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Wednesday, July 30, 2008
Steuben County adopts prescription plan
BATH — Steuben County residents soon will be able to pay less for their prescriptions.
County legislators agreed Monday to sponsor a discount prescription card that could save users up to half of their prescription costs.
The card is provided by ProAct, which will distribute the cards through mass mailings. The discount cards will also be provided to the county Department of Social Services, Public Health and similar agencies and be available at local pharmacies. The card provides a 10 percent to 20 percent discount on name-brand prescriptions and 20 percent to 50 percent reduction on the cost of generic drugs, said Mike Maenza of ProAct.
Maenza told legislators the card can be used by all consumers in the county and could allow residents with limited or no insurance to obtain medication they could not otherwise afford.
The legislature approved the plan card over the opposition of several lawmakers, including Legislator Randy Weaver, D-Hornell, an independent pharmacist.
"There is no question a minute percentage of the population will benefit," Weaver said. "But since this began, we now have Medicare Part D and (other programs) to fill in the gaps."
Maenza disputed Weaver's charge the program will be used to promote the mail-order business of ProAct's parent company, Kinney Drugs, Inc., saying no names or personal information is required for the cards.
ProAct benefits in terms of an administrative fee collected from participating pharmacists, name recognition and the potential of a closer working relationship with the county, Maenza said.
Legislator Thomas Ryan, R-Canisteo, opposed the program because he said the ProAct fee paid by pharmacies amounts to another tax.
"I just don't like all these little taxes," he said.
But other legislators and officials said the program will help those struggling with the high cost of prescriptions.
"There is no local cost," county Administrator Mark Alger said. "Whether we sponsor this program or (somebody else) does, the benefits are out there. This is a service we can provide."
Ten other counties in the state offer the card, which is also endorsed by the state Association of Counties.
Attorney General: More Internet providers will help fight child porn
IRONDEQUOIT — Attorney General Andrew M. Cuomo met with parents at East Irondequoit Middle School this morning to talk about his office's fight against online child pornography. Cuomo announced that Internet service providers Earthlink, HughesNet, Clearwire, NetZero, Juno, and BlueLight Internet have agreed to purge their servers of child porn Web sites.
They will also eliminate access to child porn Newsgroups, a major supplier of illegal images. Today's announcement comes on the heels of similar agreements with Comcast, AT&T, Verizon, AOL, Sprint, and Time Warner Cable, which were announced over the last several weeks.
In addition, Cuomo sent letters to Internet Service Providers (ISPs) that serve the Rochester region indicating pending legal action if they do not sign agreements with his office. The letters were sent to Williamsville-based LocalNet and Stamford, Conn.-based Frontier/Citizens Net. The letters can be found online at www.nystopchildporn.com/letters.html.
At the meeting, he also encouraged residents to visit his new Web site, www.nystopchildporn.com, dedicated to fighting online child pornography. Cuomo urged consumers across the state to check whether their Internet service providers have signed the code of conduct and to demand that they do so if they have not.
Cuomo's initiative against online child pornography grew out of a six-month investigation into the sources of child porn. The Attorney General's investigation reviewed millions of pictures over several months, uncovering 88 different Newsgroups that contained a total of 11,390 sexually lewd photos featuring prepubescent children, and in some cases photos of children being raped and sexual activity involving animals.
Utica officer accused of assault terminated
UTICA — A Utica police officer accused of beating a 65-year-old man while he was handcuffed to a hospital bed last September has been terminated from the department, officials said.
Former Officer Brandon Jones' employment with the Utica Police Department was ended effective July 21, city Deputy Police Chief Michael Bailey said Tuesday.
"The ruling was that termination was an appropriate penalty, but the circumstances are a personnel matter and not something we would talk about," Bailey said.
Jones, who was hired in 2002, was on administrative leave at the time of his termination, Bailey said.
Bailey would not discuss whether Jones' termination was linked to the assault allegations described in a lawsuit pending in federal court.
According to the multimillion dollar lawsuit, James Edward Payne alleges that Jones punched him in the face, head and body Sept. 11 at the St. Elizabeth Medical Center.
Payne went to the Faxton campus of Faxton-St. Luke's Healthcare around 10 a.m. Sept. 11, seeking treatment for an injury. He has post-traumatic stress disorder and experienced an episode at the hospital where he became verbally belligerent toward his wife and son, both of whom attempted to subdue Payne, according to the lawsuit.
Payne, who is represented by Frank Policelli, was eventually transported by ambulance to St. Elizabeth Medical Center, the lawsuit states. Payne was still in handcuffs when he was admitted to the psychiatric emergency room.
Despite Jones' termination, the former police officer still remains under investigation for his alleged misconduct, Oneida County District Attorney Scott McNamara said Tuesday.
Ontario County to adopt $161 million capital plan
CANANDAIGUA — The Ontario County Board of Supervisors is poised to adopt its five-year, $161 million capital improvement plan tomorrow at 6:30 p.m. at the Ontario County Court House.
The board will vote — after a public hearing — on the plan, which is a tentative outline of projects the county will tackle from 2009 to 2014. The projects range from $49 million in renovations to the Finger Lakes Community College campus in Hopewell to various road work projects.
Bill Eddinger, Manchester town supervisor and chairman of the Financial Management Committee, which creates the plan, predicted it will pass tomorrow.
But, he added, "There will be some amendments." For example, he does not expect all the FLCC projects to be built as proposed. In addition to the $49 million main campus renovation, the college plans a $12 million Geneva center renovation and $1.8 million in startup costs for a new Victor center.
Some board members have spoken out against the FLCC projects at previous meetings, in particular the renovations to the cafeteria, book store and the front door at the Hopewell campus.
Eddinger said that approving the plan doesn't mean that all of the projects are approved. Instead, it just means that the county has agreed on roughly how much each of the projects will cost.
Gorham Supervisor Richard Calabrese agreed with Eddinger's assessment that the plan will pass Thursday. Calabrese said that the next step is to start paperwork on financing projects.


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clear(redirected from clear the air)
Also found in: Dictionary, Thesaurus, Medical, Legal, Idioms, Encyclopedia, Wikipedia.
Related to clear the air: turn up, couldn't, vanish into thin air
To settle a trade by the seller delivering securities and the buyer delivering funds in the proper form. A trade that does not clear is said to fail. Comparison of the details of a transaction between broker/dealers prior to settlement; final exchange of securities for cash on delivery.
To settle a transaction by the payment of the price and often the delivery of the goods. Because so many transactions occur at a given time, and because they may directly or indirectly involve a number of third parties, such as brokers, dealers, or specialists, clearing firms settle most transactions in exchange for a fee.
To pay for securities delivered into an account and accept funds for securities delivered out of an account.
Of or relating to a trade in which the seller delivers securities and the buyer delivers funds in the prescribed manner and on time. Compare fail. See also good delivery.

subset: commoncrawl


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What is a disease?
FOR PATIENTS, disease puts a name to an affliction. It answers that question we all face at one time or another: What's the matter with me? If there is a clear and precise explanation for what's wrong, then surely there is an equally clear way to get better.
At 228 pounds, Karen Cunningham knew she wasn't in great health. The owner of a small transcribing business in Louisville, Kentucky, Cunningham had gained 60 pounds during pregnancy in 1991 and just couldn't shake the weight. She always felt fatigued, and her hands and feet were often swollen. Doctors blamed it on her weight. "They said I just needed to lose the excess and I'd be fine," she recalls. Eventually, various specialists (rheumatologists, endocrinologists, internists) offered various diagnoses (high blood pressure, hypothyroidism, osteoarthritis) and prescribed various medications (Synthroid, Celebrex). But nothing worked. "I was really at the end of my rope, really thought whatever I had was going to kill me," she says. "And it would have, had I not found out what the problem was. You can't fight an enemy when you don't know who he is."
This article has been reproduced in a new format and may be missing content or contain faulty links. Contact email@example.com to report an issue.
The breakthrough came last December when her new endocrinologist diagnosed her with something called metabolic syndrome. She'd never heard of it. As she Googled to learn more, her chronic ailments – the weight, the high blood pressure, the lack of energy – started to make sense. They even seemed treatable. She's now on Glucophage and Avandia (which both regulate blood sugar) and has lost 20 pounds by cutting out carbohydrates. "Getting a diagnosis was a relief," Cunningham says. "I have hope now, whereas I didn't have any before."
Cunningham is among the first wave of Americans to be diagnosed with metabolic syndrome, a condition that, though only concretely defined five years ago, is now said to afflict as many as 75 million Americans – whether they know it or not. We sit, indeed, amid an epidemic of metabolic syndrome, a fact all the more remarkable because so few people are familiar with it. For this is no virus on the loose, no plague that has spread unchecked. Rather, metabolic syndrome is just a new way to think about a cluster of well-known and increasingly prevalent conditions. Metabolic syndrome is characterized by five risk factors: high blood pressure, high blood sugar, high triglycerides (fatty acids in the bloodstream), low HDL ("good") cholesterol, and obesity. Of the five, obesity – which is itself often referred to as an epidemic – is the most important, because the rise of the morbidly overweight is directly driving the rise in the syndrome. Metabolic syndrome is, in fact, almost indistinguishable from obesity – at least 85 percent of those who have the syndrome are obese or overweight.
The tidiness of that correlation makes it tempting to view metabolic syndrome not as an emerging fact of medicine, but as a fiction, wholly devised and disseminated by the pharmaceutical industry. After all, drug companies have long eyed obesity as the ultimate growth market – and they just happen to have an arsenal of pills poised to target it. Such cynicism isn't misplaced. The drug industry is among the most profitable in the world; pharma's knack for generating money makes oil companies look like lemonade stands. Drug firms owe their prodigious success to doing one thing exceptionally well. R&D? No – marketing. And as perfect an opportunity as obesity might be, it's also a legitimate health crisis that's only getting bigger. The one snag is that most people don't consider being fat a disease, they see it as a lifestyle problem. Which explains the appeal of metabolic syndrome. It's a simple, compelling concept that reframes the issue in scientific terms.
But is it real? In some ways, no. You can't see metabolic syndrome through a microscope, or detect it through a single blood test. Since it's a checklist of risk factors rather than symptoms, it stretches the way we think of disease. It's very much a human invention, a "syndrome" – that term researchers assign to things they don't quite understand. But in other ways, it's absolutely real. Though championed by drug companies, it's been defined and recognized by legitimate health organizations. And it's definitely unhealthy. You can't die of metabolic syndrome, but you can die of what it leads to: diabetes and heart disease.
And even if metabolic syndrome is just another term for obesity, it wouldn't be the first condition of daily life to become a disease. Alcoholism, clinical depression, and gastritis were all once considered personal problems that are now recognized as legitimate medical disorders, with all the trimmings of diagnosis, treatment, and pharmaceuticals. Many of these new illnesses, like osteoporosis, are widely accepted. Others, like fibromyalgia and female sexual dysfunction, remain fuzzy quasi diseases with shaky standing in the medical community.
The question now is whether metabolic syndrome will become accepted – or whether it will be dismissed as bad medicine, the product of an overeager illness industry. Proponents of the concept, including the American Heart Association and the World Health Organization, say the disease illustrates the cutting edge of diagnostics. It exists because we're only now recognizing that some very bad conditions can cluster and compound one another. Certainly metabolic syndrome is compelling to researchers: In the past five years, it has been the subject of no fewer than 15,000 studies, a number that puts it among the most researched conditions in medicine.
But some wonder if metabolic syndrome really identifies anything new. Skeptics, which include the American Diabetes Association, suggest that researchers, physicians, and pharmaceutical companies have been so hasty to embrace the disease (each for their own reasons), they've overlooked evidence that the science behind the diagnosis is flimsy and conjectural. These critics say that so-called metabolic syndrome lumps together risks we already recognize and monitor – or worse, that it's just a fancy way to describe obesity. By accepting it, we medicalize a lifestyle condition that we already know how to treat: with diet and exercise.
The debate is hardly academic. The pharmaceutical industry has spent millions of dollars developing dozens of drugs aimed at obesity generally and metabolic syndrome in particular. Many of those drugs are now or will soon be submitted to the Food and Drug Administration for approval. At the same time, the industry is lobbying the FDA to recognize the syndrome as a disease and to reconsider its approach to obesity drugs, a shift that would accelerate demand for new drugs.
Metabolic syndrome, in other words, could be the great disease of our age. Or it could be a sign of how diseased our age is, a demonstration of how certain we are that there is always a scientific explanation, a diagnosis, and perhaps a pill for what ails us. Either way, metabolic syndrome is a disease whose time has come.
What is a disease?
FOR DOCTORS, disease identifies why people are sick and suggests a course of treatment. For researchers, disease fixes an area of investigation, a mystery to be studied in the hopes of finding a cause or, perhaps, a cure.
Scott Grundy is the Billy Graham of metabolic syndrome. A longtime cardiologist and researcher, and director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center in Dallas, Grundy is often found these days on the dais, spreading the good word. Over the last six months, he's discussed the syndrome at the Metabolic Diseases Drug Discovery and Development World Summit, the Obesity, Lifestyle, and Cardiovascular Disease Symposium, the Targeting Metabolic Syndrome conference, and other events worldwide. He's been evangelizing like this since 2001, when he chaired a National Institutes of Health panel on cholesterol education. The project was created to draw the public's attention to the dangers of high cholesterol. In its discussion of the risks for heart disease, the panel's report (known as the ATP III) called out a metabolic syndrome, a condition that, as Grundy put it at the time, "is as strong a contributor to early heart disease as cigarette smoking" – a remarkable statement, considering how established the risk from cigarettes was and how few in the medical community had even heard of metabolic syndrome.
Grundy was already a recognized pioneer in heart disease and cholesterol research when the ATP III report came out. In the early 1990s, he spearheaded the research proving that statin drugs lower cholesterol levels (statins, which include medications like Lipitor and Crestor, now generate $25 billion annually in sales). Now he's back in the vanguard, having written or cowritten about 90 papers on obesity and metabolic syndrome in the past five years.
The NIH first sounded the alarm on obesity rates in 1977, when the proportion of overweight or obese people in the US stood at about 40 percent. Today, two out of three Americans fall into that category, a statistic that makes obesity the most pressing public health issue of our day, Grundy says. "Have you ever been to the Orlando airport? Taken a look at the size of those people? This isn't going away." And, he adds, we have a good idea of their fate: They're more likely to develop diabetes (the number of diabetics in the US has almost doubled in the past decade, nearly all due to obesity) and more likely to die of heart disease than those who are not overweight. Boosting awareness of the syndrome, Grundy believes, may be our best chance to defuse this time bomb. By inserting a new disease into the causal chain, at a point before obesity turns into diabetes or heart disease, millions of at-risk people can be identified and treated. For many, a diagnosis of metabolic syndrome can get them off the couch in a way that a doctor tut-tutting about their extra pounds cannot.
It was 1988 when Gerald Reaven, an endocrinologist at Stanford, saw a cluster of symptoms that seemed to arise out of insulin resistance and dubbed it "syndrome X." Over the next decade, researchers began using terms like "insulin resistance syndrome" and "metabolic syndrome X." In 1998, the World Health Organization, noting the same cluster of risks, offered physicians a checklist of conditions that make up "the metabolic syndrome." The ATP III followed in 2001, identifying five factors – low HDL, high blood pressure, high triglyceride levels, high blood-sugar levels, and abdominal obesity – as the defining criteria for the syndrome. Meet any three of the five criteria and you have a diagnosis. (Though the multiple-choice route seems kludgy, it's not without precedent: Rheumatic fever and systemic lupus are likewise diagnosed through a mix-and-match of criteria.)
The ATP III codified what might have seemed like common sense into a new and suddenly dangerous ailment. With a bit of math, it became clear that metabolic syndrome was ubiquitous: As many as 50 million Americans fit under the umbrella (as the definition's cutoff points were tweaked, the number would climb to 75 million). People with the syndrome are twice as likely to die from – and three times as likely to have – a heart attack or stroke compared to people without it, according to the International Diabetes Federation (which offered its own definition of the condition last year). It's a disease more prevalent than arthritis and asthma combined.
In short order, the metabolic syndrome industry was thriving. The WHO assigned it an International Classification of Disease code – a crucial step that let physicians diagnose and refer to it in insurance documents. Conferences, research, and drug development followed. "A few things came together," Grundy says. "One, metabolic syndrome was becoming very common; with the rise in obesity, we've seen a rise in all these risk factors. Two, the drug companies saw an opportunity for new drug development, to see if they could target several things at once. So obesity is driving the syndrome, and also driving interest in the syndrome." Indeed, by last year, many pharma insiders were betting that FDA recognition of the disease as a legitimate drug target was imminent.
NOT EVERYONE IN THE MEDICAL COMMUNITY jumped on the bandwagon. In 2003, Richard Kahn, chief scientific and medical officer for the American Diabetes Association, began looking into the syndrome. He reviewed five years of research – some 10,000 papers in all – in order to assess whether the diagnosis had any clinical value. Was the syndrome, he wondered, a better indicator of long-term risk than any of the individual risks? In other words, was the sum greater than its parts?
Kahn's results, published in September 2005 as a joint statement of the ADA and the European Association for the Study of Diabetes, stunned the medical establishment: He found no proof that a diagnosis of metabolic syndrome better predicted long-term cardiovascular disease. "We found that the metabolic syndrome has been imprecisely defined," Kahn and his coauthors wrote. "There is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a cardiovascular disease risk marker." The statement continued: "Our analysis indicates that too much critically important information is missing to warrant its designation as a 'syndrome.' Until much-needed research is completed, clinicians should evaluate and treat all cardiovascular disease risk factors without regard to whether a patient meets the criteria for diagnosis of the 'metabolic syndrome.'"
A skeptic by nature – he's a committed atheist and seems to be always itching for a debate – Kahn is proud of the work. "We irrefutably present the evidence," he says. "As a way of saying you're at risk for something, it's a very poor predictor." He insists he didn't set out to take down Grundy or the American Heart Association, which has championed the concept. And he agrees that the risks underlying the syndrome are real. But Kahn says he grew alarmed that "a research tool" meant to draw attention to the obesity problem was hardening into a diagnostic set of rules. "It became codified into an explicit disease, and then the train left the station. But the definition is arbitrary, it's pulled out of the air."
A month after the ADA statement, the AHA fired back with a response (written primarily by Grundy) rejecting Kahn's analysis and reasserting the syndrome's value. Reaven weighed in with a paper titled "The Metabolic Syndrome: Is This Diagnosis Necessary?" (No, he concluded, siding with Kahn.) Kahn came out with another paper, titled "The Metabolic Syndrome (Emperor) Wears No Clothes." Grundy followed, declaring that "the common clustering of metabolic risk factors in obese persons is a fact of American medicine." As the spitballs flew, the medical community gawked at the spectacle of two of the world's largest and most powerful medical organizations engaged in a highly public dispute.
To some degree, Kahn's gambit has worked. The ADA statement "really put the brakes on things," says Donny Wong, a drug industry analyst who specializes in metabolic and obesity markets. The lack of consensus means some physicians and insurers aren't on board – that, Wong says, prevents pharmaceutical companies from maximizing the metabolic syndrome market, which he estimates could be as big as $18 billion annually. But Kahn's crusade hasn't doused enthusiasm altogether. Time and again, physicians – scientists! – brush off his data with a hem-haw reply that the concept helps get people's attention. At the ADA's annual meeting in June, Kahn took the "con" side in a debate over metabolic syndrome. His data and presentation impressed, even intimidated, the audience. Until one doctor piped up that, whatever the data, his patients find the syndrome a useful concept. Kahn was clearly exasperated: "You can't invent something just so you can treat patients," he appealed to the crowd. "Medicine isn't supposed to work that way."
And yet it does. Clearly, there's something about taking high blood pressure and obesity and calling it metabolic syndrome that makes it different – even if it's unclear what that difference is. For Karen Cunningham and thousands like her, terminology matters. Likewise for physicians. In a doctor's office, Grundy says, "physicians see a patient with diabetes or hyperglycemia and they focus so much on that, there is a real danger they will ignore blood pressure or lipids. It becomes tunnel vision. By saying that these all go together as metabolic syndrome, some of us believe it leads doctors to look at the whole patient and this patient's total risk."
Eager to paper over their dispute, executives at the ADA and the AHA have found common ground by focusing on obesity. In a joint statement released this past summer, they referred to "many unresolved scientific issues" about the syndrome, but emphasized that the core risk factors stem from the upsurge in obesity. "The growing prevalence of this condition," the statement concluded, "threatens to undermine all of our recent gains to prevent and control chronic disease."
But obesity is an old saw. No matter how many times obesity makes the covers of Time and Newsweek, it's been impossible to change the public's impression that being fat is simply a lifestyle issue, one that comes down to personal responsibility. If obesity is a health care crisis, the thinking goes, it's one of our own making.
That's what makes metabolic syndrome so compelling: It takes personal responsibility out of the equation. Turning the epidemic of obesity into a slightly smaller epidemic of metabolic syndrome puts it in the province of science, not lifestyle. With science, we're not confined to a futile path of diet and exercise. With science, we get drugs.
What is a disease?
FOR THE PHARMACEUTICAL INDUSTRY, it's a business model. Disease offers an opportunity to develop and market drugs that help people get better and, along the way, help companies make a profit.
In the late 1980s, researchers at the St. Louis University School of Medicine were investigating a question that had inspired decades of dorm-room symposia: Why do pot smokers get the munchies? The answer, the researchers discovered, is that the active ingredient in marijuana, THC, attaches itself to specific receptors in the brain, stimulating appetite. These receptors form what became known as the endocannabinoid system – a body-wide network that interacts with pain, memory, and hunger. Soon, pharmaceutical companies began developing endocannabinoid blockers, under the hypothesis that if engaging the receptors stimulates appetite, then blocking them would curtail it.
In 1996, the French pharma Sanofi-Synthelabo (now Sanofi-Aventis) began animal trials testing an endocannabinoid antagonist known as rimonabant. The results were encouraging: Obese mice given rimonabant ate less and lost 18 percent of their body weight. Then, in 2001, Sanofi began four human trials involving more than 6,600 patients; these were the largest obesity drug trials in history. The results were again impressive: Patients who took rimonabant for two years, combined with some diet and exercise, lost an average of almost 14 pounds – about 10 pounds more than those with the same routine taking a placebo.
What's more, rimonabant doesn't just promote weight loss. It improves HDL cholesterol and reduces insulin resistance. In other words, it's an ideal match for metabolic syndrome. Rimonabant has side effects – some patients reported increased depression and moodiness – but it's still hailed as the blockbuster drug of the decade. "We've been working on this problem for 20 years; we went through dozens and dozens of candidates," says Lou Aronne, director of the Comprehensive Weight Control Program at Weill Cornell Medical Center in Manhattan and a lead investigator in one of the rimonabant studies. "Rimonabant hits the right receptors for the right problem. It's no different than finding the statins," the class of drugs developed for cholesterol treatment.
The cholesterol analogy is apt in many ways. For 50 years, high cholesterol was simply one of several risk factors for heart attack and stroke, along with high blood pressure, smoking, and stress. You treated it by changing your lifestyle. But the discovery of statins in the mid-1990s gave physicians a way to control cholesterol levels, and high cholesterol became more like a disease (now called hypercholesterolemia). Today, statins are the biggest drugs in the pharmaceutical industry; Lipitor sales alone will hit $13 billion this year. Metabolic syndrome is in a similar position today. Should the right drugs come along, the metabolic syndrome market "promises to be as big or bigger" than cholesterol, Pharmaceutical Executive magazine predicted a couple of years ago. And rimonabant, also known by its brand name, Acomplia, may well be the first of those drugs. JP Morgan analysts predict that rimonabant sales could hit $5 billion a year.
That potential has spurred Sanofi, the third largest pharmaceutical firm in the world, to launch a two-tiered campaign. First the company is promoting the drug itself, spreading the word about rimonabant in the medical and financial communities. (The company has drawn criticism by announcing its rimonabant results at industry conferences rather than in academic peer-reviewed journals.) But instead of offering rimonabant as just the latest obesity drug, Sanofi is laying the groundwork for the medical community to recognize metabolic syndrome – a disease that just happens to be treatable with rimonabant. The company's education program includes sponsoring conferences, funding research, and providing certification courses for physicians. In the exhibit hall at this summer's American Diabetes Association conference, for instance, Sanofi set up a multimedia display on the endocannabinoid system, complete with polarized glasses and a 3-D movie. There was plenty of literature on cardiometabolic risk and metabolic syndrome on hand, but there was no mention of the drug that might treat it. "Being the first one to come out, the burden of education is on us," a Sanofi spokesperson says.
Sanofi's campaign was supposed to culminate this year with the FDA's approval of rimonabant to treat obesity, and perhaps this new disease, metabolic syndrome. But in February, Sanofi announced that while the FDA had found rimonabant "approvable," the agency had additional questions and conditions before rimonabant could actually be approved. The company and the FDA won't comment, but there's speculation that the drug's reported depressive side effects might be a concern. In early August, the company told financial analysts it remains "hopeful and confident" that rimonabant will be approved in the US (it went on sale in Europe this summer). But that's unlikely to happen until 2007.
In the drug industry, finding disorders like metabolic syndrome is known as "developing new disease markets" or "branding a condition." Industry critics have their own term for it: "disease mongering," they say, shaking a finger at pharmaceutical firms for devising treatments for normal conditions of life – menopause, anxiety, obesity. But as tempting a villain as the drug industry makes, it's not so clear that obesity is, in fact, a normal part of life. Blame corn subsidies or videogames or PepsiCo, but obesity has transformed our nation in the past 30 years. Diet and exercise? It's easy to recommend, and it's good in theory, but there's surprisingly little proof that lifestyle intervention actually works as a weight-loss strategy. In the late 1990s, the Centers for Disease Control and Prevention initiated its Diabetes Prevention Program, a $174 million study hoping to prove that behavioral changes can induce weight loss. To make the point, the program went to extremes. The 3,000 participants received gym memberships and personal trainers, had their food provided, and were coached with daily phone calls from nutritionists – all for two years or more. After all that hand-holding, patients lost an average of 7 percent of their body weight.
The CDC hailed the study as proof that diet and exercise work, but it just as readily proves the opposite. After all, how likely is the average American to stick with – let alone be able to afford – such an intensive program? "It's very easy to point the finger and blame people for not exercising enough," says Aronne. "But we're beginning to understand that there are metabolic issues going on."
"THE FUTURE OF OBESITY IS DRUGS." So proclaims Richard Atkinson, pathologist at Virginia Commonwealth University and president of the American Obesity Association, a drug industry-supported advocacy group. Atkinson is among the increasing number of scientists and physicians convinced that the body's propensity to store fat isn't something mere diet and exercise can correct. "We don't consider obesity a disease because it's easy to see," he says. "But obesity is biochemistry, and drugs change biochemistry." Obviously, the emphasis on drug therapies is a huge boon to the pharmaceutical industry, which has more than 350 obesity and metabolic drugs in the pipeline, many far along in clinical trials. Pfizer has CP 945598, its own cannabinoid antagonist. Manhattan Pharmaceuticals has a drug known as OE, which induces weight loss and matches up favorably with the components of metabolic syndrome. Eli Lilly has half a dozen drugs in Phase I trials. And so on. "The trouble is, it is extremely expensive and difficult to get an obesity drug to market," Atkinson says, pointing the finger at the FDA, among others.
That could be about to change. For several years, the drug industry has been lobbying the FDA to make it easier to get obesity drugs to market. In 2003, the agency started to relent, announcing it would revise its Guidance for the Clinical Evaluation of Weight-Control Drugs, the agency's checklist of standards for developing obesity drugs. First issued in 1996, the guidance has long vexed the drug industry, starting with the title itself ("weight control" implies a lifestyle problem, rather than a public-health issue). When the FDA invited public comments in 2004, 17 companies and two trade groups offered critiques of the guidance. (The American Obesity Association rewrote the entire guidance, line by line.) Almost unanimously, the industry called on the FDA to redefine obesity as a disease. "Obesity is a chronic disease, which may require pharmacotherapy," Pfizer's director of global R&D wrote. Others, including Merck and PhRMA, the pharmaceutical industry's lobby group, went further, urging the FDA to recognize metabolic syndrome as a disease, too. "Given the association of Metabolic Syndrome with obesity, and the clear link with increased cardiovascular morbidity and mortality," Merck's vice president of global regulatory policy wrote, the company "proposes that FDA consider an indication for this syndrome." The FDA has yet to issue its new guidance, saying only that it's still under review.
Getting an indication is key, because it would further establish metabolic syndrome as a bona fide disease. So goes the domino effect of recognition: First the National Institutes of Health and the American Heart Association identify metabolic syndrome as a disease, then the FDA creates an indication, and then the HMOs – which have largely refused to reimburse patients for obesity treatments – agree to pick up the tab for metabolic syndrome prescriptions, thus making physicians more likely to prescribe them for their patients. The only drawback is that the market could be too big: If the HMOs see a diagnosis that fits 75 million Americans and a potential bill for $18 billion, they might simply refuse to pay it.
That, of course, is the demographic ripple effect of diseases like metabolic syndrome. As the medical establishment reaches further down the causal chain to identify more risk factors and spot them earlier, and as it assigns names, definitions, and treatments to these diagnoses, more and more people are swept into the disease net. Add in our genetic biomarkers and it's clear that disease won't be something we can avoid anymore. It will be something we simply have, just as we have freckles or wear glasses. We will all carry our disease portfolios and will be identified through our ailments – or more precisely, our inclinations toward certain ailments. Metabolic syndrome is just the latest step on this path.
On one level, this is the inevitable progress of medicine. But on another, it makes the idea of disease – or of health, for that matter – a meaningless abstraction. "We all already have a disease," Kahn says. "Life – it's a terminal disease, you know."


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I was able to shoot the Chinese horsebow again yesterday. I used the same arrows but this time was at a friend's house, and his "yard" is about 8 acres, so we were able to shoot at about 28 yards. I am even more impressed with the bow now. We put about 50 shots through it at his crossbow target that's about 3 feet square.
Twenty eight yards is further than I've shot a bow in over a decade, and I was able to keep about 2/3 of my shots on the target. The bow shoots very flat out to that range and hit with a pretty authoritative thump. Arrows which missed the target but hit the ground next to it skidded 10 yards or more up the hill behind it.
If I get to 1,000 shots with the bow without it showing any damage, I'm going to consider it to be a heck of a bargain.


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There's that Boston/New York rivalry thing, and the fact that for a few days, New England Patriots quarterback Tom Brady had the most famous boot in America, and then all of a sudden he was MIA. But amid all the Super Bowl hype, there's been very little talk about the actual game. Who wants to deal with those insignificant details when Gisele Bundchen is a subplot?
There's that Boston/New York rivalry thing, and the fact that for a few days, New England Patriots quarterback Tom Brady had the most famous boot in America, and then all of a sudden he was MIA. But amid all the Super Bowl hype, there's been very little talk about the actual game. Who wants to deal with those insignificant details when Gisele Bundchen is a subplot?
But there is a game, and the Patriot and Giant players know it better than anybody else. Even ex-players would like to chime in — specifically a couple who have intimate knowledge of both organizations. They are also brothers who cut their teeth on the game locally while suiting up for Danvers High School.
Mark Bavaro, now 44 and living in Boxford, was an All-Pro tight end for the New York Giants, with whom he won two Super Bowl rings. Tom Coughlin, the current Giants head coach, was a receivers coach when Mark was employed by the football Giants. Bill Belichick, the current head coach of the Patriots, gave him a chance to resume his career after a one-year hiatus when Belichick took over as head coach of the Cleveland Browns. Belichick knew all about Mark when he was the Giants defensive coordinator.
Mark's brother, David, who's now 40 and a teacher at Malden Catholic, played two years for the Patriots in 1993 and 1994 — a period he considers the start of the current dynasty, because Bill Parcells — the architect of the Giants championship run in the '80s — was the Pats' head honcho, and Bob Kraft bought the team after the 1993 season.
Mark is going to sit back and enjoy the game, and hope that the best team wins. "I'm a part of the Giants alumni right now; I don't play for them anymore," he said. "I have a lot of close friends on the Patriots, and I like the fact that these two teams are in it."Pats first among the alumni
As an alumnus, Mark tries to keep in touch with the Giants through their alumni club, which was established just last year. "[The alumni club] is really not up and running as of yet, and it's certainly not like the one that the Pats have," added Mark.
David is a dues-paying member of the Pats alumni club that provides game tickets to the past players who want them.
"The Krafts allowed this to happen with the creation of NEPAC (New England Patriots Alumni Club). They are great in remembering the past players, even me," David said. "I was a meat and potatoes guy, but there's also great and talented guys associated with it."
David basically played on the special teams for the Pats, but he did start at linebacker in five games during the 1994 playoff season, and his claim to fame is that they won all of them.
"We made the playoffs that year playing Belichick's Cleveland Browns. We belonged in the playoffs, and that game went down to the wire, before [quarterback Drew] Bledsoe threw an interception," David said. "It was an honor and a privilege to be a part of something great."
The Patriots are just one Super Bowl XLII win away from a 19-0 perfect season that would arguably catapult them to best-team-ever status.
The Giants, on the other hand, had to get to the big game the hard way, winning 10 straight road games, including an overtime epic against Green Bay for the National Football Conference title.
Giants field goal kicker Lawrence Tynes missed two previously that game, but his 47-yard overtime boot caught Mark's admiration, because of the circumstances.
"It was really cold, and the ball was harder, and for that kick to go that far and that accurate in that environment was a tremendous achievement," said Mark.
Your number's up
Veteran players eventually retire, but for the most part their uniforms remain active, and ironically Kevin Boss, a Mark Bavaro clone, is currently the bearer of his No. 89.
"I never saw him play up until the last few games, but for what I've seen I like him. He's a quiet, hard-nosed kid who doesn't drop any balls," said Mark. "It's also weird that he got his start pretty much the same way I got mine. He had to replace Jeremy Shockey, who broke his leg, and I took over for Zeke Mowatt, who blew out his knee during the 1985 season."
Perfect timing
The Patriots are going for perfection, and for Mark Bavaro the timing couldn't be better.
"It's a phenomenal achievement, but the league, the way it's setup right now, is conducive for it," he said. "It's a mediocre league, and the Pats are just heads and shoulders above everybody else. In the past, there was always a group of good teams, and Belichick knows how to take advantage of everything in the league today. He's a man coaching among boys, and sometimes it's embarrassing watching the games.
"The salary cap affords only so many great players for teams, and Bill (Belichick), being a genius he is, can exploit it. He knows how to find the hidden jewels," Bavaro said. "They'd see something in a player, and then figure out how he could fit into the system. The ideal Patriots candidate is selfless, smart, willing to follow instruction and doesn't expect all of the glory, and they also believe in the coach, because they want to win championships.
"Other teams are not willing to take a chance on such players at the risk of feeling foolish, but the Pats are confident at what they are bringing in," Mark continued. "I love the Pats, because they're never the same team. They remind me of the (San Francisco) 49ers. The 49ers were always in search of new talent. They were never happy, never content. They were always looking for better value, just like the Patriots, while still maintaining a championship team."
Spies among us
The entire Spygate saga — in which the Patriots were caught videotaping New York Jets coaches' signals on the sidelines, against league regulations — initially was a black eye on the Patriots, but they used it as motivation to forge ahead.
"I'm not an insider to [Spygate]. I don't know what [the Patriots] did with the films, but the league obviously thought it was serious," Mark said. "For me personally, I don't think it was an advantage. You can also write the signals down on a piece of paper, and if the signals are that important then they can change them. I don't see the foul in it. There's no way you can use the film during a game, but that's [Belichick], he's thorough; he leaves no stone unturned [for future reference].
"For his detractors, they see an opportunity to put an asterisk next to his record, and that's a shame," said Bavaro. "They have to explain it to me, because coordinators cover their mouths with a play-card all the time so that the opposition can't read lips. Obviously, they already know that people are watching their every move."
David Bavaro has similar thoughts on the controversy. "I think it was overrated," he said. "You can only gain so much from stealing [defensive] signals, and besides any good team would change them up; they do it in baseball. If more than one coach or player is giving out the signals, it would take time to figure out who's giving out the right one.
"I certainly don't see any need for an asterisk. Some people just want to see the Pats being taken down a peg or two," added David, "and I also hate to see the Pats compared to the [New York] Yankees. [The Pats] do it differently. They bring in character guys, who are team players, and when they draft players they make sure they first talk to the janitors and ask them what they're like. If they get along with them — the blue collar, down to earth guys — they'd get along with everybody."
Belichick the Godfather
When Mark Bavaro was cut by the Giants after he blew out his knee following the 1990 Super Bowl season, he was forced to sit out one season. Bill Belichick took over as head coach of the Cleveland Browns in 1992, and one of his first moves was to give Bavaro a chance to revive his career. That opportunity led to a two-year deal with the Philadelphia Eagles.
"[Belichick] resurrected my career with Cleveland," Mark said. "After that season was over, I went into his office and told him about the Philadelphia deal. It was like sitting down with the Godfather. He gave me his blessing to leave, because he realized that I only had a couple of years left in my career and the Browns weren't going to match the offer. But I'll never forget the opportunity he gave me. I was able to extend my career in the league three extra years, because of Bill [Belichick]."
Mark also has strong positive feelings for the Giants head coach Tom Coughlin. "[Coughlin] is a great coach," he said. "He was my receivers coach when I was with the Giants, but I haven't seen him up close for a while.
"I know he's similar to [Belichick], but he hasn't been able to hand-pick his team like [Belichick] has been able to do. If his players didn't conform, he still had to put up with them. But this team finally bought into him. They now understand that he's into the particulars, and nothing gets by him."
Mark went to the New York Jets camp in 1997 to see if he would like coaching under the guidance of his first mentor Bill Parcells. But he soon found out it wasn't for him.
"Coaching demands a lot of long hours, and for me not much fulfillment," Mark said.
Making history
At the beginning of the season, the Pats were piling up the points, but in the last six games the rest of the league might have caught up to them, according to Mark.
"The Pats opened the door near the end of the season, but teams weren't prepared or disciplined enough to take advantage of it," he said. "The other coaches have stepped up their intensity level in the second half of the season to work a little harder to beat the Pats. They saw some cracks in the armor in the films, but the Pats overall depth is unbelievable. They know how to pick each other up. If it's not the personnel, it's clock management, as well as the ability to remain focused that keeps them winning games. It's all another aspect of [Belichick's] genius."As for predictions?
"My first reaction is that nobody's going to beat the Pats," Mark said, "and the Giants have to play close to perfect to beat them, while the Pats just have to play well. They just have to do what they need to do. It all comes down to Eli (Manning, the Giants quarterback). He has to play close to perfect, but he has been playing very well in the last four games."
And David said: "I'm obviously rooting for the Pats, because I once played for them. Going 19-0 should happen, and probably will happen, as long as Brady stays healthy and he doesn't have one of those crazy games, and that hardly ever happens."


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Two killed in crash blamed on bald tires in Ben Avon
Cars collide on Ohio River Boulevard, killing Christopher Lantzy and David Mooney
Two people were killed when a car skidded sideways into the path of another car in Ben Avon Wednesday morning.
Police say they believe the car was speeding when the driver lost control on Ohio River Boulevard near Dickson Drive just after 2:30 a.m. The car crossed the center line and collided with a car coming the other direction. (SLIDESHOW: Photos from the crash scene)
Three people were inside the vehicle that spun out of control, and two of them were killed by the crash. Authorities identify the victims as 22-year-old Christopher Lantzy and 19-year-old David Mooney, both from New Brighton. One passenger also suffered serious injuries, and the driver of the second car was badly hurt as well.
Investigators believe bald tires on wet pavement may have caused the car to skid into the oncoming traffic.
"Looking at the rear tires, there was no traction on the tires at all," Corporal Donald Manz with Ohio Township Police said.
Authorities also believe the car was speeding for miles before the crash: investigators say a Bellevue police officer tried to stop the car, but couldn't catch up with it.
Police say the surviving victims suffered several broken bones and leg injuries, and were conscious when they were taken to the hospital.


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Microsoft released eight patches, five critical, on Tuesday as part of its regular Patch Tuesday update cycle.
The bulletins collectively cover 23 separate vulnerabilities, six of which have been targeted by exploit code. The updates cover a fix (MS09-009) for a flaw in Excel that's become the target of attacks of recent weeks.
The patch batch also covers security updates for Wordpad and office converters, a cumulative update of IE and Windows.
Missing from the list is relief for a zero-day vulnerability in PowerPoint, actively targeted by hackers since last month.
Microsoft's summary can be found here. A more colourful and easy to understand overview from the Internet Storm Centre can be found here.
Virtual all Windows systems - client and server - will need patching. According to patching security firm Lumension, six of the eight bulletins require a restart, including one critical flaw (covered by MS09-013) that requires the restart of Windows 2003 and 2008 Servers. ®


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Forbes.com asks, "Do you live in a death spiral state?"
For those who live in Illinois and other state government disaster areas, that answer is Yes Of Course We Do.
For reference, here's how Forbes qualifies what "death spiral" means: (1) more takers than makers, which means more people who draw from the government rather than pay into it, and (2) a state credit situation downgraded for large debt, uncompetitive business climate, and weak home prices and employment numbers.
But what is a "death spiral"? What does it really mean to actual people? Well, I'm no expert on economics, but I do play one on this blog, and I know a thing or two about it, so here is my take on what a "death spiral" means for actual people.
First of all, abstract debt numbers like $80 or 90 billion help almost nobody, because almost nobody comprehends them. 'Billion' looks and sounds like 'million', but a billion is 1,000 times more than a million, so it is a much larger number. It's 1,000,000,000 vs. 1,000,000. See the difference? Nine zeros, not just six.
The majority of those who may not fully grasp the gravity of the fiscal situation in Illinois do not understand such numbers in any meaningful way – and why should they? They are irrelevant to our lives. Regular folks have no reason at all to understand them.
But regular folks do have a reason to understand that fiscal realities will eventually have a real-world impact on regular people, on our jobs, our cost of living, our taxes, our property values, and the quality of our schools, among other things. Huge debts cause lower credit ratings – which just happened again to Illinois last week – which means higher borrowing costs for the state going forward for every bond issued. Those costs are passed on to the taxpayer, of course – bonds scheduled to be issued today, in fact, will now cost the taxpayers of Illinois $95M more in interest for that single bond issue. In addition, the state income tax has already doubled, which will more than likely decrease the income to the state treasury, making the budget deficit and debt worse instead of better.
Imagine a vicious cycle of increasing tax burdens and decreasing municipal and state services which causes jobs to flee the state, incomes and property values to decline, and school quality and other community services to suffer. Each of those feeds the other, and quality of life declines in just about every conceivable way. Lather, rinse, repeat. That is what a death spiral might look like.
Need more details? How about budget cuts in the schools leading to cutting teachers, and programs like band, drama, and sports, but probably not the administrators, whose role in educating children is almost nil. Budget cuts in city and county services, like picking up garbage less often, fewer snowplows and people to man them to keep streets clear, and firing building inspectors which will slow down every real estate transaction and construction project. Higher property taxes since declining state tax revenues will impact public schools and others who rely on state funding, and the government trough has to get filled from somewhere. Higher unemployment and declining property values from all of the above, plus businesses leaving and downsizing. Add to that the many young people saddled with huge college debt that they simply can never repay (nor can they discharge it via bankruptcy), and people who cannot find work and are essentially forced to drop out of the labor force and become takers rather than makers. Lather, rinse, repeat.
People have choices in life. Those who own a business now, or would start one, have choices on where to do that. Those who have a family and career now, or are ready to start down that path, have choices on where to do that, too. They can choose a place like Illinois with a spending problem and a rather "iffy" prognosis for recovery, or a place that is stable and growing and where people have jobs and where schools are more likely to improve than to go downhill.
Is there something special about Illinois that can overcome those disadvantages? What would those be? The beautiful scenery? The fantastic climate? I don't think so.
The rational, logical side of my brain understands this and accepts the conclusion for what it is, but the emotional side of my brain says, "this sure as hell is not the world I was counting on for my kids".


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Building Solar Superchagers
Building Solar Superchagers
Remove all the chargers from 6 Dual Charger Model Ses.
Stack them in series.
Provide a 440V 120A feed.
I think "a" refers to "apart", which should be "part", right?
Maybe my English is failing me, but doesn't "be apart of something" mean "being separate of something"? That's what my dictionary claims that means. A part vs apart.
There is no such expression, Timo. One would be apart from, not apart of.
No he made the same mistake again.
What he meant was:
No, I want to be a part of the construction of the supercharger highway that will go across the USA.
Forget about the grammar. Let's talk about location, location, location! Think about building these new charging stations for those of us "snowbirds" who drive from the north/northeast every winter to Florida. We need charging stations along the major corridors to get there. These are 400 - 500 mile a day drives and we need that kind of capacity or charging stations along the road to accomplish it. So . . . think I 95 ; I 85 ; I 75 ; I 81 etc . All the major N/S routes. Thanks for listening.


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Ogilvy Potato Vodka, Scottish raspberry juice and lime.
Scottish potato vodka producer Ogilvy Spirits has launched a line of bottled vodka-based cocktail mixes that can be blended with tonic, lemonade, ginger beer or Prosecco to create the Perfect Pour.
A blend of potato vodka, fresh fruit juices and herbs, Perfect Pour is a new product range from distillery founders Graeme and Caroline Jarron who launched their signature potato vodka January 2015.
Made in Forfar, Scotland.
500ml Bottle Size


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The Financial Pyramid of Power
Dave Hodges
October 19, 2013
The Common Sense Show
Sometimes it is beneficial to pause and try to intellectually understand what the American people are fighting against. We see the daily struggles (e.g. threats to our pensions, bank accounts and civil liberties), however, what seems to be missing is a narrative which provides a macro view which reveals that there is a centralized plot designed to bring the nations of the world and its people to its knees and then impose one centralized political and economic authority.
I will not mince words here, this is also a classic battle between good and evil and for now, evil is winning hands down.
You Are Playing In a Rigged Game
Let's take a moment and examine the financial ground rules that we all live by. First, you need to realize that the first and only rule of the New World Order is that there are no hard and fast rules of the New World Order. I understand that in order to wrap your mind around this concept, it will require a huge paradigm shift because you have been raised to follow a set of established rules. This constitutes a naive world view and you need to realize that the rules that we are made to follow were only designed by the central bankers to keep you and me in line and to limit our ability to collectively compete with them both financially and politically.
Even though there are no rules when we deal with the structure of the central bankers, there are, however, two things that you can generally count on. Number one, most of you spend a significant portion of your day earning money to keep the wolf from the door. Your life is largely predicated on meeting your financial obligations so that you can survive. This principle was established by the elite in order to keep you working for them for your entire life. They have built a financial system in which they know how much to pay you and still keep you dependent on their system. Their system is a conscious predication of making you overpay on your home for 30 years because this keeps you working until just before you drop dead. Also, your retirement is the carrot they dangle in front of you for 50 years in order to keep you working for them.
For most of us, we work for peanuts in comparison to the wealth our labors collectively generate. On the other hand, the global elite spend their day trying to contemplate ways to add to their bottom line and, more often than not, your earned resources are their target. Directly, or indirectly, you work for the global elite and they compensate you with a miniscule fraction of what you make for the elite. Then your financial masters concoct plots designed to separate you from you money by using the power of government. We see evidence of this paradigm with the MERS mortgage fraud, stealing depositor's money, rigging the stock market and the central bankers printing their own money so they can acquire hard assets.
The Rest…HERE


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The minute I laid my eyes on Color Club's "Covered in Diamonds" flake polish was the minute I decided I needed it in my life! It's the most unique nail polish I've ever seen and it's utterly gorgeous. I love it over black because all of the colors shine over it, but it's equally as gorgeous on any other polish you can imagine.
{what i used}
CND stickey anchoring base coat
Wet n' Wild black
Color Club covered in diamonds
Seche Vite dry fast topcoat


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CERTIFIED 2019 MAZDA CX-5 GRAND TOURING in St. Petersburg, FL
Vehicle Pricing
- Kelley Blue Book Price
- $26,338
- Discount
- $2,522
- Internet Price
- $23,816
Vehicle Details
|Grand Touring
|Stock #
|Exterior Color
|Eternal Blue Mica
|Interior Color
|Gas Mileage
|City:24 Hwy:30
|SKYACTIV® 2.5L 4-Cylinder DOHC 16V
|6-Speed Automatic
Mazda Certified Pre-Owned Details:
* Limited Warranty: 12 Month/12,000 Mile (whichever comes first) after new car warranty expires or from certified purchase date
* Transferable Warranty
* 160 Point Inspection
* Powertrain Limited Warranty: 84 Month/100,000 Mile (whichever comes first) from original in-service date
* Vehicle History
* Includes Autocheck Vehicle History Report with 3 Year Buyback Protection
* Warranty Deductible: $0
* Roadside Assistance
CARFAX One-Owner.
Clean CARFAX.
Eternal Blue Mica 2019 Mazda CX-5 Grand Touring AWD 6-Speed Automatic PRICED WELL BELOW KBB PRICING, Bluetooth, Backup Camera, CX-5 Grand Touring, 4D Sport Utility, SKYACTIV® 2.5L 4-Cylinder DOHC 16V, 6-Speed Automatic, AWD, Eternal Blue Mica, ABS brakes, Automatic temperature control, Bose 10-Speaker Audio Sound System, Brake assist, Distance pacing cruise control: Mazda Radar Cruise Control (MRCC), Dual front impact airbags, Dual front side impact airbags, Electronic Stability Control, Emergency communication system, Exterior Parking Camera Rear, Front dual zone A/C, Fully automatic headlights, Memory seat, Navigation system: MAZDA CONNECT™, Power driver seat, Power Liftgate, Power moonroof, Remote keyless entry, Speed-sensing steering, Steering wheel mounted audio controls, Traction control, Wheels: 19" x 7J Aluminum Alloy w/Silver Finish.
Recent Arrival!
24/30 City/Highway MPG
* 2019 KBB.com Brand Image Awards
Visit our virtual showroom 24/7 at www.tyronesquaremazda.com.
Installed Options
Additional Vehicle Information
- Features
- Specs
- Mechanical
- Exterior
- Safety
- Technology
- Interior
- Comfort
|Axle ratio
|Drive mode selector
|4WD type
|on demand
|Center differential
|Rear brake type
|Front brake width
|Rear brake diameter
|Rear brake width
|Front brake diameter
|Emergency braking preparation
|Front brake type
|ventilated disc
|Braking assist
|Electronic brakeforce distribution
|Power brakes
|Electronic parking brake
|auto off
|Cornering brake control
|Front suspension classification
|Rear suspension classification
|Front struts
|Rear suspension type
|Rear spring type
|Front stabilizer bar
|Rear stabilizer bar
|Front spring type
|Front suspension type
|lower control arms
|Rear shock type
|twin-tube gas
|Front shock type
|twin-tube gas
|Cylinder deactivation
|Battery saver
|100 amps
Stability and Traction
|Stability control
|Traction control
|Hill holder control
|Moonroof / Sunroof
|tilt/slide, one-touch open/close, anti-trapping, power glass, sliding sunshade
|Daytime running lights
|Front fog lights
|cornering, auto high beam dimmer, LED, auto delay off, auto on/off, self-leveling
Tires and Rims
|aluminum alloy
|Spare tire size
|Tire type
|all season
|Spare tire mount location
|Spare wheel type
|Tire Pressure Monitoring System
Exterior Features
|Exhaust tip color
|Front bumper color
|Mirror color
|Door handle color
|Rear spoiler
|Rear spoiler color
|Grille color
|chrome surround, black
|Rear bumper color
|Fender lip moldings
|dual tip
|Window trim
|Rocker panel color
|Rear wiper
|intermittent, with washer
|Window defogger
|Front wipers
|speed sensitive, variable intermittent, rain sensing
|Power windows
|safety reverse
|Rear privacy glass
|Liftgate window
|Rear door type
|power liftgate
|Rearview monitor
|in dash
|Cross traffic alert
|Impact absorbing seats
|dual front
|Autonomous braking
|Pre-collision warning system
|audible warning, visual warning
|Lane keeping assist
|Automatic emergency braking
|Child safety door locks
|Child seat anchors
|LATCH system
|Energy absorbing steering column
|Safety brake pedal system
|Body side reinforcements
|side impact door beams
|Camera system
|Blind spot safety
|Lane deviation sensors
|Impact sensor
|alert system
|Crumple zones
|front, rear
|Airbag deactivation
|occupant sensing passenger
|Side airbags
|Front airbags
|Side curtain airbags
|front, rear
|Side-curtain airbag rollover sensor
|Power door locks
|anti-lockout, auto-locking
|Anti-theft system
|engine immobilizer, alarm with remote
|2-stage unlocking doors
|Side mirrors
|integrated turn signals, heated
|Side mirror adjustments
|power, manual folding
Audio System
|voice operated, AM/FM, HD radio
|Auxiliary audio input
|Bluetooth, jack, USB, iPod/iPhone
|Internet radio app
|Pandora, Stitcher, AHA
|Premium brand
|Antenna type
|diversity, mast
|Total speakers
|Radio data system
|Digital Sound Processing
|Speed sensitive volume control
|Surround sound
|Satellite radio
|Navigation system
|memory card, touch screen display, voice operated
|Electronic messaging assistance
|with read function, voice operated
|Driver assistance app
|roadside assistance
|Wireless data link
|hands free, voice operated
In Car Entertainment
|Connected in-car apps
|SiriusXM Travel Link, Google POIs, weather, sports, Google search
|MAZDA CONNECT™, Apple CarPlay ready, Android Auto ready
|Infotainment screen size
|7 in.
|Customizable instrument cluster
|Instrument cluster screen size
|7 in.
|Trip computer
|Driver information system
|Digital odometer
|External temperature display
|Warnings and reminders
|lamp failure, low fuel, engine oil, coolant, maintenance due, tire fill alert
|Multi-function display
|Fuel economy display
|MPG, range
|Trip odometer
|Driver seat power adjustments
|height, 8, lumbar, reclining
|Passenger seat power adjustments
|height, 6, reclining
|Passenger seat
|Driver seat
|Rear headrests
|3, adjustable
|Rear seat folding
|Front headrests
|2, adjustable
|Front seat type
|Rear seat type
|40-20-40 split bench
|Rear seat manual adjustments
|Seatbelt pretensioners
|Seatbelt force limiters
|Emergency locking retractors
|rear, front
|Seatbelt warning sensor
|Rear seatbelts
|Front seatbelts
|Turns lock-to-lock
|Steering ratio
Convenience Features
|Adaptive stop and go cruise control
|front, rear
|Memorized settings
|2 driver, driver seat
|Steering wheel
|tilt and telescopic
|Adaptive cruise control
|Power outlet(s)
|12V cargo area, center console, 12V front
|One-touch windows
|Reading lights
|front, rear
|Power steering
|Multi-function remote
|illuminated entry, panic alarm, proximity entry system, trunk release
|Cargo area light
|Retained accessory power
|Power windows
|lockout button
|Overhead console
|Steering wheel mounted controls
|audio, cruise control, phone, navigation, voice control
|Push-button start
|Vanity mirrors
|dual illuminating
|Assist handle
|rear, front
|Center console
|front console with armrest and storage
|Rearview mirror
|Universal remote transmitter
|Homelink - garage door opener
|in dash, front seatback, sunglasses holder, door pockets, accessory hook
Comfort Features
|Floor mat material
|Shift knob trim
|Steering wheel trim
|rear folding, rear center with cupholders
|Floor mats
|rear, front
|Floor material
|Door trim
Air Conditioning
|Front air conditioning
|automatic climate control
|Front air conditioning zones
|Rear vents
|second row
|Air filtration
Drive Type
|Drive Type
|Standard Seating
|Max Seating
|Head Room (front)
|39.3 in
|Head Room (rear)
|39 in
|Hip Room (front)
|55.2 in
|Hip Room (rear)
|55.3 in
|Shoulder Room (front)
|57.1 in
|Shoulder Room (rear)
|54.8 in
|Leg Room (front)
|41 in
|Leg Room (rear)
|39.6 in
|Seating Rows
Measurements of Size & Shape
|179.1 in
|83.3 in
|Width (without mirrors)
|72.5 in
|66.1 in
|106.2 in
|Ground Clearance
|7.5 in
|Track Width (front)
|62.8 in
|Track Width (rear)
|62.8 in
Measurements of Weight
|Gross Vehicle Weight Rating
|4724 lbs
|Gross Vehicle Weight Range
|4001-5000 lbs
|Curb Weight
|3679 lbs
|Gross Combined Weight Rating
|6138 lbs
|Max Towing Capacity
|2000 lbs
Truck Specifications
|Max Payload
|1045 lbs
Interior Dimensions
|Cargo Volume
|30.9 cu ft
|Interior Volume
|134.5 cu ft
|Passenger Volume
|103.6 cu ft
|Cargo Volume (rear seats down)
|59.6 cu ft
Performance Specifications
|Aerodynamic Drag
|0.33 Cd
|Turning Circle
|36 ft
|Acceleration (0-60MPH)
|8.8 seconds
Fuel Tanks
|Fuel Capacity
|15.3 Gallons
Wheels and Tires
|Front Tire Type
|Front Wheel Diameter
|19.0 x 7.0 in
|Rear Tire Type
|Rear Wheel Diameter
|19.0 x 7.0 in
Crash-Test Ratings
2019 Mazda CX-5 SUV AWD
|Front Crash Overall
|Front Crash Driver
|Front Crash Passenger
|Side Crash Overall
|Side Barrier Overall
|Side Barrier Driver
|Side Barrier Passenger
|Side Pole Driver
|Side Combined Front
|Side Combined Rear
Green Score
EPA Green Score
( California LEV-III SULEV30
EPA and California-required standards. The names refer to tables of numerical limits for the various air pollutants allowed by the standards.
|Fuel Type
Air Pollution Score ?
The Air Pollution Score is based on the government emission standards for which the vehicle was certified to comply with and reflects vehicle tailpipe emissions that contribute to local and regional air pollution, creating problems such as haze, and health issues.
Greenhouse Gas Score ?
This score reflects fuel emissions of carbon dioxide (CO2) and other greenhouse gases.
Smartway ?
SmartWay is a designation earned by those vehicles that have combined Air Pollution and Greenhouse Gas Scores that place them in the top tier (approximately the top 20%) of environmental performers. SmartWay Elite is reserved for the best of the best.
EPA Green Score
( Federal Tier 3 Bin 30
EPA and California-required standards. The names refer to tables of numerical limits for the various air pollutants allowed by the standards.
|Fuel Type
Air Pollution Score ?
The Air Pollution Score is based on the government emission standards for which the vehicle was certified to comply with and reflects vehicle tailpipe emissions that contribute to local and regional air pollution, creating problems such as haze, and health issues.
Greenhouse Gas Score ?
This score reflects fuel emissions of carbon dioxide (CO2) and other greenhouse gases.
Smartway ?
SmartWay is a designation earned by those vehicles that have combined Air Pollution and Greenhouse Gas Scores that place them in the top tier (approximately the top 20%) of environmental performers. SmartWay Elite is reserved for the best of the best.
Other Vehicles Customers Viewed
Car shopper
" Matt Geno was helpful, providing solutions, not pressure. He listened to my priorities and worked to satisfy my needs and wants in a vehicle. Brandon in finance only presented facts, not pressure. I believe he came to conclusions that fit my budget needs without hiding any "fine print". "
" Sandi Levin and Jeffery Spinger at Tyrone Square Mazda were the best. I have been looking for a new vehicle for a while. They were very helpful, explained everything in terms I could understand. I will definitely recommend Sandi and Jeffery to anyone who is looking for a vehicle. They will go to bar for you. Best car buying experience I have ever had. "
" Fabulous experience! Quick and easy, no arguing about price! My salesman was very knowledgable and efficient. If you go, ask for FRANK CARR! "
" I had a great experience this week working with Frank Carr! They were so so good to me there, everyone really, I feel like I'm part of the family. J.P. and Frank made a great team and I just had the best possible time hanging with them both! "
Car Service
" Bought a Mazda 3 very happy with vehicle and service. Thanks Bea and Rick "
" The sales, service and financing departments of Tyrone Mazda are exceptional. We previously had our first Mazda serviced at Tyrone Mazda and had professional, fair and exceptional service. We referred a friend to Tyrone Mazda, where she bought a Mazda 3 for her daughter. She also received exceptional sales and service. We recently bought another Mazda at this location, as a result of the premium customer service that we received at from all departments at this location. Matt was wonderful to us and the gentleman that arranged our financing and warranty contracts was above and beyond. We will continue to recommend this dealership. We have never worked with a better car dealership. "
" This is my 3rd vehicle I have bought from Tyrone Mazda. Frank Carr did a great job on the last day of the month. "
" After 2 weeks research and field trips to different dealerships, I finally bought my soul red Mazda from here. Alan was a nice guy who waited and welcomed me at the gate. He made greatest effort to make sure I got the best price. The price here is most fair in the Tampa Bay, and way below the KBB price. Overall, very friendly staff, good car condition and pleasant experience! "
Excellent service!
" Chris was very helpful and pleasant. Excellent service! "
" This was the most productive Saturday I have ever had in my entire life. With the amazing team of Frank Carr and Jeff from Finance I cannot thank them more for my new SUV Frank kept in contact with me throughout this week curious about what I was interested in specs price range and they fit that!! I received pictures, videos, updates on the car and Frank ran through all the software of my CX-5. Yes, they are slightly expensive compared to other used car dealers "I have done my research" but you 110% receive what you pay for from walking through the door to the 2hr test drive then finally to leaving the lot with fist bumps and smiles As far as Jeff goes he's a really down to earth guy and works with your financial status good or bad. Walked out of there paying $353 for 63 months for car and protection suitable for my drive (obviously within my monthly budget) If you need anything text Frank or call Tyrone Square Mazda anytime they have very flexible hours that work around YOU!! "
" My experience was great! They took the time and went the extra mile to help get me into the option I wanted. They were also patient and understanding of my needs during the entire purchase process of my loan. Thank you to all the staff who worked with me on this purchase. "
" Alan was very responsive to my inquiries and needs. "
" They replied quickly and were willing to help. "
" This dealership won my business simply because of their customer service and competitive pricing - you won't find a better one in the St. Pete area (I looked at 5+ And spent countless hours researching). I worked with Alexander Duke and his professionalism and honest approach to car selling is what sold me. He's a man of character, period. I would encourage anyone questioning the authenticity of a dealership to swing by this one. Thanks for the excellent service. "
" I worked with Alex Duke and it was a pleasure. He made things very easy, quick, and smooth. At other dealerships, I waited long amounts of time between them negotiating prices with their managers, appraising my trade-in, and then getting information for me on the car I was interested in. The process at Tyrone Square was very quick and I didn't waste much time sitting in a dealership office. They also gave me much more for my trade-in than I had expected! "
" Ron was a breeze to work with. We never felt pressured by him. He worked to get us a deal, and even drove to our house to return a fob I had left on my old car key. We were extremely happy with the whole process. "
Very impressed
" The process of leasing a vehicle from Tyrone Mazda went very well and took little time to finish when I came to pick up the vehicle. Everyone was nice and welcoming, from sales to business office. My only real criticism is of the physical building. Everything is very old and outdated, like a step back in time. I hope people can look past that and realize the quality of the Mazda vehicles. "
Great Experience
" Everyone at the dealership has always been friendly and professional. They have taken great care of me from the car buying experience and now from the service side. "
Happy Customer
" Matt was very helpful, doing what he said he would do efficiently and in a timely manner. I had a very good experience with him as my salesperson. "
The Cool Sales Guy
" I have been with Mazda for several years and this is my 5th Car with them. Ron is a great person, with quite the sense of humor. JP, is very cool as well, They are awesome. "
Tyrone Mazda
" Amazing dealership ! They were true to their word no hidden extra fees! Will definitely recommend! "
Exceptional service
" Mazda at Tyrone Square, St. Petersburg, gave us the most incredible service on a recent visit to the dealership. They went above and beyond to check out our vehicle and to run multiple tests to provide a comprehensive service. Their main service person, Matt, is extremely responsible and efficient and was a pleasure to deal with. Also one of their mechanics, James, was really helpful and assisted with every aspect of our service call. I would highly recommend this service provider as one of the best I have dealt with. "
My new Mazda CX5
" Awesome! This is the 2nd Mazda CX5 I purchased at TyroneSquare Mazda, Sonny Gonzales helped me answered all my questions very easy to talk to which helps me to feel comfortable buying my new car. I also felt comfortable with the payment process with Joseph everything went smooth. Thank you Tyrone Square Mazda Yvette Tiffany "
" Ron S. is the man! "
" I seen the vehicle I wanted online yesterday ( on a Sunday evening). I sent an email inquiry and Monday morning at the start of business I received an email with all the details pertaining to the car and a salesman by the name of Sonny gave me a call. I made the drive all the way from Jacksonville, Florida because the car was exactly what I was looking for. When I arrived Sonny greeted me and had the car waiting. I test drove it and I loved it. Sonny was professional and not Pushy. He didn't make me feel like I had to buy the car. By far the best and easiest car experience. The finance manager Jeff discussed my finance options and answered all my questions. Great friendly team. Yes I drove 3 hours and 30 minutes to purchase this car and I'm glad 🙂 "
" I just purchased my first Mazda from Alex Duke. It was a great experience from beginning to end. If you are car shopping, I highly recommend that you stop in and ask for Alex! "
" Marlena assisted me with my service appointment and I couldn't be happier! She was extremely professional and understanding. She made sure to run all prices by me before adding them onto my bill, and she took the time to show me how dirty my air filters were before recommending a replacement. Little things like that go a long way in building trust at a dealership, and for that I'm grateful. I can feel the difference in how my car runs now. Thanks Marlena! "
" Cannot recommend this place more! I had such a great experience shopping for my first car here! Frank was so personable and went above and beyond to get me the best deal possible. Such an easygoing, witty, and helpful guy who made the whole process quick and easy. Thank you so much Frank and Tyrone Square Mazda!! "
" Ted Lypka is amazing!! He made my first car buying experience at Mazda amazing ! Coming from an Audi to Mazda I was thoroughly impressed . Highly recommend Ted!!! "
" After going to several dealers and finding out their advertised price was several thousand below final cost of vehicle we called Tyrone Square Mazda. We spoke to Amy who was amazing and came in on her day off to meet with us. The price they advertised was the price of the car. No extra fees. I highly recommend this dealership! No hassle and no pressure sales. Very honest and upfront! I highly recommend this dealership! They made buying a car easy. "
" Super nice and great experience "
" After test driving different vehicles, I was very impressed with Mazda. The quality is unbelievable and you are getting luxury quality at affordable pricing. The sales person Amy was very helpful throughout the process, answering any questions I had by email or phone. The process of doing the paperwork for the lease was right around an hour which I appreciated so much and was electronic so nice and streamlined. Thank you! "
" Negotiation was very easy and straight forward. But after agreeing to purchase vehicle was told I had to finance with them or pay cash. Was told they would not accept funds from my credit union. I was very disappointed how the attitude changed so quickly. My credit union has earned my future buisiness. I was convinced that buying process was so easy that the dealership had also earned my future business because i purchase often. I was wrong. I cancelled my purchase. "
Very friendly dealership selling impressive cars
" Our salesman, Mike was overall the most polite, most professional, most attentive I've ever interacted with, and I'm 71-- so I've bought lots of cars and dealt with lots of sales people-- many of them excellent. Tyrone Mazda has a really good one with Mike, and we're really impressed with CX-5! I recommend the dealership and recommend you ask for Mike. "
Tyrone Square Mazda
" Exceptionall service performed on my older Mazda Miata. Service adjuster Anthony Gomez was extremely helpful and courteous when dealing with me during an extremely difficult time for me. Would highly recommend this dealership. "
Tyrone Mazda a pleasure to work with.
" Quick and easy check in. Service was done in acceptable amount of time. "
Purchased a New Vehicle
" Very Professional team. Answered all our questions. Helped us get a price we can afford. We recommend them highly. "
" Cullen did a great job getting us into our Mazda great service and hospitality go see Cullen and get into your new Mazda now "
" If you are interested in a fabulous car (2020 CX5 AWD) and an even better deal, then you need to go see Amy Potter at Tyrone Square Mazda. I've known Amy for about six years and purchased a few vehicles from her. She has never steered me wrong, has always done right by me and I would not purchase a vehicle from anybody else. You don't have to know the art of the deal because, the deal you'll get at Tyrone Square Mazda, is all you need. Congratulations on your new car and yay me for mine, I love it! 😉 "
Thank you Tyrone Square Mazda
" So clean with masks,gloves and sanitizer used. Social distancing and surfaces wiped down in the waiting room. Anthony Gomez was helpful, courteous and very efficient. Thank you. "
" Final team I dealt with deserves this rating: Jason, Matt & JP. However, the rest needs to be more personable even on the phone. "
" Amy Potter was awesome! No pushy sales and very friendly and accommodating! She even helped me hook my phone up to bluetooth after I purchased my car. Highly recommend! "
Dealership Information
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*All pricing and details are believed to be accurate, but we do not warrant or guarantee such accuracy. The prices shown above may vary from region to region, as will incentives, and are subject to change. Vehicle information is based off standard equipment and may vary from vehicle to vehicle. Call or email for complete vehicle information. All specifications, prices and equipment are subject to change without notice. Prices and payments do not include tax, titles, tags, finance charges, documentation charges, emissions testing charges, or other fees required by law, vehicle sellers or lending organizations. Preowned inventory online sale prices reflect payment by cash, certified funds or dealer assisted finance. Outside liens are not accepted.
Based on 2019 EPA mileage estimates, reflecting new EPA fuel economy methods beginning with 2008 models. Use for comparison purposes only. Do not compare to models before 2008. Your actual mileage will vary depending on how you drive and maintain your vehicle.
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By submitting my cell phone number to Tyrone Square Mazda, I agree to receive text messages and phone calls. Text messages and phone calls may be recorded and/or sent using automated dialing equipment or software from Tyrone Square Mazda and its affiliates in the future unless I opt-out from such communications. I understand that my consent to be contacted is not a requirement to purchase any product or service and that I can opt-out of these communications at any time. If applicable, I agree to pay my mobile service provider's text messaging rates.


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Group Bids: Exclusive bids from agencies published directly in the Purchasing Group
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Welcome to the New Mexico Purchasing Group!
All participating local government purchasing departments invite interested vendors to register for exclusive access to RFPs, bids and awards on the New Mexico bid system. Registered vendors benefit from more bid information in a central location, less paperwork and an easier method of doing business with New Mexico local governments. Please register to access open bids and RFPs.
Grow your government business in New Mexico! Register today to receive real-time notifications of matching bids, access documents & receive real-time addendum.


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I got an opportunity to conduct training program at JCI Durg/ Bhilai on "Be Better". I was appointed as the Pilot Faculty for MCID (Multi Chapter ID Program) along with two co-pilots Sandeep ji and Ekta ji. The program concentrated on Managing Self, Family, Profession and Social life of a person. The program was on how to better ourselves in each aspect of our life by upgrading our skills everyday or in other terms getting better each day.
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Rubio: Obama lacks guns 'courage'
Sen. Marco Rubio (R-Fla.) said Thursday that President Barack Obama doesn't have the "political courage" to "admit" his true feelings about the Second Amendment, the latest in Rubio's recent criticisms of Obama's gun proposals.
"Look, I have questions about whether he's truly committed to the Second Amendment as I understand it and most Americans would understand it. I don't think he has the political courage to admit that," Rubio said on Fox News.
( PHOTOS: Politicians speak out on gun control)
He continued: "But ultimately, I'm not worried that he's going to repeal the Second Amendment in terms of the law. I don't think they're going to do that. I do think, however, that if they don't fully understand the Second Amendment and how it's supposed to be applied — they are willing to test it, and they are willing to see how much they can infringe upon it."
He was speaking in reference to the president's gun control proposals that he announced Wednesday in response to the Dec. 14 shooting at Sandy Hook Elementary School in Newtown, Conn., where 20 children and six others were killed.
Obama urged Congress to pass legislation that would require universal background checks, an assault military-style weapons ban and a limit on gun magazines, among other proposals.
Rubio's take? It won't work.
"Here's my point: The impetus for all of this is the shooting in Connecticut, right; that's what led to this. And yet nothing he's proposing would have prevented Connecticut," Rubio said on Fox News. "So it appears to me like this is stuff they've always wanted to do and now this has created the political climate to do it. It's not going to solve the problem."
On Wednesday, Rubio — often mentioned as a 2016 contender — told Fox News anchor Bill O'Reilly on air that Obama should "have the guts to admit" if he doesn't support the Second Amendment, which gives Americans the right to bear arms.
( PHOTOS: Republicans, 2016 contenders)
"If he doesn't want the Second Amendment to be in the Constitution or if he wants to reform the Second Amendment, then have the guts to admit that," Rubio said on Fox News.
It was similar to the comments Rubio made on conservative commentator Laura Ingraham's radio program earlier Wednesday.
"There is a constitutional right to bear arms," Rubio said on the radio program. "I did not create that, and he cannot erase that. It is in the Constitution. If they want to change the Constitution, if they want to believe the Second Amendment should not be in there or if they believe it should be rewritten in the 21st century, then let them have the guts to stand up and propose that."


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File Download: PCL6 64-bit Driver - Download and Install
- Filename X-GPD_5.496.7.0_PCL6_x64B.exe
- Version 5.496.7.0
- Date Jun 29, 2016
- Size 38.7 MB
This PCL6 driver version of the Xerox Global Print Driver uses the Windows Add Printer wizard and should be used if your security policies prohibit downloading the "Install from Web" driver package. For complete instructions, please refer to the installation guide.
Note: Some printers may not support PCL6. Please refer to the documentation provided with your printer to determine the Page Description Languages that are supported by your printer.
Caution: The driver supports multiple languages. After the driver installation completes, the driver language is set to the language of the client operating system.
End User License Agreement
Click "Accept" to download, click "Decline" to cancel.