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NI FEATURE: CENTS (CONCEPTS, ERGONOMICS, NUANCES, THERBLIGS, SHORTCOMINGS) - ORIGINAL ARTICLE
Year : 2016 | Volume : 64 | Issue : 5 | Page : 1002-1009
Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler
Muhammed Afsal1, Veena Chowdhury1, Anjali Prakash1, Sapna Singh1, Neera Chowdhury2
1 Department of Radiodiagnosis, Lok Nayak Hospital, New Delhi, India
2 Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Date of Web Publication 12-Sep-2016
Muhammed Afsal
Room Number 117, Department of Radiodiagnosis, Lok Nayak Hospital, New Delhi - 110 002
Purpose: Traditionally, peripheral nerve lesions are diagnosed on the basis of clinical history, physical examination, and electrophysiological studies, and the role of imaging studies has been limited. The purpose of the study was to assess the usefulness of sonography in diagnosing peripheral nerve lesions.
Materials and Methods: Thirty adult patients with peripheral nerve lesion/s and 30 healthy adult volunteers were included in the study, and sonography of the relevant peripheral nerve/s was done. The mean cross-sectional area (CSA) of the involved nerves were compared using Student t-test.
Results: The study included patients with diabetic peripheral neuropathy (DPN), carpal tunnel syndrome, leprosy, peripheral nerve tumor, and peripheral nerve trauma. There was a significant increase in CSA of the median nerve and ulnar nerve in DPN patients, and of the median nerve within the carpal tunnel in carpal tunnel syndrome (P < 0.0001) as compared to age and sex-matched controls. Sonography showed significant thickening of both the ulnar and median nerves in patients with leprosy. On sonography, schwannoma and neurofibroma had a similar appearance and showed internal vascularity. In case of neural trauma, sonography allowed precise localization of the site and type of nerve injury.
Conclusion: High-resolution sonography is useful in characterizing peripheral nerve lesions and can complement other diagnostic investigations such as the nerve conduction study. It is easily available and has the potential to become the first modality for the evaluation of focal peripheral nerve disorders.
Keywords: High-resolution sonography; leprosy; peripheral nerve; peripheral nerve trauma; peripheral nerve tumor
Afsal M, Chowdhury V, Prakash A, Singh S, Chowdhury N. Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler. Neurol India 2016;64:1002-9
Afsal M, Chowdhury V, Prakash A, Singh S, Chowdhury N. Evaluation of peripheral nerve lesions with high-resolution ultrasonography and color Doppler. Neurol India [serial online] 2016 [cited 2022 Jan 22];64:1002-9. Available from: https://www.neurologyindia.com/text.asp?2016/64/5/1002/190269
The sonographic study of peripheral nerves began in 1988 when Bruno Fornage described the sonographic features of the peripheral nerves and associated masses.[1] Today, technological advances in diagnostic sonography and ultrasound transducers allow the peripheral nerves to be traced in their entire length with structural delineation upto the fascicular level. This has broadened the spectrum of peripheral nerve diseases that can be examined sonographically, allowing the diagnosis and guided treatment of nerve disorders that were previously deemed inaccessible.
» Materials and Methods
Thirty adult patients of either sex with suspected peripheral nerve lesions were included in the study. Thirty healthy adult volunteers were selected from the patient's relatives/hospital employees/colleagues. The study was conducted over a period of 18 months from November 2012 to April 2014. It was approved by the institutional ethics committee and review board, and informed consent was obtained from both the patients and the controls.
Clinical findings and details of relevant examination such as the nerve conduction study were noted. The sonographic procedure was explained to the patients and healthy normal volunteers, and written informed consent in vernacular language was obtained. All patients and controls were examined in the supine position, except for the evaluation of sciatic and posterior tibial nerves, where the patients were examined in the prone position.A detailed sonographic examination of the relevant peripheral nerve was then done using 5–17-MHz compact linear array transducer (iU22; Philips Medical Systems, Eindhoven, the Netherlands), and the peripheral nerve lesions were evaluated as follows:
Focal lesion: Bilateral ulnar and median nerves or any other relevant peripheral nerve were examined, both in the axial and longitudinal sections, throughout their course for any focal lesion. In the cases having a traumatic nerve injury well as neurogenic tumors, first, the involved nerve was identified using a known anatomical landmark, then the transducer was gradually moved to the area of interest; the thickness, echo pattern and vascularity of the involved nerve at the site of involvement were recorded
Diffuse lesions: The cross-sectional area (CSA) of the concerned peripheral nerve was measured in mm 2 for assessing the thickness of the nerve. In diabetic peripheral neuropathy (DPN) and leprosy patients, the CSA of the median and ulnar nerves were measured, and in the cases with carpal tunnel syndrome, the CSA of the median nerve was measured. The median nerve was measured in the carpal tunnel and 10 cm proximal to the wrist, and the ulnar nerve was measured in the Guyon's canal and behind the medial epicondyle
Vascularity of the nerve was assessed
Perineural soft tissue was also examined for any abnormality.
The sonographic findings were then compared with the clinical findings and other laboratory reports.
Similar parameters were recorded for the 30 healthy adult volunteers. For each case of DPN, carpal tunnel syndrome, and leprosy patients, age and sex-matched controls were selected from this group for comparison of sonographic findings.
Results obtained on the basis of high-resolution sonographic study of peripheral nerves of the patients were compared with those of healthy normal volunteers using the SPSS Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. (SPSS IBM Inc., Chicago). Student t-test was used to compare the means. A P value of less than 0.05 was considered to indicate a statistically significant difference.
Peripheral nerves were easily identified using high-resolution sonography by their predictable anatomic location and characteristic appearance [Figure 1].
Figure 1: (a-c): High-resolution sonography of the normal median nerve: Transverse scan in the carpal tunnel (a) and forearm (b), and longitudinal scan in the forearm (c). The normal honeycomb appearance of the nerve is appreciated with hypoechoic fascicles embedded within a hyperechoic background in the transverse scan. In the forearm, the median nerve runs between flexor digitorum superficialis (*) and profundus (+). (c) Longitudinal section showing several parallel echogenic lines within two bold echogenic lines, which represent the epineurium (*)
Five diabetic peripheral neuropathy patients, including 3 male and 2 female patients with a mean age of 56.6 years, were studied. For comparison, age and sex-matched controls were selected for each patient and examined with high-resolution sonography. On high-resolution sonography, there was a diffuse thickening of the peripheral nerve in these patients, and the mean CSA of median nerve and ulnar nerve was found to be significantly higher in patients with DPN when compared to normal matched controls [Figure 2]. On color Doppler assessment, no increase in vascularity was noted.
Figure 2: (a and b) High-resolution sonography of the median nerve in the carpal tunnel (a) and 10 cm proximal to wrist in the forearm (b) in DPN patients. Nerves appear thickened with increase in cross-sectional area. The echopattern appears normal
The mean CSA of the median nerve of patients with DPN was 10.5 mm 2 in the carpal tunnel and 8.69 mm 2 in the forearm 10 cm proximal to the wrist, whereas the CSA was 7.1 mm 2 and 5.89 mm 2, respectively at the same levels in controls. The P values for the CSA of the median nerve of patients with DPN and controls were <0.0001 at the level of carpal tunnel and 0.0004 at the forearm, implying that the difference in CSA was significant. Similarly, the difference in CSA of ulnar nerve between the DPN patients and age and sex-matched controls were also significant, the P values being 0.042 and 0.0052 for the CSA in Guyon's canal and behind the medial epicondyle, respectively [Table 1].
Table 1: Comparison between diabetic peripheral neuropathy, carpal tunnel syndrome, and leprosy
[Table 1] shows the comparison between the CSA of median nerve and ulnar nerve of the patients (with DPN, carpal tunnel syndrome, and leprosy) and age and sex-matched controls.
Six cases of carpal tunnel syndrome diagnosed by nerve conduction study (NCS) were included in the study. For comparison, age, sex, and side-matched controls were taken for each patient. All the patients with carpal tunnel syndrome were females with a mean age of 45.75 years.
The mean CSA of the median nerve at the carpal tunnel of patients suffering from carpal tunnel syndrome was 13.9 mm 2 whereas that of matched controls was 7.89 mm 2, and this difference in CSA was statistically significant (P < 0.0001) [Figure 3] and [Table 1]. The mean CSA of median nerve at the forearm, of patients with carpal tunnel syndrome, was also more than that of age-matched controls; however, this was not statistically significant (P = 0.19). There was a significant difference in the wrist-forearm ratio (which is the ratio of the CSA of the median nerve at the carpal tunnel with that in the forearm) between the patients with carpal tunnel syndrome and matched controls. All the 6 patients with median nerve involvement manifesting as carpal tunnel syndrome showed a central intraneural vascularity, while none of the median nerves in controls showed intraneural vascularity [Figure 3]c.
Figure 3: (a-c) Median nerve in the carpal tunnel (a) and 10 cm proximal to the wrist (b). There is increase in cross-sectional area of the median nerve in the carpal tunnel with an increased wrist-to-forearm ratio. On color Doppler, the median nerve shows intraneural vascularity (c)
Eight cases of leprosy (16 ulnar and 16 median nerve involvement), including 5 male and 3 female patients, with a mean age of 28.25 years were studied. For each case of leprosy, an age and sex-matched control was selected for comparison.
Only 2 of the 16 median nerves examined in the patients were clinically palpable in the carpal tunnel and in the forearm, while on sonography, there was a significant thickening (CSA > mean CSA of age and sex-matched controls + 2 standard deviation) of 8 median nerves in the carpal tunnel and 4 median nerves in the forearm [Table 1]. No ulnar nerve was palpable in the Guyon's canal in patients with leprosy, while on sonography, there was a significant thickening of 10 ulnar nerves in the Guyon's canal. On sonography, there was a significant thickening of the 9 ulnar nerves behind the medial epicondyle, which were all palpable clinically. This shows that clinical examination is unreliable for median nerve and ulnar nerve thickening in the Guyon's canal, whereas it is accurate in diagnosing significant ulnar nerve thickening behind the medial epicondyle.
There was significant thickening of the median and ulnar nerves in leprosy patients compared to age and sex-matched controls [Figure 4]. Patients with leprosy showed a focal and multifocal involvement, as opposed to diffuse involvement in DPN. In leprosy, there was an abnormal echopattern, hypoechogenecity and thickened fascicles [Figure 5]a and [Figure 5]b. Median and ulnar nerves in some patients with leprosy showed an increased vascularity [Figure 5]c and [Figure 5]d. Sonography was also sensitive in detecting complications of leprosy such as an intraneural abscess, which was detected in 2 patients, and neural and perineural inflammation, which was detected in 3 patients. Intraneural abscess was seen as a relatively well defined, heterogeneously hypoechoic area within the nerve with moving internal echoes and peripheral vascularity, whereas perineural inflammation was seen as an ill-defined heterogeneity adjacent to the nerve trunk with vascularity within [Figure 6].
Figure 4: (a-d) Nerve thickening in leprosy. There is an increase in cross-sectional area of the median nerve in the carpal tunnel (a) and forearm (b) and ulnar nerve in the Guyon's canal (c) and behind the medial epicondyle (d)
Figure 5: (a-d) Patients with leprosy showing an abnormal echopattern of the peripheral nerves (a, b) and vascularity. (a): Median nerve in the carpal tunnel showing thickened fascicles; (b): Ulnar nerve in the lower arm showing a hypoechoic echopattern with loss of normal honeycomb appearance or a fascicular pattern. On color Doppler, there is intraneural vascularity in the median nerve in the carpal tunnel (c) and in the ulnar nerve in the lower arm (d) in patients with leprosy
Figure 6: (a-d) Nerve abscess and perineural inflammation in leprosy. Gray scale high-resolution sonography of the ulnar nerve in the arm in longitudinal (a) and transverse axis (b) showing a heterogeneously hypoechoic collection with moving internal echos within the ulnar nerve. On color Doppler, there is peripheral vascularity around the abscess (c). Adjacent normal nerve and perineural tissue also show increased vascularity suggestive of inflammation (d)
The CSA of the median nerve in the carpal tunnel and the ulnar nerves in the Guyon's canal and behind the medial epicondyle were more in leprosy patients as compared to DPN patients. This increase in CSA was statistically significant behind the medial epicondyle (P = 0.047). The ulnar nerve behind the medial epicondyle showed an abnormal echopattern in 60% of DPN cases and 56.25% of leprosy cases. An abnormal echopattern was not observed in the median nerve and the ulnar nerve in Guyon's canal in DPN patients, while it was present in leprosy patients; 12.5% of the median nerves in the carpal tunnel, 18.75% of the median nerves in the forearm, and 25% of the ulnar nerves in the Guyon's canal showed an abnormal echopattern [Table 2].
Table 2: Comparison between sonographic features of diabetic peripheral neuropathy (n=10) and leprosy (n=16) including the nerve cross-sectional area and echopattern
Neurogenic tumors
There were 6 cases of neurogenic tumors, of which 5 were schwannomas and 1 was a neurofibroma. Four of the patients were male and 2 female, with a mean age of 42.25 years.
All the tumors had a hypoechoic appearance, and continuity with parent nerve could be appreciated [Figure 7]. On color Doppler, all the cases showed an internal vascularity [Figure 7]c and [Figure 8]b. One of the schwannomas was located eccentrically whereas the rest were located centrally in the peripheral nerves and showed a heterogeneous appearance with cystic areas within [Figure 8]. Both the schwannomas and the neurofibroma had a similar sonographic appearance, making it impossible to differentiate them by sonography; however, an eccentric location and marked heterogeneity favored the diagnosis of a schwannoma.
Figure 7: (a-c) Schwannoma: High resolution sonography findings. (a, b) showing a hypoechoic fusiform-shaped mass lesion in the thigh. The continuity of the lesion with the sciatic nerve can be appreciated (b). The color Doppler in the same patient showing peripheral and central vascularity within the lesion (c)
Figure 8: (a, b) High-resolution gray scale sonography (a) and colour Doppler (b) showing a heterogeneous lesion with cystic areas within, arising eccentrically from the posterior interosseous nerve and showing peripheral and central vascularity within
A total of 6 patients who had sustained trauma to the nerves were studied. They included 5 male patients and 1 female patient, all <30 years of age, with a mean age of 19 years. All the patients in the study had suffered from trauma of the upper limb nerves; 3 median nerves, 2 ulnar nerves, and 1 radial nerve. The epineurium could be easily visualized and nerve injury could be classified as exonotmesis, partial transection, and complete transection. All the 6 nerves involved in trauma showed thickening [Figure 9]. Other sonographic features seen were the development of a scar tissue, discontinuity in the epineurium, and a neuroma. Complete discontinuity of the epineurium was found in 1 case suggesting complete transection, and partial discontinuity suggesting partial transection was found in 2 cases [Figure 10]. The epineurium of rest of the 3 nerves were continuous. The neuroma appeared as a hypoechoic structure with no vascularity [Figure 11].
Figure 9: (a) In a follow-up case of trauma, high-resolution sonography showing thickening of ulnar nerve in the lower forearm with thickened fascicles. The epineurium is intact. (b) In another follow-up case of trauma, high-resolution sonography showing scar tissue (*) around the median nerve (+) in the lower forearm, which appears thickened. The epineurium is intact
Figure 10: Partial transection of the nerve: High-resolution sonography in the axial (a) and longitudinal (b) plane of median nerve shows discontinuity in the epineurium lying proximal to the transducer (marked between +), with an intact epineurium lying distal to the transducer suggestive of partial transection. Adjacent scar tissue is also noted
Figure 11: Side neuroma (a, b) and end neuroma (c). In a follow-up case of trauma, high resolution sonography in axial (a) and longitudinal (b) planes of median nerve shows an eccentric hypoechoic lesion within the median nerve causing bulge in the epineurium lying proximally to the transducer, suggestive of a side neuroma. In another follow-up case of complete transection of the radial nerve, the distal aspect of the proximal segment shows a well-defined hypoechoic lesion suggestive of an end neuroma (marked with *) in the spiral groove (c)
Peripheral nerves can be easily identified by their predictable anatomic location and characteristic appearance.[2] On longitudinal scanning, the nerves were visualized as multiple hypoechoic bands, corresponding to the neuronal fascicle, and separated by hyperechoic lines, corresponding to the perineurium. A bright rim, the epineurium, bordered each nerve. Axial scanning revealed a honeycomb appearance with a network of hypoechoic rings separated by hyperechoic lines. In the regions where peripheral nerves were accompanied by vascular structures, the use of color Doppler could help in the distinction of nerves from vessels. This was helpful in differentiating the ulnar nerve from ulnar artery in the Guyon's canal.
High-resolution sonography showed a significant increase in the CSA of median and ulnar nerves in the DPN patients compared to age and sex-matched controls. No increase in the intraneural or perineural vascularity was noted. Similar findings have been reported by many of the recent studies.[3],[4],[5] In DPN, there is diffuse involvement of the peripheral nerve, and in leprosy, there are no focal lesions. Peripheral nerve swelling in the setting of DPN presumably stems from an increased water content as a by-product of the aldose reductase conversion process of glucose into sorbitol.[6]
Carpal tunnel syndrome is a common condition, affecting an estimated 500 in 100,000 persons per year or 1–2% of the total adult population.[7] Six median nerves with carpal tunnel syndrome were studied, and there was a significant increase in the CSA of the median nerve in the carpal tunnel (P < 0.0001) and of the wrist forearm ratio (P = 0.0003) in these patients compared to age and sex-matched controls. Many explanations have been suggested for the increase in size of the nerve proximal to the site of entrapment such as endoneurial oedema, disturbance of axonal transport, and inflammation. Central intraneural vascularity was also observed in all the affected nerves, whereas none of the median nerves in age and sex-matched controls showed intraneural vascularity. Many previous studies have also reported similar findings.[8],[9],[10],[11],[12],[13]
Leprosy is the most common treatable peripheral nerve disorder worldwide.[14] Sonography showed a significant thickening of both the ulnar and median nerves in patients with leprosy when compared to age and sex-matched controls. This nerve thickening was more extensive and involved more nerves than was clinically diagnosed. The study also showed that clinical examination is unreliable in detecting significant thickening of the median and ulnar nerves, except for the finding of ulnar nerve thickening behind the medial epicondyle. Ulnar and median nerves in patients with leprosy also showed abnormal echopatterns, intraneural vascularity, intraneural abscesses, and intraneural and perineural inflammation. These findings were consistent with other sonography based studies conducted among leprosy patients.[15],[16]
Both patients with DPN and leprosy showed diffuse thickening of the peripheral nerves. However, the nerve thickening was significantly more behind the medial epicondyle in the patients having leprosy compared to patients with DPN. Abnormal echopatterns, focal lesions with thickening, and increased vascularity were not seen in DPN patients while they were present in leprosy patients.
Among neurogenic tumors, both schwannomas and neurofibromas appear hypoechoic with vascularity within its substance. Most of the neurogenic tumors were located in the central part of the nerve except the single case of schwannoma, which was eccentric in location. These characteristic appearances of neurogenic tumors have also been described in few other studies.[17],[18] Sonography was not able to differentiate a schwannoma from a neurofibroma because of their similar imaging appearance; however, an eccentric location of the tumor favoured a schwannoma.[19]
Traumatic peripheral nerve injuries occur from a variety of causes and their prevalence among patients who have had a traumatic injury is approximately 2.8%. Such injuries are increasingly recognized because of improved trauma services.[20] In our study, remote traumatic injuries involving 6 peripheral nerves were studied. All the cases involved the upper limb nerves and majority of the patients were males. The nerve which was suspected to be injured could be identified in all cases, and sonographic features correlated with clinical symptomatology. Other studies have also reported a high sensitivity and specificity for the detection of peripheral nerve injury by sonography.[21],[22] The most common sonographic features observed in nerve trauma was nerve thickening, which was noted in all the cases. The epineurium was seen as an echogenic line surrounding the nerve, and could be identified in all the cases. It was normal in 3 cases, showed partial discontinuity in 2 cases, and showed complete discontinuity in 1 case, suggestive of complete transection of the nerve. Intraneural and perineural scar tissue were present in 4 cases but absent in 2 cases. Two of the injured nerves showed a neuroma, which results from random proliferation of axons, The Schwann cells and fibroblasts, were admixed together to form a non-neoplastic mass. Out of this, one was an end neuroma seen in a patient with complete transection of the radial nerve, and the other was a side neuroma seen in another patient with partial transection of the median nerve. The neuroma appeared as an irregular hypoechoic structure within the nerve at the site of trauma with no internal vascularity. The imaging appearance of a traumatic neuroma in our study was the same as described in previous studies.[23]
Our study showed that a high-resolution sonography is an adequate and cost-effective noninvasive method for evaluating peripheral nerve disorders. Careful examination with an accurate scanning technique and a good knowledge of the anatomic relationships of the nerves to the surrounding structures provides an accurate information to the clinician for selecting the appropriate treatment. It may be used either as a first-line imaging modality in patients with suspected peripheral nerve lesions before further treatment is administered. It is also extremely useful for follow-up imaging. Ultrasonography permits the direct assessment of pathologic changes in nerve structures and/or in the adjacent tissue. These nerve lesions were traditionally diagnosed on the basis of clinical history, physical examination, and electrophysiological studies, including electromyography and nerve conduction studies. Although electrophysiological studies are helpful in determining the location and severity of the underlying nerve injury, they cannot determine the structural causes of denervation. Magnetic resonance imaging can be used to evaluate the peripheral nerve and localize the lesion; however, it has the limitations of availability and cost.[24]
The main limitation in our study was that the number of patients with each of the pathological conditions were too few for a statistically significant result to be obtained. This was mainly due to the short duration of the study. Further, all the cases of nerve trauma studied were follow-up cases; larger studies are needed to evaluate the utility of high-resolution sonography in diagnosing acute nerve injury. An important limitation is that musculoskeletal ultrasound is an operator-dependent modality, which needs focused training.
I am greatly indebted to Dr. Vinod Puri, Director Professor and Head, Department of Neurology, GB Pant Hospital and Dr. MM Mehndiratta, former Director Professor, Department of Neurology, GB Pant Hospital for their support and suggestions in carrying out this study.
There are no conflicts of interest
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11]
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It's been nice to have been back in a bit of a workout routine of late. Until today, when I had a mild asthma-meets-low-blood-sugar episode at the end of my trainer session (dizziness is not cool, body, step it up!), I have been feeling stronger and stronger as I have been adding in new routines to my workouts. The scale hasn't budged as much, but I know I am adding muscle, dropping some fat, and things will even out soon enough. I haven't been in the gym more, per se, but have been trying to make the most of the time I am in there.
On Saturday, for example, I visited the brand new LA Fitness in Buckhead (omg gorg by the way!), and ran a mile on the treadmill before hitting spin class for an hour. Double duty? Kind of. But I have to show up early to reserve a bike, anyways, so I might as well get in a little jog. I only wish that I had the time (and energy) to do that kind of workout every day!
This coming weekend, I am making the most of the day by participating in a cool race right here in town. The 9th Annual Junior League of Atlanta's Shamrock 'N Roll Road Race presented by Verizon Wireless and Belk is being held on Sunday, March 10, 2013. The Shamrock 'N Roll features a family friendly 5k, 10k and the Leprechaun Dash for Gold Tot-Trot for little runners ages five and under (cute!!).
Are you running the Shamrock too this year? It's not too late to sign up. Here are some details, if you are interested in the race.
Hosted by The Junior League of Atlanta (JLA), this ninth annual event raises funds to train and educate the membership of JLA for effective community service, as well as to continue its work in the community.
Registration is $30 in advance, $35 at packet pickup and $45 on race day. Tot Trot registration is $8. Register today at Active.com or www.shamrocknroll.org.
Pick up your packet and finish late registration at West Stride Running Store, 3517 Northside Parkway #11, Atlanta, GA 30327, (www.weststride.com) Friday, March 8 12-7PM. or Saturday, March 9 10-5PM. Packets can also be picked up race morning at the registration desk.
Stay up-to-date on all the Shamrock 'N Roll Road Race news and updates as a fan on http://www.facebook.com//ShamRockNRollRoadRace or by following @JLShamRockNRoll on Twitter.
Disclaimer: The JLA has provided me with registration for the race, but all opinions are my own. Happy racing, everyone!


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Home Health Omicron-fuelled fifth wave: Pakistan announces new travel advisory
Omicron-fuelled fifth wave: Pakistan announces new travel advisory
As a looming fifth wave of the coronavirus epidemic, this time fuelled by the Omicron variant, sends alarm bells ringing, the Civil Aviation Authority (CAA) has made PCR testing mandatory for everyone flying in from overseas. The test has to have been conducted a maximum 48 hours before every traveller's flight.
The CAA has said all travelers aged 15 and up will be required to present a negative coronavirus test report upon arrival in Pakistan.
All travelers flying from European countries will be required to take a Rapid Antigen Test upon arrival, while half of the flights from Saudi Arabia and UAE will also have to take Rapid Antigen Test.
Following are the new guidelines as announced by the CAA:
Mandatory COVID-19 vaccination and possession of proof of COVID-19 vaccination. This is applicable for all passengers above 15 years of age.
Valid negative PCR test result conducted within the 48 hours prior to commencement of travel to Pakistan. This is applicable for all passengers above 06 years of age.
Rapid Antigen Testing upon arrival for all direct flights from Europe
Rapid Antigen Testing upon arrival of a minimum of 50% inbound flights from KSA, UAE and Qatar
Selective Rapid Antigen Testing for all inbound flights other than flights mentioned at (c) and (d) above.
According to the CAA, passengers will be required to be quarantined for 10 days if they test positive.
Passengers will have the option of isolating themselves at their own expense in hotels or other locations. The CAA stated that travellers will not be charged for expenses incurred at quarantine centres set up by the health department.
The new travel advisory will take effect on January 5 at the direction of the National Command and Operation Center (NCOC), according to CAA.
The fifth wave of COVID-19, which is driven by the Omicron variant, is spreading at a rapid pace in the country, the National Command and Operation Centre said Monday as Pakistan reported its highest number of daily infections in over two months.
While addressing the epidemic curve chart data, the national immunisation plan and disease prevalence across the country in a morning session on Monday, the NCOC confirmed that the positivity rate in Karachi has risen from 2% to 6% in the last three days, with the highest number of positive instances.
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Crime Report
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Forest City, NC (28043)
Foggy this morning, then partly cloudy this afternoon. High near 45F. Winds W at 10 to 20 mph..
Clear skies. Low around 25F. Winds WSW at 5 to 10 mph.
ACA open enrollment deadline nears
By SCOTT CARPENTER scarpenter@thedigitalcourier.com
scarpenter
Dec 2, 2020 Updated Jan 8, 2021
FOREST CITY — Less than two weeks remain for people in need of health insurance to sign up for Affordable Care Act (ACA), also known as Obamacare, before the deadline of Dec. 15.
Pisgah Legal Services (PLS), and its enrollment partners, are offering free assistance to people in their 18-county service region including Rutherford, helping them review their options and sign up for plans.
Officials say the COVID-19 outbreak is making health coverage even more important in these difficult times.
"This is the most critical open enrollment period of my career, and I've been at Pisgah Legal Services for all of them," says Jackie Kiger, chief operations officer. "With high unemployment and the fact that North Carolina hasn't expanded Medicaid, there are many more uninsured people. We are seeing people who have lost jobs, income and insurance and who are struggling with the unemployment benefit system."
The ACA is the law that ensures access to quality, affordable health insurance on the Health Insurance Marketplace. With these plans, consumers are protected and can't be denied coverage for a pre-existing health condition and can't be dropped for getting sick; insurers can't charge higher premiums to women; and insurers can't sell substandard plans that don't pay for essential health care benefits.
PLS and enrollment partners offer residents free health insurance information and enrollment assistance through the N.C. Health Insurance Marketplace. These other partners are the Council on Aging of Buncombe County, Blue Dirge Community Health Services, Legal Aid of North Carolina, Mountain Projects and Western Carolina Medical Society. Citizens can also enroll directly through the website Healthcare.gov.
Scenes from the unprecedented security around Capitol Hill
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PLS has offices across western North Carolina, including Main Street, Rutherfordton. Appointments can be made online at www.pisgahlegal.org/aca or by calling 828 210-3404.
For the safety of consumers, staff and volunteers, all appointments are currently being conducted by telephone.
Shannon Cornelius, PLS health justice program director, says: "We are seeing very strong interest this year in sign-ups, but we still have some openings for safe and contact-free help with our trained assisters. There is still time to make and appointment if you act quickly."
Financial assistance for health insurance is still available to those who qualify. Last year, more than 90% of North Carolinians who enrolled for coverage through the health insurance marketplace received financial assistance to make their plans more affordable. Subsidies are based on household taxable income and may be difficult for consumers to calculate themselves. PLS can help with this process and can factor in unemployment benefits if needed. PLS can also answer questions about other coverage, such as COBRA, and help people apply for Medicaid.
John Carroll, Rutherford County Department of Social Services director, sees firsthand how people are struggling financially.
"It is important that everyone have health insurance, probably even more so now due to COVID-19," Carroll said. "We encourage those that believe they qualify for Medicaid, to apply, keeping in mind that in North Carolina only those responsible for a child 18 years old or younger, or are blind, or have a disability or has a family member in their household with a disability, or are 65 years old or older can receive Medicaid. If someone applies for Medicaid and is found ineligible they are referred to the ACA. If they apply for coverage through the ACA they are screened for Medicaid and referred there if they are likely eligible."
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We all know it: the potential for Machine Learning practitioners to make a breakthrough and drive positive outcomes is unprecedented. But how do you take advantage of the myriad of data and ML tools now available at your fingertips? How do you streamline processes, speed up discovery, share knowledge, and scale up implementations for real-life scenarios? Databricks Unified Analytics Platform is a cloud-service that provides you with ready-to-use clusters to handle all analytics processes in one place, from data preparation to model building and serving, with virtually no limit to how much you can scale.


It's too bad FX's The Americans was completely snubbed at the Emmys this year (all but Margo Martindale anyway), because I still have it down as one of the best new shows of 2013, and if there's only room for one spy thriller at awards shows, I'd choose this over Homeland, especially this season.
Set in 1981, at the beginning of Reagan's presidency and escalating tensions between the U.S. and Soviet Union, two Russian spies are hiding out in plain sight, as ordinary Americans who've been undercover for almost twenty years. They are Phil and Elizabeth Jennings, a married couple with two children, and they're played by Keri Russell and Matthew Rhys, who give two incredibly nuanced and sensitive performances- I immediately warmed to both of them from the pilot episode. Rhys is the softer one, at the beginning of the season he even considers defecting to the U.S., and he's the one who harbors feelings for his wife, even though their marriage was arranged by the state and she's never fully returned his affection. Elizabeth is still 100% loyal to "Mother Russia" and is a very icy and hard hearted spy who doesn't waver in her determination or her hatred of Americans. I wasn't expecting Keri Russell to be able to pull of that kind of hard edged bent, and was very surprised that she in fact did- she's an effective and cold antiheroine, one of the few on TV. Although in her cover role as an ordinary American, mother and neighbor, she's even more effective at conveying the sort of kindly, sweet qualities I've associated with her ever since her days on Felicity, and that all comes together to let us believe her as the kind of spy that can fool people in an instant.
The show alternates between focusing on the real or not marriage between Phil and Elizabeth, and the missions they're instructed to pull off by their Russian contact, played with steely eyed determination by Justified's Margo Martindale. There's occasional focus on the events of the time period, but nothing that strains real history as it took place. Their neighbor across the street is FBI agent Stan Beeman, whose job it is to suss out Soviet spies living among us (convenient coincidence, but necessary for dramatic purposes), and he's played by Noah Emmerich, who gives an outstanding performance here as a high level bureaucrat with secrets and troubles of his own, which slowly come to fruition over the course of the season. It can occasionally feel like a separate show with the focus split between Stan's activities and those of our two leads, but both are equally compelling, thanks to some great acting from Emmerich, and most surprisingly, unknown actress Annet Mahendru, playing Nina, Stan's Soviet mole inside the KGB.
The show takes its time to develop and explore relationships between characters, often foregoing big plot developments to focus more on smaller, intimate moments. There's an ongoing story developing here (it's not at all a procedural), but it seems to be playing out on a larger scale, trusting the audience to stay with it, even into the next season, as some plot threads are left hanging and cliffhangers you may have expected to be set up aren't. That's not to say that there's no action- there is in fact, plenty, but in contrast to a show like Homeland, not everything pays off in the first season, but promises to keep going, leaving the possibility for characters and storylines to become even more entangled as the series continues. Another tip the Homeland people can take note of is how to deal with the families of the spies- Phil and Elizabeth have two teenagers, and though the kids get enough screen time, they are decidedly not overly focused on at the expense of the more interesting adults and happily, not given the personality of a demon spawn that we wince at every time they show up (ok, ok, enough shots at Dana, no more, I promise).
The show's not perfect- the relative quietness of the drama may bug some people who expect more from a spy thriller, and the various wigs and disguises the Jennings's don are a bit laughable at times- were people in the 80's really that gullible? But the show's look at a time and place in recent history is extremely intriguing, and with some really good acting that's a lot better and more emotionally subtle than some of the stuff that was just nominated on House of Cards (ahem, Kevin Spacey and Robin Wright stole Russell and Rhy's slots, in my opinion), I recommend checking out The Americans for sure.
July 30, 2013 by Ariel Shavonne.


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Home>UAE Golf News>Ras al Khaimah Golf Challenge News, Results and Information>Adria Arnaus remains top of the pile
Ras al Khaimah Golf Challenge News, Results and InformationRoad to Ras al Khaimah Challenge Tour News, Results and Information
Adria Arnaus remains top of the pile
Spaniard Adria Arnaus in pole position heading into last day of Ras Al Khaimah Challenge Tour Grand Final
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Adria Arnaus on the 15th
Adria Arnaus will head into the final round of the Ras Al Khaimah Challenge Tour Grand Final with a three-shot lead over a quartet of players after the Spaniard carded an impressive five under par 67 at Al Hamra Golf club to top the leaderboard for the third consecutive day.
Arnaus, who is currently ranked ninth in the Road to Ras Al Khaimah in his first season as a professional, started his third round with a bang after picking up two shots in his first three holes before making his third birdie of the day at the eighth to make the turn in 33. The 24-year-old then shot a back nine of 34 to put one hand on his first piece of European Challenge Tour silverware which could see him rise to second in the Rankings.
"I am enjoying the week and everything has been working well," said Arnaus. "It would be very special for me to win this tournament, overall it has been a great and fun year and to end it with a victory would be awesome.
"It's important that I get a good result as I want to finish as high as I can in the Road to Ras Al Khaimah Rankings. That could be the difference in getting into more European Tour events next season. There are 18 more holes to play and at the end of the day so we will see what happens."
Daan Huizing, Victor Perez, Romain Langasque and Sean Crocker all share second place after a day of low scoring at the season finale.
Langasque started the week ranked 25th in the Road to Ras Al Khaimah but if the tournament were to end as it is, he would rise to 15th in the Rankings and seal the final coveted European Tour card for next season.
"I feel like my game has been pretty solid this week but I seem to mess up one or two holes," said the Frenchman. "It was difficult out there today due to the wind and the course was tough work so it's hard to have a perfect round.
"I've given myself a chance of securing a European Tour card which is really special for me and I will give everything until the end. I need to stay calm and focused heading into the final round and hopefully, I can achieve my objective. "
Max Orrin carded a five under par 67 – the joint lowest round of the day – to rise from the bottom of the leaderboard to tied 29th. The Englishman is targeting a big final round after coming into the tournament in 16th on the Road to Ras Al Khaimah and on the cusp of promotion to the European Tour.
"I've come into today with a fresh mindset and knowing that I needed two really low rounds to give myself a chance of finishing in the top 15 of the Rankings, "said Max Orrin. " I played really well, hit some nice shots and holed some good putts which were a lot better than I've done the first two days.
"It's special for us guys to reach the European Tour, it's everything we play for all year. You work hard to try and climb the golfing ladder and obviously, when you're so close coming into the season-ending event it's an even bigger thing. I've played well today so at least I've given myself a chance."
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Jessica Walters on Healing Hashimotos, brainfog, candida overgrowth, IBS, sugar craving and fatigue.
"Hi! My name is Jessica Walters. My experience with the Feel Good Foods Reboot system has been amazing! I have hyperthyroid and autoimmune condition, Hashimotos. So some of my symptoms when I started were brain fog, candida overgrowth, circulation problems in my feet and my hands were freezing, my gut was a mess, it would hurt and I would have a lot of problems. And I think my sugar cravings were on the high as well.
So, some of the things that I've noticed since I've been on it, it's my 90-day mark since I've been on this system and I think one of the first things that I noticed was that my insides didn't feel raw anymore. That was amazing for me!
I attribute that to the candida being killed off. The candida was virtually almost gone, occasionally I would feel something from it, but so much better than it was before. The brain fog was the next thing I noticed an improvement on. That improved a ton. I feel like my old self again which is amazing!
And then most recently I have noticed that my circulation has gotten better so if I turn the heater on to the temperature of 74, that's what I usually put it at, it feels hot and I noticed when I get in bed, my hands and feet aren't popsicles anymore. It's really just been amazing!
Sugar cravings down, brain fog I would say is gone, insides feeling good, and candida kicked to the curb. So it's really awesome and I look forward to continuing because I know that there's even more good things to come from it. If youre considering trying it, I would totally recommend it. You don't have anything to lose really, but wasting time.


Advent is described as an anticipatory time of waiting and preparing for the Child to be born. There is almost a passive sweetness in just "letting it happen" as it was written and taught to us. But Advent also reminds us of His eventual return and as such it becomes a call to action. We must get off our duffs and get ready.
There are scores of words that describe what we are called to do while we wait, preparing for the second Advent: believing, blessing, comforting, departing, enduring, expecting, feeding, forgiving, glorifying, hoping, identifying, journeying, keeping, loving, listening, marching, naming, obeying, pondering, quieting, renewing, repenting, stretching, trembling, treasuring, trusting, unfolding, voicing, watching, worshiping, exalting, yielding, filling with zeal. It's more than plenty to keep us busy.
There is nothing passive about Mary's response to the angel's message. She actively and willingly is accepting the call to become someone new.


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Boeing, Textron units win potential $475M Special Operations unmanned ISR contract
By Ross Wilkers
Boeing's Insitu and Textron's AAI Corp. subsidiaries have won positions on a potential six-year, $475 million contract for unmanned systems and related intelligence, surveillance and reconnaissance services to Special Operations Command.
The Mid-Endurance Unmanned Aircraft Systems III contract covers a 54-month base period, followed by four 12-month ordering periods and then an added six-month ordering period.
MEUAS III calls on awardees to provide UAS for launch, control and recovery missions to perform ISR functions and inject full-motion video into host systems, according to Deltek. Work under MEUAS III also includes site surveys to assess the adequacy of infrastructure to support ISR operations.
Insitu and AAI will compete for task orders to carry out the ISR services at multiple locations worldwide through June 2022.
AAI is also one of three companies participating in a five-year, $900 million contract awarded in April for technical services and field support to the Army for unmanned systems.
Ross Wilkers is a senior staff writer for Washington Technology. He can be reached at rwilkers@washingtontechnology.com. Follow him on Twitter: @rosswilkers. Also find and connect with him on LinkedIn.


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Federal Budget 2022
Home » Advocating for change » Federal Budget 2022
The Federal Budget has put faith in a business-led pandemic recovery, offering a suite of incentives that reward "aspiration and enterprise".
The Budget introduces tax incentives for small businesses, skills development and technology, while responding to inflationary pressures, higher global fuel prices and skills shortages.
In a "Budget for uncertain times," our national finances have significantly improved, spurred by Australia's stronger-than-predicted recovery from the COVID recession, and low unemployment.
With unemployment set to fall as low as 3.75 per cent, the Budget confirms expectations that the skills squeeze will remain tight for coming years. However, a booming economy and GDP growth that outpaces major developed nations ensures WA is well-positioned to take advantage of the opportunities ahead.
Here's what the Federal Budget means for WA businesses.
Boosting skills with apprentices, trainees
The Budget earmarks billions in funding to increase apprenticeships, including to extend the successful Boosting Apprenticeship Commencements and Completing Apprenticeship Commencements programs for a further three months until June 30, 2022.
A new streamlined Australian Apprenticeships Incentive System is aimed at developing apprentices in priority trades.
The Government has also allocated funding for an extra 800,000 training places, while small businesses will receive a bonus 20 per cent deduction for the cost of external training courses from now until June 30, 2024.
Workforce participation incentives
The Budget commits $346.1m over five years to reform the Paid Parental Leave system to allow working parents to decide how they share 20 weeks of leave. This will benefit thousands of parents, and enable more women to participate in the workforce.
$19.4m has also been added to the existing Community Child Care Fund to establish up to 20 childcare services in regional and remote areas.
Measures for SMEs
The GDP 'uplift' for PAYG instalments will be reduced from 10 per cent to 2 per cent, reducing businesses' quarterly tax bill. It also flags several tax related red-tape reduction initiatives that will reduce compliance costs for businesses across a range of sectors.
A bonus 20 per cent deduction will apply from now until June 30, 2023, for expenses and assets that support technologies such as cloud computing, e-invoicing, cybersecurity and web design.
The Budget includes funding for a new patent box for low emissions technology and agriculture, with taxes applied at almost half the corporate rate.
The Government has also outlined procurement reform, with major projects split into smaller components, which will help SMEs compete against larger bidders.
Industry and infrastructure funding
The Budget confirms $328.3m in additional funding for the Modern Manufacturing strategy, including $53.9m to enable small to medium manufacturers to innovate and adopt new technologies. There is also $250.5m to help early-stage Australian critical minerals projects reach market readiness.
Key infrastructure projects include $4.3b for a large vessel dry dock at Henderson, $1.5b to boost low emissions production in the Pilbara, and $1.7b on WA road and rail projects.
There is also $1.3b for improving regional mobile telecommunications and NBN Co's fixed wireless network nationally.
There is $468.3m to implement the Government's response to the Royal Commission, and $458.1m to manage the impacts of COVID-19. This includes $215.3m over two years to provide staff retention bonuses of up to $800.
$49.5m has been set aside to provide an additional 15,000 low and fee-free training places for existing and new entrants to the sector.
While these measures are welcome, they are unlikely to be sufficient to address the crippling workforce shortages the sector is facing, with no funding in the budget to enable providers to increase wages.
CCIWA Breakfast with The Federal Treasurer
You can hear from Federal Treasurer Josh Frydenberg in his only post-Budget speech in Western Australia at CCIWA's exclusive Business Breakfast on April 5.
CCIWA Federal Budget Breakdown
Watch Aaron Morey present expert insights on the Budget and what it means for WA's business community and economy in this 1 hour webinar.
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The iX series comprises coaxial speakers optimised for high level fixed installation in terms of ergonomics, finishes and accessories. Volume – Column speakers do not tend to be as loud as complete-size vertical line arrays. At the moment, parents are in the midst of a fierce battle over their children. Pop culture, aided by mass media, bombards impressionable youth with worth systems in conflict with these of parents and schools. Reality shows such as Pimp My Ride, American Idols, and Cribs depict life of lavish living on Simple Street. Nevertheless, the producers in no way talk about the cost of fame. To achieve street credibility, rappers exchange rap music for police rap sheets. Sadly, pop culture portrays accomplishment like it is low-cost penny candy. For that reason, our kids who are raised on the emptiness of pop culture, are destined for a rude awaking as reality hits. Some liberal thinkers think that exposing youth to adult material will make them much better folks. This is not the case. Alternatively it leaves young people with a false confidence that they know almost everything about life. POLAR 10 consists of a subwoofer and two columnar components. The sophisticated contours of the subwoofers birch ply housing are not just cosmetic the enclosure is acoustically shaped and sized to provide excellent audio benefits in combination with a specially created ten" woofer sporting an added-extended voice coil. Driven by a muscular 2,000-watt energy amplifier, this mixture delivers wealthy, low-ranging bass response that packs an impressive punch even at high volumes. COM40 aluminium body outdoor column speaker: 100V, 40W rated energy with one hundred Hz – 15 kHz frequency range, 94dB sensitivity, IP54. Principal application for outdoor use, where straightforward and trustworthy remedy is required for heavy climate situations. COM 40 has built-in four 5″ (127 mm) complete range speakers. The secret of the Bose L1 technique lies in a clever design that sends sound out on a wide horizontal sweep, but minimises its vertical range. This implies that there is no reverberation caused by sound bouncing off the ceiling, as in most standard systems. It also signifies that, since the Bose L1 method can deliver sound at close to a 180 degrees sweep, everyone will hear it, even those at the sides of the theatre. Teufel's Cubycon series provides micro surround speakers in a higher-finish format. Cubycon surround sound sets make an unbelievable sound from modest and incredibly stylish enclosures so that the choice between micro speakers or higher-finish becomes moot. It merely is not feasible to pack in more high-finish sound per cm². To best it all off, the higher-performance subwoofers that come with each program endow them with a deep however puch bass that Teufel is renowned for. Cubycon systems deliver high-definition sound for motion pictures as properly as music and games. A reference cost is provided by the seller of the item (Solid Worth). Percentage off and savings amounts are primarily based on the seller's reference price. Sellers are not necessary to supply a reference price, but if they do, it need to be (a) the Manufacturer's Suggested Retail Value (MSRP) or comparable List Price tag of the product or (b) the price tag at which the item has been lately supplied for sale and for a affordable period of time. If you feel a reference price tag is inaccurate or misleading please report it with the URL for the listing to report-abuse@. Identified in 1972, Polk Audio holds their headquarters in Baltimore, Maryland. In 2006, Directed Electronics acquired the company. It was currently a fantastic manufacturer but right after the acquisition, Polk Audio just got better. They are most recognized for house and automobile speakers and have a large market place as properly for other audio products such as FM tuners and amplifiers. The organization is certainly reputable and they claim to be 1 of the most trusted names in Surround Sound. The MC2 takes benefit of the d'Appolito principle, creating it 1 of the most efficient in its category specifically for vocal applications and low power distributed sound. With one hundred dB sensitivity in a completely controlled 90°H x 40°V coverage pattern. These column speakers offer the perfect combination of looks and acoustical qualities! The COLW101 has 10 x three,three" woofers and 1 x 1″ tweeter. A normal wall bracket and installation tools are included. As we pointed out earlier, these brands specialize in 1 or far more than one sorts of audio speakers. A particular manufacturer might make the ideal set of audio speakers for your home entertainment program but they are not necessarily the ideal for transportable Bluetooth speakers.
27. Seismic Audio Speakers, Inc. Acoustic column with energy rating of 80 W (selectable to 60 and 40 W) in 100 V line. 4 x five" bicone speaker. Frequency response of 100-17.000 Hz. Sensitivity 96 dB (1 W, 1 m and 1 kHz). Maximum sound stress level 115 dB (80 W, 1 m and 1 kHz). Weight 5.7 kg. Dimensions 197 x 905 x 118 mm. OPTIMUS model ref. C-1480. There are 60 diverse models to pick from in the wide catalogue of electronics that Cambridge SoundWorks gives. This involves property stereos, house theater systems, multimedia speakers and a lot more. Pattern Coverage – Point supply speakers attain pattern coverage based on their size, with the size and shape of the horn mainly being the determining factor, dictating how wide or how narrow the mid and higher frequencies cover. The bigger the horn, the far better the pattern control. A lot of times, the pattern manage of traditional cabinets is all that is necessary for modest- to medium-sized rooms. Most people's experience with point supply speakers includes systems that use small cabinets with modest horns, but different size alternatives are worth exploring. Bass speakers successfully total the full-range speaker systems in the low frequency variety. The ITEC Powerbass series is perfectly in tune with the ITEC sound columns and leading parts. All models have a water-resistant glued, bass reflex birch plywood housing with shock-resistant PU coating, a ballproof speaker cover, carry handles and a tripod mount. When it comes to sound, the Ultimate Ears BOOM two scores with its 360 degree surround sound. The sound makes a quite spatial impression, particularly by placing the modest box upright. On the other hand, it is also noticeable here that the bass cannot very hold up with other competing items. As a balance, the mids and highs can genuinely be heard. They sound very clean and clear. If you turn up the volume appropriately, the sound loses some of its sharpness and the bass is virtually completely lost. Nevertheless, the sound high quality is convincing, so that the BOOM two landed in second place among the greatest Bluetooth speakers for significantly less than one hundred $. Certified Protected: Nothing at all matters more than the safety of your employees and customers. Since self-powered loudspeakers incorporate amplification, they have to undergo rigorous testing by Underwriters Laboratories and other international organizations to make sure they operate safely and guard against the risk of fire, electric shock, and inadequate structural style. Take pleasure in peace of thoughts understanding Meyer Sound powered merchandise are certified by FCC, UL, CSA, CE, and CEE the most stringent agencies in the company. Acoustic column with energy rating of 60 W (selectable to 45 and 30 W) in one hundred V line. three x 5″ bicone speaker. Frequency response of 100-17.000 Hz. Sensitivity 95 dB (1 W, 1 m and 1 kHz). Maximum sound pressure level 112 dB (60 W, 1 m and 1 kHz). Weight four.4 kg. Dimensions 197 x 700 x 118 mm. OPTIMUS model ref. C-1360. Possibly it is the high demand and recognition of smaller sized Bluetooth speakers, which make these merchandise the most in-demand and high rated ones in Bose's catalogue. Offered in a range of colors in numerous shapes and sizes, you can get the identical effective Bose overall performance, whichever speaker model you pick. Designs are modern day and stylish Bose lets you take pleasure in your music in best sound top quality anyplace you go. Line source (column) loudspeakers have gained popularity for applications calling for efficiency and even coverage from an unobtrusive physical profile. Correct to the founder's mission when he first started, Cerwin-Vega speakers are nevertheless fairly priced to this day. Most importantly, audio speaker merchandise from this brand make unparalleled high top quality sound that will certainly not disappoint. With the support of the Soundcore app, the sound can be individually adjusted by means of the equalizer. The in-property BassUp technologies guarantees that the bass gains strength at the push of a button. This is exactly where the strengths of the Anker Soundcore Flare lie. If you want, you can press the button until the music delivers enough bass. Residence Theater Systems – This typically come in sets. The common residence theater technique includes a sound bar, two bookshelf-type of speakers and a subwoofer. These are normally attached to the Tv to enhance the sound and make it a lot more effective.
Cambridge SoundWorks is one particular of the very first handful of brands that began selling their items on the Web prior to producing it accessible in nearby shops. Simply because they became so well-known in the on the web market place, they have been capable to open their very first store and now up to 30 showrooms across New England and San Francisco. One of their most common offers is the Rockford Fosgate R165X3 Prime 6.5-Inch Full-Variety 3-Way Coaxial Speakers that come in pairs. It is also offered in other size varieties. Thousands of owners have generously left evaluations and ratings on this item saying that it is their very best purchase. The sound high quality is so clear and crisp and undoubtedly beats by factory stock speakers in their car by a mile. In the 1970s, sound reinforcement technology was inconsistent science at very best, and at worst, led to show-ending failures. A young John Meyer, designing loudspeakers for San Francisco's McCune Sound Service, wanted to bring top quality and reliability to sound systems, and he knew the answer lay in self-powered loudspeakers. In 1979 Meyer founded his own speaker organization early Meyer Sound innovations incorporate the iconic HD-1 self-powered studio monitor launched in 1989. Some form of entertainment in the course of the cocktail hour is certainly a plus. The facility may possibly have music piped in via its sound system, which is certainly the most economical however, for about $300 you could have live music. Most banquet facilities have a piano, occasionally on wheels, and will let you either rent the piano or use it for free of charge. Fee for the piano rental should be around $50 to $100 and a piano player anywhere from $150 to $250. The 1st firm to introduce decent subwoofers was Acoustic Study (AR), who in 1954 introduced the AR-1W – a program that could extend its bass to 20hz with out any help from equalization and was actually a woofer efficiently closed in an enclosure. The AR-1W was unsurpassed in design and style for years, and in reality is nonetheless really influential upon modern subwoofer design by its use of the acoustic suspension principle. The AR-1W was a compact subwoofer that could be effortlessly fitted onto a bookshelf in pairs, in contrast to the monstrously sized enclosed loudspeakers which had been previously on the market place. Harman Kardon is a brand founded by Sidney Harman and Bernard Kardon in 1953. This brand is a division of Harman International Industries and is the manufacturer of residence and automobile audio equipment. Harman Kardon is a brand that is synonymous to class and elegance. Whilst it has a reputation of getting really pricey, a swift look through their catalogue will reveal a number of audio speakers that are really fairly reasonably priced. Line source (column) loudspeakers have been about for effectively more than a half century, but they've gained in recognition more than the past decade due to the fact they provide a solution for applications calling for efficiency combined with even coverage from a really slim, unobtrusive physical profile. Headphones, phone accessories and other electronics and accessories make Photive the top brand that it is correct now. Created by music lovers, you can expect that Photive be manufactured to perfection according to what shoppers are really searching for. Exclusive, intelligent and handy, the brand vows to offer you a excellent listening experience and energy to last for everyday use. As of writing time, Polk Audio has announced the arrival of their brand new Magnifi MAX SR Maximum-Efficiency Residence Theater Sound Bar Program set within the next couple of months. They guarantee the greatest sound at an affordable price tag so that everybody will have access to an exceptional listening knowledge. TOA TZ-S60W Slim Array Speaker, equipped with 9 vertically arrayed 8cm speaker units, delivers higher clarity sound with a 90° horizontal x 0° vertical directivity handle. This feature enables it to project clear sound even in rooms with reverberation difficulty. Two TZ-S60W can be stacked to enhance sound transmission distance and the vertical coverage area. For installation flexibility, both low impedance and high impedance is obtainable by a rotary switch. The column speaker works somewhat like a big scale line array system that you see at larger venues or outdoor events. They are developed to cover a large region with even sound. Not too loud up the front but nonetheless loud and clear up the back to hear comfortably. The vertical coverage is pretty narrow as to not direct sound up to the ceiling and the horizontal coverage is typically relatively wide so for a lot of applications you can get away with utilizing just one particular column speaker to cover a entire region.
Micca Electronics is one more brand that might not be the initial to come in thoughts when shopping for audio speakers however, you will certainly come across it particularly if you are shopping for bookshelf speakers on the web. There are thousands of ratings and testimonials, and even professional reviewers and highly common evaluation web sites on the web claim that Micca is undoubtedly worth considering. When on a spending budget and you are not prepared to sacrifice style and sound top quality, you can take a appear at what Micca has to offer. They're also not really into the tiny speakers you will preserve in a tiny bedroom or apartment—Seismic does it large with big speakers such as monitors, subwoofers and PA speakers. No matter whether you're a music professional and you need to have speakers for your studio or you're in the concert venue business or practically anywhere that requirements effective and clear sound, Seismic Audio is the brand name to look for. For instance, when it comes to house theater speaker systems, you can basically place them all in a single location of the area but that does not guarantee the very best sound high quality even if you have the most pricey and most strong set of speakers. On an article known as Property Theater Speaker Placement" written by Christian Cawley, there are specialist suggestions on the greatest placement for your surround sound program. The method is difficult but really rewarding. There are ideas shared on where it is ideal to position the center channel, the front left and proper channels, and the subwoofer. To make certain excellent audio top quality most models supply DSP with multiband limiter, equalizer, compressor, and crossover functions. They may also supply an integrated 4-channel mixer that gives person input, principal and subwoofer level controls and a variable higher-frequency enhance that allow you to speedily shape a perfectly balanced sound. The CU420 Column Speaker is the most current addition to the Inter-M speaker range, the new CU400 Series are stylish, higher-top quality Loudspeakers featuring improved frequency response for each voice and music applications. Pyle also produced certain that they're adjusting to the demands of the new generation by generating their quite personal set of waterproof speakers. A single of the leading alternatives you have is the Pyle PLMR24B 3.5-inch 200W 3-way weatherproof mini box speaker method. Rustproof, waterproof and definitely great sounding, you are acquiring so considerably value for your funds with this set. Greater precision requires higher processing power and decrease-level manage. This is why CAL powers and controls every single driver individually, and each CAL loudspeaker houses advanced processors that use the ideal algorithms to run intensive mathematical models in genuine time. For these wanting flexibility (each with sound and convenience), this could be the column line array option for you. The JBL Eon One particular is tiny and lightweight adequate to transport in one hand, and can be utilized in a diverse variety of settings. The controls are also super simple, and it comes with nifty functions like Bluetooth for connecting to all your instruments and devices, and a bunch of different routing alternatives. At the moment, Rockford Fosgate classifies their car speakers to 3 categories. The PRIME speakers have the Rockford DNA" and are the ideal replacement for factory speakers on most cars. The PUNCH auto speakers are designed for these who would like to really feel the music aside from just listening to it. The Energy car speakers deliver a new and higher level of sound high quality that's quite clear and accurate. four. Separate Severe and Non-Serious Buyers. Fold a sheet of paper in half. On the prime of the left column, create the heading, "Severe Buyers." On the top of the proper column, create the heading, "Non-Critical Buyers." Then, contemplate all the traits, telltale signs, words, phrases, inquiries and actions of every variety of person. This will do two things: 1) Speed up your sales cycle by making qualification a LOT less difficult, and 2) Concentrate your efforts on the right men and women, as opposed to wasting your time playing to the incorrect crowd. Sound Stress Level (SPL) Capability – Some line array systems have a big number of drivers inside each and every cabinet of the array, permitting a single coherent wave front to be made. Because of all these drivers, line arrays frequently have the capability of making a higher SPL than is needed, enabling systems to operate properly under their stress point. If your church's worship style requires concert-level sound reinforcement or hosts visiting national acts, the SPL capability of certain line array models can be an benefit.
Again, whilst AYL might not be as famous as other brands, it is worth checking out. You will be surprised at the quantity of ratings and excellent testimonials for their audio speakers. If you happen to be seeking for little yet powerful speakers for individual use without having breaking your spending budget, AYL is the brand you should be searching for. At this day and age of mobile devices and portable music players, more and much more people are looking for headphones and earphones so they can appreciate their music in private. Imagine this scenario — there is 5 of you in your family and 3 persons are music fans but you do not necessarily like the exact same type of music. Your dad likes listening to Sinatra, you sister is into Justin Bieber whilst you happen to be into old college rock and roll like Queen. If you share one particular set of speakers, not everyone will be enjoying the music. Nevertheless, if each of you have headphones, then you can all get pleasure from privately and not fight about who plays what music 1st. There is far more power in the modest Bluetooth speaker than you may feel at first glance. The maximum volume is enormous. This is important if you want to cover a bigger area with sound. The sound loses a bit of its sharpness at higher volumes, but you can hardly blame the JBL Flip five for that. The bass lacks a bit of force. Apart from that, this small speaker delivers a powerful sound. General, the JBL Flip 5 offers almost everything you can expect from a Bluetooth speaker beneath 100 $. POWERLINE-S series loudspeakers are identified for their uniform sound field distribution and are ideally suited for enjoying high-quality music and speech recordings even in acoustically difficult rooms. The slim style adapts effortlessly to any interior atmosphere. What's excellent about Boss Audio is that they don't offer you just a single or a handful of generic products for all sorts of automobiles. There are audio speakers tailor produced for a range of automobile brands from your dependable old Toyota to your fashionable Porsche date vehicle. order to contemplate them some of the very best, there are certain aspects to be deemed. Even though some aren't necessarily the ideal in every element, they must be exceptional in at least a couple of. For instance, a brand might not have the most gorgeous searching speakers but the audio good quality is far better than most. In this case, the brand can be regarded as a single of the best. Study on and discover far more about these aspects. Sony's audio division is made up of several headphones, music players, wireless speakers, high-resolution audio devices, residence theater systems, radios and portable CD players, audio systems, and a wide number of accessories. Whether you are searching for huge loud speakers or tiny wireless Bluetooth speakers, Sony has got it all for you. In spite of withdrawing what could have been one of the best merchandise in the industry, Monoprice continued to cater to what their buyers are asking for by releasing inexpensive residence theater systems such as the Monoprice 108247. Hugely reviewed with really excellent ratings, this six-piece five.1-channel residence theater speaker technique includes four satellite, a single center channel and 1-subwoofer speakers. Despite its little size, testimonials from owners claim that the power and efficiency of this speaker set is truly undeniable and it will surely give you a bang for your buck. The Electro-Voice range comes with a vast range of features which includes an input panel featuring the sector-major QuickSmart DSP interface. This clever element has a super intuitive navigation technique that operates by means of LCD and a single knob. There is also the EV QuickSmart mobile app, which makes use of cutting-edge Bluetooth Low Power (BTLE) technology for operation and wireless configuration of up to six Evolve systems. This offers you high-resolution Bluetooth streaming as nicely as the sweet comfort of getting able to handle almost everything from your mobile device. Delivering extraordinary sound with a surprisingly high energy, this variety of column speakers is the sophisticated outcome of study in the field of phased array acoustics, lending itself to a wide selection of applications in acoustic tough environments such as churches, auditoria, presentation and meeting rooms where audibility and intelligibility of music and speech has high significance. They are housed in slim and sophisticated constructed enclosures produced out of aluminum materials, finished with fine perforated grills and come with incorporated multifunctional wall brackets allowing swiveling and down-tilting for ideal directional placement.
What is also innovative is that the Tribit BTS30 is even Alexa-compatible and hence enables music playback to be controlled with your personal voice – which is undoubtedly not a matter of course in this value variety. Even the battery life of this Bluetooth speaker does not have to hide from the competitors: Up to 20 hours of music playback must be much more than enough for every celebration. And if you do not have a energy socket at hand, the battery can also be easily charged utilizing a separately accessible energy bank. But be careful: a reverse charging of the smartphone battery by way of the loudspeaker is regrettably not attainable – but that is actually the only drawback of the Tribit BTS30. Amongst Harman Kardon's most common items is the Harman Kardon Onyx Studio 3 Wireless Speaker Method with rechargeable battery and constructed-in microphone. It initially came out with a price tag of over 400 USD but you can now locate it on sale for just more than a hundred dollars. There's a mini version of this as well that is about half the value. Yes, this may be a small pricey for a portable audio speaker but when you've heard the unparalleled crystal clear sound coming from a Harman Kardon speaker, you will certainly understand how considerably it really is worth each and every single dollar. AliExpress will never ever be beaten on option, high quality and price. Each day you will uncover new, online-only provides, shop discounts and the chance to save even far more by collecting coupons. But you might have to act quick as this top column speakers is set to become a single of the most sought-soon after ideal-sellers in no time. Believe how jealous you happen to be buddies will be when you tell them you got your column speakers on AliExpress. With the lowest costs on the web, low-cost shipping prices and nearby collection choices, you can make an even larger saving. American brand Bose has been in the consumer electronics industry for well over half a century. Envision all the function and experience that comes with years of manufacturing products that are largely about sound systems. They are well-liked when it comes to house audio systems and speakers, specialist audio systems, automobile sound systems as properly as noise cancelling headphones. If you want a brand that can guarantee great good quality at a great cost, then Bose is the way to go. Logitech boasts of classy and trendy styles that are largely offered in black. For significantly less than 20 USD, you can currently get crystal lear stereo sound with the Logitech Multimedia Speakers Z200. If you want better bass and a lot more strong sound, then you'd certainly appreciate the Logitech Z313 Speaker System, which is also a extremely reasonably priced set. Some of their bestsellers such as the Logitech S150 USB speakers that offer decent digital sound only cost a little over ten dollars. With thousands of ratings and critiques to back these goods up, you will certainly find the greatest Logitech audio speakers best for you in no time. There is a lengthy list of Yamaha speakers that you can select from based on your needs. Their Loudspeakers consist of the Installation Series, CBR Series, Concert Club V Series and the BR Series. Surface Mount Speakers from Yamaha consist of the VXS Series, VXS Series M model", VS Series, VXS Series F model" and the VXS Series S model". Other audio speakers sorts contain Ceiling Speakers, Powered Speakers and Powered Monitor Speakers. I personal a number of speakers like Bose and QSC. But this speaker gave me a different perspective with a fantastic value, fantastic high quality and strong sound. I ended up trading in my Bose S1 pro. Thank you Cheryl Ireland of L&M Oshawa for your assistance. If you have been to a massive-scale concert in the final handful of years, you'll probably have noticed PA technique like this 1 — and the exact same principles are at function here as in the existing crop of compact column speaker systems. Expense – Since there are fewer individual enclosures and every single box contains fewer components, point source speakers are often a lot more expense-successful than line arrays. That is prevention. Temple has also developed an intervention component, named Turning Point, where shooting victims get further counseling although they're nevertheless in the hospital. They come in, they are really scared," Goldberg stated. 'Am I gonna die? Where's my Mom?' Then, as soon as they would recover, they would not be so scared anymore, which possibly wasn't excellent." So if a victim is amongst 18 and 30 years old, he's presented a series of supports in addition to the usual visits with Charles and a social worker. Temple asks the sufferers if they want to talk to a trauma survivor. And they are provided an opportunity to view a video of their personal trauma-bay resuscitation. (The surgeries in the trauma location are videotaped for top quality control.) About half say yes. Charles shows them the video. They get psychological counseling for any PTSD symptoms, as nicely as case management solutions to support them get higher-school diplomas or jobs.
audio loudspeaker
Mocha Cherry 42 Inch Round Table Wood Base
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The TEX Report Ltd.


Channel Seven has launched a new contest thanks to which you could score a beautiful prize: a limited edition Pulsar V8 Supercars Chronograph Watch for men!
Hurry up! This competition ends on December 12, 2018. So it's now or never.


In London the evenings are cold and dark, mulled wine is simmering, and yards and yards of Christmas lights are appearing as if by magic. The UK, along with many other countries around the world, is gearing up for the start of a season of food, fun and festivities – be they for Christmas, Hanukkah, Kwanzaa, Hogmanay or one of many other celebrations.
During this period most of us get time away from work or university and we all intend to put this time off to good use – but it's not always easy. To help, we've had a good think about a few ways to keep up with your courses, as well as the celebrations.
When you're in holiday mode it's easy to lose track of the hours and days – before you know it, it's the New Year and you're back at work. To avoid this, try to plan your schedule beforehand. Mark certain days, or hours, as learning hours and set reminders on your phone or in your diary so that you stick to them. By doing this you can easily space out your learning and balance it with festive activities.
What do you want to have achieved by the end of the holiday period? Or by the end of December? Try setting yourself a goal. It might be something practical like 'finish Week 5 and 6 of my course', or it could be learning-focused like 'understand conversational Italian'.
Write your goal out nice and big on a post-it note or piece of paper and stick it somewhere you can see it, so each day you're reminded of what you're working towards.
A key thing to remember over the holidays is that you can learn in really small chunks – learning doesn't have to take over your whole day. All FutureLearn courses are split into steps so you can do a little bit here and there. If sitting down for a solid hour of learning isn't working for you, try 10 minutes at breakfast, lunch and dinner.
If you're still struggling to keep going with your learning, try making sure you have rewards for when you complete some learning. For instance, if you finish five steps of a course you could have a one-minute scroll through Twitter. Or if you finish 20 steps you can have a cup of eggnog or hot chocolate. Little rewards can help keep you motivated if you're struggling.
Got any other tips on keeping up your learning during December and January? Let us know in the comments below.
Ready to go? Find a course.
Number 4 is key. Taking it easy over the holidays will help you hit the ground running once it's time to get back to work. Another thing I'd recommend: time tracking. Pomodoro or some other form of tracking work and break time throughout the day is really helpful for people who need to structure their day to be productive.
When will Futurelearn in apps of mobilephone? The course in Law field is little, can Futurelearn creates more course for this?
First of all, I will like to say thank you all for the privilege given me to be with you guys for the past few weeks of Study. I'm here following you people all through during the course of study. I have achieved lots and I will continue to be with you people. I thanks you all for the services. Happy celebration to you all for the various events yet to come.
Useful advices! Thank you for sharing them. Greetings from Cancun, Mexico.
If you haven't got any, do get yourself some headphones to use at study times. Then you can study at odd times of the day'evening, or when others are busy being very noisy etc and you can study in peace, and you won't disturb other people by playing the videos on future learn! Just got myself some, and they're great! Going to use them all the holidays. Love the study tips by the way.
Leave a comment…perfect plan for the holidays.Thank you for that.
I want to study medicine/related feild.online.How i can?
Terrific, sensible, do-able advise for contemporary learning. Thanks for these reminder So!


text:
.. _hasura_platform:secret:

Hasura CLI: hasura platform:secret
----------------------------------

Manage secrets on a cluster

Synopsis
~~~~~~~~

Create, update, delete secrets on a hasura cluster

Alias: secrets, secret

Options
~~~~~~~

::

  -h, --help   help for platform:secret

Options inherited from parent commands
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

::

      --project string   hasura project directory where the commands should be executed. (default: current directory)

SEE ALSO
~~~~~~~~

* :ref:`hasura <hasura>` 	 - hasura controls the hasura project
* :ref:`hasura platform:secret list <hasura_platform:secret_list>` 	 - List secrets from a cluster
* :ref:`hasura platform:secret update <hasura_platform:secret_update>` 	 - Update secret for a key

*Auto generated by spf13/cobra*

redpajama_set_name: RedPajamaGithub


I AM HERE TO MAKE YOUR HOME BUYING EXPERIENCE FUN My name is Cindy Wurst. I have been with Clayton Homes in Troy for 5 years and have helped many people achieve the American Dream of home ownership. That is the best part of my job. It is important to me to help my customers get into the home they desire whether it is a starter home, a second home or a weekend place. I help customers whether they are community living, own their own land, moving to family land or purchasing land. My goal is to give my customer the dream they want and deserve. I live in Lincoln County and I live in a Clayton built home. I truly believe in the homes that I sell and am excited with each new customer. I will work hard to help each and everyone of you. Stop by and see me if you are in the market.


Okay, so Ridhi Mehra's latest collection is now out, and the designs are a gorgeous mix of modern chic and Indian aesthetics. They are so lovely, we can't even… You get it, right? This outfit, with it's beautiful shade of grey and the super pretty cape sleeves, is the height of gorgeousness, isn't it? You'll see a lot of tassels, embellishments and feminine, pastel colours in this beautiful collection.
Abu Jani and Sandeep Khosla's designs are the epitome of intricacy and detailing, and this one is no different! It's everything anyone could ask for in a wedding lehenga and much more! The colour, the work, everything is just perfect!
Talking of pretty wedding lehengas and leaving Sabyasachi out of the list is a crime against wedding fashion (oh yes, it is!). This simple yet elegant design from Sabya's bridal collection is making our hearts melt, like always TBH!
Alia looks just out of the world in this gorgeous Manish Malhotra ensemble. She donned this lehenga at the IIFA Rocks 2017 event, and made all heads turn. Well, obviously! Alia's grace and Manish's designs are a lethal combo people!
Nobody does floral designs as amazingly as Anushree Reddy. In fact, she always finds new ways of wowing us with her signature floral prints. The subtle blast of colours and those uber stylish sleeve designs. Oh-so-gorgeous!