text:
Ipilimumab With or Without Sargramostim in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed By Surgery
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Recurrent Melanoma
Stage III Melanoma
Stage IV Melanoma
Biological: ipilimumab
Biological: sargramostim
Phase 2
|Study Type:
|Study Design:
|Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:
|A Phase II Trial of GM-CSF Protein Plus Ipilimumab in Patients With Advanced Melanoma
- Overall Survival [ Time Frame: Assessed every 3 months for 2 years, then every 6 months for 3 years ] [ Designated as safety issue: No ]Overall survival is defined as the time from randomization to death from any cause.
- Progression-free Survival (PFS) [ Time Frame: Assessed every 3 months for 2 years, then every 6 months for 3 years ] [ Designated as safety issue: No ]Progression-free survival is defined as the time from randomization to disease progression or death, whichever occurs first. Response and disease progression will be evaluated using the international criteria proposed by the revised Response Evaluation Criteria in Solid Tumors (RECIST) guideline (version 1.1). Disease progression is defined as >= 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study) and the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions and/or unequivocal progression of existing non-target lesions is also considered progression.
- Proportion of Patients With Objective Response [ Time Frame: Assessed every 3 months for 2 years, then every 6 months for 3 years ] [ Designated as safety issue: No ]Objective response was evaluated using RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 criteria. Per RECIST criteria, complete response (CR) = disappearance of all target and non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). Partial response (PR)= At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. To be assigned a status of partial response, changes in tumor measurements must be confirmed by a repeat assessment performed no less than four weeks after the criteria for response is met. Objective response = CR + PR.
|Study Start Date:
|December 2010
|Estimated Study Completion Date:
|August 2016
|Primary Completion Date:
|February 2013 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Arm A (ipilimumab and sargramostim)
ARM A: Patients receive induction therapy comprising ipilimumab intravenously (IV) over 90 minutes on day 1 and sargramostim subcutaneously (SC) once daily on days 1-14. Treatment repeats every 21 days for 4 cycles. After 12 weeks of induction treatment, anti-tumor response is assessed and patients then receive maintenance therapy comprising ipilimumab IV over 90 minutes on day 1 and sargramostim SC once daily on days 1-14. Treatment with ipilimumab repeats every 12 weeks and treatment with sargramostim repeats every 21 days. After 12 weeks of maintenance therapy, anti-tumor response is reassessed and patients with responsive or stable disease then continue maintenance therapy until disease progression or unacceptable toxicity.
Biological: ipilimumab
Given IV
Other Names:Biological: sargramostim
Given SC
Other Names:
Experimental: Arm B (ipilimumab)
ARM B: Patients receive induction therapy comprising ipilimumab intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days for 4 cycles. After 12 weeks of induction treatment, anti-tumor response is assessed and patients then receive maintenance therapy of ipilimumab IV over 90 minutes on day 1. Treatment with ipilimumab repeats every 12 weeks. After 12 weeks of maintenance therapy, anti-tumor response is reassessed and courses repeat every 12 weeks in the absence of disease progression or unacceptable toxicity.
Biological: ipilimumab
Given IV
Other Names:
Detailed Description:
I. To evaluate the overall survival of patients with advanced melanoma treated with ipilimumab with versus without sargramostim.
I. To evaluate the progression-free survival of patients treated with these regimens.
II. To evaluate the response rate in patients treated with these regimens. III. To evaluate the safety and tolerability of these regimens in these patients.
IV. To explore prospectively the utility of immune-related response criteria (irRC) of patients receiving ipilimumab.
OUTLINE: This is a multicenter study. Patients are stratified according to disease stage (unresectable vs M1a/1b vs M1c) and prior therapy (none vs interferon vs one investigational therapy or one systemic therapeutic regimen). Patients are randomized to 1 of 2 treatment arms.
ARM A: Patients receive induction therapy comprising ipilimumab intravenously (IV) over 90 minutes on day 1 and sargramostim subcutaneously (SC) once daily on days 1-14. Treatment repeats every 21 days for 4 cycles. After 12 weeks of induction treatment, anti-tumor response is assessed and patients then receive maintenance therapy comprising ipilimumab IV over 90 minutes on day 1 and sargramostim SC once daily on days 1-14. Treatment with ipilimumab repeats every 12 weeks and treatment with sargramostim repeats every 21 days. After 12 weeks of maintenance therapy, anti-tumor response is reassessed and patients with responsive or stable disease then continue maintenance therapy until disease progression or unacceptable toxicity.
ARM B: Patients receive induction therapy comprising ipilimumab intravenously (IV) over 90 minutes on day 1. Treatment repeats every 21 days for 4 cycles. After 12 weeks of induction treatment, anti-tumor response is assessed and patients then receive maintenance therapy of ipilimumab IV over 90 minutes on day 1. Treatment with ipilimumab repeats every 12 weeks. After 12 weeks of maintenance therapy, anti-tumor response is reassessed and courses repeat every 12 weeks in the absence of disease progression or unacceptable toxicity.
After completion of study therapy, patients are followed up every 3-6 months for up to 5 years.
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
Histologically confirmed metastatic melanoma
- Unresectable stage III or IV disease
- For unknown primary disease, diagnosis of metastatic disease by cytology FNA is not acceptable
- Measurable disease
- ECOG performance status 0-1
- White blood count (WBC) ≥ 2,000/μL
- Absolute neutrophil count (ANC) ≥ 1,500/mcL
- Platelet count ≥ 100,000/mcL
- Hemoglobin ≥ 8 g/dL
- Creatinine ≤ 3.0 times upper limit of normal (ULN)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN
- Bilirubin ≤ 3.0 times ULN (total bilirubin < 3.0 mg/dL for patients with Gilbert syndrome)
- Negative pregnancy test
- Fertile patients must use effective contraception during and for up to 12 weeks after completion of study
- Patients with a history of autoimmune thyroiditis are eligible if their current thyroid disorder is treated and stable with replacement or other medical therapy
At least 4 weeks since prior and no concurrent therapy with any of the following:
- Aldesleukin (IL-2)
- Interferon
- Non-study immunotherapy regimens
- Cytotoxic chemotherapy
- Immunosuppressive agents
- Other investigational therapies
Chronic use of systemic corticosteroids
- Concurrent inhaled or topical steroids allowed
- Concurrent physiologic replacement doses of corticosteroids allowed
Exclusion Criteria:
More than 1 prior investigational therapy or systemic therapeutic regimen, including any of the following:
- Chemotherapy
- Biological therapy
- Biochemotherapy
- Investigational treatment
- History of central nervous system (CNS) metastases
- Pregnant or nursing
- HIV infection
- Active infection with hepatitis B virus
- Active or chronic infection with hepatitis C virus
- Underlying medical or psychiatric condition that, in the opinion of the investigator, will make the administration of study drug hazardous or obscure the interpretation of adverse events, such as a condition associated with frequent diarrhea
- Concurrent medical condition requiring the use of systemic steroids
- Prior treatment with ipilimumab or CD137 agonistor or CTLA-4 inhibitor or agonist
- Other malignancy with the past 2 years except adequately treated and cured basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix
History of autoimmune disease, including any of the following:
- Inflammatory bowel disease
- Symptomatic disease (e.g., rheumatoid arthritis, systemic progressive sclerosis[scleroderma])
- Systemic lupus erythematosus
- Autoimmune vasculitis (e.g., Wegener granulomatosis)
- Motor neuropathy considered of autoimmune origin (e.g., Guillain-Barre syndrome and myasthenia gravis)
- Prior non-oncology vaccine therapy for the prevention of infectious disease within the past 28 days or after any dose of ipilimumab
- Other systemic or local anticancer medications
Please refer to this study by its ClinicalTrials.gov identifier: NCT01134614
Hide Study Locations
|United States, Alabama
|University of Alabama at Birmingham
|Birmingham, Alabama, United States, 35294
|United States, California
|VA Palo Alto Health Care System
|Palo Alto, California, United States, 94304
|Eisenhower Medical Center
|Rancho Mirage, California, United States, 92270
|Stanford University Hospitals and Clinics
|Stanford, California, United States, 94305
|United States, Colorado
|The Medical Center of Aurora
|Aurora, Colorado, United States, 80012
|Boulder Community Hospital
|Boulder, Colorado, United States, 80301
|Penrose-Saint Francis Healthcare
|Colorado Springs, Colorado, United States, 80907
|Rose Medical Center
|Denver, Colorado, United States, 80220
|Porter Adventist Hospital
|Denver, Colorado, United States, 80210
|Exempla Saint Joseph Hospital
|Denver, Colorado, United States, 80218
|Presbyterian - Saint Lukes Medical Center - Health One
|Denver, Colorado, United States, 80218
|Saint Anthony Central Hospital
|Denver, Colorado, United States, 80204
|Colorado Cancer Research Program CCOP
|Denver, Colorado, United States, 80224-2522
|Swedish Medical Center
|Englewood, Colorado, United States, 80110
|Poudre Valley Hospital
|Fort Collins, Colorado, United States, 80524
|Front Range Cancer Specialists
|Fort Collins, Colorado, United States, 80528
|Saint Mary's Hospital and Regional Medical Center
|Grand Junction, Colorado, United States, 81502
|North Colorado Medical Center
|Greeley, Colorado, United States, 80631
|Sky Ridge Medical Center
|Lone Tree, Colorado, United States, 80124
|Longmont United Hospital
|Longmont, Colorado, United States, 80501
|McKee Medical Center
|Loveland, Colorado, United States, 80539
|Saint Mary Corwin Medical Center
|Pueblo, Colorado, United States, 81004
|North Suburban Medical Center
|Thornton, Colorado, United States, 80229
|Exempla Lutheran Medical Center
|Wheat Ridge, Colorado, United States, 80033
|United States, Connecticut
|Saint Francis Hospital and Medical Center
|Hartford, Connecticut, United States, 06105
|Manchester Memorial Hospital
|Manchester, Connecticut, United States, 06040
|The Hospital of Central Connecticut
|New Britain, Connecticut, United States, 06050
|Yale University
|New Haven, Connecticut, United States, 06520-8032
|Eastern Connecticut Hematology and Oncology Associates
|Norwich, Connecticut, United States, 06360
|United States, Florida
|Boca Raton Regional Hospital
|Boca Raton, Florida, United States, 33486
|Cancer Specialists of North Florida-Orange Park
|Orange Park, Florida, United States, 32073
|United States, Georgia
|Northeast Georgia Cancer Care LLC
|Athens, Georgia, United States, 30607
|Emory University
|Atlanta, Georgia, United States, 30322
|Georgia Regents University
|Augusta, Georgia, United States, 30912
|Saint Joseph's-Candler Health System
|Savannah, Georgia, United States, 31405
|United States, Illinois
|Rush - Copley Medical Center
|Aurora, Illinois, United States, 60504
|Hematology Oncology Associates-Berwyn
|Berwyn, Illinois, United States, 60402
|Saint Joseph Medical Center
|Bloomington, Illinois, United States, 61701
|Graham Hospital Association
|Canton, Illinois, United States, 61520
|Memorial Hospital
|Carthage, Illinois, United States, 62321
|Hematology and Oncology Associates
|Chicago, Illinois, United States, 60611
|Northwestern University
|Chicago, Illinois, United States, 60611
|Rush University Medical Center
|Chicago, Illinois, United States, 60612
|Decatur Memorial Hospital
|Decatur, Illinois, United States, 62526
|Eureka Hospital
|Eureka, Illinois, United States, 61530
|Illinois CancerCare Galesburg
|Galesburg, Illinois, United States, 61401
|Mason District Hospital
|Havana, Illinois, United States, 62644
|Hematology Oncology Associates of Illinois-Highland Park
|Highland Park, Illinois, United States, 60035
|Joliet Oncology-Hematology Associates Limited
|Joliet, Illinois, United States, 60435
|Presence Saint Mary's Hospital
|Kankakee, Illinois, United States, 60901
|North Shore Hematology Oncology
|Libertyville, Illinois, United States, 60048
|Mcdonough District Hospital
|Macomb, Illinois, United States, 61455
|Trinity Medical Center
|Moline, Illinois, United States, 61265
|DuPage Medical Group-Ogden
|Naperville, Illinois, United States, 60563
|Illinois Cancer Specialists-Niles
|Niles, Illinois, United States, 60714
|Bromenn Regional Medical Center
|Normal, Illinois, United States, 61761
|Community Cancer Center Foundation
|Normal, Illinois, United States, 61761
|Ottawa Regional Hospital and Healthcare Center
|Ottawa, Illinois, United States, 61350
|Pekin Cancer Treatment Center
|Pekin, Illinois, United States, 61554
|Proctor Hospital
|Peoria, Illinois, United States, 61614
|Methodist Medical Center of Illinois
|Peoria, Illinois, United States, 61603
|Illinois CancerCare-Peoria
|Peoria, Illinois, United States, 61615
|Illinois Oncology Research Association CCOP
|Peoria, Illinois, United States, 61615
|OSF Saint Francis Medical Center
|Peoria, Illinois, United States, 61637
|Illinois Valley Hospital
|Peru, Illinois, United States, 61354
|Perry Memorial Hospital
|Princeton, Illinois, United States, 61356
|Hematology Oncology Associates of Illinois - Skokie
|Skokie, Illinois, United States, 60076
|Memorial Medical Center
|Springfield, Illinois, United States, 62781-0001
|Carle Foundation - Carle Cancer Center
|Urbana, Illinois, United States, 61801
|United States, Indiana
|Elkhart General Hospital
|Elkhart, Indiana, United States, 46515
|Indiana University Medical Center
|Indianapolis, Indiana, United States, 46202
|Community Howard Regional Health
|Kokomo, Indiana, United States, 46904
|Indiana University Health La Porte Hospital
|La Porte, Indiana, United States, 46350
|Saint Anthony Memorial Health Center
|Michigan City, Indiana, United States, 46360
|Saint Joseph Regional Medical Center-Mishawaka
|Mishawaka, Indiana, United States, 46545-1470
|Memorial Hospital of South Bend
|South Bend, Indiana, United States, 46601
|Northern Indiana Cancer Research Consortium
|South Bend, Indiana, United States, 46601
|United States, Iowa
|McFarland Clinic
|Ames, Iowa, United States, 50010
|Cedar Rapids Oncology Association
|Cedar Rapids, Iowa, United States, 52403
|Mercy Hospital
|Cedar Rapids, Iowa, United States, 52403
|Oncology Associates at Mercy Medical Center
|Cedar Rapids, Iowa, United States, 52403
|Medical Oncology and Hematology Associates-West Des Moines
|Clive, Iowa, United States, 50325
|Iowa Lutheran Hospital
|Des Moines, Iowa, United States, 50316
|Iowa Oncology Research Association CCOP
|Des Moines, Iowa, United States, 50309
|Medical Oncology and Hematology Associates-Des Moines
|Des Moines, Iowa, United States, 50309
|Medical Oncology and Hematology Associates
|Des Moines, Iowa, United States, 50314
|Mercy Medical Center - Des Moines
|Des Moines, Iowa, United States, 50314
|Iowa Methodist Medical Center
|Des Moines, Iowa, United States, 50309
|Siouxland Hematology Oncology Associates
|Sioux City, Iowa, United States, 51101
|Mercy Medical Center-Sioux City
|Sioux City, Iowa, United States, 51104
|Saint Luke's Regional Medical Center
|Sioux City, Iowa, United States, 51104
|United States, Kansas
|Cancer Center of Kansas - Chanute
|Chanute, Kansas, United States, 66720
|Cancer Center of Kansas - Dodge City
|Dodge City, Kansas, United States, 67801
|Cancer Center of Kansas - El Dorado
|El Dorado, Kansas, United States, 67042
|Cancer Center of Kansas-Kingman
|Kingman, Kansas, United States, 67068
|Lawrence Memorial Hospital
|Lawrence, Kansas, United States, 66044
|Cancer Center of Kansas-Liberal
|Liberal, Kansas, United States, 67901
|Cancer Center of Kansas - Newton
|Newton, Kansas, United States, 67114
|Cancer Center of Kansas - Parsons
|Parsons, Kansas, United States, 67357
|Cancer Center of Kansas - Pratt
|Pratt, Kansas, United States, 67124
|Cancer Center of Kansas - Salina
|Salina, Kansas, United States, 67401
|Cancer Center of Kansas - Wellington
|Wellington, Kansas, United States, 67152
|Associates In Womens Health
|Wichita, Kansas, United States, 67208
|Cancer Center of Kansas-Wichita Medical Arts Tower
|Wichita, Kansas, United States, 67208
|Cancer Center of Kansas - Main Office
|Wichita, Kansas, United States, 67214
|Via Christi Regional Medical Center
|Wichita, Kansas, United States, 67214
|Wichita CCOP
|Wichita, Kansas, United States, 67214
|Cancer Center of Kansas - Winfield
|Winfield, Kansas, United States, 67156
|United States, Louisiana
|Ochsner Clinic Foundation-Baton Rouge
|Baton Rouge, Louisiana, United States, 70809
|Ochsner North Shore Medical Center
|Covington, Louisiana, United States, 70433
|Ochsner Clinic Foundation
|New Orleans, Louisiana, United States, 70121
|United States, Maryland
|Greater Baltimore Medical Center
|Baltimore, Maryland, United States, 21204
|Johns Hopkins University
|Baltimore, Maryland, United States, 21287-8936
|United States, Massachusetts
|Eastern Cooperative Oncology Group
|Boston, Massachusetts, United States, 02215
|Dana-Farber Cancer Institute
|Boston, Massachusetts, United States, 02115
|Beth Israel Deaconess Medical Center
|Boston, Massachusetts, United States, 02215
|Massachusetts General Hospital Cancer Center
|Boston, Massachusetts, United States, 02114
|United States, Michigan
|Saint Joseph Mercy Hospital
|Ann Arbor, Michigan, United States, 48106-0995
|Michigan Cancer Research Consortium Community Clinical Oncology Program
|Ann Arbor, Michigan, United States, 48106
|Oakwood Hospital
|Dearborn, Michigan, United States, 48124
|Saint John Hospital and Medical Center
|Detroit, Michigan, United States, 48236
|Genesys Regional Medical Center-West Flint Campus
|Flint, Michigan, United States, 48532
|Hurley Medical Center
|Flint, Michigan, United States, 48502
|Allegiance Health
|Jackson, Michigan, United States, 49201
|Sparrow Hospital
|Lansing, Michigan, United States, 48912
|Saint Mary Mercy Hospital
|Livonia, Michigan, United States, 48154
|Saint Joseph Mercy Oakland
|Pontiac, Michigan, United States, 48341-2985
|Saint Joseph Mercy Port Huron
|Port Huron, Michigan, United States, 48060
|Saint Mary's of Michigan
|Saginaw, Michigan, United States, 48601
|Marie Yeager Cancer Center
|Saint Joseph, Michigan, United States, 49085
|Lakeland Hospital
|St. Joseph, Michigan, United States, 49085
|Saint John Macomb-Oakland Hospital
|Warren, Michigan, United States, 48093
|United States, Minnesota
|Fairview Ridges Hospital
|Burnsville, Minnesota, United States, 55337
|Mercy Hospital
|Coon Rapids, Minnesota, United States, 55433
|Miller-Dwan Hospital
|Duluth, Minnesota, United States, 55805
|Essentia Health Saint Mary's Medical Center
|Duluth, Minnesota, United States, 55805
|Essentia Health Duluth Clinic CCOP
|Duluth, Minnesota, United States, 55805
|Fairview-Southdale Hospital
|Edina, Minnesota, United States, 55435
|Unity Hospital
|Fridley, Minnesota, United States, 55432
|Hutchinson Area Health Care
|Hutchinson, Minnesota, United States, 55350
|Saint John's Hospital - Healtheast
|Maplewood, Minnesota, United States, 55109
|Minnesota Oncology Hematology PA-Maplewood
|Maplewood, Minnesota, United States, 55109
|Abbott-Northwestern Hospital
|Minneapolis, Minnesota, United States, 55407
|Hennepin County Medical Center
|Minneapolis, Minnesota, United States, 55415
|North Memorial Medical Health Center
|Robbinsdale, Minnesota, United States, 55422
|Metro-Minnesota CCOP
|Saint Louis Park, Minnesota, United States, 55416
|Park Nicollet Clinic - Saint Louis Park
|Saint Louis Park, Minnesota, United States, 55416
|Regions Hospital
|Saint Paul, Minnesota, United States, 55101
|United Hospital
|Saint Paul, Minnesota, United States, 55102
|Saint Francis Regional Medical Center
|Shakopee, Minnesota, United States, 55379
|Lakeview Hospital
|Stillwater, Minnesota, United States, 55082
|Ridgeview Medical Center
|Waconia, Minnesota, United States, 55387
|Rice Memorial Hospital
|Willmar, Minnesota, United States, 56201
|Minnesota Oncology and Hematology PA-Woodbury
|Woodbury, Minnesota, United States, 55125
|United States, Nevada
|Nevada Cancer Research Foundation CCOP
|Las Vegas, Nevada, United States, 89106
|Nevada Cancer Institute-Summerlin Campus
|Las Vegas, Nevada, United States, 89135
|United States, New Jersey
|Hunterdon Medical Center
|Flemington, New Jersey, United States, 08822
|Hackensack University Medical CCOP
|Hackensack, New Jersey, United States, 07601
|Morristown Memorial Hospital
|Morristown, New Jersey, United States, 07962
|Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County
|Mount Holly, New Jersey, United States, 08060
|Cancer Institute of New Jersey
|New Brunswick, New Jersey, United States, 08903
|Overlook Hospital
|Summit, New Jersey, United States, 07902
|United States, New Mexico
|University of New Mexico Cancer Center
|Albuquerque, New Mexico, United States, 87106
|Presbyterian Kaseman Hospital
|Albuquerque, New Mexico, United States, 87110
|San Juan Oncology Associates
|Farmington, New Mexico, United States, 87401
|United States, New York
|New York Oncology Hematology PC -Albany Medical Center
|Albany, New York, United States, 12208
|Mary Imogene Bassett Hospital
|Cooperstown, New York, United States, 13326
|New York University Langone Medical Center
|New York, New York, United States, 10016
|Stony Brook University Medical Center
|Stony Brook, New York, United States, 11794
|United States, Ohio
|Summa Akron City Hospital
|Akron, Ohio, United States, 44304
|Mercy Medical Center
|Canton, Ohio, United States, 44708
|The Christ Hospital
|Cincinnati, Ohio, United States, 45219
|Cleveland Clinic Foundation
|Cleveland, Ohio, United States, 44195
|MetroHealth Medical Center
|Cleveland, Ohio, United States, 44109
|Case Western Reserve University
|Cleveland, Ohio, United States, 44106
|Saint Rita's Medical Center
|Lima, Ohio, United States, 45801
|Saint Charles Hospital
|Oregon, Ohio, United States, 43616
|Flower Hospital
|Sylvania, Ohio, United States, 43560
|The Toledo Hospital/Toledo Children's Hospital
|Toledo, Ohio, United States, 43606
|Saint Vincent Mercy Medical Center
|Toledo, Ohio, United States, 43608
|United States, Pennsylvania
|Abington Memorial Hospital
|Abington, Pennsylvania, United States, 19001
|Lehigh Valley Hospital
|Allentown, Pennsylvania, United States, 18105
|Saint Luke's Hospital
|Bethlehem, Pennsylvania, United States, 18015
|Geisinger Medical Center
|Danville, Pennsylvania, United States, 17822-2001
|Doylestown Hospital
|Doylestown, Pennsylvania, United States, 18901
|Geisinger Medical Center-Cancer Center Hazelton
|Hazleton, Pennsylvania, United States, 18201
|University of Pittsburgh
|Pittsburgh, Pennsylvania, United States, 15232
|Pottstown Memorial Medical Center
|Pottstown, Pennsylvania, United States, 19464
|Geisinger Wyoming Valley
|Wilkes-Barre, Pennsylvania, United States, 18711
|United States, South Dakota
|Sanford Cancer Center-Oncology Clinic
|Sioux Falls, South Dakota, United States, 57104
|Medical X-Ray Center
|Sioux Falls, South Dakota, United States, 57105
|Sanford USD Medical Center - Sioux Falls
|Sioux Falls, South Dakota, United States, 57117-5134
|United States, Tennessee
|Erlanger Medical Center
|Chattanooga, Tennessee, United States, 37403
|Jackson-Madison County General Hospital
|Jackson, Tennessee, United States, 38301
|Vanderbilt-Ingram Cancer Center
|Nashville, Tennessee, United States, 37232
|United States, Virginia
|University of Virginia
|Charlottesville, Virginia, United States, 22908
|United States, West Virginia
|West Virginia University Charleston
|Charleston, West Virginia, United States, 25304
|Wheeling Hospital
|Wheeling, West Virginia, United States, 26003
|United States, Wisconsin
|Langlade Hospital and Cancer Center
|Antigo, Wisconsin, United States, 54409
|Marshfield Clinic-Chippewa Center
|Chippewa Falls, Wisconsin, United States, 54729
|Marshfield Clinic Cancer Center at Sacred Heart
|Eau Claire, Wisconsin, United States, 54701
|Saint Vincent Hospital
|Green Bay, Wisconsin, United States, 54301
|Aurora BayCare Medical Center
|Green Bay, Wisconsin, United States, 54311-6519
|Mercy Health System
|Janesville, Wisconsin, United States, 53547
|UW Cancer Center Johnson Creek
|Johnson Creek, Wisconsin, United States, 53038
|Gundersen Lutheran
|La Crosse, Wisconsin, United States, 54601
|Dean Hematology and Oncology Clinic
|Madison, Wisconsin, United States, 53717
|University of Wisconsin Hospital and Clinics
|Madison, Wisconsin, United States, 53792
|Holy Family Memorial Hospital
|Manitowoc, Wisconsin, United States, 54221
|Bay Area Medical Center
|Marinette, Wisconsin, United States, 54143
|Vince Lombardi Cancer Clinic-Marinette
|Marinette, Wisconsin, United States, 54143
|Marshfield Clinic
|Marshfield, Wisconsin, United States, 54449
|Marshfield Clinic-Minocqua Center
|Minocqua, Wisconsin, United States, 54548
|Marshfield Clinic at James Beck Cancer Center
|Rhinelander, Wisconsin, United States, 54501
|Marshfield Clinic-Rice Lake Center
|Rice Lake, Wisconsin, United States, 54868
|Saint Nicholas Hospital
|Sheboygan, Wisconsin, United States, 53081
|Vince Lombardi Cancer Clinic-Sheboygan
|Sheboygan, Wisconsin, United States, 53081
|Marshfield Clinic Cancer Care at Saint Michael's Hospital
|Stevens Point, Wisconsin, United States, 54481
|Aurora Medical Center in Summit
|Summit, Wisconsin, United States, 53066
|Vince Lombardi Cancer Clinic
|Two Rivers, Wisconsin, United States, 54241
|Aspirus Regional Cancer Center
|Wausau, Wisconsin, United States, 54401
|Marshfield Clinic-Wausau Center
|Wausau, Wisconsin, United States, 54401
|Marshfield Clinic - Weston Center
|Weston, Wisconsin, United States, 54476
|Marshfield Clinic - Wisconsin Rapids Center
|Wisconsin Rapids, Wisconsin, United States, 54494
|Study Chair:
|Frank Hodi, MD
|Dana-Farber Cancer Institute
|Responsible Party:
|National Cancer Institute (NCI)
|ClinicalTrials.gov Identifier:
|NCT01134614 History of Changes
|Other Study ID Numbers:
|Study First Received:
|April 27, 2010
|Results First Received:
|March 23, 2015
|Last Updated:
|May 26, 2016
|Health Authority:
|United States: Food and Drug Administration
Keywords provided by National Cancer Institute (NCI):
Additional relevant MeSH terms:
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Nevi and Melanomas
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs
ClinicalTrials.gov processed this record on July 27, 2016


text:
Created in this Craftsy class
Craftsy Block of the Month 2012 taught by Amy Gibson
In Craftsy's first-ever Block of the Month, Amy Gibson brings you 10 specific quilting techniques - appliqué, string quilting, paper piecing and more.
Other projects made as part of this class:
QuiltingPinwheel blocks
QuiltingModern sampler quilt
QuiltingBOM 2012
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Really beautiful blocks & very well done. Great color & fabric choices. Thank you for sharing. :-)
02/19/2013 Flag
WOW! This is one of the most beautiful friendship blocks I've seen. Well done!!
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text:
Welcome to The Badger Inn
Our wonderful pub was given its present name in 1975. Previously known as the The New Inn, Praed's Arms, then The Lelant Arms (1899-1975), it was considerably extended and modernized in 1900, becoming the building we know today.
You can discover more about our history including regular visits from Virginia Woolf in the about section.
A rich history is not all we have to offer as we have a selection of regular offers and activities. Every Tuesday we host a great Quiz night. Thursday's Steak Night where you can order two steak meals and enjoy a free bottle of house wine of your choice!.
About The Badger Inn
Through history
Discover The Badger Inn and its place in history including playing host to the author Virginia Woolf.Read More About Us
The Badger Menu
Browse our culinary offerings
A scrumptious selection of wonderful treats awaits you in our restaurant...View Our Menu
Special Events
Something for everyone
The Badger Inn plays host to many events. Weddings, beer festivals and music nights are just a few to mention. Have a look and see if we have anything on that interests your diary...View All Events
Our Specials Board
Absolutley fanastic food and great staff. The chicken burger is a work of culinary art and so delicious. Thank you.


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In version 2.63 of plugin there are a few spots that give warnings about the undefined index. I only mention this in case if might help you with improving the plugin.
I have warnings on because I'm in development mode.
Down around line 185 add something like:
if (isset($backup_options['repair']) && isset($backup_options['repair_period'])) {
$repair = intval($backup_options['repair'])*intval($backup_options['repair_period']);
} else {
$repair = 0;
Then around line 400 modify the line to be:
if(isset($_POST['Submit']) && $_POST['Submit']) {


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This page requires a MaxPreps membership account.
Don't stress... It's free and easy to setup.
The Fleming Colonels basketball team won Tuesday's neutral conference game against Halifax County by a score of 64-29.
(January 24, 2012: Roanoke, VA 24017) The Fleming Colonels (Roanoke, VA) basketball crushed the visiting Halifax County Comets (South Boston, VA), 64-29 in Tuesday's league test.
The Colonels (11-7) will now prepare for their test against George Washington (Danville, VA). The Eagles go into the AAA Western Valley test with a 10-8 record. In their last test, George Washington walloped Franklin County (Rocky Mount, VA), 69-55, in a league test.
The Comets now own a 6-11 record. They take the field next when they host Martinsville for a non-league test on Wednesday, January 25. Halifax County will clash with a Bulldogs squad coming off a 71-63 league loss to Magna Vista (Ridgeway, VA). The Bulldogs record now stands at 7-10.


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Steelers duogoes for 1,000
Never in the 69-year history of the Pittsburgh Steelers has the team had two 1,000-yard receivers in the same season. What Lynn Swann and John Stallworth couldn't do, Hines Ward and Plaxico Burress can do Sunday if Burress (63 catches, 960 yards) gets 40 yards and if Ward (90 catches, 971 yards) gets 29 yards against Cleveland. Meanwhile, the Browns gave quarterback Tim Couch a bonus of $8.7 million Friday to keep him from becoming a restricted free agent. C6.
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Top Definition
In Welsh mythology, one the Gods of Death.
Arawn lived in a round castle roofed with thousands of birds.
от Cassandra Kyle 02 февруари 2007
Trending Now
In Norrathian mythology, one of the emo SKs.
In a fit of drunken rage I shall change my name to Arawn!
от Docile Cow 27 юни 2010


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We're happy to say that the waterproof version of Smashbox's Full Exposure Mascara is much better than the regular edition, which we rated "POOR." This one has the same impressive results on lashes without the drawbacks of the original which was flaking and smudging.
Full Exposure Waterproof's results are definitely on the more dramatic side and comes by its results quickly: Just a couple of swipes lead to longer, fuller-looking lashes, with added curl – the results really do make eyes appear to be more open and awake. Also a good thing: the mascara brush is "regular-sized" as opposed to the oversized brush that comes with their regular version, which made application tricky, and resulted in mascara getting in places where you wouldn't want it.
The formula for this version is a bit thick, so after multiple coats there is some clumping, but they're easily brushed out. It doesn't flake or smudge throughout the day, and does hold up to some water exposure (such as rain and tearing up of the eyes). We're glad to see Smashbox's second go at Full Exposure mascara is a winner!
Smashbox At-A-Glance
Strengths: A unique Anti-Shine product that is a must-try if you have very oily skin; mostly excellent foundations with a neutral range of shades; improved powder eyeshadows and lip color products; well-constructed makeup brushes.
Weaknesses: A few products that are better in concept than execution.
Perhaps one of the most interesting things about Smashbox is that its name refers to the early, accordion-style cameras and that Smashbox is first and foremost a Hollywood-based photography studio.
The company's creators, Dean and Davis Factor, have their heritage in makeup—their great-grandfather was the legendary makeup artist Max Factor. The makeup, which debuted in 1996, began as a collection of trendy and fashion-forward colors coupled with a pleasingly neutral palette of foundations, concealers, and powders. Nowadays, there are exceptional options to choose from, but also some color products that fall short due to too sheer formulas or other issues noted in their respective reviews.
Where Smashbox has lived up to their Hollywood makeup pedigree is with a few standout formulas, including impressive lip products as well as excellent foundations, BB and CC cream options. Of course, the brand is also well-known for their range of makeup primers—whether that's a necessary step is up for debate—but nevertheless they do offer a few products in this category that are worth considering.
For more information about Smashbox, now owned by Estee Lauder, call (888) 763-1361 or visit www.smashbox.com.
The new Beautypedia Team proudly and unequivocally maintains the commitment to help you find the best products possible for your skin. We do this by relentlessly pursuing and relying on published scientific research so you will have unbiased information on what works and what doesn't-and the sneaky ways you could be making your skin worse, not better!
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DRINK MORE KALE! Our healthy, sustainable & organic Kale Tea™ supports the installation of rooftop farms in cities around the world.
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Always loved the idea of growing own food, now I can mix that with high tech!


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I got a citation for a misdemeanor c, (theft 3). Should I be concern of being deported? I dont have a criminal record not even a traffic ticket...what should I do? should I pled guilty??
Immigration Attorney
Some theft offenses may be misdemeanors in state court but crimes of moral turpitude in immigration. Is the POTENTIAL sentence one year or more in jail? If so, there will be a problem with immigration. DO NOT PLEAD GUILTY unless you speak to an immigration attorney who is familiar with the state criminal code or both an immigration and criminal attorney in your state. Many know both ends of the law. Another problem is that a probation before judgment is considered to be just like a guilty plea for immigration purposes but not a big deal for criminal law. Many criminal law practitioners think they are doing you a big favor getting you a PBJ and they are causing you big problems instead.
This communication is intended as general information and not specific legal advice, and this communication does not create an attorney-client relationship. Consultation with an experienced competent immigration attorney is often the best way to address the complexities of individual immigration issues.
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"2000, December 04-05 At anchor in Wilds of Georgia" Little Saint Simons Island by grandmaR
Little Saint Simons Island Travel Guide: 1 reviews and 6 photos
After leaving Kilkenny Creek, we pulled out the jib in St. Catherine's Sound. It is pretty common for people in the ICW to fly their headsails if there is any wind at all. The winds are light and variable. The day is sunny and bright to the starboard without a cloud in the sky, and on the port side the clouds are grey and lowering.
Two Great Bay Pushers (Bob's name for some power boats) come past us in the South Newport River and toot at us twice. We toot back twice - that's etiquette. They do slow down a bit to pass. A big power boat from Miami named SHIPFACED passes very close. I don't think that's a good name for a boat. Pulled the jib in.
We pull out the jib again in Sapalo Sound and surf up the sound with a following wind of 3-5 knots apparent. Big flocks of gulls resting on the water fly up as we come thru.
We see more shrimp boats. The temperature outside is 41 deg. F and Bob makes hot chocolate. The Coast Guard Securite broadcasts are from Mayport FL now.
Some hysterical lady is lambasting power boats about their passing wake. She does not identify her boat, and we can't tell if she's ahead or behind. I took a picture of a tree full of snowy egrets, and a lighthouse that was abandoned and has been restored. About 2:00 we saw two houses hidden in a clump of trees. They must be accessible only by boat. We see goats on an island.
We pass two boats anchored in the Back River where I wanted to stop, but Bob wanted to go as far as possible and so I could not persuade him to stop and anchor there or in the Duplin, or Darien Rivers. I think he felt that we had lost a lot of time by stopping off at Kilkenny Creek.
We go off the ICW at SM 658 in the Altamaha River west of Dolbow Island and north of Little Saint Simons Island. We are anchored by 3:30 pm after 47 miles at 6.3 mph for a total of 726 nm.
Holding was good, but there is little wind protection. It was dead calm all night - no wind - although the boat did swing with the current when the tide changed. Tide is 8-9 feet here.
There was no traffic. ROSIE who has been following us passes, and PIKA comes in and anchors right off LIttle St. Simon's Island at the entrance of a little creek. There were no other signs of civilization.
We can only get 2 regular channels on TV - one is WTOC out of Savannah.
It got down to 34 deg F, but we were not cold inside the boat as the temperature inside was about 10 deg. higher. We both wore our clothes to bed like we used to do camping when I was a little girl, and this time we both slept under our quilts, and were not at all cold. Although getting up to use the bathroom was a bit like getting up to use an outhouse must have been. Bob started the engine at 7 and we were pulling the anchor by 7:45. His wash down pump got a short, so he just let the current wash off the chain.
A Tow Boat US passed us going north in Buttermilk Sound. We saw several dolphins.
Next: Jekyll Island
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Ginkgo tree a friendly addition to our urban landscape
Published: Sunday, July 8, 2007 at 6:01 a.m.
Last Modified: Saturday, July 7, 2007 at 11:14 p.m.
The Ginkgo or Maidenhair tree is a rather unusual tree that should be planted more often in our urban soils.
The scientific name is Ginkgo biloba. It is a deciduous tree with fan-shaped foliage. At maturity it will reach 50 to 60 feet in height with a spread of about 30 feet.
The uniqueness of this tree is its fan-shaped leaves.
You only want to plant grafted male trees, because female trees have a very foul smelling fruit.
Brief recognition factors
The negative aspects of the tree are that it is slow-growing, and awkward and sparsely branched when young.
There are only a few of these trees in the parish, and it is a good one to add to the urban landscape.
Whiteflies on Hibiscus
If you appreciate the beautiful display of flowers now that the hibiscus plants are showing you need to keep a close eye on the underside of the foliage.
We are beginning to see a high population of adult and nymph white flies. You can detect their presence by sooty mold on the leaves, and if you flip the leaves over, you see the white fly adults and nymphs with what looks like strings of angel hair or white-cottony material underneath the leaves.
They are hard to control. Treat with insecticides that include hibiscus on the label.
Most insecticidal soaps and dormant/summer horticulture oil sprays will work. It may take up to four sprayings to effectively control the flies on large plants.
Lawn concerns
Recently we have been experiencing drought conditions at this time of year. This year we have been getting enough rain to where we can cut the grass almost every four to five days.
Remember, chinch bugs are a hot-dry-summer insect problem in the lawns. We are not seeing much activity with them yet because of the rains we are getting.
Brown patch has been around since the beginning of spring, as we had ideal conditions for it to spread. Treat your yard for brown patch with a lawn fungicide. There are several on the market. Keep in mind that some can be very expensive, but they do a very good job of suppression of the disease if the label directions are followed correctly.
Tree Troopers class
We will be offering educational topics on tree-care beginning at the end of September through the first of November.
The goal of this program is to provide a volunteer-based organization as a resource on tree-care practice in the community.
Time, date, location and topics will be included in forthcoming articles and news media outlets.
Can you put too much mulch around a tree?
Answer: Yes. Mulch is a good thing. It reduces weed pressure, helps maintain soil moisture and can protect the trunk from lawnmower and weed-eater damage.
However, too much mulch can suffocate tree roots and mulch piled up against the tree trunks will keep the trunks moist and allow for insects and diseases to enter into the bark.
Properly mulched trees have no more than 3 to 4 inches of mulch, which is kept pulled away from the trunk to aid air circulation. Do not pyramid or volcano mulch trees.
Barton Joffrion is a county agent for Terrebonne Parish with the LSU AgCenter.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.
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Dressed in caps and gowns, delighted grads from Public School 6 accepted scholastic honors during graduation festivities on the campus of Erasmus Hall High School.
Eighth grade commencement exercises stepped off at the host school, 850 Flatbush Avenue, where students celebrated the end of a successful academic year with a special program, marked by speeches, congratulations and even a few misty eyes from proud parents in attendance.
Public School 6 is located at 43 Snyder Avenue.
©2009 Community News Group
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Amarillo Senior Citizens Association Inc. will sponsor its Trash or Treasure fund-raiser from 8 a.m. to 5 p.m. Saturday at the center, 1200 S. Polk St.
Based on the theory that one man's trash is another man's treasure, the garage-sale-type event allows ASCA members and friends to donate items for sale benefiting the center, according to Judi Solley, executive director.
Donations should be clean and in working order.
Among the items for sale are filing cabinets, an exercise bicycle, small home appliances, books and clothing. Lunch will be available that day from 11 a.m. to 1 p.m. for a minimum donation of $4.
The nonprofit organization has served the senior citizen populations of Amarillo and the surrounding area since 1973.
ASCA provides meals and activities seven days a week. ASCA services also include a Senior Nutrition Program that provides meals to congregate sites and homebound seniors and a Senior Aide Employment Program that provides job placement and training for qualifying seniors age 60 and older.
For more information or to donate items, call 374-5500
Amarillo Globe-News © 2016. All Rights Reserved. Terms of Service | Privacy Policy / About Our Ads


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Pedestrian Fatally Struck By Car In Scott CountyThe State Patrol says it was dark and raining when the crash happened, and there are no street lights in that area.
Man Arrested After Shooting Near Mystic LakeA driving dispute escalated into gunfire near Mystic Lake Casino on Friday afternoon.
Pedestrian, 85, Struck And Killed In Scott CountyAn 85-year-old man is dead after being struck by a vehicle in Scott County Thursday evening. According to the State Patrol, the crash happened at about 7:30 p.m. along Highway 282 near Morlock Drive.
Minnesota Resident Accused In 2005 Homicide Case In ArizonaAuthorities say a Minnesota man has been arrested in connection with a fatal shooting in Arizona a decade ago. Mesa police announced Wednesday that 46-year-old Steven Scott Wightman is being held in Minnesota's Scott County Jail awaiting extradition to Arizona.
Emerald Ash Borer Find Confirmed In Scott CountyEmerald ash borer has spread to another Minnesota county. The Minnesota Department of Agriculture on Tuesday confirmed an emerald ash borer infestation in Scott County.
1 Year After Historic Rainfall, Small Minnesota Town Still RecoveringA year after historic rainfall devastated a small Minnesota town, the recovery still isn't complete. And now, the town is losing one of its last remaining businesses. Torrential rains washed away the roads leading into Blakeley Township in Scott County last June.
Southern Minnesota Buried By Springtime SnowstormAfter an anemic season for snow, a spring storm dumped more than a foot of it on parts of Minnesota, forcing some schools to close.
S. Dakota Man Killed In Scott Co. Rollover CrashA South Dakota man is dead after a rollover crash early Saturday morning in Scott County. The Minnesota State Patrol says the crash happened just before 4 a.m. on Highway 169, south of Marystown.
Excellent Educator: Cedar SUN's Saige DecleeneIt takes years to hone your skills in any profession, and that is true in teaching, especially teaching students with special needs. But Saige Decleene has a natural gift for connecting with those students, making her this week's and one of our youngest ever Excellent Educators.
CapX2020 Project Forced To Buy Organic DairyA popular organic dairy in Scott County is closing its doors after a major power line project skirted the property. The owners of Cedar Summit Dairy won a district court lawsuit that required a power consortium to buy the farm. The CapX2020 project is constructing huge transmission towers to move electricity across the upper Midwest.
Convicted Child Molester Charged With Abusing Another Foster ChildAfter 20 years, a woman is accusing her foster parent of sexually abusing her when she was a child. The Scott County Attorney's office has charged 59-year-old Daniel Alvin Hennen with six counts of criminal sexual conduct. He is now out on bond. Detectives say Hennen ran a foster care service with his wife, Connie Hennen, out of his home in Jordan for several years in the 80s and 90s.
Sex Assault Charges Against Foster Care Provider Filed In Scott CountyA foster care provider in Scott County is accused of sexually assaulting a girl who stayed in his home around 1994.


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Bugs, Bugs, Bugs by FauxHeadWatch
©2012-2016 FauxHead
nice pictures. Is the last one a stink bug?
thank you, Nuria i really appreciate the support
They're beautiful.
You must be living in Wonderland. Beautiful!!
I really enjoy these images, and am impressed with the idea that you hunted them down and took these pictures outside, in the elements.
You did well. SMF
You did well. SMF
good job


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!http://static.flickr.com/41/106416825_62b830a62e_m.jpg![http://www.flickr.com/photos/53034700@N00/106416825/|photo sharing]
[James White dunks during H.S. All-Star Game|http://www.flickr.com/photos/53034700@N00/106416825/] Originally uploaded by eteamz photos. </span></div>
Mark over at SportzBizBlog has a fascinating article on ���high schools��� that do little more than hand out high school credits for young basketball players trying to get college eligibility. Not only do these ���schools��� rarely have teachers-- and any students other than basketball players-- but they have also formed the National Elite Athletic Association to facilitate shoe company endorsements and television deals which can line many pockets along the way.
Has the AAU phenomenon gone too far in regards to amateur basketball athletes? Should the role of extra-curricular athletic organizations be regulated when it comes to youth athletics? Or should young athletes be afforded the chance to hone their skills in a competitive and structured environment?
Go here to comment on this issue. Also check out the basketball message boards to see what other members of the eteamz community are
Should NCAA Pay for Athletes' Injuries?
Tom Slot
Should Bat Maker be Liable for Athlete's Death?
February 2009 Snapshotz Winner
Should Bat Maker be Liable for Athlete's Death?
Should Bat Maker be Liable for Athlete's Death?
ACTIVE is the leader in online event registrations from 5k running races and marathons to softball leagues and local events. ACTIVE also makes it easy to learn and prepare for all the things you love to do with expert resources, training plans and fitness calculators.


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The aortic valves are not opened at the very beginning of ventricular systole. The intraventricular pressure must be raised above the pressure in the aorta before the valves are opened, and in order to do this a definite, measurable length of time is required. This time is known as the presphygmic period or interval of the cardiac cycle. The purpose of the present work has been to measure the time of this period between the beginning of ventricular contraction and the opening of the aortic valves, and to study its variations under different pathological conditions. It seemed likely that the heart would be unable to overcome the aortic pressure and so send forth the pulse wave as quickly under certain abnormal as under normal conditions, and the study was undertaken with the hope of obtaining results that would be of practical clinical value, as well as an addition to
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Investigators who studied minutely the exotoxins of hemolytic streptococci as demonstrated by the skin test in human beings early obtained evidence of the complex nature of these toxins.
Not only did the strains from different clinical conditions produce toxins that gave different results in certain cases among a series of human beings and the same result in others of the series, but those from the same clinical condition gave toxins that showed the same phenomenon of complexity.
The toxin-producing power1 of strains of hemolytic streptococci from many different clinical conditions have been examined, but particular concentration has been put on strains from scarlet fever, erysipelas, puerperal fever and meningitis.
It was early found, as was reported some time ago, that the agglutinin absorption and the protection tests ran much more closely parallel than the toxin skin test. In other words, among the strains tested there are more or less
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ODT Online
ODT /directory
Deputy Health and
Disability Commissioner Rae Lamb has found the former Campus
Pharmacy in Dunedin and its then owner, Peter Barron,
breached a man's rights to have services provided with
reasonable care and skill after he was dispensed somebody
else's methadone and later died.
In March 2006, Christopher Wilson died after taking six times
more methadone than prescribed when he was handed, and
accepted, someone else's dose by a dispensing pharmacist who
wrongly identified him on sight. .
In a report to be released publicly shortly, Ms Lamb has
found the pharmacy and its then owner breached Mr Wilson's
rights to have services provided with reasonable care and
skill under the HDC Code of Health and Disability Services
Consumers' Rights.
The report was released to the Otago Daily Times by Mr
Wilson's parents.
Campus Pharmacy did not have adequate procedures for
identifying methadone clients in place at the time of Mr
Wilson's death, Ms Lamb found.
Investigations into the dispensing pharmacist's actions were
discontinued in December 2007, after taking into account his
acceptance of responsibility for the mistake, his poor
health, and Ms Lamb's technical adviser's recommendation that
while he did not provide adequate care for Mr Wilson, the
service he provided was common practice in that pharmacy.
Ms Lamb found that Mr Barron believed a requirement to
identify clients by asking them to state their name or
address had been made clear to staff, but was not written in
the pharmacy's standard operating procedure (SOP) for
identifying methadone clients at the time of Mr Wilson's
Three senior staff members told her it was accepted practice
to identify the client by recognition alone.
"In the circumstances, I am not convinced that pharmacy staff
had been given clear guidelines or instruction on how to
confirm the identity of the patient," she said.
She concluded it was the pharmacy's responsibility to ensure
relevant professional standards were met through the
development and implementation of SOPs.
"It is not enough to rely on reminders to staff to be
vigilant, particularly in a busy pharm-acy dispensing
methadone to up to 100 clients."
The fact two other pharmacists had also previously mixed up
methadone clients testified to the need to remove any
subjective judgement from the system and provide detailed
written instruction, she said.
Ms Lamb said she was disappointed the Campus Pharmacy was not
"proactive" about improving the SOP covering
methadone-dispensing procedures following Mr Wilson's death.
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From style of dress to the way one rocks their hair, shades and hat, Hip-Hop has been a cultural influencer for decades. It provides a platform… Read More
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Wed, 27 Jul, 2016, 7:33 AM EDT - Canadian Markets open in 1 hr 57 mins
Canadian Business has crunched the numbers and found Canada's wealthiest people for our annual Rich 100 list. And though 2012 has been a decidedly mixed year economically, it's actually been a great year for the 100 richest Canadians—individuals so wealthy they're members not just of the 1% but the 0.00028%. Eighty-six of them grew their net worth, while 69 are valued at more than $1 billion.
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I have a CentOS virtual server through Vmware. The server runs an httpd daemon which serves an php page with a form. The users complete the form, and by clicking submit the php page calls an expect scripts. If i run the httpd throught the default init.d script i get a "no more ptys" error, but if i run httpd through root terminal the script runs without problems. How can i make the httpd run the expect scripts without having to run the httpd daemon by hand.
If you are using something like
This exact same behavior was driving me crazy. Disabling SELinux seems to have allowed me to work past this. There's lots I don't know, so unfortunately, I can't offer more than that at this point.


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| View Exclusive AAUP Compensation Survey Data |
The National Collegiate Athletic Association is, on balance, achieving both gender and racial diversity on the playing fields of its members and in its own offices. But white males continue to dominate athletics director and conference commissioner positions, according to an annual report on college athletics.
For Duke University's lacrosse team, some semblance of normalcy -- if not closure -- came last weekend, when the team whose previous season had been canceled amid the now-infamous rape case that roiled the campus returned to action for the first time. Thousands of fans cheered and few (if anyone) jeered, according to published reports.
Inside Higher Ed
1015 18th Street NW
Suite 1100
Washington, DC 20036
Ph: 1-202-659-9208
Fax: 1-202-659-9381
1015 18th Street NW, Suite 1100 | PH: 1-202-659-9208
Copyright © 2016


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Book your room at Hilton Mainz
Get an overview of this hotelFamily-friendly Mainz hotel in Mainz City Center with restaurant
This family-friendly Mainz hotel is located on a river, within a 10-minute walk of Rheingoldhalle, Gutenberg Museum, and Naturhistorisches Museum. Mainz State Theater and Mainz State Museum are also within 10 minutes.
Hotel Features
This hotel features a restaurant, a fitness center, and a bar/lounge. WiFi in public areas is free. Other amenities include a conference center, a business center, and conference rooms.
Room Amenities
All 431 soundproofed rooms feature WiFi and MP3 docks. For a bit of entertainment, guests will find flat-screen TVs with satellite channels, and other amenities include wired Internet and minibars.Would you like to give us feedback? Share it! Opens in a new window
Hilton MainzRheinstrasse 68 Mainz RP 55116
Hotel Amenities
Hotel Amenities
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. This 4-star property offers access to a business center and meeting rooms.
A computer station is located on site and high-speed wireless Internet access is complimentary. 10 meeting rooms are available. This family-friendly hotel also offers a fitness center, a terrace, and tour/ticket assistance. Onsite parking is available (surcharge).
- 24-hour front desk
- Babysitting or childcare
- Babysitting or childcare (surcharge)
- Bar/lounge
- Breakfast available (surcharge)
- Business center
- Free newspapers in lobby
- Computer station
- Concierge services
- Conference center
- Conference space
- Dry cleaning/laundry service
- Elevator/lift
- Express check-out
- Fitness facilities
- Free WiFi
- Laundry facilities
- Luggage storage
- Meeting rooms 10
- Multilingual staff
- Number of buildings/towers - 2
- Number of meeting rooms - 10
- Restaurant
- RV, bus, truck parking
- Safe-deposit box at front desk
- Self parking (surcharge)
- Terrace
- Total number of rooms - 431
- Tours/ticket assistance
- Wedding services
Family Friendly Amenities
- Babysitting or childcare (surcharge)
- Cribs/infant beds (complimentary)
- Free Wi-Fi
- In-room childcare (surcharge)
- Laundry facilities
- Soundproofed rooms
Available in all rooms: Wireless internet access ( EUR from 14,95 per 24-hour period ), Wired internet access ( EUR from 14,95 per 24-hour period )
Available in some public areas: Free WiFi
Self parking (surcharge), RV, bus, truck parking
Room Amenities
- Air conditioning
- Blackout drapes/curtains
- In-room climate control (air conditioning)
- Coffee/tea maker
- Connecting/adjoining rooms available
- Free cribs/infant beds
- Daily housekeeping
- Designer toiletries
- Desk
- Flat-panel TV
- Hair dryer
- Hypo-allergenic bedding available
- In-room childcare (surcharge)
- In-room safe (laptop compatible)
- Iron/ironing board
- Minibar
- MP3 docking station
- Phone
- Premium bedding
- Premium TV channels
- Private bathroom
- Room service
- Room service (limited hours)
- Satellite TV service
- Shower/tub combination
- Slippers
- Soundproofed rooms
- Wired high-speed Internet access (surcharge)
- WiFi (surcharge)
Where to Eat
Buffet breakfasts are available for a surcharge and are served each morning between 6:30 AM and 10 AM.
Weinstube - This restaurant serves breakfast, lunch, and dinner. Guests can enjoy drinks at the bar. A children's menu is available.
Room service (during limited hours) is available.
Nearby Things to Do
The recreational activities listed below are available either on site or nearby; fees may apply.
- Bicycle rentals nearby
- Golfing nearby
- Boat tours nearby
To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
- Accessible bathroom
- In-room accessibility
- Roll-in shower
Hotel Policies
Minimum check-in age is 18
Check-in time starts at 3 PM
Check-out time is Noon
Payment types
- Pets allowed for an extra charge of EUR 50 per pet, per stay
- 1 per room
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
Service animals exempt from fees/restrictions
Parking height restrictions apply
Optional extras
- Fee for buffet breakfast: EUR 29,50 for adults and EUR 14,75 for children (approximately)
- Fee for in-room wireless Internet: EUR from 14,95 per 24-hour period (rates may vary)
- Fee for in-room high-speed Internet (wired): EUR from 14,95 per 24-hour period (rates may vary)
- Self parking fee: EUR 22.00 per night
- Pet fee: EUR 50 per pet, per stay
- Rollaway bed fee: EUR 50 per day
Hotel Name
- Hilton Hotel Mainz
- Hilton Mainz
- Mainz Hilton
- Hilton Mainz Hotel Mainz
- Hilton Mainz Hotel
We should mention
One child 18 years old or younger stays free when occupying the parent or guardian's room, using existing bedding. The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
Family Offer
Book a stay in any room type, and children 5 years and younger eat free from the breakfast buffet. Children ages 6 - 12 receive a 50% breakfast discount.
Offer subject to availability. Offer is not valid with groups/conventions and may not be combined with other promotional offers. Taxes and gratuity may not be included. Other restrictions and blackout dates may apply.


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Insurers Reluctant to Pay Claims Far Afield From Ground Zero
By JOSEPH B. TREASTER
Published: September 12, 2002
When terrorists attacked the World Trade Center a year ago, insurance companies, caught in the glaring spotlight of the disaster, were quick to begin paying claims for damage at ground zero and vicinity.
But it has been a different outcome for businesses around the country like airports, hotels and restaurants, which also lost hundreds of millions of dollars, not as a direct result of violence, but from lost sales after the authorities shut down the airlines.
In most cases, those businesses are out of luck. The insurance companies are refusing to pay, contending that unless the businesses suffered physical damage, they have no right to compensation.
A few big customers are fighting back. The big Chicago airports -- O'Hare and Midway -- as well as the main airport in Las Vegas have taken their insurers to court as has the Wyndham Hotel chain. But many businesses, afraid of losing their coverage or of having their premiums increased sharply in the midst of an extremely tight insurance market, have simply decided to swallow millions in losses.
At the heart of these disputes is what constitutes a loss under the terms of business-interruption or loss-of-income coverage, which companies typically carry as part of their property insurance. Companies argue that their policies should cover their business losses related to the terrorist attacks, even if their property was not directly affected.
Chris Mandell, the president of the Risk and Insurance Management Society, the main organization of buyers of insurance for corporations, estimated that hundreds of claims for business interruption had been rejected.
''An awful lot of people suffered indirect losses from the attacks,'' he said, ''and went to their insurer and said, 'Is there a potential for recovery?' '' In every case he knows of, the answer was no.
One claim was filed by a company that owns several restaurants in Las Vegas, said Damian Testa, a unit president at Kay Insurance Associates, a national broker in Manhattan. ''His carrier's position is that he's not covered,'' Mr. Testa said.
For claims close to the site of the World Trade Center, Mr. Testa said, the insurers have been generous. ''I don't think they want to be hard nosed,'' he said. ''They just want to do what is right in terms of what the contract calls for.''
It is hard to estimate how much money is at stake because many other companies have decided against filing claims. One large operator of hotels, which would not allow its name to be made public, said that it gave up claims worth as much as tens of millions of dollars when several insurance companies threatened to pull coverage, which the hotel operator needed to secure corporate financing from banks and other lenders.
''We concluded that the correct business decision was not to push the claim,'' the executive said. ''Some companies said they wouldn't renew with us at all. Some said they would take that coverage out of our policy and we wouldn't have it when we really needed it.''
The insurers argue that business- interruption coverage generally provides compensation only in connection with harm to property. ''An example is that I have a fire that shuts down my business,'' said Mark Greenberg, a spokesman for the Chubb Group. ''In addition to repairing my building, my coverage also takes care of a loss of profit and ongoing expenses like salaries.''
''If the government shuts down the airports and there is no physical damage to your business in Duluth, the typical policy would not kick in for business interruption,'' he added.
But there are exceptions. Many corporations buy coverage that is especially tailored for them and often provides for business interruption coverage without the stipulation on physical damage. Historically, said Alexandra Glickman of the brokerage firm Arthur J. Gallagher & Company, businesses with this kind of coverage have collected for lost income when natural disasters, like hurricanes and snowstorms, made it impossible for customers to reach them or for them to ship or receive goods.
The airports that have filed lawsuits say they bought customized policies that covered the curtailment of air traffic.
The Chicago airports say they lost $25 million in takeoff and landing fees and taxes and fees on passengers, hotels, shops and parking lots. McCarran International Airport in Las Vegas says it lost $6.5 million.
A lawyer for the Las Vegas airport, David W. Steuber, said that one insurer, the Factory Mutual Insurance Company, not only rejected the claim, but also said it intended to cancel the airport's three-year policy in October, one year ahead of its scheduled conclusion.
In a letter to the Las Vegas airport authorities, Factory Mutual said that they were misreading the insurance policy. Steven Zenofsky, a spokesman for Factory Mutual declined to discuss the specifics of the case but did say that ''we feel it regrettable but not surprising that lawsuits have arisen from this tragedy.''
Even policies without provisions for specific interruptions enable clients to collect when their business is affected by action from the police or other so-called civil authorities -- like roadblocks in Lower Manhattan after the trade center attacks. Many businesses that were cut off from their customers by the roadblocks have collected on claims, industry executives said.


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Hotel Luxembourg Parc
Situated in unique surroundings on the fringe of the forest and at a short distance from the village of Berdorf, Luxembourg, the Parc Hôtel, in its own grounds planted with many rare trees and shrubs, offers its excellent service for a most peaceful and reposing stay. So tastefully have modern amenities been introduced to the guestrooms that the... more
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Facebook can be helpful for raising awareness about an organization or cause. Using a Facebook page, you can potentially access millions of Facebook users, engage them in conversation and spread more information about what you are trying to achieve. By reaching more people, you can also use the opportunity to increase the number of donations you receive. Using PayPal's "Donate" button, you can enable Facebook users to give to your organization online.
Visit paypal.com and register for a business account. If you choose "non-profit" as the category of your business, you might have to provide PayPal with more information about your organization so PayPal can verify that you are a charitable project.
Click on the "Merchant Services" tab in your account and select "Accept Donations." Enter your details on the next page and then click on "Create Button" to access the HTML code for your donation button. Copy this code onto your browser's clipboard by holding down "Ctrl-C."
Go to facebook.com and type "FBML" into the search box. Select the app labelled "Static FBML" then confirm you want to install the app by clicking "Add to my Page" to the left-hand side of the page. The app's name stands for "Facebook Markup Language" and will allow you to add the HTML code for the donation button to your page.
Load your Facebook page where you want to place the button. Click on "Edit Page," scroll down to "Applications" and select "FBML." When you click on this, you will see a page with a blank text box.
Edit the title of the text box to include the content you want, for example "Donate to (name of your organization)." Press "Ctrl-V" to paste the code for your PayPal donate button into the blank box below.
Go back to your Facebook page and select the button marked "Add a New Tab" at the top of the page. Select the tab labelled with the title you specified for your donate button, for example "Donate to (name of your organization)." A tab for donations containing your PayPal donation button will now appear on the tab bar at the top of your Facebook page.
- Photo Credit Thinkstock Images/Comstock/Getty Images
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wolfenstein 3d classic platinum
Today's Apps Gone Free: Wolfenstein 3D Classic Platinum, iCrates, Death Rally, And More
Today's AGF list includes a classic FPS, an app for music lovers, and a top-down racer.
Tyler Tschida
| May 9
id Software Celebrates QuakeCon 2010 With A Sale
id Software's annual and completely free QuakeCon convention kicks off today in Dallas, TX, and to celebrate, the company is having a sale on all of their iPhone and iPod touch games.
Tyler Tschida
| August 12


text:
Web posted Wednesday, June 10, 1998 1:56 p.m. CT
Good Morning
Little lights shine on denomination jokes
PLAINVIEW - No denomination does everything just alike, as evidenced by the following. We hope you'll let your little light shine today and accept this in good humor.
How many Charismatics does it take to change a light bulb? One to change the bulb and nine to pray against the spirit of darkness.
How many Calvinists does it take to change a light bulb? None. God has predestined when the light will be on. They simply read the instructions and pray the light bulb will be one that has been chosen to be changed.
How many TV evangelists does it take to change a light bulb? One. But for the message of light to continue, send in your donation today.
How many Catholics does it take to change a light bulb? None. They always use candles.
How many Amish does it take to change a light bulb? "What's a light bulb?"
How many youth pastors does it take to change a light bulb? Youth pastors don't stay around long enough for a light bulb to burn out.
How many Baptists does it take to change a light bulb? Change? - DANNY ANDREWSPlainview Daily Herald
Memphis The Memphis Chamber of Commerce and the City of Memphis will sponsor a second annual Fly-In Breakfast from 8 a.m. to 10 a.m. Saturday at the Memphis Municipal Airport. All area pilots may fly in for a free breakfast. Breakfast for the public is $2 each. For more information, contact the Memphis Chamber of Commerce at 259-3144.
All area codes are 806 unless otherwise noted. Information for the Regional Events Calendar should be mailed to the Regional News Editor, Amarillo Globe-News, P.O. Box 2091, Amarillo, Texas 79166. Items will run at the editor's discretion as space permits.
We'd love to hear your feedback. © 1998 Amarillo Globe-NewsWebmaster
_uacct = "UA-2472207-1";
Amarillo Globe-News © 2016. All Rights Reserved. Terms of Service | Privacy Policy / About Our Ads


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Symphony No. 4 (Dvořák)
The Symphony No. 4 in D minor, Op. 13, B. 41 is classical composition by Czech composer Antonín Dvořák.
The work[edit]
Dvořák composed his fourth symphony between January and March 1874. The influence of Wagner can clearly be heard in this symphony. The principal theme of the second movement is a near-quotation from Tannhauser. In the Trio section of the third movement one can also catch a very brief but quite vivid reminder of a passage from the Die Meistersinger Overture. However, the influence of Brahms, which was to pervade many of his subsequent works, is just beginning to appear in this work. Dvořák shows his mastery of all formal aspects in this symphony, and some feel it is one of his best works. A portion of the scherzo was reused in the march In Troublous Times from his set of piano duets From the Bohemian Forest.
The first performance took place on May 25, 1874 at the concert of the Academy Readers' Society in Prague, and was conducted by Bedřich Smetana. The composer also revised the autograph at the end of 1887 or the beginning of 1888.[1] The first (posthumous) edition of the symphony was published in 1912, and it is possible that Dvořák's autograph differs very considerably from that edition.[1]
The work consists of four movements:
- Allegro
- Andante sostenuto e molto cantabile in B-flat major
- Scherzo (Allegro feroce); Trio in C major
- Finale: Allegro con brio
It is possible that the third movement of the symphony was initially an independent composition, completed before the other movements and added subsequently.[2] In the work is still apparent the earlier neo-romantic atmosphere, but as a whole the composition already bears the hallmark of Dvořák's artistic individuality.[1] A typical performance of the work lasts about forty minutes.
The work is scored for an orchestra of two flutes (both doubling piccolo), two oboes, two clarinets, two bassoons, four horns, two trumpets, three trombones, timpani, bass drum, triangle, cymbals, harp, and strings.
Dvořák, Antonín: Sinfonia IV. Re minore. Score. Prague: Editio Supraphon, 1990. H 3432
External links[edit]
- Symphony No. 4 on a comprehensive Dvorak site
- Basic information
- Symphony Nº. 4 Free Scores at the International Music Score Library Project.
|This article about a symphony is a stub. You can help Wikipedia by expanding it.


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Results 15 to 20 of 20
Thread: 5.5 Bolt v Storm
20th August 2014, 11:39 AM #15
- Join Date
- May 2013
- Posts
- 374
Thanks for the responses.
The 6.5 set on a 430 (with 30 to 33cm extension) looks extreme. Hence, the question.....I thought that it might have been a typo.
4th August 2015, 09:00 PM #16
- Join Date
- Nov 2009
- Posts
- 3,359
Today is probably the first time I have put the 5.5 Bolt to test in more extreme conditions both in terms of water state and wind. I am left very impressed. The wind today peaked at an average of 27knots with gusts to 35knots with some very big swell. In those conditions I would normally be on a 5m or 4.7. The Bolt 5.5 was however totally controllable even in those gusts...provided I had the strength to hold onto it! In other words the sail did not go crazy, it just became very powerful. Looking at the rigging settings, the sail is marked as 436 luff/176 outhaul. I am using the white carbon 75 430 mast which is probably 2013 and had the North XT extension ( original) on 6cm, and downhauled to max. Outhaul was 176.5 left loose by about 1 cm. So by my reckoning the sail settings on the bag are right as max settings. ( the adjustable head is as close to the top of the luff tube as I can get it). Perhaps the only negative I found....keeping in mind the wind was pretty extreme for this size of sail......was that the sail did not depower as quickly or completely as I remember the Storm doing, for example, in a gybe where you enter needing to dump power.
Anyone moving from a Storm to the Bolt is going to find the way the sail set completely alien. The Storm sets flat but with the battens above and below the boom part way behind the mast. The Bolt however uses a loose luff tube to enable the front of the sail to develop shape and the battens sit clear of the mast ( on max downhaul). There is shape pre cut into the sail below the boom and some shape remains even quite high up the luff sleeve. My outhaul setting was about neutral plus 2cm. Reducing outhaul by 1cm ( without changing downhaul) results in significant additional power. In fact the Bolt sets in a very similar manner to my North E Type sails except with quite a bit less twist/loose leech.
5th August 2015, 08:42 AM #17
- Join Date
- Dec 2007
- Posts
- 1,488
Where was this?
5th August 2015, 09:36 AM #18
5th August 2015, 11:54 PM #19
5th August 2015, 11:58 PM #20
- Join Date
- Nov 2009
- Posts
- 3,359


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