text:
Call 0800 086 8793
Trustpilot reviews

10 Year Guarantee

Peace of Mind

Beautiful bathrooms made to last

Safe and Secure

Read more
Free Delivery

Reliable and Fast

Next day delivery available
Easy Returns

Convenient and Simple

Easy returns process

Dulwich Exposed Traditional Thermostatic Shower Set Single Outlet Incl. Concentric Shower Valve, Rigid Riser Rail, 200mm Apron Shower Head - Chrome

  • QUALITY- This shower set is premium quality, with a solid brass construction and durable chrome finish. The built-in anti-scald device also means no more fluctuating water temperatures while showering. Minimum water pressure required is 0.5 bar, though min. of 1.0 bar is recommended for best performance.

  • TRADITIONAL DESIGN- This shower set is robust and graceful and will give a Victorian timeless elegance to any bathroom. It has the appearance of a classic shower tap, yet all the intricate workings of a modern shower. The shower valve has white ceramic & cross handle detailing on the chrome valve. Shower valve - 1/2 inch hot/cold inlets with 147-153mm distance in between.

  • SAFE TO USE- The twin thermostatic shower valve is anti-scald allowing to keep you and your family safe. The smart thermostat valve will automatically turn off the shower head if the cold water supply fails. This valve is fitted with two individual controls, one to select the showers temperature and one to control the water flow.

  • FULL PACKAGE SHOWER SET: X1 Thermostatic shower mixer valve, X1 730-1230mm rigid riser rail, X1 200mm large shower head, installation guide. Rainfall shower head creating a powerful shower head.

  • 10 YEAR GUARANTEE- Although our shower sets are already trusted by thousands of customers we want to provide you with true peace of mind. That's why we offer a 10 year guarantee on our shower sets.
Only 7 left

Availability: In stock

Regular Price: £199.99

Special Price £179.99

If you are after a more traditional look and feel for your bathroom or ensuite, why not complement the look with this beautiful Dulwich shower set with adjustable telescopic rigid riser rail and thermostatic valve?

The concentric thermostatic shower valve is anti-scald allowing to keep you and your family safe. The valve will automatically shut down the shower if the cold water supply fails. Features separate controls for temperature and water flow.

  • Shower valve - 1/2" hot/cold inlets with 147-153mm distance in between
  • Showerhead - supplied with swivel joint, 200mm diameter
  • Adjustable riser rail length - 730 - 1230mm
  • For more dimensions please see dimension drawing

For this shower to operate efficiently your water system will need to produce at least 0.5 bar of pressure, though we recommend 1.0 bar for best performance.
This can be achieved if you have one of the following:

  • Combination boiler systems
  • Gravity fed systems (only with a pump)
  • Megaflow system
  • Pumped hot water systems
  • Un-vented hot water systems
  • Standard pressurised hot water cylinder type systems

  • Thermostatic shower mixer valve
  • Rigid riser rail with shower head
  • Installation guide

Not for you? Browse our collections of baths, showers, taps and more - at HOUSE OF ENKI, we'll help you create the bathroom of your dreams.

Additional Info

Additional Info

EAN 5060256189428
Downloads No
Brand ENKI
MPN SH0147
Colour Chrome

Write Your Own Review

Only registered users can write reviews. Please, log in or register

Delivery & Returns

Surcharges apply on deliveries to Republic of Ireland, Northern Ireland, Highlands, Channel Islands, and other offshore destinations. Cut-off time for same day despatch is 3:30pm UK time. Please note we do not ship or deliver on Saturdays, Sundays and Public Holidays.

Standard Delivery

Fast and Reliable, 2 business days.

Express Delivery

Fast and Reliable, guaranteed next business day.

International Delivery

Fast and Reliable, 2-3 business days to most countries in Europe .

"We want you to be 100% happy with your purchase and offer a 30 day "no quibble" guarantee"

If you change your mind, or the purchase is not suitable, you may notify us to cancel the contract within 30 days after the day of receipt of item(s) and you have a duty to take reasonable care of the item(s) until we receive the item(s) back. Return posting costs will be at your expense.

For additional peace of mind this product comes with:

Convenient and Simple

Peace of Mind

You may also be interested in the following product(s)

Memory usage: real: 27262976, emalloc: 24414352
Code ProfilerTimeCntEmallocRealMem


Content-Type: application/http; msgtype=response

WARC-Identified-Payload-Type: application/xhtml+xml

WARC-Type: response

text:
New Novel "The Chamber of Curiosities" Explores Obsessive, Possessive, Forbidden Love

My soon to be published novel "The Chamber of Curiosities" explores the star-crossed love story of Darney Veska, a charismatic circus "freak" and the beautiful young trapeze artist, Clare Dupuis.  Set against the back drop of a carnival in an ancient bastion perched above a vibrant seaport, it is a tale of obsessive, possessive, forbidden love.

More about the book, scheduled for publication in 2013 at:

Click to share thisClick to share this

warcinfo:
isPartOf: CC-MAIN-2021-21
publisher: Common Crawl
description: Wide crawl of the web for May 2021
operator: Common Crawl Admin (info@commoncrawl.org)
hostname: ip-10-67-67-81.ec2.internal
software: Apache Nutch 1.18 (modified, https://github.com/commoncrawl/nutch/)
robots: checked via crawler-commons 1.2-SNAPSHOT (https://github.com/crawler-commons/crawler-commons)
format: WARC File Format 1.1
conformsTo: https://iipc.github.io/warc-specifications/specifications/warc-format/warc-1.1/


WARC-Identified-Payload-Type: text/html

text:
Good data ‘the foundation’ of reaching zero carbon | News

Asset Management Network Strip

The Asset Management Network

Good data ‘the foundation’ of reaching zero carbon

The sector will be unable to reach zero carbon by 2050 if it does not improve its data.

That was the view of a panel speaking at HQN’s event looking at the relationship between data and zero carbon.

One of the speakers, Nicholas Doyle, Director at Adecoe, called the drive a “generational change” and that he was enthused that “every day more of the sector is waking up to the zero carbon agenda”.

Looking at data, Doyle said: “Good data is a proxy for good management. This biggest challenge is existing homes, but it is also the biggest opportunity.

“You wouldn’t start to deliver zero carbon with the data we currently have. Data collection has been driven by other issues such as Decent Homes, FRAs and regulation.”

And he said this data collection being driven by other issues also is the case for the format of the data, with it often being taken for other reasons such as SAP or EPC.

“It isn’t where we should start from, but it is where we are,” he added. “We need to start thinking about how we use data moving forward.”

But he said that housing associations who are looking to start on their zero carbon journey shouldn’t use their “pursuit of better data” as an excuse not to act.

“The sector needs to act now but begin to put in place processes to help with data. That will allow the sector to be flexible and manage the changing landscape.

“Homes are going to be moving from being passive things to active things, and the data will be driving that.

“There will be a case of managing housing based on performance, not elements and there will need to be a maximising of the revenues from energy generation, storage and management. Will it offset the costs? We don’t know but the sector is in a fantastic place to make a go of it.

“Need to develop an open-source data platform to manage performance. That is an R&D challenge for the sector.

“Data is a key cornerstone, but it is not a strategy. Data is a foundation. We need more of it and we need different data.

“In the longer term, data will be become key to housing management, driven by zero carbon. We need to manage that better than we currently do.”

Using a housing association he has worked with on getting their data in a good place, Doyle was keen to stress that one of the key aspects was ensuring the whole company is involved in the zero carbon journey.

The housing association case study he used could only whole house retrofit 10% of its homes and costs would be £1bn to 2050.

He said these figures showed why new funding mechanisms are needed and why there needs to be a phased approach.

Doyle added: “By phasing the approach to retrofit, it allows us to adapt and be flexible as the landscape changes. That is critical for the sector.”

Mark Sreeves, Technical Sales Manager, Sava, also spoke at the event and gave some helpful tips for housing associations looking to start their journey.

He said: “Even though you may be concerned about the data you have, there is usually some good places to start such as stock condition, gas maintenance data and others.”

He added that it is “good to understand your data on a whole stock basis” and that there was a need to “balance what you have data-wise”.

And his colleague, Andy Flook, Director of Business Development, said other considerations have got to be around regeneration.

“We are going to get to a point with some of these properties that the work needing to be done is going to be so radical that more will fall into regeneration pot.”

He added that “some of the technology is going to need a rethink” saying that some of the retrofits happening right now might need to be more energy efficient in the future.

“It is not always a good idea to go for a low carbon solution that our tenants cannot afford. We need to make sure that tenants are able to run their home affordably,” he concluded.


text:
Demolition made easy with the Sennebogen 825 E-Series machine.

An on-site demolition job? Luckily, SENNEBOGEN has the necessary products at hand in the Rental & Used fleet of its own subsidiary SENNEBOGEN Vertriebsgesellschaft. The engineering company from Straubing, Germany, initiated the demolition of a paint shop built in the 1960s as part of the plant modernization. Hans Eberhardt GmbH, a local company specializing in building construction and civil engineering, is providing valuable expertise in performing the demolition job. They rely on the green 825 E-Series demolition machine which has the stability, reach and power required for the demolition work in the main plant: Thanks to the powerful 129 kW diesel engine, configured in accordance with the latest emission stage V standards, it operates in a fuel-saving, environmentally friendly and quiet manner – a major plus when carrying out demolition work in inner-city areas...

Investing in the future is important to the owners of the Straubing-based family company SENNEBOGEN in order to create new jobs and continue the company's success story. In addition to the other expansion projects, such as the newly built and nearby service center on the A3 freeway with state-of-the-art warehouse technology, a second plant specializing in steel construction in Líter, Hungary, the focus is also on modernizing the main plant in Straubing's city center. Currently, a paint shop built in 1964 with a length of 85 m is being dismantled: another milestone for using the latest production standards in the heart of Lower Bavaria.

BIG advantages of the SENNEBOGEN 825 demolition machine dismantling the paint shop
The advanced demolition machine, which has a rear radius of 2.8 m and specializes in confined spaces, is a perfect fit for the three-week demolition project on the company's own premises: SENNEBOGEN's 825 E demolition machine has an operating weight of 34 t and a telescopic undercarriage that can be conveniently extended from a transport width of 2.3 m to a maximum of 3.5 m in the working position. Due to the widened contact surface of the telescopic undercarriage, the weight of the demolition machine is optimally transferred into the ground, which ensures a stable stand when removing the concrete from the building and when slewing. Equipped with an Oilquick quick coupler, the operator can also set the machine up for a new task comfortably from the driver's seat: the special additional hydraulics on the stick enable the operation of various attachments, including those that require high pressures. With SENNEBOGEN's Tool Control system, pressure and oil delivery rates can be easily pre-programmed, so that after one click in the control system and after coupling the attachment, you can start work immediately.

Demolition in inner cities: The 825 E is very compact and operates with low emissions
Inner-city demolition sites are often limited in terms of the space available: This is also the case at the SENNEBOGEN plant, because directly adjacent production facilities must not be disturbed during the project, and residential units in the immediate vicinity must also remain unaffected by the operation. Controlled, selective dismantling is the keyword here, which perfectly describes the planned removal and eco-friendly sorting of the construction waste.

Like its bigger brother, SENNEBOGEN's 830 Demolition, the 825 E is a specialist for working in 360° mode: In other words, once placed, the machine hardly needs to be moved at all to grab, remove, sort or load material into containers. At the same time, the economical Stage V diesel engine is cleaner than ever, thanks to the latest technology for exhaust gas aftertreatment: demolition machines in this setup now emit around 97% fewer soot particles and 96% fewer nitrogen oxides than 20 years ago – an essential requirement for inner-city demolition projects.

Associated Businesses

  • Molson Group are the UK’s largest independent new and used equipment dealer. With a customer focused approach, we are able to provide clients of all sizes a single source supply option of market leading products, backed up by a tea...
  • Germany


text:
New York officials released a number of new guidelines for daycare and camps, including children wearing masks.

Enter your number to get our free mobile app

Physical Distancing

  • Any time that employees are less than 6 ft. from each other or interacting with children/campers, they must wear a face covering.
  • Ensure employee and children/camper groupings are as static as possible by having the same group of children/campers stay with the same staff whenever and wherever possible. Group size must be limited to no more than 10 children/campers (not including employees/staff).
  • Ensure that different stable groups of up to 10 children/ campers have no or minimal contact with one another or utilize common spaces at the same time, to the greatest extent possible.
  • Implement practices to maintain adequate social distancing in small areas, such as restrooms and breakrooms, and signage and systems (e.g. flagging when occupied) to restrict occupancy when social distancing cannot be maintained in such areas.
  • Take reasonable steps to reconfigure space to limit overall density of rooms to 10 or fewer children/ campers.
  • Prohibit non-essential visitors on site, to the extent possible. Establish designated areas for pick-ups and deliveries, limiting contact to the extent possible.
  • Limit in-person gatherings of employees (e.g. breaks, meetings) to the greatest extent possible.

Protective Equipment

  • Ensure employees wear face coverings any time they are 6 ft. apart from one another, and at all times when interacting with children/campers, regardless of distance.
  • Provide employees with an acceptable face covering at no-cost to the employees and have an adequate supply of coverings in case of need for replacement.
  • Acceptable face coverings include but are not limited to cloth (e.g. homemade sewn, quick cut, bandana) or surgical masks.
  • Clean, replace, and prohibit sharing of face coverings.
  • Consult the CDC guidance for additional information on cloth face coverings and other types of personal protective equipment (PPE), as well as instructions on use and cleaning and disinfection. Train employees on how to put on, take off, clean (as applicable), and discard PPE.
  • Limit the sharing of objects (e.g. electronic equipment, arts and crafts materials, touch screens) and discourage touching of shared surfaces; or, when in contact with shared objects or frequently touched areas, require employees to wear gloves (trade-appropriate or medical); or, require employees and children/campers to practice hand hygiene before and after contact.

Child Care Program and Camp Activities

  • For pool and aquatic activities:
    • Ensure face coverings are not worn while in the water;
    • Keep stable groups of children/campers separated;
    • Encourage water activities where staff can safely supervise older children/campers in the water without being in the water by themselves.
    • Ensure appropriate social distancing is kept, to the extent possible;
    • Enhance cleaning and disinfection protocols
  • For sport and athletic activities:
    •  Keep stable group of children/campers separated;
    • Focus on activities with little or no physical contact (e.g. hiking, running);
    • Encourage sports that involve less physical closeness over those that are close-contactor involve shared equipment;
    • Encourage activities that are lower risk such as skill-building and conditioning;
    • Enhance cleaning and disinfection protocols;
  • For food services:
    • Serve individual portions to children/ campers;
    • Keep stable groups of children/campers separated;
    • Stagger mealtimes to reduce occupancy/ congregation;
    • Separate tables with seating at least 6 ft. apart from other tables, as feasible.
  • Discourage excursions away from programs (e.g. field trips). If transportation occurs, make all reasonable efforts to maintain stable groups of children in vehicles.
    • If groups of children must be mixed within a vehicle, seating must be arranged to maximize distance between different groups of children/campers and employees.
    • All individuals (driver, employees, and children) over age 2 and able to medically tolerate a face covering must wear face coverings.

Hygiene, Cleaning, and Disinfection

  • Adhere to hygiene, cleaning, and disinfection requirements from the Centers for Disease Control and Prevention (CDC) and Department of Health (DOH) and maintain logs on site that document date, time, and scope of cleaning and disinfection.
  • Provide and maintain hand hygiene stations: handwashing with soap, running warm water, and disposable paper towels; alcohol-based hand sanitizer containing 60% or more alcohol for areas where handwashing is not available/practical.
  • Make hand sanitizer available throughout common areas on site.
  • Employees/staff and children/campers must perform hand hygiene immediately upon entering the program.
  • Require staff and children to practice hygiene in the following instances:
    • Upon arrival to the first program activity;
    • Between all program activities;
    • After using the restroom; • Before eating; and • Before departing the last program activity.
  • Provide appropriate cleaning/disinfection supplies for shared and frequently touched surfaces (e.g. door handles, multi-seat strollers, toys, art supplies, areas where children eat), and encourage employees to use these supplies before/after use of these surfaces, followed by hand hygiene.
  • Regularly clean and disinfect equipment and toys using the Department of Environmental Conservation’s (DEC) list of products identified by the Environmental Protection Agency (EPA) as effective against COVID-19.
  • Limit children/campers from using toys that can’t be cleaned/sanitized (e.g. dress-up clothes, puppets).
  • For programs with rest periods for children/campers, make individual clean bed coverings available for each child/camper, and do not allow bedding to be shared unless cleaned/disinfected.
  • Take the following precautionary measures when taking care of young children:
    • Frequent and thorough hand hygiene for both staff and children/campers.
    • Whenever a child is soiled with secretions, change the child’s clothes and clean the child, as needed.
    • When diapering/providing assistance with toileting, wear gloves, wash hands (staff and child), and follow cleaning and disinfection steps between each child.

  • Affirm you have reviewed and understand the state-issued industry guidelines, and that you will implement them.
  • Train all employees/staff on applicable precautions/ policies in the State’s guidance either remotely or inperson, using appropriate social distancing and requiring face coverings for all participants.
  • Post signage inside and outside of the facility to remind individuals to adhere to proper hygiene, social distancing rules, appropriate use of PPE, and cleaning and disinfecting protocols.
  • Conspicuously post completed summary safety plans on site

  • Instruct staff to stay home if they are sick and remind parents/guardians to keep sick children/campers home.
  • Implement mandatory health screening assessment (e.g. questionnaire, temperature check) for employees, visitors (e.g. contractors, vendors), and children/campers, either directly or through their parent/guardian.
  • Screening must ask about (1) COVID-19 symptoms in past 14 days, (2) positive COVID-19 test in past 14 days, and/or (3) close or proximate contact with confirmed or suspected COVID-19 case in past 14 days. Responses must be reviewed and documented daily.
  • For children/campers arriving to a program via bus transportation and for employees who provide supervision on the bus, screening must be completed prior to boarding the bus, where feasible.
  • In the event that a parent/guardian of a child/camper must be isolated because they have tested positive for, or exhibited symptoms of, COVID-19, the parent/ guardian must be advised that they cannot enter the site for any reason, including picking up their child.
    • If the parent/guardian – who is the a member of the same household as the child/camper – is exhibiting signs of COVID-19 or has been tested and is positive for the virus, utilize an emergency contact authorized by the parent to come pick up the child. As a “close contact,” the child/camper must not return to the child care or day camp for the duration of the quarantine.
    • If the parent/guardian– who is the a member of the same household as the child/camper – is being quarantined as a precautionary measure, without symptoms or a positive test, staff should walk out or deliver the child/camper to the parent/guardian at the boundary of, or outside, the premises. As a “contact of a contact” the child/camper may return to the child care or day camp during the duration of the quarantine.
    • If a child/camper or their household member becomes symptomatic for COVID-19 and/or tests positive, the child must quarantine and may not return or attend the child care or day camp program until after quarantine is complete.
  • Immediately notify the state and local health department about any positive test result by an employee or child/camper at their site.

New Rules For NY Bars, Restaurants Tops This Week's Hudson Valley News

Hudson Valley's Top 10 News Stories of 2019


text:
American Journalist Released Unharmed

Jill Carroll, the American reporter held hostage in Iraq was released yesterday, and told Baghdad Television: “It’s important people know that I was not harmed."

According to the Associated Press, Carroll, 28 had been held for three months by people who call themselves Revenge Brigades. The journalist for Christian Science Monitor was left on a Baghdad street in front of a Sunni political party office there she was then taken to the Sunni Political Headquarters and before she was handed over U.S Authorities where she was able to call her family, and then talk with Baghdad Television wearing a green Islamic head scarf and a gray Iraqi robe.

In the three months of captivity Carroll was seen in televised threats to murder the journalist if American forces did not release women prisoners.

Although she was seen in these clips of threats the Associate Press reported that Carroll told Baghdad Television: "They never said they would hit me, never threatened me in any way." In fact Carroll is adamant about being treated well, but not knowing where she was.

According to the Associated Press she told Baghdad Television: "I was kept in a very good, small safe place, a safe room, nice furniture," she said, adding that she was given clothing and plenty of food. "I was allowed to take showers, go to the bathroom when I wanted," she said. They "never hit me, never even threatened to hit me.”

The Baghdad Television interviewed show Carroll frequently tucking her hair under her headscarf, and appearing happy to be released after she was ambushed and her translator killed.

President Bush said he was pleased about at the news according to Associated Press. "I’m just really grateful she was released," he said. He thanked those "who worked so hard for her release. I’m glad she’s alive." He said.

In the three months that Carroll was held captive there were two different tapes of her aired on Al-Jazeera television and a private Kuwaiti TV channel, were she pleaded to American Forces to free the women prisoners.

According to the Associated Press, “Carroll is the fourth Western hostage to be freed in eight days. On March 23, U.S. and British soldiers, acting on intelligence gained from a detainee, freed Briton Norman Kember, 74, and Canadians James Loney, 41, and Harmeet Singh Sooden, 32, from a house west of Baghdad.”


text:
A plaintive plea comes o'er the sea

A plaintive plea comes o'er the sea

Author: Clara McAlister Brooks
Tune: [A plaintive plea Comes o'er the sea]
Published in 2 hymnals

Printable scores: PDF, Noteworthy Composer
Audio files: MIDI

Representative Text

1 A plaintive plea
Comes o’er the sea
From nations in distress;
From darkest night
They ask for light,
Their ruined land to bless.

A plaintive plea
Comes o’er the sea,
How long, O Lord
Still must they wait?
Oh, hasten there
With faith and prayer,
Or soon ’twill be too late.

2 The ripened grain
On India’s plain,
Still waits for reapers true;
Hours swiftly fly,
While daily die
The millions in their woe. [Refrain]

3 The strong command
To ev’ry land—
“Go, spread the gospel news!”
Then haste away,
Till truth shall sway
Its scepter o’er the seas. [Refrain]

4 A plaintive plea,
Oh, can it be
Their souls are doomed and lost?
Go save them now,
Till all shall bow
Before the Savior’s cross. [Refrain]

Source: Songs of Grace and Glory: A New and Inspiring Selection of Sacred Songs for Evangelical Use and General Worship #96

Author: Clara McAlister Brooks

Birth: Oct. 9, 1882, Parke County, Indiana, USA Death: Mar. 20, 1980, Tampa, Hillsborough County, Florida, USA Clara McAlister Brooks was one of our early songwriters and four of her pieces are in the current hymnal. From the earliest days of the movement we have had women prominent in all forms of our ministry—missionaries, evangelists, teachers, pastors, and God has honored their sacrificial labors. For that reason we can stand in amazement when here, in the 1970s, such old-line denominations as the Episcopal church are being racked with controversy over whether the ordination of women is permissible. But before we gather Pharisaic robes about ourselves, perhaps we need to look candidly at the way in which we, too, succumbed to so… Go to person page >

Text Information

First Line: A plaintive plea comes o'er the sea
Author: Clara McAlister Brooks
Copyright: Public Domain

Instances (1 - 1 of 1)

The Cyber Hymnal #10911

Include 1 pre-1979 instance
Suggestions or corrections? Contact us

It looks like you are using an ad-blocker. Ad revenue helps keep us running. Please consider white-listing Hymnary.org or subscribing to eliminate ads entirely and help support Hymnary.org.


text:
An analysis of the poem oxygen by mary oliver

Ninth and last crusade —72 Nov Edward I crowned on his return from the Crusades Apr In addition to the penny, the halfpenny and farthing were minted, and also a fourpenny piece called a 'groat' from the French 'gross' 'Decorated' Gothic period in English architecture till about Climate: Jews expelled from England by Edward I Dec:

An analysis of the poem oxygen by mary oliver

Oliver's "Unearthly Neighbors" Chad Oliver, an Anthropologist, wrote particularly plausible novels of First Contact -- a term, after all, which originated in the field of Anthropology.

An analysis of the poem oxygen by mary oliver

The first of his masterpieces. Ballentine, ; revised first hardcover edition, New York: Crown, ] in later had a sequel, "The Shores of Another Sea. Other terms for this popular genre include: Others cite Castello Holford's novel "Aristopia: Trevelyan published a nominally nonfictional article about what might have happened if Napoleon had won at Waterloo.

Alfred Toynbee, in his "A Study of History" tried the same sort of academic experiments in allohistory. Some other splendid examples are: It is one of the most enthralling science-fiction books ever written.

At once a fantasy adventure, an exceptional mystery, it is a new concept that touches the very framework of reality. What was 'The Blind Spot? The fantastic events that follow from its deceptively simple opening are the sort of stuff from which Charles Fort wove his world-shaking books and A.

Merritt wrought fabulous novels. Lapses into Imaginary History", edited by J. A Drama of the Reconstruction Period", by Arthur Goodman"Ancestral Voices", by Nat Schachnerflawed time-travel change-the-past story, in which the accidental consequence is the passage into never-beingness of tens of thousands of descendants of one killed ancestor "Sideways in Time", by Murray Leinstergives a four-dimensional view of alternate timelines, and a protagonist who switches from one to another, some in which humans never evolved.

The breakthrough into explicitly science-fictional allohistory. DickGermany and Japan conquer and split the U. Jim Rittenhouse's Alternate History and a fascinating inside look by a professional science fiction author: Stephen Baxter's "Branches in Time: Alternate Histories Are True SF" Fairly thorough search results, including anthologies, references, and listings by author may be found in: Schmunk also check out: To make the definition cover all science fiction instead of 'almost all' it is necessary only to strike out the word 'future'.

Berkeley There is a scientific basis for such speculations, namely the "Many Worlds" interpretation of Quantum Mechanics.

Aug 12,  · Mary's poems speak to me like a book of Rumi poems, like a book of Koans, like the Bible, like the Talmud, like the Quran, like an African chant, like a Hopi dance., and like a woodpecker's tapping on a tree. Jan 22,  · Everything needs it: bone, muscles, and even, while it calls the earth its home, the soul. So the merciful, noisy machine stands in our house working away in its. he Downton Abbey Trivia Page. Because it was written, filmed and designed primarily for the British audience, there are many expressions and references used in the hit TV series Downton Abbey that may not make sense to viewers living outside of page provides insights and explanations to help people better understand the series and in so doing, enjoy it even more.

The notion is that each time a subatomic particle can one of several things, it actually does all them, splitting the universe into multiple copies which differ only in that one micro-event.At the Argentinean Billionaire's Bidding, India Grey Child Development, Shyam Sunder Shrimali Hitori and Sudoku, Nikoli Insight to Success, William J.

Smith Pills and Potions ABC French Bk The Online Writing Lab (OWL) at Purdue University houses writing resources and instructional material, and we provide these as a free service of the Writing Lab at Purdue. Oxygen by Mary Oliver - An Argumentative Analysis Introduction The Poem entitled, “Oxygen” is written by Mary Oliver and belongs to her collection of poems, entitled “Thirst”.

The book was published in the year There are 43 poems in the book. LLB Aristotle University of Thessaloniki, LLB London School of Economics, MSc University of Oxford. Having qualified as a lawyer of the Greek Bar in , Antonios is now conducting doctoral research at the University of Oxford, where he specializes in the law and economics of the European Banking Union.

Bethanne McCoy Mrs. Born AP Literature 12 August Oxygen by Mary Oliver In this poem, the writer describes the love she has with her partner as the way that she needs air every day. It’s a necessity%(1). Latest environmental news, features and updates.

Pictures, video and more.

Answers - The Most Trusted Place for Answering Life's Questions


text:
73 Matching Annotations
  1. Nov 2019
    1. Example var x = "5" + 2 + 3;

      crazy javascript

      try "5" + 2 + 3 vs 5 + 2 + "3"

    1. Underscore:

    2. Hyphens: first-name, last-name, master-card, inter-city.

  2. Apr 2019
    1. Starting multiple services from the same image

      After the new extended Docker configuration options, the above example would look like:

      • name: mysql:latest alias: mysql-1
      • name: mysql:latest alias: mysql-2
    1. * Note that C1 is faster, C2 is slower, but the C1 is slow again! This is because * the profiles for C1 and C2 had merged together. Notice how flawless the measurement * is for forked runs.

      I don't have a clue what is going on here. Oo

    2. * JVMs are notoriously good at profile-guided optimizations. This is bad * for benchmarks, because different tests can mix their profiles together, * and then render the "uniformly bad" code for every test. Forking (running * in a separate process) each test can help to evade this issue.

      I did not understand a thing? What are:

      • profile guided optimizations
      • mixed profiles
      • uniformly bad code?
  3. Mar 2019
    1. *
Iteration is the set of benchmark invocations.

      How many time should it execute the method per run

    2. *
Trial is the set of benchmark iterations.

      How many time should the benchmark run

    1. It is possible to run benchmarks from within an existing project, and even from within an IDE, however setup is more complex and the results are less reliable.
      Options opts = new OptionsBuilder();
          ".*" +
          MyBenchmark.class.getSimpleName() +
      new Runner(opts).run();
    1. The goals that are configured will be added to the goals already bound to the lifecycle from the packaging selected

      Why does maven has to be so bad, this sentence is so hard to read.

    2. tasks

    1. @MethodSource(names = "data")

      Expects an array of string!

      @MethodSource(value = "data")

    2. @MethodSource(names = "genTestData")

      @MethodSource({"data"}) or @MethodSource(value = "data")

    3. Specifies a class that provides the test data. The referenced class has to implement the ArgumentsProvider interface.

      Probably best with inner class

    4. public static int[][] data() { return new int[][] { { 1 , 2, 2 }, { 5, 3, 15 }, { 121, 4, 484 } }; }

    5. 10.9.1. Using Dynamic Tests

      Might be useful, but I not well supported via IDEs or buildtools right now.

    6. If you want to ensure that a test fails if it isn’t done in a certain amount of time you can use the assertTimeout() method

      Very useful if your specs are require time critical execution

    7. 10.7. Grouped assertions

      I'm unable to see the use case, separated assertions should be way more helpful.

    8. This lets you define which part of the test should throw the exception. The test will still fail if an exception is thrown outside of this scope.

      Normally tests will fail if an exception is thrown. But sometimes throwing an exception is the behavior that is supposed to be tested. this is possible with expecting exceptions

    9. 10.5. Test Suites

      This feels like a copy paste example, there is nothing to try here and it does not work

    10. Alternatively you can use Assumptions.assumeFalse or Assumptions.assumeTrue to define a condition for test deactivation. Assumptions.assumeFalse marks the test as invalid, if its condition evaluates to true. Assumptions.assumeTrue evaluates the test as invalid if its condition evaluates to false. For example, the following disables a test on Linux:

      This is quite useful to create conditional tests

    11. 10.2. Usage of JUnit 5 with Maven This example shows how to import all components of JUnit 5 into your project. We need to register the individual components with Maven surefire: <build> <plugins> <plugin> <artifactId>maven-compiler-plugin</artifactId> <version>3.1</version> <configuration> <source>${java.version}</source> <target>${java.version}</target> </configuration> </plugin> <plugin> <artifactId>maven-surefire-plugin</artifactId> <version>2.19.1</version> <configuration> <includes> <include>**/Test*.java</include> <include>**/*Test.java</include> <include>**/*Tests.java</include> <include>**/*TestCase.java</include> </includes> <properties>  <excludeTags>slow</excludeTags> </properties> </configuration> <dependencies> <dependency> <groupId>org.junit.platform</groupId> <artifactId>junit-platform-surefire-provider</artifactId> <version>${junit.platform.version}</version> </dependency> <dependency> <groupId>org.junit.jupiter</groupId> <artifactId>junit-jupiter-engine</artifactId> <version>${junit.jupiter.version}</version> </dependency> <dependency> <groupId>org.junit.vintage</groupId> <artifactId>junit-vintage-engine</artifactId> <version>${junit.vintage.version}</version> </dependency> </dependencies> </plugin> </plugins> </build> And add the dependencies: <dependencies> <dependency> <groupId>org.junit.jupiter</groupId> <artifactId>junit-jupiter-api</artifactId> <version>${junit.jupiter.version}</version> <scope>test</scope> </dependency> <dependency> <groupId>junit</groupId> <artifactId>junit</artifactId> <version>${junit.version}</version> <scope>test</scope> </dependency> </dependencies> You can find a complete example of a working maven configuration here: https://github.com/junit-team/junit5-samples/blob/r5.0.0-M4/junit5-maven-consumer/pom.xml The above works for Java projects but not yet for Android projects.

      this is not up to date. Use the official maven surefire docs. you only need to import one dependency.

    12. <dependency> <groupId>junit</groupId> <artifactId>junit</artifactId> <version>${junit.version}</version> <scope>test</scope> </dependency>

      Not needed anymore.

    13. This class can be executed like any other Java program on the command line. You only need to add the JUnit library JAR file to the classpath.

      java -cp myBuild.jar:junit.jar de.vogella.junit.first.MuTestRunner

    14. static

      what does import static do?

    1. people believe that asking system for time is dirt cheap

      Not cheap oO?

    1. $ java -cp target/benchmarks.jar your.test.ClassName

      Target will be run from inside your class, that is hopefully inside benchmark.jar, Need to check

    2. $ mvn clean install

      Why do I need to install the my project? As far as I know benchmark.jar will contain everything.

  4. Feb 2019
    1. In this example I have added a nested static class named MyState. The MyState class is annotated with the JMH @State annotation. This signals to JMH that this is a state class. Notice that the testMethod() benchmark method now takes an instance of MyState as parameter. Notice also that the testMethod() body has now been changed to use the MyState object when performing its sum calculation.

      Why do I need to provide a state with an additional class? I could also just provide the whole class as state.

    2. You should let the computer alone while it runs the benchmarks, and you should close all other applications (if possible). If your computer is running other applications, these applications may take time from the CPU and give incorrect (lower) performance numbers.

      or, make the test environment as real as possible

    3. Writing a correct Java microbenchmark typically entails preventung the optimizations the JVM and hardware may apply during microbenchmark execution which could not have been applied in a real production system. That is what JMH - the Java Microbenchmark Harness - is helping you do.

      This is maybe wrong, Benchmarks should be able to give you a snapshot on what is happening. On all possible machines. Why should the be without optimizations? Especially if you need to bench for a real machine.

    1. The column store has the additional advantage that you can use different primitive types for each column. In the record store you are pretty much forced to use a byte array to make sure you can support all types of fields. With a column store, one column can be an array of short, int, long etc. or whatever else you need.

      In general, we are back to C, or even before that.

    2. Using a column store it is very fast to search for records with column values matching a given criteria. You can just scan through the column arrays for the columns you want to search in. This is faster than searching in a record store, since you do not have to skip over unused fields.

      Also fields could be skipped in a record store, but the memory would be more fragmented, resulting in non sequential reads.

    3. A record store is actually a long byte array with "records" in. Each record consists of several fields which are stored after each other in the byte array. Each field may consist of one or more bytes.

      Are fields, like fields of an object or fields like addresses.

    1. The reason is, that all caching strategies are based on the assumption that your program will access data sequentially.

      But why?

    1. Additionally, if your server works on many tasks at the same time (e.g incoming HTTP requests), the other CPUs in your server may already be busy working on their own tasks. Parallelizing tasks gain you nothing then, as the CPUs are already busy. In fact, it may hurt performance (unless you have way more CPUs than you are using on average).

      This is an interesting point, running your system at 100% might slow it down

    2. Object allocation and garbage collection is slow.

      Creating and removing objects is shlow

    3. However, even now with Java 8, this is not correct. Algorithms, data formats, data structures, memory usage patterns, IO usage patterns etc. matter! There are many situations where you can optimize your code better than the Java compiler and JVM, because you know more about what your system is trying to do, its data structures, data usage patterns etc. than Java does.

      Yes, but optimizations are not general, this might create an immense technical debt.

    4. Second, we Java developers have been fed a lot of untrue stories about the Java compiler and the Java Virtual Machine. It is often said that the Java compiler or VM can do a better job of optimizing your code than you can.

      This is an interesting statement. Hope there will be an explanation.

  5. Jan 2019
    1. streams the children set, maps over this stream, creating a new CountingTask for each element, executes each subtask by forking it, collects the results by calling the join method on each forked task, sums the results using the Collectors.summingInt collector. ?123456789101112131415public static class CountingTask extends RecursiveTask<Integer> {     private final TreeNode node;     public CountingTask(TreeNode node) {        this.node = node;    }     @Override    protected Integer compute() {        return node.value + node.children.stream()          .map(childNode -> new CountingTask(childNode).fork())          .collect(Collectors.summingInt(ForkJoinTask::join));    }} The code to run the calculation on an actual tree is very simple: ?123456TreeNode tree = new TreeNode(5,  new TreeNode(3), new TreeNode(2,    new TreeNode(2), new TreeNode(8))); ForkJoinPool forkJoinPool = ForkJoinPool.commonPool();int sum = forkJoinPool.invoke(new CountingTask(tree));

      Good example

    2. This instance controls several re-used threads for executing these tasks.

      It is important to note, that those threads are reused. Even if thread creation requires less overhead than process there is still some. By reusing threads this overhead should be reduced even further.

    1. The plugin will prevent binary files filtering without adding some excludes configuration for the following file extensions jpg, jpeg, gif, bmp and png. If you like to add supplemental file extensions this can simply achieved by using a configuration like the following:

      Should be the other way round. Nothing is filtered if not explicitly stated!

    1. If you have both text files and binary files as resources it is recommended to have two separated folders. One folder src/main/resources (default) for the resources which are not filtered and another folder src/main/resources-filtered for the resources which are filtered.

      This is so incredibly stupid. Totally rips your project apart, now you have to check two or more directories for files that might even have a complex folder structure. MAVEN IS SHIT

    1. Repositories are home to two major types of artifacts. The first are artifacts that are used as dependencies of other artifacts. These are the majority of plugins that reside within central. The other type of artifact is plugins. Maven plugins are themselves a special type of artifact. Because of this, plugin repositories may be separated from other repositories (although, I have yet to hear a convincing argument for doing so). In any case, the structure of the pluginRepositories element block is similar to the repositories element. The pluginRepository elements each specify a remote location of where Maven can find new plugins.

      Why are there even plugin repos ...

    2. Whenever a project has a dependency upon an artifact, Maven will first attempt to use a local copy of the specified artifact. If that artifact does not exist in the local repository, it will then attempt to download from a remote repository.

      But in which order?

    3. Repositories are collections of artifacts which adhere to the Maven repository directory layout.

      So to be a Repo you have to contain artifacts in a maven repo structure. Done

    4. The Build type in the XSD denotes those elements that are available only for the "project build". Despite the number of extra elements (six), there are really only two groups of elements that project build contains that are missing from the profile build: directories and extensions.

      I don't even get what they are talking about. It this whole page somehow expects me to be a hardcore maven developer

    5. id: Self explanatory. It specifies this execution block between all of the others. When the phase is run, it will be shown in the form: [plugin:goal execution: id]. In the case of this example: [antrun:run execution: echodir]

      Not the plugin id

    6. check the entire dependency tree to avoid this problem; mvn dependency:tree is helpful.

      Interesting command

    7. If you then use dependencyManagement to specify an older version, dep2 will be forced to use the older version, and fail.

      Seems stupid, should be handled by maven

    8. Exclusions tell Maven not to include the specified project that is a dependency of this dependency (in other words, its transitive dependency)

      I don't get, why we should exclude transitive dependencies. An example is missing and also a good explanation. This documentation is so bad. :(

    9. nstall the dependency locally using the install plugin.

      Or install with a special local repo and ship with the project

    10. The valid types are Plexus role-hints (read more on Plexus for a explanation of roles and role-hints)

      Goddammit, link this shit!

    11. The POM defined above is the minimum that both Maven will allow

      Once again inconsistent information! The minimal pom looks like this:

      <project> <groupId>gID</groupId> <artifactId>aID</artifactId> <version>x.x.x</version> </project>

      Inheritance takes care of everything else, since the superPom will be parsed first

    12. That is currently the only supported POM version for both Maven 2 & 3, and is always required.

      But gets in inherited

    1. Firefox Send and Firefox Lockbox will continue in active development in 2019 as standalone products. Notes, Firefox Color, Side View, Price Wise, and Email Tabs will all remain available at addons.mozilla.org for the foreseeable future. (ed note: I’ll add links to these new URLs here once I have them early next week)

      I was never aware of those extensions, have to check them out!

    1. these forms are now deprecated and should not be used.

      Which forms, exactly please!

    2. One factor to note is that these variables are processed after inheritance as outlined above. This means that if a parent project uses a variable, then its definition in the child, not the parent, will be the one eventually used.

      what? I don't get it. needs an example, why is the whole manual so badly written :<

    3. To address this directory structure (or any other directory structure), we would have to add the <relativePath> element to our parent section.

      Looks less robust. But might be fine as long as the whole project is shipped with the folderstructure

  6. Dec 2018
    1. Headers in a manifest Header Definition Name The name of the specification. Specification-Title The title of the specification. Specification-Version The version of the specification. Specification-Vendor The vendor of the specification. Implementation-Title The title of the implementation. Implementation-Version The build number of the implementation. Implementation-Vendor The vendor of the implementation.

      It would be nice to have a bit more background, why this stuff is called like this

    1. To load classes in JAR files within a JAR file into the class path, you must write custom code to load those classes. For example, if MyJar.jar contains another JAR file called MyUtils.jar, you cannot use the Class-Path header in MyJar.jar's manifest to load classes in MyUtils.jar into the class path.

      So, other jars have to be extracted.

    2. The Class-Path header points to classes or JAR files on the local network,

      Wait, WHAT? on the local network??? Why would it look on the local network?

    1. To modify the manifest, you must first prepare a text file containing the information you wish to add to the manifest. You then use the Jar tool's m option to add the information in your file to the manifest.

      You don't add a manifest, but you add a second file that contains additional fields

    2. Warning: The text file from which you are creating the manifest must end with a new line or carriage return. The last line will not be parsed properly if it does not end with a new line or carriage return.

      This is very stupid....

    1. As an example, suppose you wanted to put audio files and gif images used by the TicTacToe demo into a JAR file, and that you wanted all the files to be on the top level, with no directory hierarchy. You could accomplish that by issuing this command from the parent directory of the images and audio directories: jar cf ImageAudio.jar -C images . -C audio .

      Don't preserve relative paths

    2. Though the verbose output doesn't indicate it, the Jar tool automatically adds a manifest file to the JAR archive

      OHHHH GOD, WHY!!! it's already verbose. ADD EVERYTHING

    1. The contents of the settings.xml can be interpolated using the following expressions: ${user.home} and all other system properties (since Maven 3.0) ${env.HOME} etc. for environment variables Note that properties defined in profiles within the settings.xml cannot be used for interpolation.

      Dind't get that part

  7. Nov 2018
    1. Interaktives Profiling
    2. Micro-Benchmarks sind Vergleichsmessungen, bei denen die Performance verschiedener, alternativer Algorithmen gemessen und anschließend verglichen wird, um den besseren (d.h. schnelleren) Algorithmus zu bestimmen

      Don't have to be only to determine the fastest algorithm but also to run different variations of data within an unaltered environment (Memory layout, etc.)

    3. Beim Profiling wird, anders als beim Micro-Benchmarking, die gesamte Anwendung gemessen und analysiert.

      Yes, but also the JRE


text:
Pollutant starting location(large area) matter

Topics about the HYSPLIT dispersion model.
Post Reply
Posts: 16
Joined: July 12th, 2019, 1:28 am
Registered HYSPLIT User: No

Pollutant starting location(large area) matter

Post by solkim »

Dear HYSPLIT Users.

I have question about starting location matter.
I want pollutant occur in large area. and It seems i can set wide pollutant occuring location using matrix.
But when i set matrix, Only rectangular pollutant starting area appear.
In sample, dust storm simulation, which on the web, I can see flexible pollutant starting location. To help your understand, I attached image of sample dust storm simulation.

Here is the question, I want to set pollutant starting location as not rectangular one. In manual, It is written that "there is editor program". I think it is dustbdy.exe file.
What should i do to set flexible pollutant starting area?
Please let me know i really need your help.

Best regards
Posts: 451
Joined: November 9th, 2012, 4:23 pm
Registered HYSPLIT User: Yes

Re: Pollutant starting location(large area) matter

Post by barbara.stunder »

See the help file c:\hysplit4\html\S417.htm. Or through GUI, Advanced - File Edit - Emissions File.

See also the Dust sections of the Tutorial. https://www.ready.noaa.gov/HYSPLIT_Tutorials.php
Post Reply


text:
The tuberculosis diagnostic pipeline

Javid Syed

After a spurt of activity in new tuberculosis (TB) diagnostics and algorithms approved for widespread use by the World Health Organization (WHO), this year the TB diagnostics cupboard is bare, with no new test or strategy expected to be reviewed for WHO approval until next year.

This lull is due to the dearth of investment in new TB diagnostics, despite the still pressing need for a true TB point-of-care (POC) test.

However the TB and TB/HIV programme implementers of the world should be busy this year with the important rollout and scale-up of the Xpert MTB/RIF TB test in high-burden countries where the new test – which can diagnose TB and multidrug-resistant tuberculosis (MDR-TB) within two hours rather than the two months of traditional culture – must rapidly be implemented if its lifesaving promise is to be realised.

This 2011 TB diagnostics pipeline focuses on products or strategies likely to be submitted for review by the WHO for use worldwide in the next three years.

From 2007 to 2010, the WHO’s Strategic and Technical Advisory Group for Tuberculosis (STAG-TB) reviewed and recommended the widespread implementation of eight new diagnostic tests and strategies (see Table 1).

Table 1. Diagnostic tests approved by the WHO, 2007?2010*

HTML table to be added

Sources: World Health Organization 2007b, 2008b, 2009, and 2010b.

These new tools have the potential to vastly speed up diagnosis and permit prompt initiation of proper treatment for TB. They could bring previously inaccessible technologies closer to patients, improve the accuracy of testing available at peripheral district health centers, and increase the speed with which TB and drug-resistant disease can be confirmed at both peripheral and reference laboratories.

However, none of the newer TB tests is ideal because of the cost, complexity, requirements for electricity, laboratory infrastructure, biosafety equipment, and the need for highly trained staff. The rollout of these newly recommended technologies will be slow and riddled with challenges. No TB test yet recommended by WHO is a true POC test appropriate for health posts – where 60% of people with TB seek services – or household testing (O’Brien 2009).

The lack of scientific investment is the key barrier in TB diagnostics discovery and development. To restore the TB diagnostics pipeline to health, robust, sensitive, and specific biomarkers for MTB infection, disease, and cure need to be discovered and technology platforms developed that can detect them.

Factors essential in a new TB diagnostic

The utility of a test is defined by the following factors linked to test accuracy and the place within the health system that the test is likely to be used.

Sensitivity: The ability of the test to accurately identify people with the disease. Low sensitivity of a test will cause people who have the disease to not be identified, not get appropriate treatment, suffer due to disease progression, and transmit the disease to others.

Specificity: The ability of the test to accurately identify people who do not have the disease. Low specificity means that more people who do not have a disease will wrongly be identified as having it, leading to inappropriate treatment.

Impact of test results on clinical decisions and patient outcomes: Sensitivity and specificity are surrogates for a test’s ability to improve treatment outcomes. Even a highly sensitive and specific test may not result in improved treatment decisions or reduce morbidity and mortality if it takes too long to provide results, thus failing to allow prompt initiation of proper treatment (Stall 2011).

Diagnostic algorithm: An algorithm is a recommended sequence in which tests and procedures – such as symptom screens – can be used for diagnosis and treatment. Even a less-than-perfect test can improve access to treatment depending on how it can be paired with other diagnostic tools in an algorithm.

Where within the health system the test can be used: A test’s usefulness depends in part on how decentralised its use can be. In this report the health system is divided into the health posts, peripheral laboratories, and reference laboratories.

  1. Health posts: These are the most decentralised locations of the health system, serving 60% of TB patients. They do not have access to electricity, water, or trained laboratory staff, and do not support diagnostic or biosafety equipment.
  2. Peripheral laboratories or health centers: These settings include district hospitals and laboratories and serve 25% of people in need of TB services. They have trained staff and the capacity to conduct sputum smear microscopy but only inconsistent electricity and minimal biosafety capacity
  3. Reference laboratories: These sophisticated laboratories serve 15% of those in need of TB services. They have highly skilled staff, reliable electricity and water supply, can ensure biosafety, and can conduct culture and nucleic acid amplication tests (NAATs) (O’Brien 2009).

Table 2. TB diagnostic tests and processes in the pipeline, 2011

HTML table to be added

What is in the TB diagnostic pipeline?

At the heath post level

An instrument- and electricity-free POC or lateral flow dipstick test with simple training and no biosafety requirements would be ideal for the health post level. A quick, accurate, noninvasive POC test that allows for same-day results could have a massive impact on early case detection and appropriate treatment initiation. Immediate initiation of treatment would reduce onward transmission of TB (Abu-Raddad 2009; Medecins Sans Frontiers/Treatment Action Group/Partners in Health 2009). Several research avenues are being pursued to reach this elusive POC dipstick test. Volatile organic compounds from the breaths of people with active TB disease are being analyzed using modern technology like gas chromatograph/mass spectroscopy or through less high-tech methods such as using the giant African pouch rat to essentially smell breath and detect TB (Phillips 2010; Poling 2010; Weetjens 2009).

The Foundation for Innovative New Diagnostics (FIND) has identified TB proteins making up 0.5% of the total TB genome that are reactive to serum from persons with active disease. Lead candidate proteins that could be useful for a POC test are being purified (Kunnath-Velayudhan 2010).

Alere is developing DetermineTM TB LAM Ag, a lateral flow test for use in health post settings. Similar to Alere’s Clearview TB LAM ELISA test, the Determine test detects lipoarabinomannan (LAM) in urine. LAM is a TB cell wall protein released by metabolically active TB bacteria. The noninvasive test detects TB in unprocessed urine samples, making sample collection easier than sputum collection. Like the Clearview, the Determine assay may be more sensitive in people with HIV with advanced immunodeficiency, a population in which TB is currently hard to diagnose. Alere states that the test can provide results in 25 minutes. Studies are evaluating the usefulness of this test for diagnosing extrapulmonary TB and TB in HIV-positive children (Baker 2011).

No POC test is likely to be ready for STAG-TB consideration in the next three years.

In peripheral laboratories

1. The LAMP TB assay

A loop-mediated isothermal amplification process (LAMP)-based NAAT by Eiken Chemical and FIND is being studied for use in peripheral laboratories. If validated, this manual NAAT could replace microscopy.This closed-system LAMP test does not require heating and cooling, highly trained laboratory workers, or advanced biosafety equipment, as the sputum processing and instrumentation required have been greatly simplified. The prototype is being studied in Japan and elsewhere. The previous version of the test had high sensitivity (97.7%) in smear-positive sputum specimens, but only 48.8% in smear-negative sputum, while the specificity was high at 99% in both (Boehme 2007). No data are available on the sensitivity and specificity of the new prototype. The LAMP test may go before STAG-TB in 2012.

2. The LAM TB ELISA test

Alere’s Clearview TB ELISA test detects LAM protein in urine within three hours, using antibodies that bind with LAM in the urine sample. The bound antigens cause a color change to indicate presence of TB.

The LAM ELISA test was 59% sensitive and 96% specific in one study. The test sensitivity increased as CD4 cell counts declined in HIV-positive people and was 85% in those with CD4 cell counts below 50 (Shah 2009). This inverse relation between LAM ELISA’s sensitivity and CD4 cell count was seen in another study where test sensitivity reached 67% in those with fewer than 50 CD4 cells, but the sensitivity in people with CD4 cell counts higher than 100 was very low at 4% (Lawn 2009). The quantitative analysis of LAM using the Clearview test showed that a higher measure of LAM correlated with greater bacterial burden in sputum, with disseminated TB in the blood of HIV-positive people, and with lower CD4 counts (Shah 2010). A study in South Africa is comparing the utility of both Alere’s LAM Clearview ELISA and its Determine LAM lateral flow tests to diagnose TB among people with HIV initiating antiretroviral therapy. Clearview TB ELISA is available commercially in the United States and may be brought to STAG-TB in 2013 (Baker 2011).

A meta-analysis of results obtained with the LAM ELISA test confirmed that though this noninvasive LAM assay may identify TB in HIV-positive people with severe immune suppression, its suboptimal sensitivity requires that the populations in which it can be used be defined carefully (Minion 2011).

3. Rapid colorimetric drug susceptibility testing

FIND and the London School of Hygiene and Tropical Medicine are studying the feasibility of a rapid colorimetric drug susceptibility testing (DST) method using thin layer agar (TLA) at microscopy centers. Colorimetric DST is conducted by culturing TB from sputum sample on a TLA plate that has four different colored quadrants, three of which contain isoniazid, rifampicin, and a quinolone. The plate is sealed after the sputum is transferred onto the plate, which obviates the need for rigorous biosafety precautions. The plate is then incubated; any growth causing a color change is examined under a microscope to confirm MTB. Results take two to three weeks (Sandarac 2011).

A systematic review and meta-analysis of three colorimetric DST studies using non-TLA methods showed that the method was 100% accurate for detecting rifampicin and isoniazid resistance, and the mean time to result was 11 days (Minion 2010). The TLA DST’s sensitivity and specificity needs to be confirmed.

In reference laboratories

1. The GenoType® MTBDRs/

The WHO approved line probe assays (LPAs) for rapid diagnoses of MDR-TB in 2008. MDR-TB is resistant to two of the most powerful first-line TB drugs, rifampicin and isoniazid. The MTBDRsl test by Hain Lifescience is an LPA being developed to detect certain second-line TB drug resistance-associated genetic mutations. The test uses probes to detect gene mutations associated with resistance to fluoroquinolones (FQs); aminoglycosides/cyclic peptides including the injectable TB drugs amikacin, kanamycin, and capreomycin; and the first-line drug ethambutol. When used with the LPA for rifampicin and INH resistance, this test can identify extensively drug-resistant TB (XDR-TB) strains – MDR-TB strains also resistant to any FQ and at least one second-line injectable.

Peer-reviewed studies examined the test’s ability to detect resistance to mutations in clinical isolates, but not on direct sputum samples. One such study showed the test to be sensitive in detecting FQ (75.6%) and kanamycin (100%) resistance and less so for ethambutol (64.2%). The specificity was 100% for all three drug classes (Kite 2010). Similar results from another study showed MTBDRsl sensitivity and specificity to be 87% and 96% for FQ, 100% and 100% for amikacin, 77% and 100% for kanamycin, 80% and 98% for capreomycin, and 57% and 92% for ethambutol respectively (Brosier 2010).

The rapid LPA to detect XDR-TB provides results in less than five hours, and can prevent inappropriate treatment with ineffective drugs to which the patient will not respond. In 2010 a WHO-convened expert group considered the MTBDRsl test but a decision on the test was postponed until further data are available on its performance using direct sputum samples. FIND and Hain Lifescience are gathering these data. STAG-TB may review the results in 2012.

2. The MTB MIC plate

The US National Institutes of Health?funded TB Clinical Diagnostics Research Consortium (CDRC) and TREK Diagnostic Systems are collaborating to study the Sensititre® MTB MIC Plate. This test contains 12 first- and second-line anti-TB drugs in a single plate for the assessment of minimal inhibitory concentrations (MICs). The plate has a minimum of seven dilutions for each of 12 drugs. To detect drug-resistant TB the plates are inoculated with the TB isolates, sealed, and then incubated at 34?36 degrees Celsius for up to 21 days. Resistant strains are usually detected in ten days. The plate eliminates the need for each laboratory to create its own antibiotic dilutions as it contains standardised quality assured antibiotics at correct concentrations. This can avoid a major source of errors in conducting DST. The CDRC is studying the Sensititre MTB MIC Plate to assess the incremental improvement it can offer in identifying multidrug?resistant and extensively drug-resistant TB. WHO may review the results by 2013 (Dorman 2011; Sullivan 2010; TREK Diagnostic Systems 2011).

Resources for a point-of-care test

The biggest unmet need in TB diagnostics is for a POC test. There is an urgent obligation to fully resource efforts to identify biomarkers that can detect those at risk for progression from TB infection to active disease, and biomarkers correlated with disease, cure, and drug resistance.

To accelerate this progress, in February 2011 the Bill and Melinda Gates Foundation announced a new grant programme, Biomarkers for the Diagnosis of Tuberculosis, which will provide up to US$12 million to identify host and/or pathogen biomarkers that can quickly identify TB disease in low-resource settings.

Biomarker discovery requires well-characterised samples from people with and without TB and at various stages of disease and cure so that candidates can be validated in specimens from a wide variety of patients. In 2010 the US Food and Drug Administration provided funds to the TB Alliance to create a sample bank with the TB Trials Consortium and the AIDS Clinical Trials Group; the Consortium for TB Biomarkers (CBT2) will bank samples collected from study participants, many of whom will be followed through the duration of the study and monitored for relapse. It will have well-characterised samples from different phases of TB disease and cure. Although this effort is focused on identifying surrogate biomarkers for treatment outcomes, the CBT2 may provide opportunities for biomarker discovery work.

As the CBT2 is being established, another sample bank at the WHO’s Special Programme for Research and Training in Tropical Diseases (TDR) is in danger of being closed due to budget cuts. Instead of closing, sample banks need to expand and store a wider variety of samples in order to support the research required for the development of new diagnostics.

Ensuring that the global TB diagnostics pipeline includes all developers

The current diagnostics pipeline of the New Diagnostics Working Group (NDWG) of the Stop TB Partnership does not include all TB diagnostics in development. There is an urgent need for the NDWG to conduct an independent and transparent assessment of TB diagnostics in the all stages of development using agreed-upon specifications. The WHO and the Stop TB Partnership need to facilitate new developers and funders entering the TB diagnostics field. The WHO should clarify data standards it requires a product to meet to pass an expert review and be recommended by STAG-TB.

Addressing regulatory gaps in TB diagnostics

TB diagnostics are not well regulated, especially in high-TB-burden settings. This is demonstrated by the fact that commercial serological tests for TB antibody detection are available in 17 of 22 high-TB-burden countries, despite evidence of their poor performance and though no international guideline recommends their use. In India alone it is estimated that 1.5 million serological tests were done annually at a conservative cost estimate of US$15 million – most of which was borne by patients (Gernier 2011). The TDR conducted an evaluation of the performance of 19 commercially available rapid antibody detection tests for the diagnosis of TB and found that the sensitivity of all the tests was very low, the highest being 59.7% (World Health Organization 2008a). Based on these data the STAG-TB passed a negative recommendation against the use of commercial serological tests for TB in 2010 (Morris 2011; Steingart 2011; World Health Organization 2010b).

In 2010 the WHO recommended against the use of interferon gamma release assays to diagnose active or latent TB in low- and middle-income countries (World Health Organization 2010b).

Information about the WHO-recommended TB diagnostic tests and algorithms should be widely disseminated to educate all TB providers and civil society organizations to promote proper use of good tests and procedures and to prevent inappropriate use of inaccurate diagnostics (Specter 2010). Regulation of diagnostics in high-burden countries needs to be improved and incentives are needed to encourage the private sector to replace serological tests with WHO-endorsed tools (Pai 2011).

Scaling up WHO-recommended diagnostics in the absence of better tests

Though an ideal TB diagnostic does not yet exist, the scale-up of recently recommended diagnostics could reduce disease burden among populations in greatest need for improved TB diagnostics.

1. Algorithms for the identification of smear-negative and extrapulmonary TB and to rule out active TB in HIV-positive adults at the peripheral laboratory level

The WHO has recommended several algorithms to diagnose and treat TB in people with HIV, a population in which TB is difficult to identify using the sputum smear test. There is growing evidence to support the scale-up of these algorithms for the identification of smear-negative and extrapulmonary TB in adults with HIV (World Health Organization 2007a, 2010a).

A South African study examined the use of the WHO algorithm to diagnose and provide rapid access to treatment for smear-negative TB in seriously ill people with HIV. The study showed that 83% of those whose access to treatment was managed with the WHO-recommended algorithm were alive eight weeks after admission compared to 68% of patients diagnosed and treated using standard practices (Holtz 2011). A study in Cambodia using the algorithm to diagnose TB in ambulatory HIV-positive people showed that the median time to treatment initiation was five days. The time to initiation was longest at nine days for smear-negative TB and shortest at two days for extrapulmonary TB. The sensitivity and specificity of the algorithm to diagnose smear-negative TB in people with HIV were 58.8% and 79.4%, respectively (Koole 2011).

A study that looked at the use of cough of any duration, fever, and night sweats to identify people with TB had concluded that the algorithm to screen out active TB should include a combination of all three symptoms rather than focus only on cough (Cain 2010). In 2010 the WHO developed a simple symptom-based screen to rule out risk of TB disease in people with HIV using current cough of any duration, night sweats, fever, or weight loss. A meta-analysis of observational studies had showed that using the absence of all of these four symptoms, the screen was able to accurately predict those without TB by 97.7% if the prevalence of TB in people with HIV was at 2%. The test’s ability to predict absence of disease declined to 90% when TB prevalence was 20%. Because of its ability to rule out the presence of TB disease this symptom screen is recommended to identify people with HIV who don?t have TB disease and can be given isoniazid preventative therapy (IPT) (Getahun 2011). Recent studies comparing 36 months of IPT to six months of IPT showed a 43% reduction of TB in people with HIV living in Botswana (Samandari 2011).

2. Xpert® MTB/RIF: a recently recommended TB and MDR-TB diagnostic test for the peripheral laboratory level

In 2010, STAG-TB recommended the use of the Xpert MTB-RIF test – a rapid, automated NAAT that can diagnose TB and rifampicin resistance in two hours and does not require biosafety equipment or highly skilled laboratory workers. Because of its many advantageous specifications, the test can potentially be done at district health centers; however, it does need a consistent supply of electricity. Though it is shown to be cost-effective, its current price is US$17,000 for the machine and nearly US$17 per test (Roscigno 2010).These requirements will impede Xpert’s rollout in many settings. The Xpert MTB-RIF test’s overall sensitivity was 90.3% in all culture-confirmed TB and 76.9% in smear-negative cases. The specificity for the Xpert MTB-RIF test was 99%. For rifampicin resistance the Xpert test was 94.4% sensitive and 98.3% specific. The sensitivity of smear microscopy was lower than the Xpert MTB-RIF test at 67.1% and varied from 44.6% in people with HIV to 72.3% in people whose HIV status was negative or unknown.

Xpert MTB-RIF reduced time to TB detection to an average of zero days, compared with one day for microscopy, 30 days for solid culture, and 16 days for liquid culture. The time to initiate treatment for smear-negative TB was reduced from 56 days for smear-negative, culture-positive TB to five days for Xpert MTB-RIF. Although the Xpert MTB-RIF results did not inform initiation of MDR-TB treatment, the use of the test reduced time to detection of rifampicin resistance to one day, compared with 20 days for a line probe assay and 106 days for a culture DST. This study clarified the test could be run successfully on batteries; other factors like temperature and humidity still posed challenges. The manufacturer does not recommend the use of the test over 30 degrees Celsius, and the test cartridge stability requires the temperature to remain between 2 and 28 degrees Celsius. Dust and humidity caused a few breakdowns, but information was not available about the specifics of these failures and the subsequent cost or time to repair the machine. The company is devising methods to perform the annual calibration of the machine in the least disruptive manner (Boehme 2011).

Since the first evaluation of Xpert MTB-RIF in 2010, at least 15 studies and articles have been published. The accumulating evidence clearly shows that the test outperforms sputum smears in everyone and especially in HIV-infected persons, and it reduces time to results and allows more rapid initiation of treatment. Studies are needed to examine its usefulness outside a district laboratory setting and examine its effect on improving treatment outcomes.

Disseminating results of diagnostics scale-up to strengthen TB diagnostics advocacy

The WHO and the Stop TB Partnership should work with the lead sponsor of a recommended diagnostic to track the rollout of recommended tools, facilitate coordination of its implementation, and gather operational and outcome data important to patients and programmes. Documenting the lessons and successes of scale-up can inform advocacy for increased funding and highlight effective practices to expedite scale up effective diagnostics.

The WHO’s Global Laboratory Initiative is creating a website to provide information on the uptake of the Xpert MTB-RIF test. This website will have data from partners implementing the test and track where it is being rolled out, who is providing funding, and how many tests are being performed. The website will collect information from the manufacturer to track challenges in scale-up and how these are being addressed.

Documenting the impact of effective diagnostics is essential to support advocacy to increase global funding for TB diagnostics, which in 2009 was at a paltry US$41 million – far short of the US$740 million need estimated by the Global Plan to Stop TB: 2011?2015 ( Jim?z Salazar 2011).

After a burst of activity in the past four years, the pace of new diagnostics being brought to STAG-TB is slowing down, while there are major gaps in the availability of tools appropriate for use in all levels of the health system and especially at the health post level. Restoring a more robust pipeline requires a well-funded research agenda to develop biomarkers, technological platforms, and resources such as sample banks critical for the development of new diagnostics. Furthermore, a comprehensive and proactive strategy is needed to ensure that all diagnostic developers are contributing to the global TB diagnostics pipeline tracked by the NDWG.

Abu-Raddad LJ, Sabatelli L, Achterberg JT, et al. 2009. Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics. Proc Natl Acad Sci USA 2009;106(33):13980?85. Epub 2009 Aug 3.

Baker J 2011. Personal communication. 14 April 2011.

Boehme CC, Nabeta P, Henostroza G, et al. 2007. Operational feasibility of using loop-mediated isothermal amplification for diagnosis of pulmonary tuberculosis in microscopy centers of developing countries. J Clin Microbiol. 2007;45(6):1936?40.

Boehme CC, Nicol MP, Nabeta P, et al. 2011. Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: A multicentre implementation study. Lancet 2011;377(9776):1495?1505. Epub 2011 Apr 18.

Brossier F, Veziris N, Aubry A, et al. 2010. Detection by GenoType MTBDRsl test of complex mechanisms of resistance to second-line drugs and ethambutol in multidrug-resistant Mycobacterium tuberculosis complex isolates. J Clin Microbiol. 2010;48(5):1683?89. Epub 2010 Mar 24.

Cain KP, McCarthy KD, Heilig CM, et al. 2010. An algorithm for tuberculosis screening and diagnosis in people with HIV. N Engl J Med. 2010;362(8):707?16.

Dorman S 2011. Personal communication. 19 April 2011.

Getahun H, Kittikraisak W, Heilig CM, et al. 2011. Development of a standardised screening rule for tuberculosis in people living with HIV in resource-constrained settings: Individual participant data meta-analysis of observational studies. PLoS Med. 2011;8(1):e1000391.

Grenier J, Pinto L, Nair D, et al. 2011 Widespread use of serological tests for tuberculosis: data from 22 high-burden countries. European Respir J. 2011 (in press).

Holtz TH, Kabera G, Mthiyane T, et al. 2011 Use of a WHO-recommended algorithm to reduce mortality in seriously ill patients with HIV infection and smear-negative pulmonary tuberculosis in South Africa: An observational cohort study. Lancet Infect Dis. Epub ahead of print 2011 Apr 20.

Jim?z Salazar E 2011. Tuberculosis research and development: 2010 report on tuberculosis funding trends, 2005?2009. 2nd ed. New York: Treatment Action Group, 2011.

Kiet VS, Lan NT, An DD, et al. 2010. Evaluation of the MTBDRsl test for detection of second-line drug resistance in Mycobacterium tuberculosis. J Clin Microbiol. 2010;48(8):2934?39. Epub 2010 Jun 23.

Koole O, Thai S, Khun KE, et al. 2011. Evaluation of the 2007 WHO Guideline to Improve the Diagnosis of Tuberculosis in Ambulatory HIV-Positive Adults. PloS One 2011;6(4):e18502.

Lawn SD, Edwards DJ, Kranzer K, et al. Urine lipoarabinomannan assay for tuberculosis screening before antiretroviral therapy diagnostic yield and association with immune reconstitution disease. AIDS 2009;23(14):1875?80.

Medecins Sans Frontiers/Treatment Action Group/Partners in Health 2009. Expert Meeting on Defining Test Specifications for a Point-of-Care TB Test. Paris, 17?18 March 2009. Retrieved 19 May 2011 from

Minion J, Leung E, Menzies D, et al. 2010. Microscopic-observation drug susceptibility and thin layer agar assays for the detection of drug resistant tuberculosis: A systematic review and meta-analysis. Lancet Infect Dis. 2010;10(10):688?98.

Minion J, Leung E, Talbot E, et al. 2011. Urinary lipoarabinomannan (LAM) antigen detection for the diagnosis of pulmonary tuberculosis: A systematic review and meta-analysis. Eur Resp J. 2011 (in press).

Moore DA, Caviedes L, Gilman RH, et al. 2006. Infrequent MODS TB culture cross-contamination in a high-burden resource-poor setting. Diagn Microbiol Infect Dis. 2006;56(1):35?43. Epub 2006 May 6.

Morris K 2011. WHO recommends against inaccurate tuberculosis tests. Lancet 2011;377(9760):113?14.

Nathanson CM, Cuevas LE, Cunningham J, et al. 2010. The TDR Tuberculosis Specimen Bank: a resource for diagnostic test developers. Int J Tuberc Lung Dis. 2010;14(11):1461?67.

O?Brien R. 2009 Progress in the development of new TB diagnostic tools – What is in the pipeline? Paper presented at the Fourth Scientific Symposium on the Occasion of World Tuberculosis Day, 22?23 March 2009, Berlin.

Pai M 2011. Improving TB diagnosis: Difference between knowing the path and walking the path. Expert Rev Mol Diagn. 2011;11(3):241?44. Phillips M, Basa-Dalay V, Bothamley G, et al. 2010. Breath biomarkers of active pulmonary tuberculosis. Tuberculosis 2010; 90(2):145-51. Epub 2010 Feb 26. doi:10.1016/

Poling A, Weetjens BJ, Cox C, et al. 2010. Using giant African pouched rats to detect tuberculosis in human sputum samples: 2009 findings. Am J Trop Med Hyg. 2010;83(6):1308?10.

Roscigno G 2010. Xpert MTB/RIF: Update on price negotiations and market dynamics. Paper presented at the Implementation and Scale-up of the Xpert MTB/RIF System for Rapid Diagnosis of Tuberculosis and Multidrug Resistance Global Consultation, 30 November 2010, Geneva.

Samandari T, Agizew TB, Nyirenda S, et al. 2011. 6-month versus 36-month isoniazid preventive treatment for tuberculosis in adults with HIV infection in Botswana: A randomised, double-blind, placebo-controlled trial. Lancet 2011;377(9777):1588?98.

Shah M, Martinson NA, Chaisson RE, et al. 2010. Quantitative analysis of a urine-based assay for detection of lipoarabinomannan in patients with tuberculosis. J Clin Microbiol. 2010;48(8):2972?74. Epub 2010 Jun 9.

Shah M, Variava E, Holmes CB, et al. 2009. Diagnostics accuracy of a urine lipoarabinomannan test for tuberculosis in hospitalised patients in a high HIV prevalence setting. J AIDS 2009;52(2):145?51.

Kunnath-Velayudhan S, Salamon H, Wang H-Y, et al. 2010. Dynamic antibody responses to the Mycobacterium tuberculosis proteome. Proc Natl Acad Sci USA 2010;107(33):14703?8.

Specter M 2010. A deadly misdiagnosis: Is it possible to save the millions of people who die from TB? New Yorker, 15 November 2010.

Stall N, Rubin T, Michael JS, et al. 2011. Does solid culture for tuberculosis influence clinical decision making in India? Int J Tuberc Lung Dis. 2011;15(5):641?46.

Steingart KR Flores L, Dendukuri N, et al. 2011. Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: An updated systematic review and meta-analysis. PLoS Med. 2011 (in press).

Steingart KR, Ramsay A, Pai M 2007. Optimising sputum smear microscopy for the diagnosis of pulmonary tuberculosis. Expert Rev. Anti Infect Ther. 2007;5(3),327?31.

Sullivan N, Sotos J, Anhalt K, et al. 2010. Preliminary results from a new TREK Sensititre® Mycobacterium tuberculosis MIC plate (MYCOTB). Retrieved 19 May 2011 from

Sundaram L 2011. Personal communication. 28 April 2011.

TREK Diagnostic Systems 2011. Sensititre® webpage. Retrieved 19 May 2011 from mycobacterium.asp.

Weetjens BJ, Mgode GF, Machang?u RS, et al. 2009. African pouched rats for the detection of pulmonary tuberculosis in sputum samples. Int J Tuberc Lung Dis. 2009;13(6):737?43.

World Health Organization 2010. Strategic and Technical Advisory Group for Tuberculosis (STAG-TB) Report of the tenth meeting. Geneva, Switzerland: World Health Organization, 2010. Retrieved 19 May 2011 from

World Health Organization 2008. Laboratory-based evaluation of 19 commercially available rapid diagnostic tests for tuberculosis. Geneva, Switzerland: World Health Organization, 2008.

Links to other websites are current at date of posting but not maintained.


text:
4th Industrial Revolution

Total 33 Posts

Botshabelo Digital Hub expected to enhance job creation in South Africa's Free State province

The Botshabelo Digital Hub will serve as training centers for community members, provide access to Information and Communication Technology (ICT) facilities, and incubation for mainly young entrepreneurs operating in the ICT sector.

South Africa's Tshimologong has launched a program to help grow female-owned technology businesses

Tshimologong Ya Basadi in 4IR program is targeting primarily women-owned businesses, which are already trading and have a clear understanding of how tech can scale their businesses.

Promoting hardware innovation in Africa

A big number of the serious problems facing Africa today require innovations that are hardware-based, and this is why Africa needs to ensure that the technicians and engineers and are equipped to solve the most challenging problems.

COVI-ID app launched to kickstart South Africa’s economy

The app operates on blockchain technology in order to ensure the privacy of all users information, offering a decentralised solution. One of the unique selling points is that even those without access to a smartphone can benefit and make use of COVI-ID.

Emerging technologies punted as solutions for Africa's problems

New report identifies gaps in Africa’s use of digital platforms for solving challenges. It calls on governments to invest in digital platforms for sectors such as finance and health.

Importance of Africans producing content on the Internet

We need to tell our stories on the Internet, specifically on our own platforms (not behind the walled gardens of social media platforms), our own websites, that are out on the open web. That no Jack, Mark or Larry can censor or suspend you from.

Technology kills jobs but equally creates new ones

While we complain complaining that "they(technology based solutions) are taking our jobs," other countries are improving their competitiveness and potentially leaving us behind, further destroying the very jobs we are trying to protect.


text:
Iain Lee – Wednesday 5th December 2018

Play episode

Iain wants to start a peaceful revolution and Iain needs a cabinet, The boss forces Iain and Katherine to sit together, Helen talks working in an addiction clinic, Alistar claims ABBA are the best band ever, The 90s pop quiz, Iain creates the horny time song and Scumbag journalists

More from this show

The Iain Lee & Katherine Boyle Vault
Episode 615


text:
Day Tours Services

Hua Hin

Family friendly and relaxed Thailand’s original beach resort Hua Hin is a revitalizing blend of city and sea with lively markets, 8 nearby golf courses, international cuisine and excellent accommodation. Founded in the early 19th Century as a small fishing village, Hua Hin became a resort destination for Thai royals and although now offering many amenities has not been overdeveloped or lost its small-town vibe. Hua Hin, is a good budget destination with great seafood and being 199 km south-southwest of Bangkok takes less time and effort to reach from Bangkok than other holiday destinations.

Surrounded by three rivers that connect the city to the Gulf to Thailand the historic city of Ayutthaya was founded in 1350 as the second capital of the Siamese Kingdom. Growing to be one of the world’s largest and most cosmopolitan urban areas it was a center of global diplomacy and commerce reaching its peak between the 14th and 18th centuries. Connecting the East and the West, the Ayutthaya Royal Court exchanged ambassadors from around the world including the French Court at Versailles, the Mughal Court in Delhi, and the imperial courts of Japan and China. The city was attacked and damaged by the Burmese army in 1767, so a new Thai capital was founded.

Popular with both Thais and foreigners, Pattaya is the city with everything a tourist needs. Multicultural Pattaya boasts excellent places to stay, eat and shop with high-rise condominiums, beach side hotels, entertainment areas and international restaurants. 19 world class golf courses surround Pattaya. The city is built around a wide, crescent-shaped bay that was one of Thailand’s first beach resorts in the 1960s. North Pattaya is more upmarket while Pattaya South remains the nightlife hub. Further south Jomtien is a laid-back resort for watersports and seaside massages, while to the north Naklua is also quieter, with some top-end resorts at Wong Amat.

Khao Yai

Established in 1962 as Thailand's first national park, Khao Yai is just 2.5 hours away from Bangkok. Covering 2,168 km², including rain/evergreen forests and grasslands this UNESCO World Heritage site Khao Yai is popular for hiking and biking. The area features many accomidations from simple resorts to 5-star hotels. Animals often seen in Khao Yai include mammals include elephant, macaque, deer, gibbon, porcupine, civet and around 300 resident and migratory birds.

Floating Market.

The Floating Market is a top attraction located only 1.5 hours from Bangkok. Huge, colourful, energetic, featuring a flotilla of boats selling food and fruits the Floating Market presents the perfect with opportunity to capture the ideal photo to show off for friends back home.

Kanchanaburi is an ideal destination for a relaxing holiday. With luxurious resorts and fine-dining restaurants clustered along it river banks, the town provides a remarkable array of cuisine and accommodation. Dining on one of the rivers’s famous floating restaurants while enjoying the river scenery is very popular. Kanchanaburi is the site of the Burma Railway ("Death Railway") bridge built by Allied POWs during WWII and immortalized in the movie Bridge Over the River Kwai. Many attractions in Kanchanaburi honor this important chapter in history including the JEATH War Museum with displays about life of the prisoners of war who died building the bridge, the Thailand–Burma Railway Centre that explores the wider history of the railway and the Kanchanaburi War Cemetery where thousands of Allied soldiers are buried.


text:
Events Calendar

Upcoming events

    • 19 Oct 2021
    • 8:00 AM (EDT)
    • 21 Oct 2021
    • 10:00 PM (EDT)
    • Rochester, New York
    • 27

    IAPP (Rescheduled) Fall 2021 Conference

    There is an old saying “Third Times the Charm”.  We at IAPP are keeping our fingers crossed to see how true that phrase will be.  Our first two Conference attempts, October 2020 and April 2021 have been dashed because of Co-vid 19 restrictions and safety precautions for our members.  So, the IAPP conference once again is being moved to the fall of 2021.  Thanks to the hotel staff and cooperation from the liaisons at our venues. We will finally be landing in Rochester, New York albeit a year late.  Come spend time in the beautiful North Eastern U.S.A. with all its fall colors. The dates are October 19th through the 21st with a tag on day for those who wish to visit the finger lakes area for more scenic views and try some of its finest vineyards.  We will start off our adventure with a photo day at Letchworth State Park.  Visit the upper and lower falls area, many hillside streams and hiking trails. The Genesee River gorge carving its way north to Lake Ontario.  Later we’ll spend time to explore the George Eastman Museum and see some of the early equipment used in the making of panoramic photography and view the gardens.  Our time will include a visit to The Rochester Institute of Technology where we can interact with some of the imagemakers of the future.  As usual, there will be our panoramic photo contest (details coming soon).  Come one, come all who enjoy film or digital panoramic formats to learn some history, new innovations in panoramic photography and enjoy some wonderful photographic opportunities.

    Member price                         $149.00

    Non-member price                 $224.00 (includes a 1-year membership to IAPP)

    Guest price                             $  45.00

    Student membership              $  25.00  (1 year membership to IAPP with student ID)

    Hotel Information: (We have 20 rooms on reserve through 9/18/2021) After that normal hotel rates will apply.

    Rate: $109.00 plus taxes

    Angel Vazquez, General Manager (is our contact).  Tell him you are with the IAPP group.

    Holiday Inn Express Rochester - University Area

    717 East Henrietta Rd, Rochester NY 14623

    P: 585-272-7800 F:585-272-1211

2021 © International Association of Panoramic Photographers
Powered by Wild Apricot Membership Software


text:
Frequently Asked Questions

If you’ve got a question, chances are you aren’t the first person to think of it! Check out some of our frequently asked questions below to see if you can find the answer that you’re looking for. If it’s not there, please just head over to the Get In Touch page and we will get back to you as soon as possible.

Yes. Every day activities tighten your muscles enough to give you aches and pains, which massage will help to resolve. Also general gym goers really benefit from sports massage as it loosens the muscles you are training and allows you to train harder and longer with less chance of injury.

Every person is different and it varies between every individual, there is no set amount of sessions that will cure you. Your Sports Therapist will give you their advice following your first treatment.

Dress in loose fitting clothing. The therapist will need to see the affected body part, so for lower limb bring shorts and upper limb you may be required to remove your top.

We accept cash or online bank transfer following the treatment.

Once you book your slot the time is confirmed and another client will not be able to attend at that time. The deposit will be deducted from your final total but if for any reason you are unable to make your session, the deposit mitigates some of the loss we incur through the loss of the booking slot.