text:
Q: javafx - display dialog and make user wait for method to finish In a JavaFX application a custom method "retrain" takes a long time when given large input. I want to display a dialog and make the user wait for the method to end. The code here allows the user to close the dialog which I would rather them not be able to. When I take away the cancel button, the dialog won't close at all due to the implementation of Dialog in java. If anyone could point me in the right direction I would really appreciate it.
@FXML
    private void handleMarkovText() {
        textgen.MarkovTextGenerator mtg = mainApp.getMTG();
        Task<textgen.MarkovTextGenerator> task = new Task<textgen.MarkovTextGenerator>() {
            @Override
            public textgen.MarkovTextGenerator call() {
                // process long-running computation, data retrieval, etc...

            mtg.retrain(textBox.getText());
            return mtg;
        }
    };

    Dialog<Void> loadDialog = new Dialog<Void>();
        loadDialog.setOnCloseRequest( e -> {

            if(!task.isDone()) {
                e.consume();
            }

        });

    loadDialog.setContentText("Training MTG...");

    task.setOnRunning( e -> {
        ButtonType cancelButtonType = new ButtonType("Cancel", ButtonData.CANCEL_CLOSE);
        //Dialog<Void> loadDialog = new Dialog<Void>();
        loadDialog.getDialogPane().getButtonTypes().add(cancelButtonType);
        loadDialog.show();
        if(task.isCancelled()) {
            System.out.println("Cancelling on running");
        }
    });

    task.setOnSucceeded(e -> {
        System.out.println("Succeeded");
        loadDialog.close();
        textgen.MarkovTextGenerator result = task.getValue();
        mainApp.showMarkovDialog(result);
        // update UI with result
    });

    task.setOnCancelled(e -> {
        System.out.println("Cancelled");
    });

    task.setOnFailed(e -> {
        //System.out.println("failed");
    });
    //ProgressBar bar = new ProgressBar();
    //bar.progressProperty().bind(task.progressProperty());
   Thread thread  = new Thread(task);
   thread.start();

    // train/retrain markov
    // show results

}


Celsius (℃) to Fahrenheit (℉) Conversion – What is 2192 Celsius (℃) in Fahrenheit (℉)?
You can easily convert 2192 Celsius to Fahrenheit wherever you are if you understand the relationship between the two units. At sea level, water has a range of 100 degrees in the Celsius scale from freezing point to boiling point, with 0℃ being the freezing point and 100℃ being the boiling point; however, this range is not the same in the Fahrenheit scale. To convert Celsius to Fahrenheit, you should multiply the figure by1.80 and then add 32 i.e. (1.8 * ℃ + 32). With this understanding in mind, you can now solve your problem.
What is 2192 Celsius (℃ in Fahrenheit (?)?
Celsius (℃) to Fahrenheit (℉) Conversion – What is 2191 Celsius (℃) in Fahrenheit (℉)?
Celsius (℃) to Fahrenheit (℉) Conversion – What is 2193 Celsius (℃) in Fahrenheit (℉)?
Cups to Quarts unit conversion – how many Quarts are in 317 Cups?
Yards (yd) to centimeters (cm) conversion – What is 1466 yards in centimeters?
Cups to Pints unit conversion – how many pints are in 865 Cups?
Conversion of Pounds from Ounces – how many lb are in 1357 oz?
Converting millimeters to inches – what is 2903 mm in Inches?


text:
package util

import (
	"encoding/hex"
	"fmt"

	"github.com/juju/errors"
	"github.com/pingcap/tidb/context"
	"github.com/pingcap/tidb/kv"
	"github.com/pingcap/tidb/util/sqlexec"
	goctx "golang.org/x/net/context"
)

const (
	loadDeleteRangeSQL     = `SELECT job_id, element_id, start_key, end_key FROM mysql.gc_delete_range WHERE ts < %v ORDER BY ts`
	completeDeleteRangeSQL = `DELETE FROM mysql.gc_delete_range WHERE job_id = %d AND element_id = %d`
	updateDeleteRangeSQL   = `UPDATE mysql.gc_delete_range SET start_key = "%s" WHERE job_id = %d AND element_id = %d AND start_key = "%s"`
)

// DelRangeTask is for run delete-range command in gc_worker.
type DelRangeTask struct {
	JobID, ElementID int64
	StartKey, EndKey []byte
}

// Range returns the range [start, end) to delete.
func (t DelRangeTask) Range() ([]byte, []byte) {
	return t.StartKey, t.EndKey
}

// LoadDeleteRanges loads delete range tasks from gc_delete_range table.
func LoadDeleteRanges(ctx context.Context, safePoint uint64) (ranges []DelRangeTask, _ error) {
	sql := fmt.Sprintf(loadDeleteRangeSQL, safePoint)
	rss, err := ctx.(sqlexec.SQLExecutor).Execute(goctx.TODO(), sql)
	if err != nil {
		return nil, errors.Trace(err)
	}

	rs := rss[0]
	for {
		row, err := rs.Next(goctx.TODO())
		if err != nil {
			return nil, errors.Trace(err)
		}
		if row == nil {
			break
		}
		startKey, err := hex.DecodeString(row.GetString(2))
		if err != nil {
			return nil, errors.Trace(err)
		}
		endKey, err := hex.DecodeString(row.GetString(3))
		if err != nil {
			return nil, errors.Trace(err)
		}
		ranges = append(ranges, DelRangeTask{
			JobID:     row.GetInt64(0),
			ElementID: row.GetInt64(1),
			StartKey:  startKey,
			EndKey:    endKey,
		})
	}
	return ranges, nil
}

// CompleteDeleteRange deletes a record from gc_delete_range table.
// NOTE: This function WILL NOT start and run in a new transaction internally.
func CompleteDeleteRange(ctx context.Context, dr DelRangeTask) error {
	sql := fmt.Sprintf(completeDeleteRangeSQL, dr.JobID, dr.ElementID)
	_, err := ctx.(sqlexec.SQLExecutor).Execute(goctx.TODO(), sql)
	return errors.Trace(err)
}

// UpdateDeleteRange is only for emulator.
func UpdateDeleteRange(ctx context.Context, dr DelRangeTask, newStartKey, oldStartKey kv.Key) error {
	newStartKeyHex := hex.EncodeToString(newStartKey)
	oldStartKeyHex := hex.EncodeToString(oldStartKey)
	sql := fmt.Sprintf(updateDeleteRangeSQL, newStartKeyHex, dr.JobID, dr.ElementID, oldStartKeyHex)
	_, err := ctx.(sqlexec.SQLExecutor).Execute(goctx.TODO(), sql)
	return errors.Trace(err)
}

redpajama_set_name: RedPajamaGithub


Ambitious $14 Billion government investment program (PAG) for five years.
A GDP of 5% minimum per year, for the next five years.
Peaceful and democratic political Environment.
Rich and diverse cultural and outdoor attractions.


Sara Blumenkranz received her 200hr certification from Mang'Oh Yoga in the Spring of 2015, a mentorship through Sky Ting Yoga in the Spring of 2016 and a second 200hr Katonah Yoga certification in the Fall of 2018. In life, she refers to, BYTT (Before Yoga Teacher Training) and AYTT (After Yoga Teacher Training) as it was sincerely life transforming. She found that balance, calmness, and fulfilment through a yogic lifestyle is truly the key to harmony.
Sara is a footwear designer by day and yogi by night. She invites you to explore the magic of yoga in every class. Her goal is to create a safe and comfortable environment in every class. She brings a mix of vinyasa flow filled with a blend of several styles including Katonah Yoga, Pranayama and Classical Hatha. Pairing a fresh playlist in every class, weaving in essential oils during savasana, you will undoubtedly find euphoria.


text:
Ansal Institute of Technology Customer Service Phone Number
Phone Number of Ansal Institute of Technology is 01244116111, 01244750400 .
Ansal Institute of Technology - AIT Gurgaon was established in the year 2000 under the Chiranjiv Charitable Trust. Ansal Institute of Technology is located in the foothills of Aravallis and is situated near major MNCs and Malls in Gurgaon. It is situated in Sector-55 of Gurgaon close to Faridabad border in specific. The college offers various services for students commuting from National Capital Territory (N.C.T) of India. Ansal Institute of Technology is also known as AIT.In a short period of over eight years, Ansal Institute of Technology has indeed come a long way. It has been successful only because of the quality of its innovative programmes. The institute follows innovative approach in delivery of education towards achieving excellence by giving practical exposure. The synergy between education and practical training has enabled our students to have an edge over others in securing much sought after professional positions in MNCs and many Ansal Institute of Technology pass outs have displayed entrepreneurial acumen.
At Ansal Institute of Technology - AIT Gurgaon, Innovation in Education is provided to student, it is strongly believed that every student who maintains a proper focus and motivation is sure to succeed. The thrust is in building personalities and careers, and a realistic road map is suggested to every student at Ansal Institute of Technology for a successful professional career comprising Bachelor's degree, Master's degree and an appropriate paid internship (as a part of academic training)
Vision of Ansal Institute of Technology - AIT Gurgaon to emboss a bright spot on the world map of professional and technical institutions and to be in the network of International Academic Collaborators. Mission of Institute to develop the institute into a world-class institution of higher learning, providing one and all with equal and just access to quality education in professional and technical fields. To take it to the heights where it actualizes its students' inborn potential into the professional and technical capabilities of the highest order, and where it triggers in them an indomitable spirit of enquiry and awakens in them a strong social and moral sense. And to expect down the line a regime of knowledge creation and dissemination in all fields of human activity, leading ultimately to sustained economic growth and social justice.
Ansal Institute of Technology - AIT Gurgaon gives top priority to interactive dialogue with students on a one-to-one basis. The on-going online interaction between students and teachers as well as the confidential feedback from the students on each course in every semester is the hallmark of education system. This helps the faculty to introduce innovations and continuously improve and refine the methodology of delivery to meet the ever-changing requirements of the students. Online confidential feedback for academic administrators like Director, Deputy Director, Dean and Heads of Schools has been extremely useful in bringing progressive changes in the system.
Ansal Institute of Technology - AIT Gurgaon has been led by a group of highly committed academicians from the IITs. Well begun, they say, is half done. Ansal Institute of Technology in the first eight years has seen a group of qualified and dedicated professionals working together as a team and successfully introducing entirely new dimensions to the system of higher education in India. Thanks to their innovative approach and relentless efforts, Ansal Institute of Technology today is firmly established as a launch pad for global careers and is now recognized as a leading provider of higher education in professional fields.
Ansal Institute of Technology - AIT Gurgaon aims to provide the best learning system and facilities for scholarly activities including research and development with the following objectives: To provide quality education to produce world-class professionals. To develop state-of-art infrastructure and high-quality, learning resource centre. To provide curricular education to students through innovative teaching methodology. Ansal Institute of Technology - AIT Gurgaon carry out research in frontier areas of technology, science, management, architecture and other relevant fields to serve the shared need of society. To design and develop the curricula through regular industry–academic interaction. To develop contemporary professional skills and competencies in students, besides imparting domain knowledge.To bring out the best in every student by providing stimulating learning environment and world-class teaching practices. Ansal Institute of Technology - AIT Gurgaon encourage a close faculty – student relationship, in a very caring environment. To pursue active interaction with various institutions and industries, to help students for placement. To hone the ethical, social and cultural values in the students, to foster good business ethics and social responsibility.
Ansal Institute of Technology - AIT Gurgaon provides graduate and post graduate courses to the students such as Bachelor in Business Administration, Bachelor in Business Administration ,Bachelor in Business Administration (Hotel Management) ,Bachelor in Computer Application (BCA), B.Tech, MBA etc.
In Ansal Institute of Technology - AIT Gurgaon the broad based curriculum developed on the US pattern and curriculum similar to that followed in the IITs is important not only for personality development, but also for attaining professional expertise. The holistic approach adopted by Ansal Institute over the years by embedding value added courses for skills/competencies development has yielded extraordinary dividends in that its students & graduating product have found very good placement in companies like Wipro, Hughes Systems, ICICI, Sapient, Mahindra British Telecom, Citi Bank, IDBI, Sahara India, KPMG, John Deere, IBM, Cisco etc. Over 600 students from Ansal Institute of Technology - AIT Gurgaon have been accepted by ranking and reputed universities in the US, Australia and Canada in the last few years and are bringing laurels to the Institute. Most of these students have gone on scholarship/assistantship demonstrating the International recognition of Ansal Institute's high-quality education.
Ansal Institute of Technology - AIT Gurgaon Alumni in the US have won more than 150 President's and Dean's honor awards for their excellent academic performance. Most of them are either pursuing higher studies at reputed universities including Ivy League or getting professional work experience. The alumni network is so effective and strong that some of them are voluntarily helping fellow AIT Alumni in internships and placements.
Ansal Institute of Technology Address
The address of Ansal Institute of Technology is Sector 55, Gurgaon, Haryana.
Ansal Institute of Technology Email Address
The email address of Ansal Institute of Technology is feedback@aitgurgaon.org.
Ansal Institute of Technology Website
The Website of Ansal Institute of Technology is www.aitgurgaon.org.
Ansal Institute of Technology Customer Support Service Phone Number
The customer support phone number of Ansal Institute of Technology is 01244116111, 01244750400 (Click phone number to call).
Ansal Technical Campus Customer Service Phone Number
Ansal University Customer Service Phone Number
The postal and official address, email address and phone number (helpline) of Ansal Institute of Technology Service Center and Ansal Institute of Technology customer service phone number is given below. The helpline of Ansal Institute of Technology customer service phone number may or may not be toll free.
Click Here To View Ansal Institute of Technology Customer Service Phone Numbers
www.aitgurgaon.org
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redpajama_set_name: RedPajamaCommonCrawl


Barcelona boss Ernesto Valverde believes Lionel Messi will soon return to international duty to represent Argentina again.
The attacking star has not featured for his nation since their World Cup last 16 exit at the hands of France with doubts that he would not return to international action again.
"But we know that he wants to go to the national team, and he will go. The best news for Barcelona is, if Messi goes to the national team, that he is happy, and that is what we want to happen.
Messi, 31, has netted 65 times in 128 appearances since making his Argentina debut in August 2005.


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text:
Q: MAVEN build Error, com.fasterxml.jackson.core:jackson-databind:jar:2.3.2 & unable to find main class I'm suddenly getting a build error using Maven to build a JavaFX application that utilizes com.fasterxml.jackson.core:jackson-databind, I haven't updated the POM for about 3-4 weeks, therefore Im perplexed as to why this suddenly occurred.
The entire error message is:
The POM for com.fasterxml.jackson.core:jackson-databind:jar:2.3.2 is invalid, transitive dependencies (if any) will not be available, enable debug logging for more details
The artifact org.apache.commons:commons-io:jar:1.3.2 has been relocated to commons-io:commons-io:jar:1.3.2
I updated the com.fasterxml.jackson.core & commons-io, now when building I get:
The POM for com.fasterxml.jackson.core:jackson-databind:jar:2.3.2 is invalid, transitive dependencies (if any) will not be available, enable debug logging for more details
When I run the application from NetBeans I get:
--- exec-maven-plugin:1.2.1:exec (default-cli) @ Video_Assembler ---
Error: Could not find or load main class com.conuretech.video_assembler.MainApp
Here is my POM.xml:
<?xml version="1.0" encoding="UTF-8"?>
<project xmlns="http://maven.apache.org/POM/4.0.0" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://maven.apache.org/POM/4.0.0 http://maven.apache.org/xsd/maven-4.0.0.xsd">
    <modelVersion>4.0.0</modelVersion>
    <groupId>com.conuretech</groupId>
    <artifactId>Video_Assembler</artifactId>
    <version>1.0-SNAPSHOT</version>
    <packaging>jar</packaging>
    <name>Video_Assembler_v1</name>
    <properties>
        <project.build.sourceEncoding>UTF-8</project.build.sourceEncoding>
        <!-- For testing <mainClass>com.conuretech.test.test</mainClass>-->
       <mainClass>com.conuretech.video_assembler.MainApp</mainClass>
    </properties>
    <organization>
        <!-- Used as the 'Vendor' for JNLP generation -->
        <name>conuretech</name>
    </organization>
    <repositories>
   <repository>
   <id>xuggle repo</id>
   <url>http://xuggle.googlecode.com/svn/trunk/repo/share/java/</url>
  </repository>
  </repositories>
  <dependencies>
      <!-- apache commons io
      <dependency>
    <groupId>org.apache.commons</groupId>
    <artifactId>commons-io</artifactId>
    <version>1.3.2</version>
</dependency>-->
<!-- updated due to previous error-->
    <dependency>
    <groupId>commons-io</groupId>
    <artifactId>commons-io</artifactId>
    <version>1.3.2</version>
</dependency>
      <!-- amazon aws start-->
      <dependency>
    <groupId>com.amazonaws</groupId>
    <artifactId>aws-java-sdk</artifactId>
    <version>1.9.27</version>
</dependency>
 <dependency>
    <groupId>com.fasterxml.jackson.core</groupId>
    <artifactId>jackson-core</artifactId>
    <version>2.4.4</version>
</dependency>
 <dependency>
    <groupId>com.fasterxml.jackson.core</groupId>
    <artifactId>jackson-annotations</artifactId>
    <version>2.5.3</version>
</dependency>
<dependency>
    <groupId>com.fasterxml.jackson.core</groupId>
    <artifactId>jackson-databind</artifactId>
    <version>2.5.3</version>
</dependency>
      <!-- amazon aws end-->
<!-- xuggler start -->
  <dependency>
   <groupId>xuggle</groupId>
   <artifactId>xuggle-xuggler</artifactId>
   <version>5.4</version>
  </dependency>
     <dependency>
      <groupId>org.slf4j</groupId>
      <artifactId>slf4j-api</artifactId>
      <version>1.6.4</version>
      <scope>compile</scope>
    </dependency>
    <dependency>
      <groupId>commons-cli</groupId>
      <artifactId>commons-cli</artifactId>
      <version>1.1</version>
      <scope>compile</scope>
    </dependency>
    <dependency>
      <groupId>ch.qos.logback</groupId>
      <artifactId>logback-core</artifactId>
      <version>1.0.0</version>
      <scope>runtime</scope>
    </dependency>
    <dependency>
      <groupId>ch.qos.logback</groupId>
      <artifactId>logback-classic</artifactId>
      <version>1.0.0</version>
      <scope>runtime</scope>
    </dependency>
    <dependency>
      <groupId>junit</groupId>
      <artifactId>junit</artifactId>
      <version>4.5</version>
      <scope>test</scope>
    </dependency>
    <dependency>
      <groupId>xuggle</groupId>
      <artifactId>xuggle-utils</artifactId>
      <version>1.22</version>
      <scope>test</scope>
    </dependency>
    <!-- xuggler end-->
    <!-- dropbox core api -->
    <!--
<dependency>
  <groupId>com.dropbox.core</groupId>
  <artifactId>dropbox-core-sdk</artifactId>
  <version>[1.7,1.8)</version>
</dependency>
<dependency>
    <groupId>org.controlsfx</groupId>
    <artifactId>controlsfx</artifactId>
    <version>8.20.8</version>
</dependency>-->
<dependency>
    <groupId>org.controlsfx</groupId>
    <artifactId>openjfx-dialogs</artifactId>
    <version>1.0.2</version>
</dependency>
  </dependencies>
    <build>
        <plugins>
            <plugin>
                <groupId>org.apache.maven.plugins</groupId>
                <artifactId>maven-dependency-plugin</artifactId>
                <version>2.6</version>
                <executions>
                    <execution>
                        <id>unpack-dependencies</id>
                        <phase>package</phase>
                        <goals>
                            <goal>unpack-dependencies</goal>
                        </goals>
                        <configuration>
                            <excludeScope>system</excludeScope>
                            <excludeGroupIds>junit,org.mockito,org.hamcrest</excludeGroupIds>
                            <outputDirectory>${project.build.directory}/classes</outputDirectory>
                        </configuration>
                    </execution>
                </executions>
            </plugin>
            <plugin>
                <groupId>org.codehaus.mojo</groupId>
                <artifactId>exec-maven-plugin</artifactId>
                <version>1.2.1</version>
                <executions>
                    <execution>
                        <id>unpack-dependencies</id>
                        <phase>package</phase>
                        <goals>
                            <goal>exec</goal>
                        </goals>
                        <configuration>
                            <executable>${java.home}/../bin/javafxpackager</executable>
                            <arguments>
                                <argument>-createjar</argument>
                                <argument>-nocss2bin</argument>
                                <argument>-appclass</argument>
                                <argument>${mainClass}</argument>
                                <argument>-srcdir</argument>
                                <argument>${project.build.directory}/classes</argument>
                                <argument>-outdir</argument>
                                <argument>${project.build.directory}</argument>
                                <argument>-outfile</argument>
                                <argument>${project.build.finalName}.jar</argument>
                            </arguments>
                            <tasks>
                            <echo>***BASE DIRECTORY ${project.basedir}</echo>
                        </tasks>
                        </configuration>

                    </execution>
                    <execution>
                        <id>default-cli</id>
                        <goals>
                            <goal>exec</goal>
                        </goals>
                        <configuration>
                            <executable>${java.home}/bin/java</executable>
                            <commandlineArgs>${runfx.args}</commandlineArgs>
                        </configuration>
                    </execution>
                </executions>
            </plugin>
            <plugin>
                <groupId>org.apache.maven.plugins</groupId>
                <artifactId>maven-compiler-plugin</artifactId>
                <version>3.1</version>
                <configuration>
                     <fork>true</fork>
          <meminitial>128m</meminitial>
          <maxmem>1024m</maxmem>
                    <source>1.7</source>
                    <target>1.7</target>
                    <compilerArguments>
                        <bootclasspath>${sun.boot.class.path}${path.separator}${java.home}/lib/jfxrt.jar</bootclasspath>
                    </compilerArguments>
                </configuration>

            </plugin>
            <plugin>
                <groupId>org.apache.maven.plugins</groupId>
                <artifactId>maven-surefire-plugin</artifactId>
                <version>2.16</version>
                <configuration>
                    <additionalClasspathElements>
                        <additionalClasspathElement>${java.home}/lib/jfxrt.jar</additionalClasspathElement>
                    </additionalClasspathElements>
                </configuration>
            </plugin>

        </plugins>
    </build>

</project>

Im not sure how to further resolve the "com.fasterxml.jackson.core:jackson-databind:jar:2.3.2" issue and I have already declared main class using <mainClass>com.conuretech.video_assembler.MainApp</mainClass>, any help will be appreciated.
Thanks

redpajama_set_name: RedPajamaStackExchange


There is a very big part of the world GDP that is actually connected to the oil industry making it one of the very important industries in the world today because of the big role that is playing. There are a number of things that you need to understand about the oil industry for example, it is able to touch the life of every person in the world today. Since oil is one of the main sources of energy in the world today contributing more than 90% especially for industries, it is very important to evaluate the importance of oil sustainability. One of the things that many people are usually not aware of is that oil sustainability and the World Oil Corp are important because most of the industries in the world today use oil as the main source of energy for the different equipment that they are using. There are a number of things that are very important for people to understand for example, the oil that is provided for the industries help the industries to produce goods and services that people can be able to use. Replacing the oil industry as the main source of energy that provides power in the world is actually not really possible, renewable sources of energy cannot be able to do this.
One of the things that you need to understand about oil sustainability is that countries that are able to eliminate the use of vehicles that consume a lot of oil products can be able to reduce the amount of inputs that they bring in for oil. Ensuring that oil is sustainable for a number of generations is actually very important and that is the reason why, these ideas must be embraced by countries that wants to ensure that they are able to meet this goal. Oil imports are usually very expensive and therefore, eradicating or reducing the level of oil imports is going to give the country an opportunity to be able to develop by focusing the money on something else.
Giving subsidies is something that has also continued to happen and all this is usually done by governments to make the oil at least more affordable for most people. However, this is an issue that is able to cause a lot of debate because quite a number of people may think that it's not important to give subsidies to industries that are making a lot of profits. Sustaining the level of energy in the world today can easily be done if people are more careful about oil sustainability.


Contact us for current pricing @ 610-269-2991 By utilizing a Memory Foam Mattress and Spring Seat Suspension, the Moonton Sofa and Sleeper Collection provides a restful sleep and supportive seating - this is the Moonton Sleeper difference. The Moonton Sofa and Sleeper Collection features a fully sprung seat cushion using no-sag construction and sits just like a high quality Sofa. With the finest High Resiliency foam, it sleeps just like the best memory foam beds on the market. The frame is made from kiln-dried hardwood with corner blocks for extra strength. Typical sleeper sofas from other manufacturers are well over 100?; which makes it hard to even walk around it in a tight space. The Moonton Sleeper, when fully opened, is only 84? into the room. That makes it the shortest footprint in the industry! The Moonton offers incredible comfort in your choice of fabric or leather. Multiple Sleeper, Sofa and Sectional sizes available. Design your own Moonton from a wide range of shapes, sizes, and covers. Made in the USA.
Contact us for current pricing @ 610-269-2991 By utilizing a Memory Foam Mattress and Spring Seat Suspension, the Dayton Chair and Sleeper Collection provides a restful sleep and supportive seating - this is the Dayton Sleeper difference. -- The Dayton Sofa and Sleeper Collection features a fully sprung seat cushion using no-sag construction and sits just like a high quality Sofa. -- With the finest High Resiliency foam, it sleeps just like the best memory foam beds on the market. -- The frame is made from kiln-dried hardwood with corner blocks for extra strength. -- Typical sleeper sofas are well over 100? long, which makes it hard to walk around it in a tight space. -- The Dayton Sleeper, when fully opened, is only 84? into the room--the shortest footprint in the industry! -- Multiple Sleeper, Sofa and Sectional sizes available. The Dayton offers incredible comfort in your choice of fabric or leather. Design your own Dayton from a wide range of shapes, sizes, and covers. Designed, Quality-crafted, and Made To Order in the USA.
Contact us for current pricing @ 610-269-2991 By utilizing a Memory Foam Mattress and Spring Seat Suspension, the Moonton Chair Sleeper Collection provides a restful sleep and supportive seating - this is the Moonton Sleeper difference. The Moonton Sofa and Sleeper Collection features a fully sprung seat cushion using no-sag construction and sits just like a high quality Sofa. With the finest High Resiliency foam, it sleeps just like the best memory foam beds on the market. The frame is made from kiln-dried hardwood with corner blocks for extra strength. Typical sleeper sofas from other manufacturers are well over 100?; which makes it hard to even walk around it in a tight space. The Moonton Sleeper, when fully opened, is only 84? into the room. That makes it the shortest footprint in the industry! The Moonton offers incredible comfort in your choice of fabric or leather. Multiple Sleeper, Sofa and Sectional sizes available. Design your own Moonton from a wide range of shapes, sizes, and covers. Made in the USA.


text:
Q: SQL Group by - Listing all rows by group? Given data such as
Type    Value
A       This
A       is
B       Will
A       a
B       this
A       test
B       work

I would like to end up with
Type    Value
A       This is a test
B       Will this work

Is this possible? Thanks!

A: Use GROUP_CONCAT().
SELECT Type, GROUP_CONCAT(Value SEPARATOR ' ') AS Value
FROM MyTable
GROUP BY Type;

Ensuring the words are concatenated in the order you want can be tricky, however.  GROUP_CONCAT() has an ORDER BY clause (see the docs) but your example doesn't include any column that can be used to determine the order.  Relying on the physical storage order isn't reliable.


With approximately 18 hectares irrigated, this highly productive property subdivided into 21 paddocks features an array of outbuildings including new stables and new three bedroom homestead plus office and self contained sleepout.
With contour ranging from flat through to easy downs and to a rear hill block, this property is ideally suited for cattle and sheep, but particularly well suited for calf raising and as equine agistment proposition.
Currently, the home of the successful One Over Lodge Standardbred horse stud, this sheltered and well managed property is now for sale due to vendors retiring to Dunedin.
Only 10 minutes by car to Waimate for schooling and supplies, 30 minutes to Oarmau, 40 Minutes to Timaru and 2.5 hours to Wanaka or Mount Cook and the ski fields.
With asphalt seal up the valley from State Highway One and to the gate of Broad Gully Farm, the treats are only just beginning. Over the cattle stop and through the lush Rhododendrons that tower on either side of this picturesque entrance, and you emerge into this enclave encapsulating the 320sq.m, three bedroom home surrounded by magnificent specimen trees. The homestead is ideally orientated to capture the sun and provide for indoor and outdoor entertainment of family and friends. Built in 2010, and clad in smooth faced Oamaru stone block, the three bedrooms, master with ensuite plus walk-in robe and open plan living, dining, kitchen plus second lounge, office and sleepout, provides ample space for family living. Other features include large internal access double garage, separate laundry, main bathroom with shower and bath, heatpump, Pioneer wood burner, underfloor heating, double glazing throughout and ample decks plus a spa pool.
Separate and to the rear of the homestead, is a self-contained sleepout with garage / workshop and wash room, This complex will suit a parent, teenager, farm worker or simply rent out to earn some pocket money!
If you are keen on storage and a place for every conceivable vehicle or animal, the out buildings on this property certainly oblige. The modern five bay stable with tie-up area is a stunning complex which any equine enthusiast will love, but equally, it could be used to raise calves. For vehicles and tools, the 6 bay implement shed with lockable workshop means you can buy even more trucks and tractors and hand tools and keep them protected from the elements. Broad Gully Farm is steeped in history with an historic woolshed with attached barn with loft, taking pride of place among the outbuildings. For those wanting a project, the restoration of the small cottage with quaint covered veranda would be a worthy cause and this could be used for farm homestays or again, extra accommodation for family or farm workers.
Other outbuildings include garden shed, two woodsheds and glasshouse. Stock handling facilities include the 100 head capacity wool shed, sheep yards and cattle yards with a bale and stock stuck loading facilities for both sheep and cattle.
Subdivided into 21 paddocks and with approximately 18 hectares being irrigated with K Line and pods, this property is highly productive due to a sheltered aspect and good management history.
Broad Gully Farm is ideally suited to general grazing and fattening, but also as a dairy run-off, calf rearing, horse training, horse breeding and because of the range of contour, perfectly suited for agisting horses.
The contour is flat through easy slope to a rear hill block with a broad top surrounded by forestry which affords the property protection from prevailing weather.
Fencing is all of a good standard with post and wire plus electric top wire and many fences with an equine wire for the horses.
Wintering stock numbers have been 90 cattle, 30 horses and 50 sheep.
Please call Judd on 0275 367 440 to arrange a viewing.


I've seen this truck several times at the end of my street. It's a medical supply truck. I thought it was for the tiny lady who lives at the top of the hill.
I once knocked on her door trying to catch my obnoxious puppy. I assumed she owned the tramp that Gifted Puppy chased. Nope. She said, "I'm a shut-in." My heart broke a little bit that morning. And this is a good reminder that I need to get to know her better.
However, when I pulled into my driveway yesterday, I noticed the truck in my next-door-neighbors' driveway. He's fighting cancer and it breaks my heart. They're the grandparent type of neighbors who adopt you before they even remember your name.
My three-year-old talks to them like nothing's wrong. She just shares her life. How wise.
Tragedy struck our own family hard last year when my beloved sister died from surgery complications. I almost forgot a few days ago as I picked up the phone to call her.
When I was sending my family a group text picture of my sweet little ones graduating from preschool, her name popped up. Tears sprung up out of nowhere. It's ok. I missed my sister. She's the one who would've responded first and with "Cute" and "So big" and "I miss them." Oh, sweet Michelle, we miss you most.
I took a Facebook break that didn't really last all that long, and when I rejoin, I see the tragedy of divorce and death affecting dear friends and loved ones.
The only thing I know to do when these things happen is to pray and reach out. You never know what that listening ear will do for someone who is carrying a burden too big for them to bear.
When my three-year-old was beside herself because she slept through the awards program at church, all I could do was pick her up and hold her. She knew what to do – draw near to love.
When my sister died, I didn't feel like I got the time and space I needed to really mourn her loss. I was too busy with my kids. How can I sit in bed and cry when someone needs help in the bathroom or seventh breakfast?
There were times I felt guilty that I wasn't a mess. In my mind when tragedy strikes, the world should break. And it does at times, but I realized something. The routines of life and are a gift for the brokenhearted.
Ask a three-year-old. You still need breakfast and hugs and to dunk all your puppies in the kiddie pool.
I had a reason to not sit in my bed and cry – three precious, hungry children who seemed preoccupied with where people and pets go when they pass on. They were constantly asking to pray for our lost puppy and my sister. In their innocent, precious way, they get it. They understand on a soul level that we are not carrying this burden alone. Jesus sees every tear and every hard moment.
And you know, it's not just tragedy that puts us at the brink of wanting to stay in bed and cry. This life is really hard. We're all struggling – watching a loved one suffer from a disease, wayward children, personal struggles that don't have clear answers.
A few months ago, I was about to crumble because I had so much on my plate that I walked into Bible study bursting with frustration.
The leader looked at me and asked me how I was. I couldn't help but hand a little of my burden to her. She wrapped an arm around me and prayed for me right there. That little gesture showed me that even when it all seems too tough, we are not alone.
Don't be afraid to ask for help bearing your burdens.
A few nights ago a friend's three-year-old daughter was carrying her own tea to the dinner table. It was about to spill. I told her to take a big sip. That still didn't help, so she asked me to carry it.
That's what He wants you to do. When it's all too much, put those arms up and ask for help.
If you're going through something tough, (nothing is too small) please know that you have a Helper and Healer. If you need prayer, please reach out to someone. I'd be happy to pray for you. Just leave a comment or email me at amanda c brandon at gmail dot com. Blessings, my friends.


text:
#ifndef FORMFADEWIDGETDEMO_H
#define FORMFADEWIDGETDEMO_H

#include <QWidget>
#include "qbasicformfadewidget.h"
#include "qencryptionkit.h"

namespace Ui {
class FormFadeWidgetDemo;
}

class FormFadeWidgetDemo : public QBasicFormFadeWidget
{
    Q_OBJECT

public:
    explicit FormFadeWidgetDemo(QBasicFormFadeWidget *parent = 0);
    ~FormFadeWidgetDemo();

private slots:
    void on_pushButton_clicked();

protected:
    void paintEvent(QPaintEvent *e);
    void showEvent(QShowEvent *e);

private:
    /*!
     * \brief drawShadowPlanA
     *  画边框阴影方案A
     */
    void drawShadowPlanA();

    /*!
     * \brief drawShadowPlanA
     *  画边框阴影方案B
     */
    void drawShadowPlanB();
private:
    Ui::FormFadeWidgetDemo *ui;
    QEncryptionKit m_encryption_instance;
    QPixmap m_shadow;
};

#endif // FORMFADEWIDGETDEMO_H


text:
What you need to know about ticks in the Netherlands
05 April 2017, by Kiri Scully
The number of ticks in the Netherlands has increased in April, meaning that people who go out on trips to the dunes, forests, woods or other green areas, must be extra careful to avoid getting bitten.
Every year, 1,3 million people are bitten by ticks. Many are also unaware of the dire health issues that can result from a bite.
Symptoms of infection
Lyme disease is caused by bacteria called B. burgdorferi spirochete that gets transmitted from the tick into the blood of humans. Symptoms in early stages often include unrelenting fatigue, recurring fever, headaches and migraines and achy muscles and joints. In many cases, it starts with a red ring or patch on the skin, but this is not always present.
In more severe cases, the illness can completely immobilise a person, causing severe pain, muscle spasms, loss of motor coordination, and even intermittent paralysis, meningitis, and heart problems.
It is worth noting that tick bites can also cause other diseases, but the most common one is Lyme.
Lyme disease statistics
Of the 1,3 million people that are bitten each year, 25.000 people get Lyme disease. Whilst mild forms of the disease can be treated or at least managed with antibiotics, about 1.000 to 2.500 people's symptoms continue after treatment.
Research is currently being conducted by the Dutch National Institute for Public Health and Environment to find out why this is. The first results of the survey, which monitors Lyme disease patients for a whole year, will be announced in 2019.
How to avoid getting bitten
NU.nl spoke to two experts on tick bites and how to avoid getting one.
"A tick should be removed as soon as possible", says Kees van den Wijngaard, an epidemiologist at the Rijksinstituut voor Volksgezondheid en Milieu (National Institute for Public Health and Environment).
For more maps that show the distribution of tick species around Europe, visit the European Centre for Disease and Control.
According to Tim Hogenbosch ranger in the Utrecht region, it is important to dress well in preventing tick bites. Ticks can drop from trees but are usually found in low grassland areas, for example, in dunes and forests.
"Put your socks on over your pants. It is also a good idea to wear tick-resistant clothing and stay on main paths. It is especially wise to check yourself well, and have others check over parts of your body that you can't see."
DEET is also available at the pharmacies and may help in keeping ticks at bay.
If you get bitten by a tick, it is wise to remove it immediately. There are several tools, but Van Den Wijngaard suggests using pointed tweezers.
"Place the tweezers close to the skin and pull the tick straight out. Disinfect the wound afterwards with alcohol."
Many people think that you have 24 hours to remove a tick, but it's important to remove it as soon as possible. If you have a pet, then it's best to buy a pipette to kill the ticks on the skin.
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Raised a global citizen, to an Irish father and American mother, Kiri has lived and worked in five countries over three continents. Fuelled by culture curiosity at an early age,...
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Only registered members can reserve the book online.
1. Search for a book.
2. Click on 'Reserve' with the title of the book you want to reserve.
3. Login in to your account using your card number and password.
4. If the book is available, reserve the book by using a click on 'Reserve' buttons.


text:
Q: Surface doesn't have a colorkey I coming back on a project writen few months ago with SDL 2.0.5 AFAIR and I now update it to the last available version.
And when my application calls SDL_CreateTextureFromSurface( renderer, surface ), SDL_GetError() complains with Surface doesn't have a colorkey message.
I'm almost sure this error is new but I cannot figure out why.
My code is:
SDL_Surface* surface = IMG_Load( imgName );
SDL_ClearError();
texture = SDL_CreateTextureFromSurface( renderer, surface );
if (strlen(SDL_GetError()) > 0)
{
    LOG_mes(WID_ERR_NO_TEXTURE, SDL_GetError());
}

If you could help me please and maybe point me to the SDL2_image doc because informations found here don't really help me as the links seem broken.


Description: Ford Motor Company (Ford) is recalling certain 2013 Ford Mustang vehicles sold, or ever registered in the states of Alabama, California, Florida, Georgia, Hawaii, Louisiana, Mississippi, South Carolina, Texas, Puerto Rico, American Samoa, Guam, the Northern Mariana Islands (Saipan), and the U.S. Virgin Islands or "Zone A." Additionally, Ford is recalling certain 2010 Ford Edge, Fusion, Mustang and Ranger, Lincoln MKX and Zephyr/MKZ, and Mercury Milan vehicles ever registered in the states of Arizona, Arkansas, Delaware, District of Columbia, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Virginia, and West Virginia or "Zone B." Ford is also recalling certain 2009 Ford Edge, Fusion, Mustang and Ranger, Lincoln MKX and Zephyr/MKZ, and Mercury Milan vehicles ever registered in the states of Alaska, Colorado, Connecticut, Idaho, Iowa, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wisconsin, and Wyoming or "Zone C." These vehicles are equipped with air bag inflators assembled as part of the passenger frontal air bag modules, used as original equipment or replacement equipment (such as after a vehicle crash necessitating replacement of the original air bags), that may explode due to propellant degradation occurring after long-term exposure to high absolute humidity, temperature and temperature cycling.
Corrective Action: Ford will notify owners, and dealers will replace the passenger frontal air bag inflator, free of charge. Owners may contact Ford customer service at 1-866-436-7332. Ford's number for this recall is 19S01.
Description: Bearing Technologies Ltd (Bearing) is recalling certain Duralast Wheel Spindles, part number DL930676K, sold as a service part for the front wheel hub spindle of 2007-2010 Ford Edge vehicles. The affected wheel spindles have wheel mounting studs with an oversized shoulder that can prevent the wheel from being installed correctly.
Defect: If the wheel is installed incorrectly, the wheel may vibrate or wobble, increasing the risk of a crash.
Corrective Action: Bearing will notify the distributors of the spindles. If the studs on a defective spindle are not loose, Bearing will replace the studs at no charge. If the studs on a defective spindle are loose, Bearing will replace the spindle assembly at no charge. Bearing will also pay shop labor for the remedy. The recall began on October 16, 2017. Owners may contact Bearing Technologies customer service at 1-800-597-3486 or visit www.recall17E053.com.
Description: Ford Motor Company (Ford) is recalling certain model year 2007-2011 Ford Ranger vehicles, 2006-2011 Ford Fusion, Mercury Milan and Lincoln Zephyr/MKZ vehicles, 2007-2010 Ford Edge, Lincoln MKX vehicles, 2005-2006 Ford GT vehicles, and 2005-2011 Ford Mustang vehicles originally sold, or ever registered, in Alabama, California, Florida, Georgia, Hawaii, Louisiana, Mississippi, South Carolina, Texas, Puerto Rico, American Samoa, Guam, the Northern Mariana Islands (Saipan), and the U.S. Virgin Islands, or "Zone A." Additionally, unless included in "Zone A" above, Ford is recalling certain model year 2007-2008 Ford Ranger, Edge and Lincoln MKX vehicles, 2006-2008 Ford Fusion, Mercury Milan and Lincoln Zephyr/MKZ vehicles, 2005-2006 Ford GT vehicles and 2005-2008 Ford Mustang vehicles originally sold, or ever registered, in Arizona, Arkansas, Delaware, District of Columbia, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Virginia, and West Virginia, or "Zone B." Any vehicle not included in "Zone A", or "Zone B" is not included in the safety recall. These vehicles are equipped with certain air bag inflators assembled as part of the passenger frontal air bag modules, and used as original equipment or replacement equipment. In the event of a crash necessitating deployment of the front air bags, these inflators may rupture due to propellant degradation occurring after long-term exposure to absolute humidity and temperature cycling.
Corrective Action: Ford will notify owners, and dealers will replace the passenger frontal air bag inflator, free of charge. Ford mailed interim letters informing owners that parts are not yet available on July 15, 2016. Owners will receive a second notice when remedy parts become available. Owners may contact Ford customer service at 1-866-436-7332. Ford's number for this recall is 19S01.
Description: Ford Motor Company (Ford) is recalling certain model year 2009-2010 Ford Edge vehicles manufactured September 11, 2008, to July 1, 2010, and Lincoln MKX vehicles manufactured September 23, 2008, to July 1, 2010, originally sold in, or currently registered in, Connecticut, Delaware, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, West Virginia, Wisconsin and the District of Columbia. Due to corrosion from salt water exposure such as from road salt use, the affected vehicles may leak fuel from the fuel tank seam weld under the tank mounting reinforcement brackets.
Defect: A fuel leak in the presence of an ignition source increases the risk of a fire.
Corrective Action: Ford will notify owners, and dealers will inspect the vehicles and either clean and treat the fuel tank with a corrosion preventative or replace the tank, free of charge. The recall began on May 10, 2016. Owners may contact Ford customer service at 1-866-436-7332. Ford's number for this recall is 15S31.


Based off designs of the Son of Batman animated movie comes the Nightwing!
This Son of Batman Nightwing action figure features multiple points of articulation and comes in blister card packaging. Nightwing stands slightly over 6 3/4-inches tall.


text:
Long-term outcome after bilateral lung transplantation – a retrospective study from a low-volume center experience
Shun-Mao Yang1,
Shu-Chien Huang1,
Shuenn-Wen Kuo1,
Pei-Ming Huang1,
Sung-Ching Pan2,
Jang-Ming Lee1,
Hong-Shiee Lai1 &
Hsao-Hsun Hsu1
The aim of this study is to review the long-term outcomes of bilateral lung transplantation (BLTx) in our institution and examine the potential issues that may influence outcomes in a low-volume center.
A retrospective review of BLTx performed in our institution between July 2006 and December 2012 was conducted. Standardized donor selection, procurement, and preservation protocols for brain-dead donors were applied. Measured outcomes were in-hospital mortality and actuarial survival using the Kaplan-Meier method.
Twenty-five consecutive patients (13 male, 12 female) underwent BLTx with a mean age of 41.8 ± 13.5 years. Before LTx, the mean body mass index was 18.3 ± 3.1 kg/m2. Seven of these patients (28%) required oxygen supplementation at rest before LTx, while the remaining patients (72%) required noninvasive mechanical ventilation (n = 6, 24%), invasive mechanical ventilation (n = 9, 36%) or extracorporeal membrane oxygenation (ECMO) (n = 3, 12%). The lung grafts were procured from brain-dead donors with the mean age of 26.8 ± 11.4 year and the best PaO2 / FiO2 ratio of 513 ± 77 before procurement. All cross match results between same-race donors and recipients were negative. The percentage of same-sex matching and CMV mismatching were 64% and 4%, respectively. The mean time listed on the transplant list was 308 ± 261 days. The mean ischemic time for the first and second grafts were 222 ± 62 and 361 ± 67 minutes. During transplantation, 22 (88%) patients depended on ECMO and one (4%) on cardiopulmonary bypass support. All but two patients (82%) were discharged home in good condition; two (8%) patients died within 3 months after BLTx. The cumulative survival rates at 1-, 2-, 3-, and 5-years were 88%, 83%, 72%, and 72%, respectively.
Although the comparatively few annual LTx performed is consistent with the low donation rate, our single-center growing experience demonstrates that good post-lung transplant outcomes can be achieved at a low-volume LTx center.
Owing to the development of improved immunosuppressants and refinements in surgical technique, lung transplantation (LTx) has become the standard of care for most causes of end-stage lung disease over the last two decades. The first LTx in Taiwan was performed in 1991, but by the end of 2013, the total number of LTx was less than 150 cases due to the shortage of suitable cadaveric lung donors. Currently, there are eight medical centers authorized to perform LTx in Taiwan; however, none of them have been able to reach 10 LTx per year. The official transplantation report published in 2011 by the Taiwan Organ Registry and Sharing Center (TORSC) demonstrated that the national LTx survival rates (or the average survival rates of all LTx centers) from January 2006 to December 2010 in Taiwan were 65% at one year and 56% at 3 years, respectively. These numbers are inferior to the worldwide average data published by International Society for Heart and Lung Transplantation (ISHLT) [1]. This has led some physicians to re-examine the risks and benefits of LTx, leading to delayed referral of potential candidates. In the TORSC report, however, some important issues affecting the LTx outcomes were not well-examined. The national donation rate, the varieties between different transplant centers, the effects of transplant center volume, the urgency-based organ allocation policy, and donor and recipient matching all impact survival after LTx. In an attempt to address the void of information and provide more clarity regarding the current information, we report our single-center experience with long-term outcomes after bilateral LTx (BLTx) and evaluate the effects of several important issue that may influence the long-term outcome of LTx.
We performed a retrospective analysis of consecutive patients who have undergone BLTx at the National Taiwan University hospital from July 2006 to December 2012, excluding heart-lung transplantation. Donor, recipient, and surgical data were extracted from patient charts and the Transplant database. This study was approved by the Institutional Review Board of National Taiwan University Hospital, with the informed consent waived.
Recipient and donor selection
The criteria for donor and recipient selection were identical to those established by the ISHLT. All donor lungs were retrieved from brain-dead donors. In Taiwan, the preference in donor allocation is given to patients with the highest short-term risk of death. When the waiting-lists were listed on the national organ allocation network, they were categorized into three different status according to the disease severity. The status II meant the patient has been qualified as a waiting list and could wait for a suitable donor. The status IB meant the waiting-list needed to be hospitalized due to disease progress. The status IA meant the waiting-list has already relied on ventilator or ECMO support. The first priority of lung donor allocation was the severity of recipient's disease, which meant that the more severe the underlying disease, the more preference for organ allocation. Because the total national number of LTx in Taiwan was less than 150 cases, the post-LTx survival did not take into account for organ allocation. The other priorities of organ allocation included the results of cross-matching between donor and recipient, and size matching. Because Taiwan is a small island and the national transplant network run well, we have enough time to perform the cross-matching tests and wait for the results before performing LTx. Therefore, the cross-matching results between donors and recipients were all negative in our LTx patients.
Lung transplant protocols
During the study period 2006 to 2012, standardized protocols were applied; these have been described previously but are summarized briefly here [2]. All donors were evaluated by our institution's transplant surgeons. Techniques used to assess lung quality included chest radiography, arterial blood gas, bronchoscopy, and visual inspection. For donor lung procurement, a bolus injection of prostaglandin E1 500μg was administered into the main pulmonary artery immediately before cross-clamping the aorta. The donor lung was perfused with 70 mL/kg of Perfadex (Vitrolife AB, Goteborg, Sweden) anterograde through the main pulmonary artery and 1 liter of Perfadex retrograde through the pulmonary veins. BLTx was carried out through a clamshell incision from the 4th or 5th intercostal space. The intraoperative extracorporeal membrane oxygenation (ECMO) system was routinely set up to provide adequate hemodynamic support during BLTx when the recipient already depended on ventilator or ECMO support before BLTx, or when the recipient could not tolerate pneumonectomy of the first native lung. In general, ECMO was weaned off in the operating room after BLTx. However, if there were signs of severe reperfusion lung edema or acute primary graft dysfunction that did not allow the transplanted lung to function well, ECMO was continued during transport from the operating room to the intensive care unit (ICU). Protective ventilator management with low tidal volumes (6 mL/kg of the donor body weight) and high positive end-expiratory pressure was used postoperatively. Early adequate enteral nutrition was achieved via nasal feeding tube inserted to the proximal jejunum under endoscopic guidance 2 days after LTx. A triple drug regimen, including a calcineurin inhibitor (cyclosporine or tacrolimus), an antimetabolite (azathioprine or mycophenolate mofetil), and corticosteroids, was used for maintenance immunosuppression. The choice of antibiotics was based on the results of sputum culture from donor and recipient. In the early post-transplant period, prophylactic valganciclovir was routinely used to prevent cytomegalovirus. Voriconazole was used for fungus and yeast if infection was suspected.
Continuous data are expressed as the mean with the standard deviation; proportions are represented as numbers (%). Categorical data are presented as a frequency and percentage. Cumulative survival following lung transplantation was determined using the Kaplan-Meier method. Overall survival was determined by the time from BLTx to death or to last follow-up through December 31, 2013.
Recipient characteristics
The total cohort included 25 consecutive patients (13 men, 12 women), with a mean age of 41.8 ± 13.5 years (range, 18 ~ 67 years). At the time of LTx, mean recipient body mass index (BMI) was 18.3 ± 3.1 kg/m2 (range, 12.9 - 24.1 kg/m2); five recipients (20%) were hepatitis B virus (HBV) carriers. Before LTx, 7 (28%) patients required oxygen supplementation at rest, 6 (24%) patients needed noninvasive mechanical ventilator (MV) support, 9 (36%) patients depended on invasive MV support (IMV), and 3 (12%) patients were supported by ECMO combined with IMV. The underlying diseases necessitating transplant included bronchiectasis (n = 7), lymphangioleiomyomatosis (n = 5), bronchiolitis obliterans (n = 4), pulmonary arterial hypertension (n = 3), pneumoconiosis (n = 3), idiopathic pulmonary fibrosis (n = 2), and chronic obstructive pulmonary disease (COPD) (n = 1) (Table 1).
Donor characteristics
The mean donor age was 27 ± 11 years (range, 15 ~ 53 years). Seven (28%) donors were female and 8 (32%) donors had a smoking history. The causes of brain death were head trauma (n = 18, 72%), cerebrovascular accidents (n = 5, 20%), and other conditions (n = 2, 8%). Before harvest, the best ratio of arterial partial pressure of oxygen (PaO2) to 100% fraction of inspired oxygen (FiO2) was 513 ± 77 (range, 350 ~ 674) and the mean time dependent on the ventilator was 66 ± 52 hours (range, 23 ~ 252 hours) (Table 2). The transplant variables used to match donors and recipients are presented in Table 2 and included negative cross-match results (100%), same ethnic origin (100%), gender (64%), identical blood group (68%), compatible blood group (32%), and cytomegalovirus (CMV) status (96%).
Table 2 Donor characteristics
Operative and postoperative characteristics
The mean time between placement on the waiting list and transplantation was 308 ± 261 days (range 19 ~ 1064 days). The ischemic times for the first and second grafts were 222 ± 62 minutes (range 125 ~ 337 minutes) and 361 ± 67 minutes (range 253 ~ 463 minutes). ECMO was used during transplantation for 22 (88%) recipients, and 1 recipient (4%) required the heart-lung machine for cardiopulmonary bypass. For maximal utilization of available resources, 13 (52%) donor lungs underwent concomitant resection of unhealthy areas intraoperatively. Seven of 13 donor surgeries were anatomical lobectomies (three for downsizing resection and four for localized pathological present), and the others were volume-reduction surgeries for size mismatching (Table 3).
Table 3 Operative data
The intensive care stay after BLTx was 45 ± 24 days (range 15 ~ 98 days), and the total hospital stay was 76 ± 45 days (range 21 ~ 206 days). Two recipients died (1 primary graft failure, 1 pulmonary infection) within 3 months; the other recipients (92%) were discharged home without incident and followed up regularly as outpatients. By the end of the study period, four of these discharged recipients had died. The causes of death were pulmonary infection (n = 2), sepsis (n = 1), and bronchiolitis obliterans syndrome (n = 1) (Table 4). The mean survival of all 25 patients was 1272 ± 784 days (range 21 ~ 2544 days). Kaplan-Meier survival for all patients after BLTx at 1-, 2-, 3-, 5- years was 88%, 83%, 72%, and 72%, respectively (Figure 1).
Table 4 Postoperative outcome
Kaplan-Meier actuarial survival after bilateral lung transplantation.
This retrospective study presents the long-term outcome of 25 consecutive patients receiving BLTx in a low-volume center. This report demonstrated that the satisfactory outcome can be achieved using the urgency-based organ allocation criteria in a donor-scare country.
According to the TORSC report, the average annual organ donation rate after brain death in Taiwan was around 6.5 per million of population (PMP) in recent years, which is far below that of Spain (35.3 PMP), Belgium (30.1 PMP), Portugal (28.1 PMP), the U.S.A. (25.6 PMP) and France (25 PMP). The low donation rate in Taiwan creates a severe shortage of donor lungs and limits the annual number of LTx. Ample evidence now exists confirming a relationship between surgical outcome and volume of the procedure, which becomes especially important for complex procedures such as transplantation [3-6]. Weiss et al. reported that the cumulative risk of mortality at 30 days, 1 year, and 5 years after LTx was highly dependent on volume. In general, high-volume centers (those centers achieving an average of 20 LTx per year) had superior short- and long-term outcomes, and low-volume centers (those centers achieving less than 10 LTx per year) have alarmingly high mortality rates. In Taiwan, none of the seven authorized LTx centers have been able to reach 10 LTx per year due to the low organ donation rate. Based on these findings, it is easier to understand why the official report of national LTx outcomes in Taiwan is worse than those reported by the ISHLT. Interestingly, some low-volume centers have been able to produce excellent outcomes, implying that factors influencing mortality after LTx are far more complex than simply volume. Weiss et al. speculate that low-volume centers may be able to provide similar outcomes as the high-volume centers if they are equipped with specialized staff, integrated patient support systems, and a culture of excellence. These characteristics provide a benchmark for LTx centers to strive for, no matter the size or volume of the center.
The other important issue that significantly impacts transplant outcomes is the organ allocation system. The new allocation rules implemented in France since 2007, which prioritize allocation of donor lungs to candidates with conditions posing an immediate threat to life, are similar to those in Taiwan. The national LTx report from France demonstrated that the survival results for emergency LTx (ELTx) were worse than those for non-urgent LTx [7]. Survival rates in the ELTx group were 64.5% and 55% at 1 and 2 years, respectively, which were significantly lower than the regular, nonurgent LTx group (77% and 71%, respectively). As with France's experience, Spain and the United States also have similarly poor outcomes for emergent or urgent LTx [8,9]. According to the United Network for Organ Sharing (UNOS) data, patients on MV or ECMO before LTx had decreased survival after LTx [10]. The 1-year survival associated with ventilator and ECMO support groups were 67.7% and 57.6%, respectively, which were both inferior to those in the high lung allocation score group. Based on these findings, it is reasonable to conclude that this kind of urgency-based allocation policy may contribute to futile and unsuccessful transplantation, especially for low-volume, limited experience LTx centers in donor-scare countries, such as those in Taiwan.
Our report is consistent with the conclusion that lung allocation policy has great influence on the distribution of underlying disease indications for LTx. Although COPD was one of the major diagnoses for LTx in the UNOS and ISHLT reports, only one patient with COPD (4%) received LTx in our study population [1,11]. This unique phenomenon may result from the urgency-based lung allocation system in Taiwan. These allocation rules could potentially make access to LTx more difficult for patients not fulfilling the emergency criteria when donor lungs are scarce, gradually leading to an increase in waiting-list mortality for non-urgent patients, such as those with COPD.
In this study, eighteen (72%) patients were already dependent on MV or ECMO support prior to LTx. In order to provide adequate hemodynamic support during LTx, ECMO was used preferentially as an alternative to cardiopulmonary bypass (CPB). We prefer the ECMO circuit to assist LTx instead of CPB for several reasons. First, modern ECMO technology, including replacement of silicone oxygenators, the introduction of heparin-bonded circuits, and new centrifugal pumps, gives ECMO the capacity to support gas exchange without the need for high-dose heparin administration or anticoagulation therapy. Second, our institution is one of the highest-volume ECMO centers in the world. In our institution since 1994, more than 1,950 patients have been treated with ECMO for sundry causes of cardiopulmonary collapse. Therefore, the refined technical aspects of ECMO combined with the experience using ECMO in our hospital significantly decreases the incidence of major ECMO-attributed complications, including bleeding and peripheral access-related limb ischemia, in our transplant population. Finally, ECMO can provide a bridge to transplantation in patients unresponsive to maximal pulmonary-respiratory support [12-15]. In this report, of 23 patients (92%) receiving BLTx under ECMO support, only one needed to switch to traditional cardiopulmonary bypass (due to severe hemodynamic instability). Furthermore, ECMO allowed 3 (12%) patients cardiopulmonary failure to be stabilized before LTx and thus be successfully bridged (up to 86 days) to BLTx in a high-urgency setting; each of these patients was weaned off ECMO smoothly and discharged without any complications.
The 1-, 3-, and 5-year survival rates after BLTx in this study are similar to those of the Japanese registry report (86%, 79%, and 73%), and are slightly superior to those from UNOS (84%, 66%, 51%) and ISHLT (79%, 64%, 53%) [11,16,17]. Given the small sample size in our study, we can only speculate on the reasons for our improved outcomes. Most likely, a combination of specialized staff, operative technique, and optimal recipient-donor matching (100% cross match and race matching, and only 4% CMV mismatching) is responsible for these outcomes; however, further investigation of these trends is warranted to confirm this speculation.
This study is limited by its single-institution, small sample size, and retrospective nature. Moreover, there was no control group to reduce the influence of selection bias. However, a control group may present ethical challenges because LTx is a promising, feasible and lifesaving procedure for patients with end-stage pulmonary disease.
Owing to refined surgical technique, adequate perioperative support, and improved postoperative care, we believe LTx can be performed with acceptable post-transplant mortality and satisfactory long-term outcomes in a low-volume center such as ours using the urgency-based organ allocation criteria.
BLTx:
Bilateral lung transplantation
LTx:
TORSC:
Taiwan Organ Registry and Sharing Center
ISHLT:
International Society for Heart and Lung Transplantation
ECMO:
Extracorporeal membrane oxygenation
ICU:
HBV:
Mechanical ventilator
COPD:
CMV:
PMP:
Per million of population
UNOS:
United Network for Organ Sharing
Christie JD, Edwards LB, Kucheryavaya AY, Benden C, Dipchand AI, Dobbels F, et al. The registry of the international society for heart and lung transplantation: 29th adult lung and heart-lung transplant report-2012. J Heart Lung Transplant: the official Publ Int Soc Heart Transplant. 2012;31(10):1073–86.
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We would like to thank Yu-Mei Lai for providing the assist in the collection of patients' information. There was no source of support for this study.
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan
Shun-Mao Yang, Shu-Chien Huang, Shuenn-Wen Kuo, Pei-Ming Huang, Jang-Ming Lee, Hong-Shiee Lai & Hsao-Hsun Hsu
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan
Sung-Ching Pan
Shun-Mao Yang
Shu-Chien Huang
Shuenn-Wen Kuo
Pei-Ming Huang
Jang-Ming Lee
Hong-Shiee Lai
Hsao-Hsun Hsu
Correspondence to Hsao-Hsun Hsu.
No author has financial or other interest in the product or distributor of the product involved in the present study.
SMY, HHH, SCH, SWK, PMH, SCP, and JML were all involved in the transplant surgery, including the donor procurement and recipient transplantation. SCH, SWK, and SMY set up and maintained the ECMO life support system. HHH, SMY, SCH, and HSL has been involved in drafting the manuscript and also made substantial contributions to conception and design of the study, and acquisition of data. HHH, SCH, SWK, SMY, SCP, and JML were also involved in the postoperative patients' care. SMY, SWK, PMH, HSL, and JML substantial contributions to conception and design as well as interpretation of data. HHH was the director responsible for general organization and instruction. All authors read and approved the final manuscript.
Shun-Mao Yang and Shu-Chien Huang contributed equally to this work.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Yang, SM., Huang, SC., Kuo, SW. et al. Long-term outcome after bilateral lung transplantation – a retrospective study from a low-volume center experience. BMC Surg 15, 28 (2015). https://doi.org/10.1186/s12893-015-0010-8
Low-volume center


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package for configuring language
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redpajama_set_name: RedPajamaWikipedia


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