'setter_args' => $user,
                    'expected' => $user
            ]],
            ['permissions',[
                'default' => "@".Permissions::class,
                'setter_args' => $permissions,
                'expected' => $permissions
            ]],
        ];
    }

    public function testShouldBeAnImageMetadata()
    {
        $ob = new ImageMetadata();
        parent::assertEquals(Image::class, $ob->getOwnerFileClass());
    }
}

redpajama_set_name: RedPajamaGithub