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redpajama_set_name: RedPajamaGithub


text:
This introduction distinguishes between the key terms 'documentation' and 'documentary' and outlines the metatheme of the seven chapters making up this part of the book. It argues that because of a tendency to see the exercise of authorship in film-making and ethnographic value as mutually incompatible, throughout the history of ethnographic film-making, there has been a tendency to deny, sidestep or control for authorship, or to consign it either to the subjects or to the audience. It proposes that because of this failure to embrace authorship, coupled with a lack of technical competence, ethnographers working in the period prior to the Second World War left a very slight filmic legacy. Fortunately, however, film-makers with very different motivations, ranging from the propagandistic to the commercial, actively embraced authorship, producing films that, after the fact, have often been acclaimed as masterworks of ethnographic cinema.
Throughout most of the twentieth century, ethnographic film-makers, particularly those in the English-speaking world associated with academic institutions, were ill at ease with the idea of authoring their films. From the 1890s, when anthropologists first started to take moving image cameras with them to the field, until as late as the 1970s, cameras were considered primarily to be scientific instruments that in the ideal case would allow researchers to bring back objective visual records of certain aspects of their fieldwork. Any exercise of authorship in making these records was seen as diminishing their value. Therefore, as I describe in Chapters 1, 3 and 4, throughout this period academic ethnographic film-makers adopted a range of strategies aimed at eliminating authorship, or when this was not possible, at least minimising it or making it invisible.
But around the middle of the 1970s, there was something of a change of heart. Authorship in ethnographic film-making came to be recognised as inevitable, but nevertheless as something that should be exercised with restraint. As I describe in Chapters 5 and 6, one response to the new climate was the idea that ethnographic film authorship, while clearly unavoidable, could be controlled by means of a 'reflexive' declaration on the part of the film-maker about the subjective elements that they brought to the making of their film. Another was the development of more 'participatory' praxes that entailed, at least to some degree, the sharing of authorship with the subjects of the film. In the 1980s (see Chapter 7), some ethnographic film-makers took this process one logical step further and either alongside their own films, or even instead of making their own films, dedicated their energies to enabling the indigenous peoples who had been the subjects of so many ethnographic films in the past to become the authors of their own films.
Finally, in the 1990s, taking advantage of the new interactive digital media, some anthropologists sought to assign the authorship of their films, at least the final stages of it, not to the subjects, but rather to the audience. They sought to achieve this by placing their film footage, sometimes partially edited but not usually assembled into a single unitary narrative, first on CD-Roms and later on the Web, where it would be available, along with any photographs or texts that they might have produced on related topics, so that audiences could develop their own narrative pathways through their material. This form of assigned authorship lies beyond the scope of this book, but there is a substantial literature on work of this kind to which interested readers may turn. 1
These anxieties about the exercise of authorship had the most debilitating effect on the first seventy-five years of ethnographic film-making. The period from the 1890s to the 1960s was one of immense cultural and social change, arguably considerably greater than the changes that have taken place in the almost equivalent period since the 1960s. This was also the period of the great fieldwork-based textual monographs that formed the foundations of the modern academic disciplines of social and cultural anthropology. But owing to the lack of a well-thought-through intellectual rationale for film-making within these disciplines, combined with a lack of resources and technical competence, the filmic accounts produced by anthropologists during this period constitute no more than the palest of pale shadows of their textual accounts.
This is particularly true of the period before the Second World War, when anthropologists, though often first-hand witnesses to the most momentous processes of cultural change, produced very little film material of any consequence. Anyone who has reviewed, as I have done, the archives of ethnographic film held in institutions such as the Smithsonian in Washington, the American Museum of Natural History in New York, or the Bibliothèque nationale de France in Paris would surely share my profound sense of a great historical opportunity almost tragically lost.
It is fortunate, then, that alongside this almost century-long agonising over the implications of authorship on the part of academic film-makers, there were also other film-makers, whose original motivations ranged from the artistic to the commercial, or some combination of the two, who made films of broadly ethnographic interest but who had absolutely no qualms about exercising their authorship. In the early twentieth century, as I describe in Chapter 2, these films emerged from two popular genres in particular, the travel film and the melodrama set in exotic locations. Many of the films made under the umbrella of these genres were at best crass and at worst grotesquely racist. The nature of the authorship was such that it is often difficult to disentangle fact from fiction in the final form of these films. And yet, from a general humanistic perspective, we should be grateful that these genres existed since they generated a filmic legacy that is of far greater ethnographic significance than that left by academic ethnographers. Always provided that it is approached critically – though also without presentist prejudice – this legacy remains of immense value not just to academic researchers, but also to the descendants of the subjects of these films.
A film-maker whose work figures prominently in Chapter 2, since it remains central to the ongoing debate about the nature of ethnographic film, even today, is Robert Flaherty. Although he made a number of influential films in the course of a long career, he is arguably still most remembered as the director of his first major film, Nanook of the North , a two-days-in-the-life portrait of an Inuit (Eskimo) man and his family living in the Canadian Arctic. Released in 1922, this film is routinely identified as the ur-film of ethnographic cinema and, as its maker, Flaherty is described with similar regularity as the 'father of ethnographic documentary', or even of 'documentary' film generally. But in considering these accolades, one should exercise considerable caution. For, seemingly unnoticed by many authors who write about 'documentary', the meaning of this term has changed so radically since the 1920s that its present-day meaning is almost diametrically opposed to its original meaning.
The first use of the term in the English-language literature, as innumerable text books on the history of documentary film relate, was not actually with reference to Nanook, but rather in relation to Flaherty's second major film, Moana , released in 1926, which follows the coming-of-age ceremonies of a young man of that name on the island of Samoa. The term was used in a review of this film by John Grierson, a leading non-fiction film-maker in his own right and the leader of the so-called British Documentary Movement. Some years afterwards, in the early 1930s, Grierson would formulate a definition of the genre that has since echoed down the decades: it involved, he suggested, an approach to cinema based on 'the creative treatment of actuality'.
Much ink has been spilt in the debate as to what, exactly, Grierson meant by this phrase. The most plausible of the many explanations offered, at least to my mind, is that Grierson was referring to the dramatisation ('the creative treatment') of footage that purported to be about the real world ('actuality', which in the 1930s was a synonym for newsreel footage). Certainly this would be an accurate description not only of the great majority of Flaherty's films but also of the films made by Grierson and his colleagues in the British Documentary Movement. If films of this kind were to be made today they would be called 'drama-documentaries' or perhaps 'docufictions'. They would certainly not be called 'documentaries' without at least some form of qualification.
Exactly why and when 'documentary' changed its meaning is a matter of academic debate. But it appears to have done so gradually in the period following the Second World War when, owing to the development of lightweight equipment, faster film stocks and portable lip-synchronous sound, it became possible for non-fiction film-makers to work in a different way. Prior to the development of this technology, it had been necessary for non-fiction film-makers to direct their subjects in a very precise manner just to meet the most basic technical requirements of filming. The camera had to be set up, on a tripod, at a spot where there was sufficient light to film, and the subjects then had to be invited to perform a version of their lives directly in front of it. But once the new technology became available, it became possible for film-makers simply to follow their subjects around, without anything like the same need to intervene in what their subjects were doing in order to be able to film.
This shift in meaning was probably also a consequence of the term 'documentary' being commandeered by film-makers working for television news programmes who had a greater concern for literal factual accuracy than the makers of 'documentaries' of the interwar period who drew their inspiration rather from the 'seventh art' of cinema. Certainly by the 1960s, 'dramatisation', understood as the performance of an imagined reality specifically for the camera by the subjects, and 'documentary' had become so clearly opposed that if any of the former was included in a film that purported to be the latter, it was regarded as a matter of contention unless this was clearly indicated.
And yet, even though 'dramatisation' may have become incompatible with the notion of 'documentary', the making of a film of this kind continues to involve some degree of 'creative treatment', albeit in a more general sense. For even when a 'documentary' is made by the most fact-scrupulous of film-makers, it always involves more than holding up a mirror to the world. For a start, a whole range of factors to do with the apparatus of film-making itself limit its literal objectivity: these include the aspect ratio of the image (that is, the ratio of width to height), the perspective offered by the lenses, the balance of the colours offered by the film stock and the balance of sounds offered by the microphones. All these features of the technology, and many more, may be consciously manipulated by the film-maker in a creative manner.
But the sense in which a modern documentary film-maker most actively exercises their creativity is surely in relation to the development of a narrative. For, just as in a fiction film, most documentaries are structured by a narrative that is intended to propel, guide or merely nudge the audience along as the film proceeds. This will usually entail the substantial manipulation of the rushes in the edit suite in order to present a story or argument that has a beginning, a middle and an end, though not necessarily in that order, as Jean-Luc Godard is famously said to have remarked and if so, with good reason, since there are any number of ways of jumping back and forth in time in the course of the unfolding of a film narrative, be it in documentary or fiction.
On account of the ambiguities associated with the term 'documentary', some practitioners of ethnographic film-making have preferred to describe themselves as makers of 'non-fiction film'. However, on balance, I prefer to use the term 'documentary' for a number of pragmatic reasons, mainly linguistic. Not only is it more succinct, but there is also something inherently unsatisfactory about identifying an activity by its antithesis. There is also the consideration that this genre of cinema, however closely its practitioners may believe that it should be tied to the real world of fact, continues to involve certain features that are akin to those of fiction film-making. By referring to it as 'non-fiction', one appears to be denying that this is the case.
Unless otherwise stated, in this book, I use the term 'documentary' in what I refer to as the 'modern' sense, that is, a film based on images gathered in the real world as opposed to an imaginary world performed specifically for the camera, though this does not preclude authorial creativity having been exercised in its making, be it in terms of its technical realisation or its narrative shaping. To what degree and in what form this exercise of authorial creativity is appropriate to a documentary film that has ethnographic objectives is one of the central threads of discussion throughout the entire course of this book.
1 A good starting point would be the overview account of the use of interactive digital media for anthropological purposes published by Sarah Pink (2011).

redpajama_set_name: RedPajamaCommonCrawl


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Escape from Monkey Island é um jogo eletrônico de aventura desenvolvido e publicado pela LucasArts em 2000. É o quarto jogo da série Monkey Island e o primeiro a utilizar gráficos tridimensionais.

O jogo se centra no pirata Guybrush Threepwood, que retorna para sua casa com a sua esposa Elaine Marley após sua lua de mel, para descobrir que sua morte foi erroneamente declarada, e o emprego dela como governador foi posto em eleição. Guybrush precisa achar um jeito de recolocar Elaine no poder, enquanto descobre uma trama para transformar o Caribe em atração turística, comandada por seu arqueinimigo LeChuck e um conspirador australiano de nome Ozzie Mandrill.

Escape from Monkey Island foi o último jogo de aventura da Lucas Art e o segundo e último a utilizar o motor GrimE, depois de Grim Fandango. O jogo está disponível agora no GOG. com.

Jogabilidade
Escape from Monkey Island é um jogo de aventura que consiste no diálogo com personagens e a resolução de quebra-cabeças. O jogo é controlado inteiramente por teclado ou por joystick.

Uma nova adição ao jogo foram as linhas de ação. Guybrush irá apontar para qualquer item com o qual possa haver interação; o jogador poderá usar os botões Page Up ou Page Down para selecionar o item com o qual quer interagir.

Monkey Kombat
Uma das marcas registradas da série Monkey Island, as lutas de espadas com insultos - os duelos de espada no qual quem souber mais insultos e réplicas vence - é mencionado como uma "queda de braço com insultos", e um duelo invencível contra Ozzie Mandrill.

Na segunda parte do jogo, os jogos de insultos são substituídos pelo "Monkey Kombat", um nome parodiado de Mortal Kombat. Monkey Kombat é um jogo do estilo pedra, papel, e tesoura, no qual você precisa memorizar linhas de "insultos de macacos e respostas", que consiste em composições aleatórias de "palavras de macaco", como "oop", "chee", "ack" e "eek".

Enredo
A história começa com Guybrush Threepwood e Elaine Marley retornando a Ilha do Vale-Tudo de sua lua de mel, para onde embarcaram no final do jogo anterior, Curse of Monkey Island. Lá eles descobrem que Elaine foi declarada legalmente morta, e sua posição como governadora foi posta a votação, e sua mansão à ser destruída.

Guybrush mais tarde encontra com três de seus antigos "amigos", Meathook, Otis e Carla (que apareceram previamente no primeiro jogo da série como sua tripulação, em Secret of Monley Island). Juntos, descobrem uma conspiração planejando expulsar todos os piratas do Caribe, fazendo das ilhas um paraíso turístico. LeChuck e um novo vilão de nome Ozzie Mandrill encabeçam o plano. Eles procuram por um talismã vodu conhecido como o Insulto Definitivo.

Ligações externas
  da LucasArts (atualmente fora do ar)

Jogos eletrônicos de 2000
Monkey Island
Jogos eletrônicos da LucasArts
Jogos eletrônicos de aventura
Jogos para Mac OS Classic
Jogos para PlayStation 2
Jogos para Windows
Jogos eletrônicos desenvolvidos nos Estados Unidos
Jogos eletrônicos escritos em Lua

redpajama_set_name: RedPajamaWikipedia


Riau, 25 January 2019 - The Siak IV Bridge Project that was worked on by PT Brantas Abipraya (Persero), this state-owned construction company has reached the final stage of construction. This is evidenced by the ceremonial enclosure (final casting) of the last casting on the main span or playing span of the bridge. The final casting was carried out by the Governor of Riau, H Wan Thamrin Hasyim. Also present were the Head of Riau Public Works and Spatial Planning (PUPR) Office Dadang Eko Purwanto and Haryadi Chief Commissioner and PT Brantas President Director Abipraya Bambang E Marsono.
"This is an important access for the people of Riau, especially Pekanbaru. With this cerimonial enclosure, the main physical work of the Siak IV Bridge has been completed and can connect two sides of Pekanbaru City, namely Senapelan and Rumbai, "said Bambang E. Marsono.
Bambang added that in Wan Thamrin's remarks, it was said that the inauguration of the Siak IV Bridge could be held on February 14th. After the inauguration, the Siak Bridge can be utilized by all Pekanbaru people.


You probably still remember about my friend who got scammed from online dating, she's till doing it and two days ago she has her membership upgraded. She has confessed to me that she is actually tired with dating online but her curiosity to find a good guy keeps her going.
To be able to get more features from the online dating site she takes further step by upgrading her membership. She's now able to get in touch with whoever contact her by message or a forum chat.
"You sure you wanna do this?" I questioned her in the few last minutes before she filled in the form online.
"Yes. This the only way I can get in touch with a guy I really want" She replied positively.
Dating online can be helpful if you know to keep away from frauds (remember the story of the army guy?). If you're smart and know how to protect yourself from scams you might get the guy you really want. I know some people who start their relationship from dating online and then get married - it's not just about lucky that they got the really good one but because their 'intellectuals thinking' to get the right person.
I see too often girls/boys lament to their unhappy relationship/single life and they don't change the way of (quality) thinking about the person they want to be with.
I hope you all find the true one.


text:
Features > Summer Homes > Country Homes > Risen from the Ashes
BD257: Risen from the Ashes
A thatched cottage that only three years ago almost burnt to the ground has had new life breathed into it by its resourceful and creative new owner. 'A garden and character,' were Harriet Orr-Ewing's only two stipulations when looking for a cottage in West Oxfordshire. Having lived in London for 20 years, 'Ten years too long, I now realise,' she says, she was more than ready for a change. Since trading in her office job for her true love and vocation, Garden Design, she had grown out of flat mates, pavement pounding, parking fines and the confines of small city garden jobs and wanted to broaden her canvas to larger, greener, more varied outdoor spaces. 'I loved the energy and diversity of London but I'm a country girl at heart,' she confesses. Feature >> Lightbox
BD257_01 (RM)


ANDRE RIEU FAN SITE THE HARMONY PARLOR: Rieu Wins Classic Brit Awards Album of The Year Third Time in a Row!
Rieu Wins Classic Brit Awards Album of The Year Third Time in a Row!
King of the Waltz André Rieu has won the Classic FM Album of the Year award at this year's Classic BRITs - for the THIRD YEAR IN A ROW.
October 2, 2013: His album Magic of the Movies beat competition from other nominees including Andrea Bocelli, Friar Alessandro, Lang Lang and Nicola Benedetti among others.
Dutch violin superstar André Rieu becomes first artist to win the same award three years in a row.
The award was announced tonight at the Classic BRIT Award ceremony in London's Royal Albert Hall by Classic FM presenter, Aled Jones. ~ "With so many incredible albums released over the past 12 months I can honestly say that whoever wins this prestigious award tonight must have created something truly phenomenal to triumph against this competition," Aled said as he introduced the category.
(André) "I'm so sorry I could not come to collect this fantastic prize you gave me again, for the third time," he said, in a video acceptance speech. "I had a lot of fun making this record, and I heard you had a lot of fun listening to it!"
The award for Classic FM Album Of The Year has tonight gone to Dutch violinist André Rieu & his Johann Strauss Orchestra.
Welsh classical stars Katherine Jenkins and Catrin Finch have lost out on one of the top prizes at the Classic Brits. Dutch violinist André Rieu & his Johann Strauss Orchestra beat them and seven others, including tenor Andrea Bocelli and pianist Richard Clayderman, to win the only category voted for by the public – Classic FM Album Of The Year.
Rieu broke Classic Brit records by becoming the first act to win the same category three years running with Magic Of The Movies. He was presented with his award by Welsh TV and radio presenter Aled Jones.
Dear André, Congratulations! I am so proud of you and I am proud to be Dutch. Greetings, Veronica.
André congratulations for winning for the 3rd year in CLASSIC BRIT AWARDS!
Your music is a ray of sunshine in my heart!
Mega congratulations, Andre & the JSO for the record 3rd win in a row! Well done!
Many, many Congratulations!! Again, this indeed shows how very much Andre and his incomparable JSO are loved by an adoring publicum who have voted in their thousands to give them this well-deserved accolade for yet another year. (Nothing to do with the wonderful sparkling blue eyes of course!).
Wow, wow, wow!!! Three times in a row, that is fantastic!!! I am so happy!!!
Très cher André, toutes mes plus sincères félicitations pour ce succés très mérité, c'est génial et je suis vraiment enchantée pour toi et tes musiciens. Encore bravo, cher Maestro. Francine.


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@interface ViewController : UIViewController

-(instancetype)initWithThumbImagesUrls:(NSArray *)thumbImagesUrls BigImagesUrls:(NSArray *)bigImagesUrls;

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Based on the 2007 Israeli film of the same name, The Band's Visit has received critical acclaim since it first opened off-Broadway. With lyrics and music by famed Broadway composer David Yazbek, The Band's Visit is a musical masterpiece that keeps fans coming back for more. Less than a year after its premiere, the critically acclaimed show opened on Broadway and has continued to enjoy success ever since. The show has won several awards, including the Drama Desk Awards for Outstanding Music and Outstanding Lyrics, and the Tony Awards for Best Book of a Musical, Best Musical, and Best Original Score. The cast received a combined twelve Tony Awards in 2018 out of fourteen nominations.
One of the biggest names to take the stage at the launch of The Band's Visit's Broadway run is Tony Shalhoub. Known for his television and film work, Tony Shalhoub gives a riveting performance, which earned him a Tony Award for Best Actor in a Musical. Tony Shalhoub has numerous acting credits, including the television shows Monk and Wings, along with filsms such as Men in Black, The Siege, Galaxy Quest, and Spy Kids. He has been nominated for numerous awards and has appeared in genres from dark drama to horror, comedy to kids' films. His talent made him perfect to launch the Broadway debut in the role of Tewfiq Zakaria. Shalhoub has since stepped away from the role and the production.
Katrina Lenk opened the show with her portrayal of Dina, winning the Tony Award for Best Actress in a Musical. Katrina Lenk has starred in many regional productions in her hometown of Chicago, as well as Broadway productions of Spider-Man: Turn Off the Dark, Once, and Indecent.
Actor and playwright John Edward Cariani opened the show playing Itzik. Theatergoers will recognize John Edward Cariani from his role in Law & Order as Julian Beck, the forensics expert. He has many credits to his name, including Almost, Maine, which he wrote. Almost, Maine has become one of the most frequently produced plays in the United States. He also starred in Something Rotten! as Nigel Bottom and the 2004 Broadway revival of Fiddler on the Roof as Motel the Tailor, a role which earned him a Tony Award Nomination.
The Band's Visit made its off-Broadway debut at the Atlantic Theater Company in November of 2016. The Band's Visit opened on Broadway at the Ethel Barrymore Theatre, with the first preview on Oct 7, 2017. It officially launched Nov 9, 2017.
The Band's Visit covers mature subject matter and is recommended for audiences 12+.
While most Broadway shows run about 2 hours with intermission, The Band's Visit's official runtime is 90 minutes with no intermission. As with any live show, it could run slightly shorter or slightly longer.
Photo credit for gallery at the top of this page: Matthew Murphy 2017.


text:
Ontario, British Columbia and Manitoba have issued invitations to candidates to apply through their most recent rounds of Provincial Nominee Program (PNP) draws.
Most Canadian provinces and territories (except Quebec and Nunavut) operate their own PNPs. Through these programs, interested candidates may be invited to apply for provincial nominations. Obtaining a provincial nomination can be beneficial in obtaining permanent residency.
Quebec's immigration programs are administered by the province and are different from Canada's immigration programs. Quebec is the only province that has controls on immigrants from all economic classes.
There are 105,000 PR enrollments per year in the Provincial Nominee Program (PNP). It started in 1998 and since then there has been a steady increase in the annual number of PNP admissions. Both the federal and provincial governments consider it an effective tool for promoting economic development outside urban centres.
Provincial Immigration Results Jan 7-Jan 13
On January 10, Ontario issued 404 invitations to apply to candidates in the overseas worker stream of the Employer Job Offers: Ontario Immigrant Nominee Program (OINP). The two invitations were issued as part of the Economic Mobility Pathways project. The draw targeted candidates in a skilled occupation who have a full-time job offer in a skilled occupation in TER category 0, 1, 2 or 3 of the National Occupational Classification (NOC). Qualified candidates need a score of 35 and above.
The province announced on 22 December that it had invited the maximum number of candidates allocated for the year. In total for 2022, Ontario issued invitations to 9,750 candidates.
The province says new applications, and applications already submitted to OINP, will continue to be accepted and considered under the program's 2023 enrollment allocation.
British Columbia issued 123 invitations to apply to candidates in a targeted draw for technical occupations on January 10.
Invitations were issued to candidates in the Skilled Worker and International Graduate categories and this included Express Entry candidates. Since the BC PNP's Tech stream launched in 2017, more than 6,000 tech workers have been enrolled for provincial enrollment.
Candidates need a minimum SIRS score of 90. SIRS works much like the Express Entry Comprehensive Ranking System (CRS), but is used only for the PNPs of British Columbia.
The province also conducted an invitational round for candidates working in the following occupations.
Early Childhood Educator and Assistant (NOC 4214) with a score of at least 60 points;
17 Healthcare Worker from Skilled Worker, International Graduate, including Express Entry category, with a score of at least 60 marks and;
Other demanding occupations with a score of at least 60 points.
Manitoba invited 322 candidates through the Manitoba Provincial Nomination Program on January 12. To receive an invitation, candidates must meet a baseline of criteria specific to their program. Overall, provinces invited:
Skilled workers in Manitoba issued 260 invitations with a minimum score of 734.
Skilled Workers Overseas issued 20 invitations with a minimum score of 713.
International Education stream issued 42 invites without the requirement of score.
Of all those invited to apply, 27 had profiles in the Express Entry system.
© CIC Updates All Rights Reserved. Visit Worldoverseasimmigration.com to find your Canadian immigration options.
Posted in BLOGS, CanadaTagged apply, British, Columbia, invitations, issue, Manitoba, nominations, ontario, provincial


Our biggest front runner, 6m polycraft.
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For the best and largest range of boat hire on the Noosa River, book a hire boat with O Boat Hire. If you need something bigger or are on a budget, we have the solution for you with such a large range to choose from. O Boat Hire's range includes, Deluxe BBQ pontoons, BBQ Pontoons, wheelchair friendly pontoons, cuddy cabs, front runners, kayaks and jet skis.


Outward Sound is pleased to announce the third round of grant recipients for 2018.
Applications for the next round of Outward Sound grants close on October 15th, 2018 at 5pm.
Media enquiries should be directed to international@nzmusic.org.nz. Artist photos are available upon request.


We are always looking for talented people in our area of expertise so if it's you, sounds great!
To apply to be added to our pool of contributors simply go to the contact us page and drop us a line. If you are applying as a voiceover artist do give the web address where your voicereel is located so we can listen to it and we'll be in touch - thank you!


SiempreTax+ Ranked a Top New Franchise by Entrepreneur Magazine | Liberty Tax, Inc.
For the second consecutive year, SiempreTax+ has been ranked a Top New Franchise by Entrepreneur magazine. The magazine's Top New Franchises list recognizes the Top 100 companies that have been franchising for five years or less, based on data submitted to the magazine. Liberty Tax, Inc., the parent company of SiempreTax+, created the national brand in 2014 to serve the unique and diverse needs of Hispanic consumers.
SiempreTax+ franchises are an affordable option in a reliable industry. The brand is backed by Liberty Tax Service, an award-winning franchise and a leader in tax preparation services. SiempreTax+ is an innovator that provides professional tax preparation plus a wide array of services, such as ESL classes, notary, faxing, and more, for the growing Hispanic market.
Entrepreneur's 2018 Top New Franchises ranking was determined using the company's Franchise 500 formula, which is a comprehensive evaluation of more than 150 data points in the areas of costs and fees, size and growth, franchisee support, brand strength, and financial strength and stability. The position of SiempreTax+ on the ranking shows that the brand has made a strong start on its franchising journey.
SiempreTax+ was launched in 2014 as a national Hispanic tax preparation franchise. SiempreTax+ is supported by its parent company Liberty Tax, Inc. (NASDAQ:TAX) and is committed to providing 100% customer satisfaction and solutions to Spanish-speaking clients. SiempreTax+ is uniquely focused on serving the Hispanic community and provides a wide array of services, including but not limited to tax preparation, Individual Taxpayer Identification Number (ITIN) applications, competitive financial products, driver's license information, and notary services. For more information about SiempreTax+, visit our website SiempreTax.com or call 1-855-474-3677. For franchise opportunities, visit SiempreTaxFranchise.com or call 1-844-743-6773.


As architect Peter Israel designed Golf House, a boutique luxury apartment block in Surry Hills, he kept one concept front of mind: the idea of home.
Taking a seat in the development's display suite while fashion designer Collette Dinnigan, who shaped the interior design, supervises a photo shoot of her handiwork, Israel describes the elements that help create a feeling of home.
"I'm interested in the emotional, intellectual and spiritual impact of materials and how they are combined," says Israel, whose practice, PTI Architecture, developed the striking look of the 46-apartment, seven-storey complex named after the golf shop that stood on the site for decades. Many Sydneysiders will remember the iconic animated neon sign that crowned the roof of the shop, once Sydney's premier golf store. When pro golfer Lindsay Sharp bought the business in 1985, the sign changed to read Sharpies Golf House. The 1950s neon sign is now part of the Powerhouse Museum collection.
Surry Hills itself has been a major source of inspiration for Israel. "Surry Hills has such character now – it's a great part of Sydney," he says. "As a place to live, it's got a lot of heart and soul." He also thinks Dinnigan's involvement is apt, given that Surry Hills is the traditional heart of Sydney's rag trade.
For more information visit www.thegolfhouse.com.au or call Savills Residential Projects on 1800 959 833.


Thanks for all the replys and offers!
Last edited by bykemike; 02-17-2019 at 01:02 PM..
I have a sport one.
I have one and might consider trading. Can you post a pic of the ZTechnic you have to trade?Thanks!
Vladecvc; what is a sport windshield?
I have one too, in Chicago IL area...e-mail me if you're interested.
Are you still interested in the stock wind screen?
Thanks for the reply but I just installed on I received a week or so ago and it is perfect.
Ill take down my request!


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It`s a slit equipment with high precision and high sensitive and function for detecting unhealthy basic film or aluminium film. Running performance is stable, easy to operate, visual, and high automatically degree etc advantages. It can meet different slit width and using demand from client. It`s the necessary equipment in printing, packaging, food, pharmecutical.


The news broke Sunday morning that the Kansas City Royals have agreed to terms (pending a physical) with OF/1B Brandon Moss. This well traveled former member of the Red Sox, Pirates, Phillies, Athletics, Indians and (the dirty, dirty) Cardinals should add some pop from the left side and be a part of the equation to replace the production hole left from the departure of Kendrys "Pulled Pork" Morales.
Needed to do something. Downstream HR power (w/ Soler) is always a good thing.
can't beat em join em?
Why not just keep Morales then?
Follow us on Twitter @RoyalsBlue_Com and have your voice heard.
IT'S THE ROYALS BLUE.COM PODCAST!!!!!!!!


text:
Organic Body Oils
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The Mosquitos Are Coming For Us - NY Times
They are our apex predator, the deadliest hunters of human beings on the planet. - By Timothy C. Winegard
July 28, 2019 - It has been one of the most aggravating sounds on earth for more than 100 million years — the humming buzz of a mosquito.
She gently lands on your ankle and inserts two serrated mandible cutting blades and saws into your skin, while two other retractors open a passage for the proboscis. With this straw she sucks your blood, while a sixth needle pumps in saliva that contains an anticoagulant that prevents that blood from clotting. This shortens her feeding time, lessening the likelihood that you splat her across your ankle.
The female mosquito needs your blood to grow her eggs. Please don't feel singled out. She bites everyone. There is no truth to the myths that mosquitoes prefer women over men or blondes and redheads over those with darker hair. She does, however, play favorites. Type O blood seems to be the vintage of choice. Stinky feet emit a bacterium that woos famished females, as do perfumes. As a parting gift, she leaves behind an itchy bump (an allergic reaction to her saliva) and potentially something far worse: infection with one of several deadly diseases, including malaria, Zika, West Nile, dengue and yellow fever.
Mosquitoes are our apex predator, the deadliest hunter of human beings on the planet. A swarming army of 100 trillion or more mosquitoes patrols nearly every inch of the globe, killing about 700,000 people annually. Researchers suggest that mosquitoes may have killed nearly half of the 108 billion humans who have ever lived across our 200,000-year or more existence.
Flying solo, the mosquito does not directly harm anyone. It is the diseases she transmits that cause an endless barrage of death. Yet without her, these pathogens could not be vectored to humans. Without her, human history would be completely unrecognizable.
The mosquito and her diseases have accompanied traders, travelers, soldiers and settlers (and their captive African slaves) around the world and have been far more lethal than any manufactured weapons or inventions.
Malarious mosquitoes patrolling the Pontine Marshes facilitated both the rise and the fall of the Roman Empire. Initially shielding the Eternal City from the Visigoths, Huns and Vandals, they eventually pointed their proboscises inward on Rome itself. Mosquitoes defended the Holy Land during the Crusades by laying waste to armies of cross-adorned Christian soldiers. By infecting European soldiers with malaria and yellow fever, they reinforced numerous successful rebellions in the Americas during the late 18th and early 19th centuries, including the British surrender at Yorktown during the American Revolution.
Mosquitoes also played a role in steering slave ships from Africa across the Atlantic, because plantation owners in the Americas believed that Africans withstood the onslaught of mosquito-borne disease better than indigenous slaves or European indentured servants. During the American Civil War, Confederate forces suffered from shortages of the antimalarial drug quinine, and the mosquito eventually helped hammer the final nail in the coffin of the institution of slavery. But these examples only scratch the surface of her historical impact.
Malaria, a parasitic disease, is the unsurpassed scourge of humankind. Dr. W. D. Tigertt, an early malariologist at Walter Reed Army Medical Center, said, "Malaria, like the weather, seems to have always been with the human race." He continued, "And as Mark Twain said about the weather, it seems that very little is done about it." Even today, more than 200 million unlucky people contract malaria each year.
Malaria often produces a synchronized and cyclical pattern of symptoms: a cold stage of chills and shakes, followed by a hot stage marked by fevers, headaches and vomiting, and finally a sweating stage. After a period of respite, this progression repeats itself. For many, especially children under 5, malaria triggers organ failure, coma and death.
Mosquitoes also transmit a catalog of viruses: dengue, West Nile, Zika and various encephalitides. While debilitating, these diseases are generally not prolific killers. Yellow fever, however, is the viral exception. It can produce fever-induced delirium, liver damage bleeding from the mouth, nose and eyes, and coma. Internal corrosion induces vomit of blood, the color of coffee grounds, giving rise to the Spanish name for yellow fever, vómito negro (black vomit), which is sometimes followed by death.
Today, roughly four billion people are at risk from mosquito-borne diseases. As our ancestors can attest, our battle with the mosquito has always been a matter of life and death, and it's beginning to look as though this confrontation is coming to a head.
In "Silent Spring," Rachel Carson wrote that "our attitude toward plants and animals is a singularly narrow one," that "if for any reason we find its presence undesirable or merely a matter of indifference, we may condemn it to destruction forthwith." She could not have anticipated the arrival of Crispr — the gene-editing technology that can tremendously speed up the meaning of "forthwith."
Unveiled in 2012, Crispr snips out a section of DNA sequencing from a gene and replaces it with another one, permanently altering a genome. This innovation has been called the extinction machine because it allows us to intrude on natural selection to wipe out any undesirable species. Crispr has been used to design mosquitoes that produce infertile offspring. If those mosquitoes were released into the wild, the species could become extinct. Humanity would never again have to fear the bite of a mosquito.
And yet, it would also mean that science fiction would become reality. "We can remake the biosphere to be what we want, from woolly mammoths to nonbiting mosquitoes," Henry Greely, the director of the Center for Law and the Biosciences at Stanford University, told Smithsonian magazine. The question is: "How should we feel about that? Do we want to live in nature, or in Disneyland?"
We also have valid, although yet unknown, reasons to be careful what we wish for. If we eradicate disease-vectoring mosquito species, would other mosquito species or insects simply fill the ecological niche? Would one disease be swapped out for another? What effect would eliminating mosquitoes (or any other animal) have on mother nature's biological equilibrium?
But perhaps now, as in the past, we are underestimating the mosquito. She evolved to endure global showers of the eradication chemical DDT and may genetically outflank Crispr as well. History has shown the mosquito to be a dogged survivor. She has ruled the earth for millions of years and has killed with unremitting potency throughout her unrivaled reign of terror. She has steered the course of history, scratching her indelible mark on the modern world order.
Dr. Rubert Boyce, the first dean of the Liverpool School of Tropical Medicine, bluntly stated in 1909 that the fate of human civilization would be decided by one simple equation: "Mosquito or Man?" Across the ages, we have been locked in a life-or-death struggle for survival with the not-so-simple mosquito. Historically, we did not stand a chance.
https://www.nytimes.com/2019/07/27/opinion/sunday/mosquitoes-malaria-zika-history.html?smid=nytcore-ios-share
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Aksarben Cinema is the only locally and family-owned theatre in Omaha, NE. Aksarben Cinema works each day to provide a superior movie-going experience to its patrons.
This gift card is redeemable for admissions and concessions at Aksarben Cinema. Not redeemable for cash. Please guard against loss or theft. Lost or stolen cards cannot be replaced. Additional value may be added to the card at the theatre Box Office. www.aksarbencinema.com.


What are some of the reasons for the increase in passenger disturbances? Serving unlimited alcohol on flights, particularly in first and business class is encouraged by many airlines. With the decrease in cabin pressure at normal cruising altitudes, boarding the flight on an empty stomach can cause inebriation much more quickly. Additionally with airlines prohibiting smoking on their flights, smokers tend to substitute alcohol for cigarettes. Arriving early for a flight and the long delays experienced at most airports, therefore boarding the aircraft already inebriated. It is often difficult for the passenger agent with the brief contact they have with the passenger's prior and during boarding to detect that a passenger has had too much to drink.
Paying several hundred or even thousands of dollars for an airline ticket seems to give some people the sense they can do whatever they please on an airplane. Many of the passengers are successful entrepreneurs, business leaders, or even professional athletes or entertainers who are use to being in control of their personal and professional lives and resent giving up control to airline employees. They may resent obeying safety rules, fastening seat belts, returning to their seats during expected turbulence, and turning off devices like cell phones or laptop computers.


Site Feed up and running – I think?
For a while now I've been thinking of setting this blog up with a site feed. Blogger's automatic atom feed wasn't publishing correctly, perhaps because I host this blog on my own hosting, but I believe I have it sorted out now.
Using Feedburner and blogger's automatic atom feed publisher, I've set it up so that you can subscribe to the feed using RSS or Atom, and using any reader out there (at least, that's what Feedburner says). I still don't understand the technical aspects of RSS and Atom feeds 100%, so if anyone finds any problems with my feed, please let me know.
The WHO LINKS TO ME icon shows sites that have links to me – right now, there are a few blogs and a bunch of search engine results, but hopefully that list will grow to a lot of blogs and a few search engine results; my lack of reading other people's blogs recently has not been particularly helpful in getting my blog publicized, but I'm working on better time management.
As for the BLOGROLL ME icon, if you don't already know what BlogRolling is about then check out www.blogrolling.com. It's a pretty sweet concept – I can add links to my blogrolling list when I visit them online instead of having to manually edit my template. Extremely useful; too bad the free version is limited to 1 blogroll, as I could use a 2nd one.


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Slowthai Fortune Sound Club, Vancouver BC, September 7
Photo: Sharon Steele
By Leslie Ken Chu
Last May, British rapper Tyron Frampton, aka Slowthai, released his debut album, Nothing Great About Britain. It was a Molotov cocktail hurled straight through a window of Buckingham Palace, a smart-assed polemic against British nationalism, Brexit, classicism and deepening poverty in Britain.
Slowthai's Vancouver debut at Fortune Sound Club on Saturday was explosive, but for its political content, he let the music do the talking.
Ironically, despite his anti-authoritarianism, he was less concerned about talking politics than he was about directing traffic and making sure the audience had a good time. "Open it up," he instructed, calling for mosh pits, not that anyone needed his prompts to get riled up: the crowd-surfing began as soon as he stepped onstage, before he even started his first song, the album's title track. In fact, the first pit broke out naturally and as if by ironic design, during bittersweet, nostalgic ballad "Toaster."
And so it went all night: fans peeled off their shirts, mixing sweat with aerial booze. As did Slowthai, his ridiculously jacked producer Kwes Darko, and Slowthai's mascot/hype man Woioii the Crack Rabbit. When joints flared, Slowthai accepted a bit of legal Canadian hospitality from the audience and puffed away, too.
Fans reciprocated Slowthai's relentless energy. Together, they roared eloquent phrases like "Fuck off!," "You cunt!," and, on "GTFOMF," "Get the fuck out my face!" The last of these phrases devolved into Slowthai wildly yelling "Face!" at the top of his lungs three times. He lost control of his fans during "Doorman," though. He ordered them to open up a circle and follow Woioii as Woioii ran counter-clockwise in the middle. But his fans were too amped up, and the circle instantly collapsed into a normal pit.
The audience became so rabid during "Drug Dealer," Slowthai performed it a second time near the end of his set. He made sure to cool them down afterwards, pouring water into thirsty mouths in the front row.
Slowthai also performed a couple of his collaborations. He and his crew handled Tyler, the Creator's "What's Good," but for "Inglorious," Slowthai pulled a fan onstage to sub in for Skepta. Despite the fan's insistence that he knew Skepta's verse, though, he was clearly nervous and struggled to keep up with Slowthai. Ultimately, the fan made it through the song and, per Slowthai's encouragement, psyched himself up enough to stage-dive back into the crowd.
Slowthai also treated fans to an unreleased track called "Psycho," a collaboration with Denzel Curry, due September 10. As one would expect of a track between the two rappers, "Psycho" was a dramatic track with a twisted, booming beat.
Slowthai delivered relentless and intense grime beats with total punk attitude. This grind risks being too one-note for some audiences, but for everyone else, everything about it was great.
More slowthai
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Both uproarious MCs in their own right, Denzel Curry and Slowthai have now come together on a new single. The pair collide on "Psycho," w...
Brockhampton Plot "Heaven Belongs to You Tour"
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There was no overtime this time, so the BC High hockey team had to settle for a come-from-behind 2-2 tie with Pope Francis on Thursday.
In a rematch of last year's Super 8 final (a 2-1 OT victory at TD Garden for BC High), the host Eagles came from two goals down to earn a point at UMass-Boston.
Pope Francis (9-1-2) took a 1-0 lead into the first intermission, courtesy of a goal from Spencer Stewart.
Makem Demers made it 2-0 at 3:09 of the second period, redirecting a point blast from defenseman Joe Salvon.
Thomas Kramer (Bridgewater) shaved the deficit in half for BC High (9-2-2) on a shorthanded goal with 5:26 left in the second.
P.J. Donahue (Canton) knotted the score at 7:50 of the third.
Kramer had a shorthanded breakaway in the final minute, but Pope Francis goalie Ben Zaranek denied him.
BC High was coming off a 2-1 road loss to Framingham on Monday.
Cohasset 50, South Shore Christian Academy 19: Molly Greer scored 18 points, and Kate Cunning added 6 as the Skippers (4-9) beat SSCA (3-7) on the road.
Thayer Academy 2, Tilton 1 (OT): The Tigers (11-7) won on the road.


the condition of being anonymous.
obscurity, facelessness, namelessness, nowhere, nowheresville, etc.
Since there are no rules in A.A.
I place myself where I want to be, and so I choose anonymity.
I want my God to use me, humbly, as one of His tools in this program.
Sacrifice is the art of giving of myself freely, allowing humility to replace my ego.
With sobriety, I suppress that urge to cry out to the world, "I am a member of A.A." and I experience inner joy and peace. I let people see the changes in me and hope they will ask what happened to me.
I place the principles of spirituality ahead of judging, fault-finding, and criticism.
Few of us are anonymous so far as our daily contacts go. Though we earnestly request reporters not to disclose our identities, when we speak before semi-public gatherings.
We wish to convince audiences that our alcoholism is a sickness we no longer fear to discuss before anyone. If, however, we venture beyond this limit, we shall surely lose the principle of anonymity forever. –As Bill Sees It | More… (p.278).
We now fully realize that 100 per cent personal anonymity before the public is just as vital to the life of A.A. as 100 per cent sobriety is to the life of each and every member.
Moved by the spirit of anonymity, we try to give up our natural desires for personal distinction as A.A. members, both among fellow alcoholics and before the general public.
Anonymity provides protection for all members from identification as alcoholics, a safeguard often of special importance to newcomers. Attraction is the main force in the Fellowship of A.A.


text:
Boycott Profile
ClearChannel
Target Stock: Clear Channel Communic. (CCU)
Launched by: maxbroker
Launch date: May 05, 2003
Total Participants: 141
Join this Boycott
Recruit a Friend to Join this Boycott
Exchange: NYSE Stock Price ($): 30.77
Industry: Broadcasting & Cable TV Market Cap ($MM): 9,800
Sector: Services Shares Outstanding (MM): 318
BVR: Sales TTM ($MM): 8,073
P/E: Short Interest Ratio (%): 3.9800
Last Update: Feb 06, 2011 @ 09:00 pm
Clear Channel Communications, Inc. is a diversified media company with three reportable business segments: radio broadcasting, outdoor advertising and live entertainment. As of December 31, 2001, the Company owned, programmed, or sold airtime for 1,240 domestic radio stations and a national radio network. In addition, the Company has equity interests in various domestic and international radio broadcasting companies. The Company also is engaged in outdoor advertising, with a total advertising display inventory of 156,623 domestic display faces and 573,416 international display faces. In addition, the Company is a promoter, producer and venue operator for live entertainment events. As of December 31, 2001, the Company owned or operated 104 live entertainment venues domestically and 31 live entertainment venues internationally. The Company also owns or programs 19 television stations, owns a media representation firm and represents professional athletes.
Related News & Views:
Boycotts - Clear Channel Communications Inc., the nation's largest owner of radio stations, has fired unidentified employees and disciplined others after an internal payola probe found evidence of wrongdoing. - Wednesday, October 12, 2005
The information and opinions expressed above are solely those of the author. Karma Banque makes no assurances as to the validity of this information. Please do your own research before deciding to boycott a company!


The table legs were created for a renovation of the Asprey and Garrard luxury goods flagship store on Bond Street in London, the crown jeweler. The design is inspired by the 18th-century furnishings favored by Prince Charles. Created for the artist's home.
Made in Chicago, 1998. Feet; acid-washed magnesium-aluminum alloy. Top; oiled mahogany.


Our mission is the core of what we do. It honors our history, reflects our day-to-day and focuses on the future. It leads us in designing and delivering programs that improve the lives of more than 10,000 children and families each year.
We believe children belong in families and families belong in strong communities.Every day, our dedicated staff works with hundreds of children and families to ensure they have the prevention, treatment and support services they need to heal and become more resilient for the future. When you work with us, you are positively impacting thousands of lives by helping keep children safe, families strong and communities healthy.


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The Morotai white-eye (Zosterops dehaani) is a species of bird in the family Zosteropidae. It is endemic to Morotai in the northern Moluccas. It was separated from the cream-throated white-eye based on distinct plumage, exceptional dawn song, and submontane/montane ecology

References

Morotai white-eye
Birds of the Maluku Islands
Morotai white-eye


Due to the high price of the properties, it's impossible for most of the prospective buyers to purchase a flat or house by paying the entire amount upfront. In such situations, buyers turn to banks for home loans for which lenders seek a down payment of up to 20 percent. Arranging this kind of money for down payments can be a tough task for many. Some even think of retreating money from their Employee Provident Fund (EPF) accounts. But is it a wise idea? Let's see how it works.
As per the new EPFO rules, the subscribers can withdraw 90 percent of EPF accumulations to fund the purchase or construction of house or flat. You can additionally avail the interest payment subsidy on Pradhan Mantri Awas Yojana (PMAY) on the payments made for home buying through EPF. Moreover, to be eligible for withdrawal from EPF account, you must be associated with EPF for at least three years and have at least Rs 20,000 account balance.
Looking at the benefits, it sounds a good option for salaried individuals. But is it really that smart?
EPF is designed to provide a regular income stream for you in retirement. This is designed to meet your income requirements when you are no longer working. Hence, it should not be withdrawn before its maturity as this could jeopardize your retirement. You are exposing yourself to immense risk by leaving no funds to sustain your retirement. Just remember, there are many banks that are willing to give you money to buy a house. But no one lends you cash to live a retired life.
In an EPF account, the employee and employer make an equal contribution towards savings that can be availed on retirement. As the salary increases, your contribution also goes up. This makes a large corpus, provided that you do not withdraw it for any other purpose. Owning a house is a social and psychological need for many of us. Taking such decisions can surely land you in huge trouble and must be avoided at any cost. If you have enough savings, then buying a home is a wise decision rather than using your EPF money for the same. As later on, you may find it difficult to pay for your day-to-day expenses once you retire.
It's better to make a plan for home buying from the very beginning. Accumulate money for at least down payment and avail home loan after you make the down payment, but do not touch your EPF amount.
The repayment of home loan principal and interest provides attractive tax benefits on a home loan. Under Section 80C of the Income Tax Act, you can avail tax benefits of up to Rs. 1.5 lakh on principal repayment. But, you can avail the benefits only after the construction of your house is complete. You can claim a deduction of up to Rs 2 lakh every year on the interest amount that you have paid on your residential property, as per section 24 of the Income Tax Act. This is applicable for self-occupied properties. You can also claim deductions on a joint home loan and under-construction properties, provided that you meet certain conditions. In most cases, the cost of a home loan is lower than the rate of return received on EPF accounts, which makes the home loan better means to pay for your home.
Hence, it's advisable that you not withdraw your EPF account. Let your EPF balance compound and help you live a rich retired life.


text:
kevin@twistedimage.com
Kevin Roche has been making costumes since he was 8 (and has the photographic evidence to prove it!). He was honored with the International Costumers Guild Lifetime Achievement Award in 2007. In his secret identity as a research scientist at IBM's Almaden Research Center, he's hard at work wrangling giant robot vacuum chambers and electrons in the growing field of spintronics. Kevin and his husband Andy Trembley set out in 2002 to bring Costume-Con back to California, and ~900 hundred costumers showed up at CC26 in 2008 to join the fun. More recently, Kevin and Andy threw an olive tasting/bid hoax party at a Westercon, culminating in their co-chairing Westercon 66 for nearly 800 people in 2013. They then successfully bid to bring the World Science Fiction Convention to San Jose in 2018, so Kevin is now the chair of Worldcon 76 in San Jose!
Kevin is also the creator of Thinbot, the gold-medal winner in the robotic bartending event at Robogames, the international robotics competition, in 2012, 2013, 2015 & 2016. Thinbot is frequently found hard at work serving visitors to Kevin and Andy's parties at conventions. He is also the editor of Yipe! The Costume Fanzine of Record (www.yipezine.com).
My Guests Sessions
Getting Your Goodies Through Airport Security Without Having or Causing a Meltdown Sumac
From the ground up: launching a first year con SandPebble A
Harassment- And we're going to keep talking about this Sumac


text:
Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. It occurs amongst all races and nationalities, is the most common hormonal disorder among women of reproductive age, and is a leading cause of infertility. The symptoms and severity of the syndrome vary greatly between women. While the causes are unknown, insulin resistance (often secondary to obesity) is heavily correlated with PCOS. more...
Hallermann Streiff syndrome
Hantavirosis
Hantavirus pulmonary...
HARD syndrome
Harlequin type ichthyosis
Harpaxophobia
Hartnup disease
Hashimoto's thyroiditis
Heart block
Heavy metal poisoning
Heliophobia
HELLP syndrome
Helminthiasis
Hemangioendothelioma
Hemangiopericytoma
Hemoglobinopathy
Hemoglobinuria
Hemolytic-uremic syndrome
Hemophobia
Hemorrhagic fever
Hemothorax
Hepatitis D
Hepatorenal syndrome
Hereditary amyloidosis
Hereditary angioedema
Hereditary ataxia
Hereditary ceroid...
Hereditary coproporphyria
Hereditary elliptocytosis
Hereditary fructose...
Hereditary hemochromatosis
Hereditary hemorrhagic...
Hereditary...
Hereditary spastic...
Hereditary spherocytosis
Hermansky-Pudlak syndrome
Hermaphroditism
Herpangina
Herpes zoster oticus
Herpetophobia
Heterophobia
HIDS
Hirschsprung's disease
Hodophobia
Holocarboxylase...
Holoprosencephaly
Horner's syndrome
Howell-Evans syndrome
Human parvovirus B19...
Hunter syndrome
Hurler syndrome
Hutchinson Gilford...
Hutchinson-Gilford syndrome
Hydatidiform mole
Hydatidosis
Hydranencephaly
Hydrophobia
Hymenolepiasis
Hyperammonemia
Hyperbilirubinemia
Hyperchylomicronemia
Hypereosinophilic syndrome
Hyperimmunoglobinemia D...
Hyperkalemic periodic...
Hyperlipoproteinemia
Hyperlipoproteinemia type I
Hyperlipoproteinemia type II
Hyperlipoproteinemia type...
Hyperlipoproteinemia type IV
Hyperlipoproteinemia type V
Hyperlysinemia
Hyperprolactinemia
Hyperreflexia
Hypoaldosteronism
Hypocalcemia
Hypochondrogenesis
Hypochondroplasia
Hypokalemic periodic...
Hypophosphatasia
Hypoplastic left heart...
Hypoprothrombinemia
Hypothalamic dysfunction
Other names for this disorder include:
Polycystic ovary disease (although this is not correct, as PCOS is characterised as a syndrome rather than a disease)
Functional ovarian hyperandrogenism
Hyperandrogenic chronic anovulation
Ovarian dysmetabolic syndrome
There are two definitions that are commonly used:
In 1990 a consensus workshop sponsored by the NIH/NICHD suggested that a patient has PCOS if she has (1) signs of androgen excess (clinical or biochemical), (2) oligoovulation, and (3) other entities are excluded that would cause polycystic ovaries.
In 2003 a consensus workshop sponsored by ESHRE/ASRM in Rotterdam indicated PCOS to be present if 2 out of 3 criteria are met: (1) oligoovulation and/or anovulation, (2) excess androgen activity, (3) polycystic ovaries (by gynecologic ultrasonography), and other causes of PCOS are excluded.
The Rotterdam definition is wider, including many more patients, notably patients without androgen excess, while in the NIH/NICHD definiton androgen excess is a prerequisite. Critics maintain that findings obtained from the study of patients with androgen excess cannot be necessarily extrapolated to patients without androgen excess.
Common symptoms of PCOS include:
Oligomenorrhea, amenorrhea - irregular/few, or absent, menstrual periods; cycles that do occur may comprise heavy bleeding (check with a gynaecologist, since heavy bleeding is also an early warning sign of endometrial cancer, for which women with PCOS are at higher risk)
Infertility, generally resulting from chronic anovulation (lack of ovulation)
Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS), causing hirsutism and occasionally masculinization
Central obesity - "apple-shaped" obesity centered around the lower half of the torso
Androgenic alopecia (male-pattern baldness)
Acne / oily skin / seborrhea
Acanthosis nigricans (dark patches of skin, tan to dark brown/black)
Acrochordons (skin tags) - tiny flaps of skin
Prolonged periods of PMS-like symptoms (bloating, mood swings, pelvic pain, backaches)
Signs are:
Multiple cysts on the ovaries. Sonographycally they may present as a "string of pearls".
Enlarged ovaries, generally 1.5 to 3 times larger than normal, resulting from multiple cysts
Thickened, smooth, pearl-white outer surface of ovary
Chronic pelvic pain, possibly due to pelvic crowding from enlarged ovaries; however, the actual cause is not yet known
The ratio of LH (Luteinizing hormone) to FSH (Follicle stimulating hormone) is 2:1 or more, particularly in the early phase of the menstrual cycle.
Increased levels of testosterone.
Decreased levels of sex hormone binding globulin.
Hyperinsulinemia.
HAIR-AN Syndrome: A Multisystem Challenge - hyperandrogenism, insulin resistance, and acanthosis nigricans
From American Family Physician, 6/15/01 by Kathleen B. Elmer
HAIR-AN syndrome is an acronym for an unusual multisystem disorder in women that consists of hyperandrogenism (HA), insulin resistance (IR) and acanthosis nigricans (AN). The precipitating abnormality is thought to be insulin resistance, with a secondary increase in insulin levels and subsequent overproduction of androgens in the ovaries. Long periods of hyperinsulinism and, some suspect, hyperandrogenism can result in the cutaneous manifestation of acanthosis nigricans. Patients are often concerned about the physical manifestations of this disorder, including virilization and acanthosis nigricans, and may be less aware of systemic problems. Physicians should assess women with these problems for an underlying endocrine abnormality. Although a treatment regimen for the HAIR-AN syndrome has not been established, antiandrogen therapy and weight loss are useful. (Am Fam Physician 2001;63:2385-90.)
The hyperandrogenism, insulin resistance and acanthosis nigricans (HAIR-AN) syndrome is an unusual condition that affects females. Persons with the disorder usually present with obesity and insulin resistance during the prepubertal period.(1) About 1 to 3 percent of women with hyperandrogenism are thought to have this condition, with many cases remaining undiagnosed. Occasionally, patients with autoimmune disorders such as Hashimoto's thyroiditis and Graves' disease also have HAIR-AN syndrome. Other nonmalignant endocrine disorders with features of androgen excess include Cushing's syndrome, polycystic ovary syndrome, acromegaly and congenital adrenal hyperplasia.(2)
Clinical Presentation and Differential Diagnosis
In young women, hyperandrogenism manifests as oily skin, hirsutism, acne, menstrual irregularities and, in some cases, androgenic alopecia, deepening of the voice, clitorimegaly and changes in muscle mass (Table 1). Insulin resistance can present in different forms; some persons have high concentrations of insulin but normal levels of glucose, while others have glucose measurements in the diabetic range. A history of diabetic symptoms such as polydipsia, polyuria and weight loss may sometimes, but not always, be present.
Insulin resistance is categorized as type A or type B, depending on the etiology. Type A syndrome is an inherited form of severe insulin resistance caused by mutations of insulin receptors or varied target cell disorders in insulin response. Type B insulin resistance is acquired, resulting from autoantibodies against insulin receptors.(3) This type of insulin resistance occurs in patients with less severe acanthosis nigricans and may accompany other immunologic abnormalities.(4) It is associated with a positive antinuclear antibody screen.(5)
Acanthosis nigricans lesions are velvety, hyperpigmented patches of skin that occur with HAIR-AN syndrome after long-term exposure of the keratinocytes to insulin. Human keratinocytes have insulin and insulin-like growth factors on their surface.(6,7) Stimulation caused by the high insulin levels that accompany HAIR-AN syndrome probably induces formation of the acanthosis nigricans lesions. In fact, acanthosis nigricans occurs in 60 to 80 percent of adolescents with type 2 diabetes mellitus (formerly called non-insulin-dependent diabetes mellitus).(8)
Acanthosis nigricans can also occur in patients who have a malignancy, the most common being adenocarcinoma of the stomach. Malignancy should be suspected in persons older than 35 years, especially in those who are not overweight. Rapid onset and extensive presentation of acanthosis nigricans found during a normal endocrine work-up should prompt a search for malignancy.(9,10) Obese patients with no other disease can also develop acanthosis nigricans.
Two cases of organic mood disorders have been reported in association with HAIR-AN syndrome. In both cases, the depression responded to treatment with oral contraceptives. Hypothalamic abnormalities can cause both depression and a disruption in insulin regulation, which may explain the coexistence of both conditions.(11,12)
The most prominent physical characteristics of women with HAIR-AN syndrome are usually related to acanthosis nigricans or hyperandrogenic features. According to case reports of young girls with hirsutism involving the face and prominent lesions of acanthosis nigricans, the significant psychologic impact of these visible manifestations is the main reason that these patients consult physicians(13) (Figure 1). In addition, women may present with menstrual abnormalities, such as amenorrhea and infertility, or may note masculinization of the body with increased muscle mass, loss of breast tissue or androgenic alopecia.(3)
Whenever a woman is found to have diabetes, the physician should look for evidence of acanthosis nigricans and signs of virilization (i.e., indicators of the presence of HAIR-AN syndrome). Areas of the body that are likely to develop acanthosis nigricans lesions include the axilla, nape of the neck, antecubital fossae and groin. However, the entire surface of the skin may be affected. In addition to changes in pigment, the affected skin is usually rough, thick and covered with velvety papillomatous ridges (Figures 2 and 3). Numerous acrochordons (skin tags) are also found in these patients. In patients with malignancy, acanthosis nigricans tends to be pruritic, the hyperpigmentation is more extensive and the lesions are more widespread.(3)
Laboratory Studies
In addition to a thorough history and physical examination, a targeted laboratory evaluation may be indicated in patients with HAIR-AN syndrome. A complete blood cell count and thyroid screen, serum prolactin, glucose and insulin measurements, and serum electrolyte panel are recommended. Because women with hyperandrogenism have an increased risk of hyperlipidemia and secondary coronary artery disease, a lipid panel should also be obtained.(14,15) Autoimmune abnormalities may be associated with type B insulin resistance; therefore, an antinuclear antibody test and erythrocyte sedimentation rate are also warranted.
In moderate to severe cases of insulin resistance, elevated insulin levels in the face of normal or elevated glucose readings are found in the fasting state. Milder cases of insulin resistance may present with normal fasting concentrations of insulin and glucose. In these instances, a glucose tolerance test may be necessary to reveal the underlying abnormality of insulin resistance.(2)
To evaluate the possibility of hyperandrogenism, total testosterone should be measured on two to three occasions. Levels of 17a-hydroxyprogesterone, dehydroepiandrosterone sulfate (DHEAS) and morning cortisol after a low dose of dexamethasone should be determined, as should levels of luteinizing and follicle-stimulating hormones, depending on physical findings, history and concern about an ovarian or adrenal abnormality (Table 2).
The main reason for measuring the testosterone level is to screen for a possible virilizing tumor. An elevated level of DHEAS should raise concern about the possibility of an androgen-producing tumor of the adrenal gland. In congenital adrenal hyperplasia, the enzyme deficiencies result in an excess of 17a-hydroxyprogesterone. Production of testosterone increases because 17a-hydroxyprogesterone is an androgen precursor. Patients with Cushing's syndrome have elevated levels of circulating androgen, as well as abnormal secretion of cortisol, manifested by increased basal levels of cortisol and failure of suppression after stimulation with dexamethasone.(16-18)
In patients who have HAIR-AN syndrome without underlying ovarian tumors or adrenal abnormalities, testosterone levels can become significantly elevated while DHEAS and 17a-hydroxyprogesterone concentrations are normal. The levels of gonadotropins are also normal.(3)
If an underlying carcinoma is suspected because of a more severe presentation of acanthosis nigricans or as a result of a review of systems, further investigation is necessary. Studies to rule out lesions of the gastrointestinal tract, including abdominal/pelvic computed tomography or magnetic resonance imaging, and upper and lower endoscopy should be considered.(18)
An algorithm for the diagnostic process is presented in Figure 4.
Weight loss may help to decrease insulin resistance in overweight patients. Suppression of gonadotropins with estrogen-progesterone oral contraceptives has also been shown to help by reducing the production of ovarian androgen.(2) Contraceptives containing newer progestins, such as desogestrel (Desogen) and norgestimate (Ortho-Cyclen), appear to have fewer androgenic side effects and may be safer to use in persons with abnormal lipid levels or hirsutism.
Antiandrogenic agents may also be used, alone or in combination with oral contraceptives.(17) Spironolactone (Aldactone) inhibits the action of testosterone by binding to its receptors. The standard dosage is 50 to 100 mg twice daily, but higher dosages may be required. Combination therapy with oral contraceptives and spironolactone may be needed in women with severe hirsutism. The irregular menstrual bleeding that can occur with spironolactone can often be improved by adding an oral contraceptive. Flutamide (Eulexin) is another antiandrogen that can be used, but it is considered more potent than spironolactone and has resulted in hepatotoxic reactions.
Finasteride (Proscar) is a 5a-reductase inhibitor that reduces the conversion of testosterone to dihydrotestosterone. It is useful in the treatment of hirsutism in dosages as low as 5 mg per day.(19,20)
Patients with HAIR-AN syndrome may have spontaneous exacerbations and remissions in their insulin resistance and must be monitored closely for progression to diabetes. Those with type B insulin resistance generally follow this course, with fluctuations in the symptoms of insulin resistance, secondary acanthosis nigricans and hyperandrogenism depending on the level of circulating anti-insulin-receptor antibodies.(3)
Treatment of insulin resistance with an insulin sensitizing drug such as metformin (Glucophage) has shown promising results. Metformin is a biguanide that improves peripheral tissue sensitivity to insulin but inhibits hepatic glucose formation. The drug reduces the levels of circulating insulin and androgens. After using metformin, women with polycystic ovarian syndrome have shown an improvement in reproductive functioning. The usual starting dosage is 850 mg once daily, with an increase to twice daily.(20-22)
Despite the available therapies, severe forms of insulin resistance may be refractory to even high doses of insulin and may be managed best with support from an endocrinologist.
Final Comment
Women with HAIR-AN syndrome often present with cosmetic concerns such as virilization and acanthosis nigricans. Family physicians must maintain a high index of suspicion for HAIR-AN syndrome when assessing women with these conditions. Patients with the syndrome should be screened for an underlying malignancy or autoimmune disorder. By being aware of HAIR-AN syndrome and its associated conditions, the astute clinician can diagnose and treat the more serious underlying endocrine disorder.
The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense, the Department of the Army or the Department of the Air Force.
(1.) Friedman CI, Richards S, Kim MH. Familial acanthosis nigricans. A longitudinal study. J Reprod Med 1987;32:531-6.
(2.) Barbieri RL, Ryan KJ. Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol 1983;147:90-101.
(3.) Esperanza LE, Fenske NA. Hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) syndrome: spontaneous remission in a 15-year-old girl. J Am Acad Dermatol 1996;34:892-7.
(4.) Kuroki R, Sadamoto Y, Imamura M, Abe Y, Higuchi K, Kato K, et al. Acanthosis nigricans with severe obesity, insulin resistance and hypothyroidism: improvement by diet control. Dermatology 1999;198:164-6.
(5.) Magsino CH, Spencer J. Insulin receptor antibodies and insulin resistance. South Med J 1999;92:717-9.
(6.) Misra P, Nickoloff BJ, Morhenn VB, Hintz RL, Rosenfeld RG. Characterization of insulin-like growth factor-I/somatomedin-C receptors on human keratinocyte monolayers. J Invest Dermatol 1986;87:264-7.
(7.) Verrando P, Ortonne JP. Insulin binding properties of normal and transformed human epidermal cultured keratinocytes. J Invest Dermatol 1985;85:328-32.
(8.) Pinhas-Hamiel O, Zeitler P. Clinical problem-solving. The importance of a name. N Engl J Med 1999; 340:1418-21.
(9.) Barbieri RL. Hyperandrogenism, insulin resistance and acanthosis nigricans. 10 years of progress. J Reprod Med 1994;39:327-36.
(10.) Stuart CA, Gilkison CR, Keenan BS, Nagamani M. Hyperinsulinemia and acanthosis nigricans in African Americans. J Natl Med Assoc 1997;89:523-7.
(11.) Levin TR, Terrell TR, Stoudemire A. Organic mood disorder associated with the HAIR-AN. J Neuropsychiatry Clin Neurosci 1992;4:51-4.
(12.) Morales-Rosello J. HAIR-AN syndrome and mental disorders [Letter]. J Neuropsychiatry Clin Neurosci 1995;7:538-9.
(13.) Zemtsov A, Wilson L. Successful treatment of hirsutism in HAIR-AN syndrome using flutamide, spironolactone, and birth control therapy. Arch Dermatol 1997;133:431-3.
(14.) Derman RJ. Effects of sex steroids on women's health: implications for practitioners. Am J Med 1995;98:137S-43S.
(15.) Redmond GP. Androgens and women's health. Int J Fertil Womens Med 1998;43:91-7.
(16.) Chang RJ, Katz SE. Diagnosis of polycystic ovary syndrome. Endocrinol Metab Clin North Am 1999; 28:397-408,vii.
(17.) Goudas VT, Dumesic DA. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 1997;26:893-912.
(18.) Gordon CM. Menstrual disorders in adolescents. Excess androgens and the polycystic ovary syndrome. Pediatr Clin North Am 1999;46:519-43.
(19.) Taylor AE. Polycystic ovary syndrome. Endocrinol Metab Clin North Am 1998;27:877-902,ix.
(20.) Futterweit W. Polycystic ovary syndrome: clinical perspectives and management. Obstet Gynecol Surv 1999;54:403-13.
(21.) Nestler JE. Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications. Semin Reprod Endocrinol 1997;15:111-22.
(22.) Ehrmann DA. Relation of functional ovarian hyperandrogenism to non-insulin dependent diabetes mellitus. Baillieres Clin Obstet Gynaecol 1997;11: 335-47.
KATHLEEN B. ELMER, MAJ, USAF, MC, FS, is currently serving a residency in dermatology at Brooke Army Medical Center/Wilford Hall Medical Center in San Antonio. She earned her medical degree from the Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, Md., and served as a flight surgeon in the U.S. Air Force.
RITA M. GEORGE, M.D., is currently in private practice of dermatology in Phoenix, Ariz. She was previously chief of the dermatology service at Langley Air Force Base, Va. She received her medical degree from the Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, and completed a residency at Wilford Hall Medical Center, Lackland Air Force Base, Tex.
Address correspondence to Maj. Kathleen B. Elmer, 107 Rimdale, Universal City, TX 78148 (e-mail: kelmer@satx.rr.com).
Reprints are not available from the authors.
COPYRIGHT 2001 American Academy of Family Physicians
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