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Related UKC Forum discussions
In this comparison review, the UKC team has looked at 6 different lightweight sport climbing ropes from different manufacturers.
I remember back in 2008 I was in Lofoten with Mark Glaister for 2 weeks. We had done a fair share of the classic trad routes and wanted a day on the sport crag of Eggum. Of course, we only had double 9mm ropes with us so we climbed on these. Now anyone who is used to sport climbing on a single rope knows that double rope sport climbing is a right pain. It didn't take us long to reject the double ropes and push on with a single 9mm rope which obviously wasn't rated for single rope use (since we were not working any routes and mostly just lowering off this didn't seem too alarming although it is not recommended). What I noticed though was how great it was climbing with a lightweight 9mm rope - the clipping action was easy, the rope drag less, the knot was tidy and the rope felt really nice and supple.
Roll on 4 years and suddenly lightweight single ropes are all the rage. They also seem to come in some amazingly thin diametres like 8.9mm! So we decided to have a look at the current range and see how they perform - do they feel as good as the 9mm I used in Eggum?
Why would you want a lightweight rope?
Why wouldn't you want a lightweight rope?
The Testing
The ropes were sent to us in May 2012 and have been used by various members of the UKClimbing team since then. This included two trips where the ropes were present together so that we could contrast and compare them all. We assessed them as single ropes only despite the fact that some were triple-rated (rated for single, double and twin use).
What we tested:
Belay devices
Colour and Middle mark
Sterling Nano in action at Auzat in the Ariege.
© UKC Gear, Nov 2012
What we didn't look at:
Manufacturer specifications - Weight/metre
Manufacturer specifications - Rope Length
You own a 60m rope that is really 65m but you don't know that. You climb a route and just get down to the ground when lowering. Someone else turns up and wants to do the same route and you tell them that a 60m rope is long enough. They lower off and end up 5m short - ouch!
Perhaps some standardisation in official extra rope length is called for? (Remember - always tie a knot in the end of your rope when lowering!)
Manufactures specifications - Diametre
Rope Treatments
Summary Table of Manufacturer Specifications
Beal Joker 9.1mm
The rope arrived factory-coiled and comes with a roomy and usable rope bag. We actually received a black rope which didn't have a middle-mark but I am assured that the normal colours available are anis-green and orange which do have middle-marks. The black we used is now discontinued.
The Joker has quite a thick and solid feel for its diametre giving you the impression that it is fatter than its stated 9.1mm. Despite this, it handles well with a reasonably smooth clipping feel. It creates a decent small knot without being ultra compact. It is a triple-rated rope (rated for single, double and twin use) which makes it appealing as a one-rope suits all solution.
During the testing the rope was used for sport climbing in France, the Peak and Spain, plus numerous sessions as single rope on gritstone trad. It took several falls while sport climbing. It didn't give the softest of catches but was certainly adequate. On a few routes it was used for basic working before a red-point and performed well for this since it's more-substantial feel gave more reassurance.
For belaying the Joker works well with all the main devices giving a reliable grip despite its diametre.
The abrasion of the gritstone and French granite did take their toll on the rope but was up to the job. Some slight fraying but nothing more than would be expected for the use it had. The middle mark wasn't present on our black test version so we can't comment on how durable it is on the current colour range of anis-green and orange.
Summary - A more substantial rope that feels fatter than it is. It doesn't give the lightness of touch that many might expect from a lightweight single but does appear to be more resilient so could be an option for those who want a more lightweight rope that can be used for sport and trad owing to its triple-rated status.
Revelation Mammut 9.2mm
The Revelation 9.2 is a single rope for 2012 but it will be triple-rated in 2013. It arrived in a correctly looped coil making it easy to unpack. It didn't come with a free rope bag but did have a middle mark.
This was certainly the most substantial of the ropes we had on review. It really did feel like a 10mm but had the specifications of a much thinner rope which meant that it didn't handle and feel as light as the others. The clipping action was solid but not very supple.
It was used primarily for sport climbing in France, Kalymnos and Spain. Some falls were taken and the catch again felt more like a 10mm rope - solid but not very elastic. It handles well enough with the belay devices we tried.
Where this rope lost out on feel and touch, it gained on durability. Mammut ropes are renowned as being hard wearing and this certainly fits that bill since it looked pretty much as new 6 months into use.
Summary - The most solid-feeling of the ropes we tried. Ideal for those after a lightweight rope with the handling and durability of a 10mm work-horse. It could also be a good choice for those who want a lightweight rope but need the mental reassurance that they have something a little more substantial tied into their harness. It will be triple-rated in 2013.
Additional Notes on Mammut Revelation - Duncan Campbell - After the review team had finished with these ropes I was given this one by Alan as it was a spare rope he didn't need. After reading through this review I felt that the Revelation wasn't represented as well as it could have been throughout the short space of this review. I have recently returned from a 10 week climbing trip to America, during which I used the Revelation virtually everyday, mainly on granite, which is a very unforgiving rock type for ropes. I felt that the handling and light weight of this rope were very good, yet it easily took all the abuse I put it through over those 10 weeks and still has a lot of life left in it.
I used it both as a single and as a half rope, and found whilst it is useable as a half, it felt a little heavy in comparison to other triple rated ropes I have used. However, these have often felt alarmingly skinny when used as a single and would not be able to handle 10 weeks of use as a single without looking significantly more tired than the Revelation. All in all, I think this is a great, hardwearing, yet light single rope and will certainly be looking to get a longer one for European sport climbing trips.
Edelrid Kite 9.2mm
The Edelrid Kite 9.2 was an exceptionally slick and thin rope for the first couple of months of use. This gave advantages in that it reduced rope drag, and was easy to pay out, but perhaps due to the slippy nature of the coating, the rope had to be used with caution, even in assisted devices such as a Petzl Gri-Gri 2. In fact it was so slick that any belayer who was not familiar with the rope was given an extra warning at the start of the climbing day.
After a couple of months of use the rope had bedded in nicely and was a joy to use, being both supple, easy to use and also very responsive in the belay plate. Lots of falls were taken, and the rope performed well. After 6 months of use it is now showing classic signs of wear close to the ends, but on the whole has been an excellent rope with no serious wear issues.
The green colour has been slowly replaced with a good old dirty black, as the rope has been used, but the black middle mark (a double black stripe) has remained visible and usable. The rope is supplied loop-coiled secured with two tensile bands and a cardboard wrap. No rope bag was included.
Summary - The Edelrid Kite is a good thin and light rope for those wanting to climb long routes or push their grade. The handling was at first too slick and not recomended for novice users or people belaying a much heavier climber.
Tendon Master 8.9mm
The thinnest of all the ropes on trial and also a triple-rated rope (rated for single, double and twin use). It arrived factory-coiled and with a small storage bag which wasn't usable as a rope bag.
The Master 8.9mm had a very light feel, almost wire-like. Although only 0.2 or 0.3mm thinner than most of the other ropes, it felt significantly thinner than most of them. It has an incredibly light feel and is beautifully easy to clip.
The rope was used for sport climbing in France, Spain, the Peak District and trad climbing in the Peak and North Wales. It took a few sport falls and gave a soft catch with a reasonable amount of stretch. For belaying it was fine with all the main devices although you do need to be very careful to stay within specifications since some devices aren't rated for diametres of less than 9mm.
Despite its lightness, the rope appeared to stand up to the job showing little signs of wear and tear after a summer of reasonably heavy use.
Summary - An excellent rope which combines a very lightweight feel with a decent amount of durability. It does feels like you are climbing on a half rope, which might not suit everyone, but handles well as a single rope giving you the best of both worlds (if your head can take it). This was probably the stand-out performer of the set and as a triple-rated rope, it can also double-up as a one-purchase solution for all your rope requirements but, at £200, it is quite expensive.
The tidy knot on the 8.9mm Tendon Master
© UKC Gear, Dec 2012
DMM New Breed 9.4mm
This is in DMM's Pro range of ropes which have been designed to handle high levels of use. It is supplied shrink-wrapped for protection and factory-coiled requiring it to be properly flaked out prior to use.
The rope was used for sport climbing in France and the Peak District and lots of trad climbing in the Peak District. There was no problem with belaying using the Gri-gri 2, traditional bugs or the Click-Up. The rope did become dirty quite quickly and it is unclear why this happened but most likely it was from use of an old and tarnished belay device. The rope responded well to a session with some Beal rope cleaner though and there was no visible damage to the sheath other than slight discolouration in places.
Even though this is the thickest rope on test here, it still felt very soft and is easy to clip with thanks to DMM's Pro-dry treatment. Its use with the Click-Up was noticeably smoother than an old 10mm single in comparison.
The mid-point is clearly marked with dye (see the photo right) so should easily stay visible for the lifetime of the rope.
Summary - After a season of concerted use this rope still feels great and should stand up to plenty of abuse. It'll be ideal for those looking for a lightweight single for trad and sport routes that gives great handling while offering added reassurance of a more substantial rope.
Sterling Nano 9.2mm
This is the second Sterling Nano 9.2mm rope that I have owned and its technical characteristics have not changed since I reviewed the rope for UKC in this article last year. However this purchase was made with a new colour in mind - a vivid block orange, not a choice for those who are looking for understatement or subtlety. At 80m this Nano was procured with continental sport climbing in mind, its minimal weight being good for both carrying to and from the crag as well as keeping the weight and volume of hold luggage down for the plane journey.
The rope was supplied in a plastic bag and factory-coiled. The solid colour of the rope contrasts well with the thick black middle mark of the Nano making its passing easy to spot as well as when looking out for it on the ground when attempting to see 'how far is it to the halfway' mark.
The Nano handles extremely well being a relatively stiff line coupled with what I can only describe as a cloth like textured sheath, which allows the rope to be easily held and clipped whilst still retaining the smoothest of passage through karabiners and belay devices. The Nano knots easily but does seem to pick–up dirt on the sheath more quickly than other ropes I have used, although this has done little to dull, the vivid orange or purple colour that I had previously. The older of the two Nano's that I have owned is still in regular use and shows no more wear than my experience of ropes would suggest, being still easily handled, coiled and with no signs of severe wear on the sheath. The ropes have both held a good number falls and have provided a softish take and have not slipped or run in any of the belay devices.
The Nano is rated for use not only as a single rope but is triple rated being OK for use as a double or twin line, which could be handy if need be on the odd Trad route where a separate set of double ropes is not really necessary.
Summary - The Nano has proved to be an excellent lightweight sport rope that is both hard-wearing and possess superb handling characteristics.
General Summary
We tested 6 ropes and, to be honest, they were all pretty good. This wasn't such a surprise though since rope technology has come on so far in recent years and the manufacturer that makes a bad rope is unlikely to get very far.
The ropes dropped into 2 fairly distinct styles. On one hand we had the ropes like the Tendon Master, the Sterling Nano and the Edelrid Kite that gave performance like a previous generation 9mm half-rope that had been engineered to fulfil the specs of a single. These are the ones to consider if you are a confident climber after a rope that you can virtually ignore and concentrate on your climbing. On the other hand we had the Mammut Revelation, the Beal Joker and the DMM New Breed that seemed as if they had approached the problem from the other side by making thin versions of their thicker 10mm single ropes. Go for this category if you are the sort of person who feels your knot before a run-out and likes to use the reassurance of the rope to boost your confidence before a hard move but still wants the performance of a lightweight rope. As a third buying option, if you want to buy just one rope to fulfil all their climbing needs - sport, trad, twin, single and double - then consider one the triple-rated options - Tendon Master, Beal Joker and Sterling Nano currently, with the Mammut Revelation being added to this list in 2013.
Price-wise they are all quite expensive but shop around a bit since many are available on better deals than the RRPs. Also, always consider buying the longest rope you can afford; one of the golden rules of sport climbing is that you never regret buying a longer rope so go for a 70m or an 80m if you can afford it.
UKC Articles and Gear Reviews by Alan James, contributions from Jack Geldard, Mark Glaister and Paul Phillips:


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It is the commercial name for the drug oseltamivir phosphate. It is commonly used to treat people above the age of two, for influenza. It is prescribed only in cases where symptoms have persisted for not more than two days. Recently it was used to treat and protect patients from swine flu. According the FDA it is not a medicine that can reduce the chances of contracting the flu.
Ask an expert
- Natco gets USFDA tentative nod for generic Tamiflu
Natco Pharma today announced that it has received tentative approval from the US health regulator to sell generic version of Roche's Tamiflu, used to
- Bengal reports first swine flu case after three years
Experts in Kolkata have confirmed on Thursday that West Bengal has reported its first swine flu case after a gap of three years. The last case of
- Rajkot swine flu update: one more succumbs, total toll reaches 51
A 21-year-old woman died due to swine flu at Civil Hospital in Rajkot late on Sunday. The deceased Ranidevi Rai was a native of Bihar and was
- Rajkot swine flu update: 50 people dead, one more succumbs
Swine flu has claimed yet another victim, this time in Amreli of the Saurashtra region. According to official records, the 50-year-old woman from
- Pune swine flu update: Health measures stepped up
Civic health authorities in Pune have stepped up screening measures after the spurt in swine flu cases in the city. There have been seven fatalities
- Tamiflu resistant swine flu virus has experts worried
Researchers in Australia have discovered that the Tamilflu – the most-effective drug against swine flu – might be losing its effect. While
- A drug that can destroy the influenza virus, now on the horizon
Scientist in Canada have discovered a more effective substance that has shown the ability to destroy the Influenza virus. Simon Fraser University
- Coming soon – drugs highly effective against viral flu?
Till now, there have been no drugs that can be called 'effective' in the true sense against the viral flu due to the virus' highly mutating nature. A

subset: commoncrawl


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U.S. manufacturing activity last month hit a three-year low, and factories in Georgia slowed down, too.
Culprits: Superstorm Sandy and the fiscal cliff.
The decline, while not a surprise, was more severe than expected. Nationally, the Purchasing Manager's Index, based on a survey of manufacturers, fell to 49.5, the lowest since July 2009. A score below 50 indicates contraction.
In Georgia, the index fell to 46.4 in November, down 5.3 points from October. Most of the underlying components of the index declined, including new orders, production and employment.
State factory activity improved in September after declining for four consecutive months through August, then turned down in October.
Don Sabbarese, director of the Econometric Center at the Coles College of Business at Kennesaw State, said, "We believe this sharp drop can be attributed to the negative effect of … Sandy in the northeast and the uncertainty of Washington's handling of the fiscal cliff. Until Washington resolves this problem it will remain difficult for manufacturers to plan for the future."
December 3rd, 2012
2:50 pm
Quick, build a billion dollar stadium!


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LACED UP Sneaker Showcase Jacksonville, FL Recap
The LACED UP Sneaker Showcase event in Jacksonville, FL that went down on January 13th was a huge success. The packed event had people from around the country to showcase rare sneakers like AJ4 Laser samples, Eminem AJ4′s, and more.
Giveaways and raffles were given throughout the day with cash money given out to winners of sneaker battles and the crowd favorite. If you were not able to didn't make it to the LACED UP Sneaker Shoecase, then check out the full recap of rare sneaker heat below. Shout out to Jsun TheINFADER for putting the event together.
Follow @TheShoeGame on Twitter & Instagram
Click through the gallery below for a detailed look.
About the Author (Author Profile)Senior Editor for TheShoeGame.com Twitter: @FootSole_ja & Instagram: @alexthagr8_tsg
Comments (7)
I was there! Had a great time at the event!
Damn I wish I couldve made it, looks like they had a lot of heat as expected
awesome! thanks for the recap!
All I can focus on is the heat in the Bulls hat.
It was a great event, set the bar very high for the year, salute @theinfader and S/O to TSG and AdaGreat for the recap!
Nice collections of kicks.
Wish I was there…but looks like a good event…
Thats me with the VC3 All Star… #Nice… IG- Just4Kicks212


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Porthmadog Wales
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Aaron Shust Has Longest Running #1 Hit in 2011 "My Hope Is In You" Eight Weeks At Top Spot On AC Monitor Chart Nashville, TN (December 15, 2011) —– A hearty congratulations are in order for Centricity Music's Aaron Shust for reaching a career milestone. Shust's single, "My Hope Is In You," this week became [...]Continue Reading »
QUEEN'S ROGER TAYLOR ANNOUNCES WINNERS OF "THE QUEEN EXTRAVAGANZA" COMPETITION THAT INCLUDES NASHVILLE'S MARC MARTEL, LEAD SINGER OF DOWNHERE WINNING LINE-UP TO TOUR NORTH AMERICA IN 2012 WITH GRAND PRODUCTION FEATURING CLASSIC QUEEN SONGS Roger Taylor (Los Angeles, CA – December 8, 2011) Four decades later, the music of Queen hasn't just survived, it's thrived. The [...]Continue Reading »
Review of Me In Motion's "Yes We Can-EP" by a staff reviewer at www.NewReleaseTuesday.com Check out their new EP and preview all the songs HERE To read the full article click HERE Perfection In Motion | Posted November 30, 2011 Staff Reviewer It was a longstanding joke in the music industry that Christian music was always, stylistically, two [...]Continue Reading »
Check out NewReleaseTuesday.com Behind the Song with Kevin Davis. This article is about Jason Gray's song, "Remind Me Who I Am" Here is part of the article, to read it in full go HERE By Kevin Davis Look no further than first single and opening track, "Remind Me Who I Am," for a classic example of Jason [...]Continue Reading »
Aaron Shust Performs At Focus On The Family Thanksgiving Chapel and Interviews with KBIQ As His Single My Hope Is In You Stays #1 For 5th Week On AC Monitored Chart Left to Right: Aaron Shust, Jack Hamilton Nashville, TN (November 22, 2011) —– Aaron Shust had a busy schedule last week with a trip [...]Continue Reading »
Aaron Shust's song, "My Hope Is In You" has been #1 on adult contemporary Christian radio for 5 weeks.Continue Reading »
Eaglemont Entertainment Artist High Valley Big Winner At This Year's GMA Covenant Awards With Five Wins Including Group And Artist Of The Year Nashville, TN (November 8, 2011) —- Eaglemont Entertainment's Country band, High Valley, won big award categories during the GMA Convenant Awards in Canada. High Valley won five categories that included: Group of [...]Continue Reading »
Centricity Music Artist Downhere Wins Two Awards At This Year's GMA Covenant Awards Including Song Of The Year Nashville, TN (November 8, 2011) —- Centricity Music's high-profile band, Downhere, won two major categories during the recent GMA Convenant Awards in Canada. The group won Song of the Year (Let Me Rediscover You) and Pop/ Contemporary [...]Continue Reading »
Me In Motion's new release, Yes We Can-EP is available now. You can find it on iTunes for $2.99. To buy the album click HERE To preview all the songs click HERE Track list 1. Yes We Can 2. Back 2 Life 3. Let Mercy Hold You 4. Eye of the Hurricane Find Me In Motion On [...]Continue Reading »
Aaron Shust Reaches #1 Position On AC Monitor Chart With Current Single, My Hope Is In You Song Has Been #1 On AC Indicator Chart Five Weeks and Soft AC Chart Six Weeks Chart-Topping Song Marks Centricity Music's First #1 AC Hit Nashville, TN (October 27, 2011) —– Aaron Shust's single, My Hope Is In [...]Continue Reading »


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FLCC Connects Volunteers
Welcome to FLCC Connects Volunteers, a Website intended to link would-be volunteers with local agencies in need of volunteers. Whether you represent an agency looking for help or are someone looking to lend an hand, we at Finger Lakes Community College hope you find this site helpful.
Please note that some agencies have listings indicating a need for regular volunteers while others sometimes post special events representing one-time volunteer opportunities. We have dozens of agencies in our databank and will continue to build on that information. If you don't see a volunteer opportunity that fits, please visit this site again and look for updated opportunities. If you want to list a volunteer opportunity, let us know.
As you proceed through the site, you can search our databank by looking in any of the eight specific categories, or by viewing all agencies in the system. The eight categories are: animals/environment; arts and culture; children/youth; computers/technical; education/literacy; health related; seniors; sports and recreation.
If you are a would-be volunteer: When you find an agency that interests you, click on the link to access more details about the organization and its needs as well as contact information.
If you represent an agency and would like to have your volunteer opportunities included on this site: Contact the Student Life Office at FLCC by calling (585)785-1264, or e-mail us at email@example.com. Volunteer opportunities can also be submitted by e-mail using our FLCC Connects Volunteers form.
Volunteering can be a rewarding experience for both the volunteer and the agency associated with a mission or project. Thank you in advance for supporting the community with your most precious commodity – your time!


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New Dunkin' Donuts locations will create additional tax revenues, 100 new jobs in Western New Yorkby jmaloni
Press release
Dunkin' Donuts today announced that Buffalo franchisee Tim Cloe has signed agreements to build four new Dunkin' Donuts locations this year with Amherst-based Bevilacqua Development.
The new locations are slated to open in 2013 in Lockport, Hanover and Amherst (near UB North and on Transit Road) and will all feature the new modern Dunkin' Donuts look introduced this year.
"Dunkin' Donuts continues to expand in the Buffalo area in response to strong demand from our loyal and growing base of consumers," Cloe said.
The announced openings will bring to 48 the number of Dunkin' Donuts restaurants in the greater Buffalo area, including nine new locations since the beginning of 2012.
"We are very excited to be working with the Cloe Group to bring the Dunkin' Donuts brand to more people across Western New York," said Jonathan Bevilacqua, president of Bevilacqua Development. "We are currently pursuing other locations, which will be a good fit to further expand the presence of Dunkin' Donuts in this market."
Dunkin' Donuts is one of the leading baked goods and coffee chains in the world, selling 1.5 billion cups of hot and iced coffee and more than 2.4 billion donuts and Munchkins donut hole treats every year. Today, there are more than 7,000 Dunkin' Donuts restaurants in 38 states across the U.S., plus the District of Columbia, and more than 3,000 international restaurants in 32 countries.
To learn more about Dunkin' Donuts, visit www.DunkinDonuts.com or follow the company on Facebook (www.facebook.com/DunkinDonuts) and Twitter (www.twitter.com/DunkinDonuts).


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Police raided a business in Jacksonville on Friday and arrested a man for running a gambling establishment.
According to Jacksonville Police, Saeed Oehme, 58, was arrested and charged with Keeping a Gambling Place, a Class A Misdemeanor.
Oehme is the owner Jacksonville Beer and Wine and DC Warehouse.
Jacksonville Police say they had been keeping an eye on Saeed Oehme for five years when nine gambling machines were removed from his store Friday afternoon.
Jacksonville Police had been watching a couple of eight-liner gambling machines in the front of the store, but they did not have proof of the gambling ring until they responded to a disturbance between Oehme and a disgruntled employee at the business on Thursday. While there, they noticed a locked door in the back of the business labeled "Lavatory."
"I had officers in the building doing the disturbance notice signs on the wall that were, one of them said $500 maximum cash payout, and the other said this game hit $260 three days ago," said Jacksonville Police Chief Reece Daniel. "So it was obvious it was gambling going on. And we got information at the same time that the machines in the front were just for show, that there was an actual gambling place in the back behind a locked door."
Officers returned to the establishment Friday with a search and arrest warrant and discovered nine electronic gambling machines behind the locked door.
"Sure enough, behind the locked door we found nine or ten machines and a full-fledged gambling establishment there," Daniel said.
Police say gamblers would pay cash into the machines but would have to receive their payouts from the front of the store.
They say they only plan to charge Oehme for operating the establishment - although they say they've already received complaints for shutting the gambling room down.
"I've already had a woman up here complaining that we put him out of business," Daniel said. "So, I suppose some of them enjoyed it."
Oehme was arrested around 11 a.m. Friday. He is currently behind bars in the Jacksonville City Jail awaiting a bond hearing, which should take place Saturday.
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Blog & Updates
DREAM Act is Reintroduced in the House and the Senate
March 26, 2009 - Posted by Mario Moreno
Senator Dick Durbin (D-IL) has joined forces with Senator Dick Lugar (R-IN), Congressman Howard Berman (D-CA) and Congressman Lincoln Díaz-Balart (R-FL) and several other Republican and Democratic Representatives to reintroduce the Development, Relief and Education for Aliens Minors Act or DREAM Act. The DREAM Act is an important component of comprehensive immigration reform that would provide a path to citizenship to immigrant students who have been raised in the U.S., graduated from a U.S. high school, have stayed out of trouble and attend college or serve in the military.
Ruben Rumbaut, a sociology professor at the University of California at Irvine who has been studying immigrant children since the 1960s accurately called these students the "1.5 generation"; highly bilingual and high achievers, working to "make good" in the eyes of parents who made substantial sacrifices on their behalf. They have been beating the odds all of their young lives.
These hard-working individuals were brought to the U.S. when they were just children and call America home, are deprived of achieving their full potential because they are punished for a decision they had no control over. Ignoring their situation and ignoring the inadequacies of our outdated immigration system will not resolve our immigration problems.
As our country seeks ways to rehabilitate our economy, we should keep in mind the many young and talented individuals who are already living in the U.S. and who could be part of the skilled and educated workforce of the future that will help us compete in the global economy.
Today's introduction of the DREAM Act is additional proof that Congress is getting ready to work on immigration reform. We applaud these courageous Members of Congress who have set partisan wedge politics aside and are ready to engage meaningfully to find a practical and fair solution to our immigration troubles.
You can read our press statement here and show support for the DREAM Act here and here


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(This story is Bella's point of view)
My perfect piece of forever was supposed to be the end of the story. But I think it's time I should talk about what happens afterwards.
I've been thinking about how my life used to be. My dull, boring, human life. My life, before Edward (which I think is pointless). If there was no Edward in existence, what would be worth living for? Nothing. Not every person gets exactly what they want because life isn't fair.
But for me, I have everything I could have asked for and more. For instance all I've ever wanted since I came to Forks was Edward. He is finally mine and I'm now known as Mrs Cullen (I've always liked the sound of that). I soon enough realized I wanted to marry him and I got what I wanted. I wanted to live for eternity with him, I got my way again. I also wanted Jacob to be my friend after I'd been changed the way it's supposed to be, and yet again I got exactly that.
But what I didn't ask for was a daughter, which I now have as well. Mine and Edwards's beautiful daughter, Renesmee. She's a big part of me and Edward now. I knew before I had conceived her that I was doing the right thing, keeping my precious baby alive. I vaguely remember thinking that my baby was a boy, a little Edward. I didn't want the baby to have interference from me. But now I realise that just makes her more perfect. But back to reality (which I don't think exists anymore) I've been on a long journey and yet it still continues. So here goes . . .
Please comment!
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Who is this Tina? Where does she come from? Please update soon!
You'll know soon. ;)
.id just read ur tory.,. please keep me updated. :))
Chapter fifteen
We decided to go home today, there was no point in being here anymore. Renesmee didn't talk much. Well she actually didn't talk at all, even on the way home. She just sat in silence staring into space. When we got home she went back to the cottage to be alone for a while. Me and Edward went back to the house. Carlisle said he hadn't seen Jacob since the wedding. Well what was supposed to be the wedding. Alice was on search for the future, for anything that might happen. She was finding it difficult considering she was looking for Jake and Nessie. Jake was harder but it wasn't impossible.
We just sat talking about why Tina had done this, why would she want to? So any questions with no answers. I was stressed by this, I needed to know the answers. Why? How? She wasn't here when Jake had said all those things. So who was? Just family. No-one here would do something like that.
My thoughts we're interrupted when there was a loud banging sound as I watched a box full of Carlisle's work tumbled down the stairs out of Alice's hands. Her eyes were like glass, flickering, I knew she was seeing something. And that was when I remembered something so similar to this moment, the time when Alice had dropped a vase and she had seen Irina go to the Volturi. I flinched at the memory. So this was something bad, I ran up the stairs and spoke to Alice.
"What is it Alice? What's wrong? Is it Renesmee or Jake?"
After a minute of impatience she spoke quickly.
"It's Jake, he's gone to the Volturi. He's asking to be turned into one of us because he knows it will kill him."
"No." Edward whispered in shock.
"We have to stop him. We can't let him die it's not his fault." Esme hissed.
"We can't all go, it'll only make things worse." Rosalie said.
"Who will go then?" Carlisle said in a strained voice.
We all glanced around the room deciding what would be the best decision.
"I'll go. I'm faster" Edward called out.
I shot down stairs and kissed him.
"Hurry." I said.
"There wouldn't be anything in the world that would stop me from protecting my daughter and someone as innocent as Jake." He whispered. And then he was gone.
"I'm going to tell Renesmee, she deserves to know." I said so quietly no-one human would be able to hear it.
I began to think on my way there. Suddenly I had a feeling that 'showing' wasn't her gift. I was sure it was something else. That was when the pieces of the puzzle started to come together. Tina was I Tanya's coven, the coven of which Irina had been in. I knew this Tina was close to Tina back when she was alive, well as a vampire anyway. I also remembered the Reason Irina had caused trouble for my family and myself when Renesmee was little. Anger, pain, mistaken. Revenge. That was when Irina didn't know the truth about Renesmee, didn't know what she really was. That was also when she met Tina. At that moment I knew Irina had done this, she had told Tina to ruin Renesmee's life when she didn't know she wasn't an immortal child. Irina had got into Edwards head when he had heard all the things Jake had said and so Irina had told Tina to use it against Jake. Tina didn't have the gift of 'showing' like Renesmee at all. Her gift was showing people what she wanted them to see. And so Irina had succeeded, she had in fact ruined Renesmee's life. Renesmee would finally know that it was all a lie. But by then it would be too late.
Thankyou! You'll find find out soon whether it's safe for him or not. But as i'm not team Jacob what do you think? ;L
I will update soon. :)
Once again its Bella who puts the pieces of the puzzle together. I hope they can get to Jake and change Renesmee's mind in time!
Yes Bella has room to think now that she's imortal. Oh and you'll find out soon enough. :)
Chapter sixteen
Edwards P.o.v
I was almost there, I could tell by my surroundings. I took a flight to Italy and rented a car, it didn't take long as planned. Time was something I didn't really have right now.
I was always searching, it was easier to find Jacobs scent because of the awful smell. It was the easiest next to Bella's anyway.
I got out of the car and started running at the fastest pace humanly possible. It's a very public place here by the Volturi I don't really understand why.
I still couldn't find it yet but I was sure what Alice had seen was true, it seemed like a thing Jake would do. Stupid, yes. But understandable considering what he thinks is the truth. But it can't be I know that.
Any one back home could have figured it out by now and I wouldn't even know. It could be Alice with her visions, it could be Bella as she's always figuring things out. Or it could be Carlisle always searching for an answer.
Soon I found myself outside the gates and came face to face with a guard. Felix. How strange, he's not usually someone who stands at the gates.
"Hello Edward, wasn't expecting to see you again." Felix teased.
"What is the reason for your presence." He continued.
I opened my mouth to tell him it was an emergency and that I needed to get through and fast. But then my senses kicked in and I caught his scent. Jacobs. But the thing that scared me was it wasn't his normal wolfy scent.
It was the scent of his blood.
It's not a very long chapter but it's a good one. I knew how i wanted it to end (the chapter) but i didn't need alot of writing for this one. ;) I'll update more soon.
PLEASE Update like reallly SOON!! Its realllly GOOOD!
Oh i will i'll start writing now. ;)
LOL, thanx and i'l start writing the next chapter now. ;)
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An Ouchless Emergency Room Visit?
New guidelines from the AAP aim to help children and parents alike keep calm and carry on in the ER
Taking your child to the emergency room can be a frightening experience—for both of you. To keep kids calm (and hopefully stop parents from freaking out, too), the American Academy of Pediatrics (AAP) released new guidelines for reducing children's anxiety and discomfort in the ER.
First and foremost, the AAP encourages ER departments to pay more attention to managing children's pain—something that tends to go undertreated. Why? One explanation is that ER doctors aren't always comfortable administering pain medications to children, and they often have a hard time deciphering just how much pain a toddler or baby is actually experiencing. Also, a child's pain is often overlooked if the ER is busy.
To rectify this problem, the AAP encourages doctors and other emergency personnel to put together a sort of "triage" for comfort and pain relief that begins with instructing parents to offer appropriate pain relievers or fever reducers before leaving for the hospital. If a child is transported in an ambulance, the report recommends EMT medics be allowed to administer pain relief, including numbing creams and other analgesics, to young children. (Currently, there is no standard for what medics can and can't provide kids).
Upon arrival at the hospital, ER medical staff should assess young patients for pain and anxiety using age-appropriate scales: pain in a newborn can be evaluated using the Neonatal Infant Pain Scale, and pain in infants, young children, and those with cognitive impairment can be assessed using the FLACC (face, legs, activity, crying, and consolability) scale. A decision can then be made about what medications to administer.
Why so much attention to pain relief? "It can make such a huge difference in the experience of the child and the family," Dr. Audrey Paul, pediatric ER physician and an associate professor of emergency medicine at Mount Sinai School of Medicine, tells NBC news. "It's just about being educated and being aware [of the options]."
However, some young children brought to the ER may not require pain medication, but still could use an extra dose of comfort. The best way to provide this, says the AAP, is to allow the child's adult caregivers to continuously stay with the child throughout the ER stay. When a comforting distraction is needed during needle pricks or other procedures, a pacifier dipped in sugar water—or breastfeeding, we presume, if fluids are allowed—might do the trick just fine, according to the report. Hospitals are also encouraged to provide calming amenities such as kid-friendly videos and music, and "distraction kits" equipped with items like bubble wands and pinwheels.
What else works to help everyone stay calm? The emergency department at Northwest Medical Center in Coral Springs, Florida, recommends three basic ways to make ER visits as ouchless as possible:
- Bring a bit of home: To make the hospital feel a little more familiar and comfortable, bring a blanket, lovey, or some other small comfort item for your child, pack extra diapers and a bottle (or a toddler-friendly snack), and don't forget to grab something quick for you to eat like a granola or power bar.
- Speed things up: Because sometimes things can move fast in the ER, be ready with your child's health history so your child can be promptly—and properly—treated. Information to have at your fingertips includes allergies to medications, known health issues, previous injuries, dates and reasons for prior hospitalizations, health insurance, and the name and phone number of your child's pediatrician.
- Make a plan: No one wants to think about the possibility of taking a child to the emergency room, but taking time to organize emergency phone numbers, going on a test run to your local ER to understand the shortest route and where to park, and calling local EMTs (on their non-emergency line) to discuss how they transfer babies and young children can all go a long way to help you keep the focus on your child in the event of an emergency.
And, knock on wood, this will be a plan you never need to use.


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Alumni Reception in Chicago
Dean Mary Crossley cordially invites you to a reception for Pitt Law alumni and friends, held in conjunction with the ABA Administrative Law & Regulatory Practice Section Dinner. Complimentary Reception will be held at 6-7pm with dinner from 7-9:30pm(optional, $100 per person*).
Please RSVP for the Reception to Pitt Law Alumni Office by Friday, July 24 at 412-648-1305 or firstname.lastname@example.com
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Save the Date!
The 2015 Las Vegas Epicurean Affair is Scheduled for Thursday May 21st
The Las Vegas Epicurean Affair is the gourmet event of the year. Set in a lush poolside paradise, the Las Vegas Epicurean Affair will take your senses on a wild ride. From the savory cuisine and succulent cocktails, to the stunning sights and sounds of sultry surroundings, this is truly an event that offers its guests the best of everything. Join us for a night of divine indulgence!
2014 Participants
Wirtz Beverage Nevada Brands Include: Brown-Forman, Diageo, Jackson Family Fine Wines, J Lohr, Kobrand, Stella Artois, Rum Chata/Tippy Cow, Infinium Spirits, Proximo, Tito's, William & Grant, Bacardi, Voss Water.
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2003 Saab 9-3 Sport Sedan
By Dan Jedlicka of MSN Autos
Bottom Line:
Much-needed new mainstream sedan is a genuine rival to European rivals.
The redesigned Saab 9-3 Sport Sedan finally gives the Swedish automaker a midsize sports sedan that promises to have mainstream appeal, although some will have to get used to the car's trim designations: Linear, Arc and Vector.
But never mind the quirky names. The new 9-3 is a slick, fast, roomy "near-luxury" car that Saab hopes will help generate much-needed sales. It represents a $450 million investment in new facilities and machinery and is a solid alternative to rival sports sedans from Audi, BMW, Infiniti, Lexus and Mercedes-Benz—pretty heady company.
As with French automakers, Saab long has gone its own way with car design. It has built offbeat but safe, rugged, fun-to-drive autos that never enjoyed a lot of sales success in America. They were too quirky for a big audience and thus haven't had the resale value of more conventional cars. Few Americans even noticed the nifty front-drive Saab Sonett sports car sold here from 1966 to 1974.
However, the 2003 9-3 is expected to attract younger buyers and those who never considered a Saab.
Timely Arrival
The 9-3 recently went on sale in $25,900 Linear trim. The more luxury oriented $29,995 Arc version and sportier $32,495 Vector trim arrive next spring. The Linear has 175 horsepower, while the Arc and Vector get 210 horsepower. All have turbocharged 4-cylinder engines.
Based on New GM Platform
Meanwhile, the $39,995 Saab 9-3 convertible will be sold with the old Saab platform until replaced in about a year by a modernized version. A 9-3 station wagon version and "crossover" vehicle also are scheduled to be here by the 2006 model year.
No More Hatchbacks
The 9-3 has a conventional sedan body style with a regular trunk, like its rivals. That's big news because hatchbacks have been a Saab hallmark for decades—and, ironically, are beginning to make a comeback in America.
But, while practical and favored by Saab loyalists, hatchbacks don't have the "formal" appeal to most Americans of a notchback European sedan with a regular trunk.
Saabs always have had front-wheel drive, and that's what you'll find in the new 9-3. The wheelbase has been increased 2.3 inches, and the car is more than 2 inches wider to allow more cabin breathing room.
Handsome Appearance
Despite styling changes, Saab says the 9-3 Linear's wedge-shaped profile and integrated headlights and grille help give the car a "distinctive Saab identity." Actually, the car has a pronounced Germanic look.
The 9-3 Linear keeps Saab's traditional console-mounted ignition switch between the front seats. The unusual location makes it easier to reach than a switch buried on a steering wheel column. The switch now is entirely electronic in operation; the customary, mechanical Saab reverse manual gear lock that was facilitated by the switch's location has been replaced by an automatic electronic steering column lock.
New Powertrain
There also are an improved 5-speed manual gearbox and new 6-speed manual transmission.
Saab always has been big on safety. The rigid body of the new 9-3 is very strong to help enhance safety, along with handling.
Major Safety Features
Also standard are stability and traction control systems. And standard anti-lock all-disc brakes work with an electronic brake assist for panic stops. A new cornering brake control system is activated when the car is cornering during heavy braking—a situation that can quickly put an auto into a skid.
A dirty windshield hampers safe driving, so Saab has given the new 9-3 four windshield washer jets that work at twice the power of most other systems.
The Linear's smooth 2-liter, 175-horsepower engine provides lively acceleration. Saab is a master at getting lots of power from small turbo engines, but there's a slight turbo lag when accelerating.
Estimated miles per gallon with the Linear engine is in the low 20s in the city and low 30s on the highway.
Higher Horsepower
The 9-3 has sharp, buttoned-down handling for a front-drive car, with such things as wider front and rear tracks. There's also a new passive rear-wheel steering system that improves handling and stability.
Steering is precise and the brake pedal has a reassuring feel. The supple new all-independent suspension easily handles road irregularities, but is on the soft side and sometimes lets the car become a little bouncy.
Aircraft Influence
Front seats are very supportive and have precise manual rotary seatback adjusters. All doors have storage pockets and rear windows lower all the way.
Large Cargo Area
The 9-3 Linear is impressive, and the higher-line versions promise to be even better. But will GM provide Saab with the marketing muscle to draw a good number of people to Saab showrooms to try out the car?
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Jury selection is now underway in the trial of Leonardo Cardoza.
The 27-year-old is charged with open murder with a deadly weapon - and attempted murder with use of a deadly weapon.
Police say an altercation started as road rage back on January 26, 2013. Prosecutors say Cardoza hit Desiree Bragg with his car outside her mother's home pinning Bragg against the garage door - in Carson City.
The 19-year-old passed away at the hospital four days later.
Cardoza has pleaded not-guilty to both charges.
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Click here to view ALL Young Band titles
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Carl Fischers Repertoire Classics series consists of comprehensive and progressively graded collections of classic solos with piano accompaniment.
Each book contains a fine mix of transcriptions of familiar classics along with solos written specifically for the instrument. Many of the pieces in these collections appear on state contest and festival required music lists.
The pieces featured cover the performance levels of grade 2 through 5, representing all style periods, and include works by some of the greatest composers of all time.
As an added bonus, the included data CD contains MP3 audio files of the piano accompaniments to make practicing more fun. It also contains piano accompaniment parts for all pieces in the collection in PDF format.
Our innovative and unique packaging allows Carl Fischer Music to provide you with large and useful collections of solo literature at affordable prices, and players will find them useful for years to come.
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Each book is only $9.95. This series is available for:
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This collection contains 32 trios in a variety of styles from classical to folk, and includes some new original works as well. Each piece is playable by any combination of three wind instruments. Trios are a great way to learn how to play in a chamber music setting, and this unique collection gives players the opportunity to do it with anyone else that plays a wind instrument, making for an almost limitless combination of instruments. Compatible Trios for Winds is especially useful in a school setting where students are eager to play music with friends. The flexibility of these trios makes them a must-have for any wind player. Includes tunes such as "The Irish Washerwoman," Brahms "Hungarian Dance No. 5," Larry Clarks original "Harvest Moon," and more.
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NOW PLAYING: 8 of 8
Experts including Dr. Barbara Haber and Dr. Elizabeth Rand provided detailed updates on Biliary Atresia at the annual BA Education Day. CHOP's Biliary Atresia Clinical Care Program has been caring for children with the liver disorder since the 1970s.
Speaker: This year I'm talking about biliary atresia and liver transplantation because a lot of the stuff that was covered in that other talk has actually been very capably covered by the previous speakers.
So I'm going on to be talking about biliary atresia and liver transplantation. And just, sort of — we've really been over most of this already, but biliary atresia has a lot of surgical treatment. Most of the big improvements in care were operative. So we all have heard already about the Kasai procedure and the Porto-enterostomy that was introduced in this country in the early 70's. The goal of the procedure being to restore the bile flow that's interrupted as the major feature of biliary atresia.
Occasionally, a Kasai procedure may be revised so that, if bile flow is initially established with the Kasai procedure but then later becomes interrupted, perhaps as a result of cholangitis, for example, this surgery may then be repaired, and bile flow may be reestablished. And generally, establishment of bile flow is, sort of, the holy grail of treatment of biliary atresia.
However, as we all know, the Kasai procedure sometimes doesn't work, in fact, a significant amount of the time it doesn't work and, furthermore, even if it does work, as you've just heard, there can be additional complications or progression of scarring within the liver that can lead again to complications that are life threatening, and that we need other options for. So liver transplantation is where we, kind of, come to as a final end point of all those types of complications.
And as has been mentioned earlier but, for example, surgery, tube feedings, and transplant — we don't want to think of these things as, you know, a feeling of failure, we want to think of these things as opportunities. So, for example, if you can, as bad as it is to be a parent of a child with a chronic disease today, if you can imagine, you know, a parent in 1950, there were no options. And the child with biliary atresia was expected to die between, certainly by age 3, many of them by age 2. And there really were no options available. In that context the Kasai procedure seems pretty good and then, you know, through the 1970's and 80's, you could have a Kasai procedure, but, if it didn't work, again your child would be expected to die between ages 2 and 3. And so those people would have been pretty happy to have an option of liver transplant, and that's where we are today. That, although those things are not so much fun to think about, at least we still have options so that the outcomes, as you'll see, are really quite excellent.
Liver transplant was first attempted in 1962 with very unfortunate outcome. Liver transplant first was worked on in animal model, in dogs, primarily. And, after trial and error with various technical matters and preservation techniques, it really blossomed into a viable option in the 1980's, and that's in part because of improvements in surgical techniques and the preservation fluid and in part because real immunosuppressive drugs were developed that could be used.
So we want to talk about liver transplant more globally. Approximately 6,000 transplants are done in the U.S. annually. About 10 percent of the recipients are children. And somewhere around 50% of children who receive liver transplants in this country have biliary atresia as their diagnosis, and the rest have a whole hodgepodge of other things.
As many of you know, we know from the initial poll of the centers that were involved with BARC that something like 50 percent of the kids with biliary atresia had undergone transplant by age 2 years and then, of course, more kids undergo liver transplant at older ages for a variety of reasons that you've heard about. And in fact, kids with biliary atresia can require a liver transplant for a variety of different reasons. And actually that's kind of an interesting thing to me as a transplant — I'm wearing my transplant hat — because what brings you to transplant for biliary atresia, since it's different, there can be different outcomes within that subgroup. So, if you're a very malnourished, sickly infant coming for a liver transplant, that's going to be a lot different from a healthier teenager that may have complications of portal hypertension for a variety of reasons.
So we want to have, sort of, an overview. Why might a kid need liver transplant? When should it be done? What are the logistics? We're going to talk about how children get onto the list. How the organs are chosen or assigned. How is the surgery done? What are the outcomes? And how do I know if my kid needs a liver transplant? These are some of the questions that people ask me the most, and that's why I picked them. Also at the end, and I will warn you when I get to this point. I have some intraoperative photographs, and I found that most parents whose kids have had liver transplants are eager to see pictures from the operating room. So I usually take the few at each transplant to give to the parents, and so I have some intraoperative pictures and I've selected non-gory pictures. I only take non-gory pictures. But, before I show those in case, I'll give some warning so that the PG-13 or whatever can —
Okay, so why and when? Well, okay, if the Kasai procedure fails, that's pretty obvious. There's no bile drainage. There's progression to liver failure, jaundice, poor growth, bleeding, ascites, it should be done as soon as possible. But it's not an emergency. And this is sometimes a difficult concept. If the Kasai procedure doesn't work, it's inevitable that the child will die without a liver transplant. However, it doesn't mean that you need a liver transplant today. In fact, most of the kids can benefit from some time on the waiting list because they may be very small and the technical difficulties of transplanting a small infant are great.
We do have all kinds of great ways of supporting kids nutritionally now. So, if we can get them a little bit bigger, it actually makes their outcome better. So a lot of times parents are more focused on this goal of, like, I need to get a liver for my kid. But actually it's not that, you know, our goal isn't the transplant. Our goal is the healthy child. So we have to weigh and balance these things, but in any case, this is not a subtle thing. And Tina showed you this picture before. This is an infant with biliary atresia, and she has a lot of wasting. She's very malnourished. Any part of her that looks like it's fat it's actually fluid. She's got all this ascites, and she definitely needs a transplant. This is her a few months after her liver transplant. So you can see it really works. She's now about 12 years old, by the way. Doing fine.
So, you know, why do we want to do a liver transplant? Why and when? If it wasn't because of the early failure of the Kasai, then we have late complications, and you've heard about some of these so I'm not going to kind of belabor this. But chronic and recurrent cholangitis is one possibility. We sometimes have kids, this is not common, but it does happen, who have well-functioning Kasai procedures. They are not jaundiced, but they get repeated episodes of that ascending cholangitis, where the bacteria creep up into the liver, and, you know, require multiple courses of intravenous antibiotics, lengthy treatments, and continue to have these types of infections and that in itself can be an indication, although not a hugely common one.
Then we have kids who have complications of cirrhosis, like you heard about the portal hypertension, variceal bleeding, and ascites, growth and malnutrition you've heard about. Bone disease can be an important problem. We have some kids who, even though they may not be jaundiced, may have significant difficulties with vitamin D and have multiple repeated fractures, and sometimes this can be really, very life altering. So that can also be an indication.
And, in all of these the timing is a lot more complicated. These can be subtle findings. How many times do you have to have recurrent cholangitis before it's enough? You had a variceal bleed, and you did fine for a few years. But now you're having repeated bleeds, and we haven't be able to keep them under control. How many before we decide we're done? These are all things that are very individualized and tailored, you know, both to and for the individual kid. So these things can be subtle and input, you know, about the quality of life, as you heard earlier, is also really important, I think, in making these decisions.
And I've always been really impressed that, you know, the parents know, they're not generally surprised when I say, "I think it's time to move on." Occasionally, we have situations where we think a kid's ready for a transplant, and we get everything, kind of, ready and then actually they start doing a little bit better. They stop having the variceal bleeds or the infections, or they're doing a little better in school. Things seem to stabilize and then we may, you know-- we don't have to do it. We can change our mind. And then, you know, we may wait a little longer and then we may go forward again. So this is a little bit more difficult sometimes to decide, "When is the right time?"
So once we've decided the nurse is saying "Anything from the organ cart today?" You know, it's not so easy. You can't just dial up for a liver. And, you know, I hope that someday we will be able to. For example, people are working on trying to grow livers in tissue culture from cells that would be from that person. I mean, that would be really fantastic. But these are things that are not ready for prime time.
So what are things like today? So, as of this morning when I updated this data — this is just to, kind of, give you a bird's-eye view of the list. There's over 106,000 people waiting for solid organ transplants. That's not just livers but kidneys and hearts and lungs as well. And over almost 16,000 are listed for liver transplant. And you can see the breakdown between adults and children. And in 2009, as I said in the beginning, around 6,000 had liver transplants and about 10 percent of them were done in children. If you have the book, you'll notice that you have the unupdated slides in the book. But you'll see these numbers are very much the same from year to year.
So what are some of the logistics? Cadaver or deceased donor transplantation is the most common, and that means a person who is brain dead has donated, or their family has donated, their organs. And those organs are allocated through UNOS by act of Congress. This is not something that's just done haphazardly.
With potential recipients for any type of organs are listed with UNOS, which is done via an online, secure network after a formal evaluation and family meetings and everybody being clear on what's happening when. The allocation is based on disease severity score. So that the main mandate, which is again a mandate of Congress to us is that the sickest people receive transplants first. So, in other words, you know, there should be nothing else other than the degree of illness that determines when a person receives transplant. Now, in order to make the transplant successful there has some sort of matching. So there's matching by blood group and by size. But one of the things that's most complicated is trying to decide what is the degree of illness. How do you decide who's sicker, and who's less sick? It used to be 15 years ago that the doctors got to decide, and we just said, "Yeah, this one is sicker." This is 1, 2, 3, 4 were the levels, and we could just decide. We didn't have to explain ourselves. It was pretty clear that different physicians did that differently, and it really wasn't equitable between different parts of the country and even between different potential recipients at the same hospital. So, therefore, a fancy scoring system was devised, and for adults it's called MELD, which is the Medical End-Stage Liver Disease score — originally invented at the Mayo Clinic and they called it MELD too, but they had a different M — and then PELD is the pediatric version.
And the formula is complicated. I mean, you cannot do this on a back of a napkin at home. But what you can do is you can go to the UNOS.org Web site, and actually there's a whole bunch of different Web sites, if you put PELD calculator into Google, you can go to a variety of sites. It will ask you — it that will give you a calculator, and you can just enter bilirubin, albumin, whatever, and it will tell you the score.
And then, although we're matching by size and blood group, we're also really carefully selecting donors on a clinical basis, especially for pediatrics this is really important to us. So we want healthy, young donors for our kids, and they have to be the right size when they go into the kid. So, if you're an adult and you have liver cancer because you have hepatitis C, you're probably happy to accept, you know, the liver of a motorcycling, drug abusing, hepatitis C positive donor who's otherwise pretty healthy. But for a kid, you know, we're not going to be accepting that. So we really want the best because our plan is for these livers to last these kids a lifetime.
And then in terms of whole versus split livers, some people think that it's, sort of, intuitive that a whole liver is best, but actually that's not true. A split liver is sometimes better, especially for infants. If we get whole liver donors from the infants that are brain dead, those actually have higher complication rates than splits because of the very small size of the blood vessels. So it's not always so intuitive.
So there's also live donor transplantation as another possibility. In this case, of course, the recipient is getting a segment of the liver, but in the case of pediatric liver transplantation, the adult's — the segment of the adult's liver may be just the right size for a baby for a whole liver, and that's why it works so nicely. So it varies a lot from center to center, but at big centers, like here, the outcomes are the same for live versus deceased donor. Everybody who's getting a live donor liver transplant is still on the UNOS list and that's required by UNOS in part to ensure that people aren't unscrupulously transplanting people who don't meet criteria for the standard transplant.
We still need to match the blood type and the size and the donor evaluation is actually even more extensive than the deceased donor evaluation. So there's blood work. There's history and physical examination. There's imaging of the liver. There may be angiograms to look at the anatomy of the blood vessels of the donor, and this is both for the recipient's protection, but also for the donor's protection because we don't want to do harm to any donors. And obviously we're going to be leaving behind the other segment of the liver with its vessels and bile ducts, and we want to make sure that that's going to work fine for the donor.
There's a lot of advantages of live donor transplantation, including that you can control the timing of the transplant and the quality of donor. The disadvantages include the risk of surgery for a healthy person and increased family stress. I mean, it's pretty tough on a parent when their spouse is in the OR at the same time their kid is in the OR.
So some of the logistics — the surgery lasts — whoa, do not — Oh, my gosh. Do not reboot now. So the surgery generally lasts about six hours, but the kids may be in the operating room significantly longer than that. Because there's time for putting in lines, for example, and, kind of, getting things ready, and then there's a period at the end of the surgery before the child comes out of the OR. So this is sometimes stressful, and we have lots of updates to the parents during surgery.
The bile ducts of the healthy liver graft are going to be attached to the existing roux limb. But it's not a Kasai, because in a Kasai, remember, there are not ducts separating the liver from the roux limb. Now, there are going to be ducts. So that's what makes it a transplant. And the thing is there are other times when kids undergo liver transplantation for other diseases and the bile duct of the donor may not exactly match up in size with the bile duct of the recipient and so a roux limb is made in that situation too. So a lot of children that have liver transplants have roux limbs even if they didn't have biliary atresia. So that's an important thing to know.
The scar is a little bit bigger than the biliary atresia scar. It sometimes has an up part of it in addition to that part that you've seen for the Kasai, and often times they'll be able to use pretty much, at least for this part, use the same scar.
Kids are in the ICU usually for two to five days depending on their age and their condition at time of transplant. And they may not be able to eat for quite some time afterwards. And this is because, with all that, sort of, dissecting down to get the old liver out, there can be compromise of that roux limb, and they don't want any risk of bowel perforation or postoperative complications.
So medications, of course, medications change when you have liver transplant. So we generally use two immunosuppressive medications that prevent rejection and then like seven other medicines to prevent complications of the first two, which sounds kind of crazy, but there it is. The old medicines are mostly gone, although there may be a period while the kids are catching up that they still need vitamin supplementations and nutritional support. The immunosuppression is gradually tapered, and one of the two medications we usually stop between three and sixth months after transplant, and the other one is gradually reduced so that, by the end of the year after transplant, most children just take the one immunosuppressive drug twice a day and the other things are all gone. Of course, there is variation. But this is the most common course.
After kids are transplanted they're discharged home obviously. They usually go home — older kids the average length of stay is around 10 days. For younger kids it's closer to three weeks, but it's actually pretty quick. I mean, when I was a fellow, the average length of stay was closer to three months. Return to school in four to six weeks, again depending on the age. Initially the clinic visits are frequent. They're weekly for the first month. But then every other week for a month and then monthly. And it gradually spaces out so that by the time kids are two years out from transplant, they're just coming once a year and having quarterly blood work. But it is really important even when you get further out to keep up with the medications and the scheduled blood draws and so on, because this screening is the only way that sometimes that we'll pick up early potential problems with the graft while we can still take care of it more easily.
It's really important for kids to continue with their general pediatricians. A lot of times people don't recognize how important this is because, you know, they still need their immunizations, their vision screens. There's a lot of other things that are part of routine child care that we're not doing in transplant clinic.
So CHOP liver transplant results. I pulled the data going back to 1998, which is basically when our current program leadership was installed and, kind of, represents our current era. So going back to that time, we've done 125 transplants overall. Actually, I think that should be — yeah that's right — 125 transplants overall — wait a minute. No, this might be the old slide. I think it's actually — well, yes, I have another slide, I think, of this later on. So we'll just go through this, and we'll come to the new slide. Overall graft type — this is just showing you the type of transplants that we're doing. So about 70 percent whole, 25 percent, roughly, split, and the rest live donor. And actually in recent years, this is not including last year, we're starting to do more live donor so that this — and most of the live donor is coming at expense of the whole.
This is looking at patient and graft — recipient and graft survival rates. So, of course, sometimes the graft doesn't do well, and we may need to have retransplantation. That's not a common problem, but it does happen. But, luckily, we continue to have 100 percent of patient survival and that's, of course, our most important goal.
So this is the updated slide. So actually that 125 you saw before was including retransplants and combined transplants. So, actually, I redid the data just looking at primary liver transplant — kids who are having their first liver transplant. Fifty-two of those done in this time period were children with biliary atresia. So it's about 40 percent. So we're a little bit less than half, and I think that's partly because we're such a big referral center for other types of liver problems as well.
The overall survival 121 out of 129. So that's 94 percent. And that's, you know, so some of those kids are 12 years out and some of them are a few months out. But that's the overall survival. So in the seven children without biliary atresia who have died since transplant most of it was due to the underlying diagnosis that may affect other organs or infections. And we — our biliary atresia survival in that time period is 98 percent, 51 out of 52. And our one death, unfortunately, was a child who died in a fire, smoke inhalation in a house fire.
So the liver transplant outcome is quite good. Our goal is for normal quality of life. Generally, after transplant there are no restrictions on activities or diet, except for grapefruit and grapefruit juice, which, as many people know, interferes with the metabolism of a bunch of different medications. And so it's discouraged. We have generally normal fertility as you heard earlier. But there is a lifetime need for follow-up and monitoring for known and unknown complications, both of the medications and of the surgery. And that's true even for kids who may come off of immunosuppression, which we're beginning to recognize that that's possible in a greater number of children than we ever suspected. But, even if you come off of your immunosuppression, you still should be followed up. I mean, this is clearly not your average minor issue.
So really liver transplant is an excellent treatment for end-stage liver disease. It's not without short and long-term complications, but, you know, it's really a good option if you're facing significant complications from your biliary atresia. And the decision to move to transplant can be really obvious or it can be subtle. And it really involves the family and the teams working together and, for those of you who've been through transplant evaluation, our process has really grown and become more comprehensive, I guess, over the years so that children are assessed by need, by the surgeons, they have echocardiograms, and ultrasounds, and there's a psychologist and a social worker and a big team so that we can make sure that we have served everything tuned up for this kid as perfectly as possible so that not only will they do well with the surgery, but everything's in place for an uneventful recovery and long-term health.
So this is the part where I show some pictures. They're really — these pictures I don't think are gory. But there are some pictures that are in the operating room. I'm going to build up to the potentially goriest ones.
So this just shows one of our new operating room suites. At CHOP we have something like — some obscene number of operating rooms now. Tina, how many? Do you know? 30, I think you're right. I think it's something like 30 operating rooms. They're running all the time. We have fantastic OR staff and anesthesia staff. We have dedicated general anesthesia staff that do transplant, and it's really quite impressive. But this is how an empty room looks.
There's a lot of different equipment that's used during transplant. What you're seeing here is just a close-up of the various clamps and forceps and scissors and so forth that are used. They all have different names. None of them have an obvious name like I would want it to be the "small one." The small forceps, the big clamp. No. They all have names of famous doctors that invented them.
So here's a picture of surgery in progress. And this is Mary Hiller and, if any of your kids have had surgery recently, she often is the scrub nurse for liver transplants and also for Kasai procedures. Whoops — and she takes a big interest in our kids and so she's often come out and meet parents afterwards. And you can see here this is that same big array of stuff, and she passes it off to them.
This is Dr. Shaked here. And then various other surgeons, and there's an anesthesiologist back there and another anesthesiologist over here. So there's a lot of people, and it's really — it's a beautiful thing to watch. It really is almost like a dance — it's so — everybody really works together, and it really unfolds in a beautiful way.
So this is a liver — these are two liver grafts, and they're in the "slush bucket." This is a sterile bag here, and the liver is down in there. And in this one they're trying to pick it up a little bit. In some of the these pictures you're going to see where the surgical light is right on it, it's too much for my camera, so you kind of get this white out. But there's a — the liver's actually sitting in slush, which is made of this preservative fluid. This thing is a refrigerated device underneath, and it actually, kind of, moves up and down so it keeps the slush stirring around so that the temperature — it almost looks like it's breathing to me when I'm in the OR and I'm watching it do that.
This is working on the graft. So what they'll do is they'll actually, kind of, hunker around the slush bucket there as you see, and there's a scrub nurse helping Dr. Olthoff and one of the fellows and what they're doing is they're actually trying to work on these vessels. So this is a very tiny artery of the liver and you can see, like, here's a finger so you can see how really small this is, and this is what they're going to have to sew without having it clot off. And that's why you know it's so difficult, and we worry about these things so much. And you'll see later also they're wearing glasses that actually have jeweler's loupes glued to them because this is so tiny it gives them a chance to be able to see it better.
And here's Dr. Shaked, and you can see his loupes. He, of course, has the biggest loupes. And he's actually holding here a segmental graft, and you can see the vessel, I think, a little bit hanging off of it there. This is actually a live donor graft. This transplant was just done a few weeks ago, not on a biliary atresia patient, but it was a good picture. So it's showing that segment that was taken from that child's uncle.
These are some livers that came out of children with biliary atresia, and you can see — this is the underside of the liver, and you can see how, sort of, lumpy it is. It should be very smooth and pink. It's very lumpy, and it's very green. So this is from a child that the Kasai didn't work. And similarly here's the same liver or similar one — I'm not sure — sliced open, and you can see how green that is, and it shouldn't be like that. I think now we're coming into some more operative pictures.
So in this case the liver graft now is back in place, and since they've tied down all the vessels it's actually nice and pink because it's reperfused, and you can see the difference between this liver, you know, and this one. I think you would definitely rather have this one, if you could. And I think that's my last picture.


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Excellent helmet! Good looks, light, and best of all, great price. Have not "crash" tested it and have no immediate plans to do so. Very good helmet for the money.Read All Reviews
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Great knee pads. Very comfortable, not bulky, cant hardly tell your wearing them.Read All Reviews
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My first motocross pants. What can I say except wow. Fit great, feel great. They breathe well, and dry quickly. Would love some pockets though.Read All Reviews
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Love this helmet for my son!! It is bright and we can see him coming through all the others!Read All Reviews
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These boots were so comfortable for my son. He is miniature so the shorter boot gave him more comfort.Read All Reviews
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Find a Youth Glove sizing chart (I had to google it) measure your kids' hands and order the size, it will fit like a glove. The glove itself offers only basic protection. There are no reinforced areas to protect against impact, it is merely a glove. Kid loves it and it has saved those little fingers from minor falls.Read All Reviews


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Visit & Venues
The University of Surrey is based in Guildford, in the South East of England. The main University campus, Stag Hill, is situated close to the Guildford mainline train station and within a short walk of the town centre.
Find out about visiting and getting to the University.
To help you find our venues on campus, download our campus map.
Please note - Visitor Parking information:
Mon-Fri, 09:00-17:00:
Visitors should use the Pay & Display Car Park near the Main Car Park (see campus map)
Mon-Fri, after 17:00 and Sat-Sun all day:
Parking is free. Visitors should use the Main Car Park or Car Park 1 (see campus map)
Find out more about our venues on and off campus below:
On Campus
Ivy Arts Centre
Located at the entrance to the Stag Hill site, the latest exciting addition to the University of Surrey campus is now open.
Lewis Elton Gallery
The Lewis Elton Gallery is situated at the heart of the University of Surrey's campus. It hosts an extensive and dynamic schedule of exhibitions and events. The Lewis Elton Gallery is also responsible for the maintenance of the University Art Collection as well as a range of special collections.
Performing Arts Technology Studios (PATS)
Located a short walk along the spine road from the main entrance and next to the NatWest Bank, this building is home to the studios:
PATS Studio One - a flexible capacity concert hall and sound recording studio, seating up to 260. This is our primary performance space for music concerts and recitals at the University.
PATS Dance Studio - a multipurpose rehearsal and performance space for dance and theatre. This venue is also used for regular film screenings. 115 capacity raked seating.
University Hall
The University Hall is a very flexible venue, hosting events from rock gigs and jazz evenings to ballroom dances and a range of dance classes.
Wates House
Wates House hosts a number of the more relaxed concerts and gigs at Surrey, including rock and jazz events.
School of Management Lecture Theatre
Lecture Theatre Block
Off Campus


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ANGRY CUB is a blend of an endless running platform game where you must jump over gaps and avoid obstacles with a platform shooter where you take your big gun and mow down loads of enemies. Acquire the best score by staying alive, shooting enemies, and pulling off airborne tricks. The angry cub starts off slow but will get faster and faster as you progress in your pursuit of the military that leads to exciting scenarios and will test your reflexes to the max.


text: Policy: Budgets & Deficits Reuters: Syria vote complicates U.S. fiscal debate; stop-gap more likely | September 2, 2013 | 12:00 am Topics: Congress Around the Web Debt Ceiling Syria Budgets and Deficits Congress,Around the Web,newsgatherr,Debt Ceiling,Syria,Budgets and Deficits A vote in Congress over whether to launch U.S. attacks against Syria is expected to wreak collateral damage - leaving too little time on Capitol Hill to deal with fast-approaching fall deadlines to fund government agencies and raise the debt limit. Read the rest of this post on the original site » Sign Up for the Politics Today newsletter! Please enter your email address below to begin receiving the Politics Today newsletter. You must enter a valid email address in the field above! Thank you for signing up for the Politics Today newsletter! You should receive your first newsletter very soon. We're sorry, there was an error processing your newsletter signup. Please click here to visit our Newsletter Signup Center to register for this newsletter. Web URL: http://washingtonexaminer.com/article/2535074 Share this article on Facebook or Twitter Print this article View article comments Leave a comment


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The Latest
4BI9 Media X Dale Talkington Co-Lab
This past winter we got together with Dale not only to produce a segment for our upcoming film but to also create a piece for the TGR Co-Lab contest. All of the videos are now live over on the TGR website so be sure to go and check them out. And even give us a vote if you see fit.
All Damn Day – Official Teaser
At this time we are excited to officially announce our upcoming film, All Damn Day. Here is our official teaser trailer to go along with the announcement. Hope you all enjoy!
Supported By: Saga Outerwear, The North Face, Nordica, Philpark, K2 Skis, Tall-T Productons, ON3P Skis
Mahalo Missionaries Take A Trip To Spread The Lifestyle
Earlier this April a crew of highly enlightened individuals took it upon themselves to spread the Mahalo Lifestyle. Dale Talkington, Karl Fostvedt, John Ware, Collin Collins, and a very dedicated band of partiers travelled by RV to a little place we all know as Sun Valley for the Orage Masters. Mai-Tais were drank, disorder was caused, and the true AM


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Jefferson Northeast Georgia Mountains
Only an hour's drive from Atlanta, Jefferson was designated the county seat of Jackson County on November 24, 1806. The city, named for President Thomas Jefferson, was the site of a previous Indian settlement named Thomoccoggan. The city was then incorporated as Jeffersonville. Later, the name was changed to Jeffersonton and finally shortened to its current name on June 30, 1824.
Main Street Jefferson hosts an array of community events throughout the year. The Crawford W. Long Museum highlights the life and medical career of Dr. Long, who was the first to use ether as anesthesia in 1842. The picturesque buildings in downtown house some great local shops and restaurants. Hurricane Shoals Park is a great family outdoor escape while Gresham Motorsports Park offers spectators state-of-the-art oval- track racing and entertainment. Another must see is the Shields Ethridge Heritage Farm, an outdoor agricultural museum.
Visitor Information Center
28 College Street
Jefferson, GA 30549
Phone: 706-367-5714
Official Visitor Information
Just in Jefferson
Things to do and see in Jefferson, Georgia.
Website: http://www.cityofjeffersonga.com/
Phone: 706-367-5714
Historic Jefferson Walking & Driving Tour
Spend an afternoon in Jefferson learning about our rich history.
Website: http://www.cityofjeffersonga.com/
Phone: 706-367-5714
Jackson County CourthouseDowntown on U.S.Hwy 129View on Map
706-335-1896The Jackson County Courthouse, constructed in 1879 with elements of the Neo-Classical style, is a focal point in the City of Jefferson, the county seat. The courthouse... Find Out More
Gresham Motorsports Park500 Lyle Field RoadView on Map
706-367-9461Opened as Jefco Speedway with a NASCAR Late Model Sportsman (now Nationwide) race in 1967, Gresham Motorsports Park has served the auto racing community for more than... Find Out More
Crawford W. Long Museum28 College StView on Map
706-367-5307The Crawford W. Long Museum commemorates Dr. Long's discovery of ether's use as an anesthetic on this site March 30, 1842. The three-building complex houses a medical... Find Out More
Hurricane Shoals Covered Bridge and ParkGA Hwy 82 SpurView on Map
706-367-6350Natural setting park with shoals. Reconstructed covered bridge, gristmill. Swimming and wading on shoals. Pavillions for rent, playgrounds, as well as an 1850 Heritage... Find Out More
Comfort Inn - Jefferson4880 US Hwy 129 NView on Map
706-693-4582Comfort Inn, a Jefferson hotel near the Pendergrass Flea Market The Comfort Inn® hotel is ideally located off Interstate 85. This Jefferson, GA hotel is convenient... Find Out More
Black Pot Cooking FestivalOct 18, 2014 - Oct 18, 20142355 Ethridge RoadView on Map
706-367-2949Spend a fall day at the Shields-Ethridge Heritage Farm on October 18, 2014, from 11 a.m. to 2 p.m. to see cooking the way it used to be. Enjoy Bluegrass music by The... Find Out More
Jefferson Community Theatre presents "Biloxi Blues"Jan 15, 2015 - Jan 18, 2015575 Washington StreetView on Map
706-367-5714Jefferson Community Theatre is proud to present Biloxi Blues. This is the second in Pulitzer Prize-winning playwright Neil Simon's trilogy which began with Brighton... Find Out More
Jefferson Holiday MarketNov 7, 2014 - Nov 9, 201465 Kissam StreetView on Map
706-367-5714We are thrilled to bring you our 10th Holiday Market, being held November 7-9, 2014. There will be everything from floral designs, jewelry, Christmas items and so much... Find Out More
Jefferson Farmers MarketNow through Oct 25, 2014South Public SquareView on Map
706-367-5714Join us at the Jefferson Farmers Market. Vendors will have a wide variety of vegetables, plants, baked goods and home made items. All products are Georgia made or grown... Find Out More
Shane's Rib Shack388 Highway 82 SView on Map
McDonald's4875 Highway 129 NView on Map
Redds Que & Stew7226 S Apple Valley RdView on Map
Dairy Queen545 Panther DrView on Map
The dining information on this page is supplied by the Georgia Restaurant Association.


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Retired Navy captain, pharmacist speaks about leadership
Posted on August 29, 2014 in Clinical Research, Students
Over 100 faculty, staff, and students filed into Ed Herring Lecture Hall to hear a lecture on leadership given by retired Navy Captain and pharmacist, Mark Brouker, on Wednesday, August 27. Captain Brouker has learned much regarding the art of leadership and is absolutely passionate about helping others on their leadership journey.
Campbell Comments Summer 2014
Posted July 16, 2014. View all announcements.
Pharmacy students receive first white coats of their career
Posted on August 26, 2014 in Pharmacy, Students
Campbell University's College of Pharmacy & Health Sciences (CPHS) rounded out its back-to-school events with the Doctor of Pharmacy Class of 2018 White Coat Ceremony on Friday, August 22.The White Coat Ceremony marks the transition from pre-professional to professional students and represents the responsibility students undertake upon matriculating through a pharmacy program.
Campbell holds first interprofessional education event of the semester
Posted on August 24, 2014 in Interprofessional Education, Nursing, PA Program, Pharmaceutical Sciences, Pharmacy, Physical Therapy, Public Health, Students
Campbell University's first year interprofessional education (IPE) event signaled the beginning of the academic year as first year students from all disciplines of health sciences headed towards main campus on Wednesday, August 20. This year's event focused on autoimmune encephalitis, the mysterious disease which is discussed in the New York Bestseller Brain on Fire by Susannah Cahalan.


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Say a quote from the twilight saga movies. for example
Somebody: "You think you can ought run me?"
Someone else: Edward Twilight
and then they say a quote
I'll start!
" How can sombody so small be so anoying?'
Views: 55
Alice. About Peter and Charlotte coming. In Midnight Sun.
"I think she wants protection, and she put Riley in charge of creating the front line."
I can't think who said that. At first I thought maybe Jacob. but I'm not sure.
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12 Holiday Hostess Gifts
You know not to show up empty-handed, but that doesn't mean you have to bring the standard bottle of wine. Here are a dozen ways to show your thanks.
By Samantha Emmerling
Oval Platter
Inspired by antique marbled endpapers in 18th century books, each platter is unique and handmade in Paris. $194. johnderian.com.