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Bill Whittle and Stefan Molyneux discuss peak political correctness, cultural confidence and being the bigger dog.
One for a quiet hour and a tall glass of something.
Posted at 16:32 in Academia, Politics, Religion | Permalink
Comments (18)
Theodore Dalrymple on intellectual evasions:
Sometimes the employment of a single word in common use gives away an entire worldview. There was just such a usage in the headline of a story in the Guardian late last month: "How the 'Pompey Lads' fell into the hands of Isis." […] The word that implied a whole worldview was "fell." According to the headline, the young men "fell" into the hands of Isis as an apple falls passively to the ground by gravitational force. The word suggests that it could have happened to anybody, this going to Syria via Turkey to join a movement that delights in decapitation and other such activities in the name of a religion — their religion. Joining Isis is like multiple sclerosis; it's something that just happens to people. The word "fell" denies agency to the young men, as if they had no choice in the matter. They were victims of circumstance by virtue of their membership of a minority, for minorities are by definition victims without agency.
Mick Hartley quotes Anne Applebaum on the new titan of the British left:
Jeremy Corbyn, would-be leader of the Labour party, is the latest in a long line of useful idiots. Corbyn has recommended that his Twitter followers watch the Russian propaganda channel Russia Today, which he has described as "more objective" than other channels. Never mind that Russia Today interviews actors who claim to be "witnesses" and invents stories — for example, that a Russian-speaking child was crucified by a Ukrainian.
When not describing Hamas and Hizballah as "friends" and declaring his "solidarity" with the regimes of Cuba and Venezuela, our Islington radical finds time to be a fearless supporter of taxpayer-funded homeopathy, which apparently "compliments 'conventional' medicine" because "they both come from organic matter."
And Tim Blair ponders the cultural and economic powerhouse that is taxpayer-funded interpretive dance:
As Australia transitions from a mineral export-based economy to a dance-based economy, it is clearly important to make certain that the dance sector is as stable as possible. Choreographer Lucy Guerin told the [senate] hearings [into arts funding] that to do otherwise would risk us "eventually severing the future of artistic development in Australia and setting us back 30 years." "It's that serious," she added, with all the gravity you'd expect from a choreographer addressing a bunch of senators.
Behold ye, wealth creation.
Feel free to share your own links and snippets in the comments.
Posted at 07:51 in Anthropology, Art, Modern Savagery, Politics, Religion | Permalink
Comments (45)
Roger Kimball on the unacknowledged charms of Swedish multiculturalism:
In 1975, the Swedish parliament unanimously decided to change the formerly homogeneous Sweden into a multicultural country. Forty years later the dramatic consequences of this experiment emerge: violent crime has increased by 300%. If one looks at the number of rapes, however, the increase is even worse. In 1975, 421 rapes were reported to the police; in 2014, it was 6,620. That is an increase of 1,472%.
Christopher Snowdon on why BBC documentaries aren't always to be trusted:
To be clear, nobody is snaffling anybody's cake. The cake has been getting bigger for all, including those in the rest of the top [income] decile. But whilst inequality has not risen in the nation as a whole, it has risen sharply within the upper echelons. It is not the richest ten per cent who have "pulled away from the pack." It is the very rich who have pulled away from the rest of the top 10 per cent. It is, then, the upper-middle classes who may feel that they are having their cake scoffed. If so, it may explain why there is currently such a sense of resentment and antipathy from the wealthy (a group that includes politicians, professors, television presenters and BBC editors) towards the very rich.
And Mark Steyn on the blatherings of the Most Clever President Ever:
"Islam has been woven into the fabric of our country since its founding," says the President. You might think that Islam has been entirely irrelevant to "the fabric of our country" for its first two centuries, and you might further think that Islam, being self-segregating, tends not to weave itself into anybody's fabric, but instead tends to unravel it - as it's doing in, say, Copenhagen, where 500 mourners turned up for the funeral of an ISIS-supporting Jew-hating anti-free-speech murderer.
Feel free to share your own links and snippets in the comments. It's what these posts are for.
Posted at 07:26 in Media, Politics, Religion | Permalink
Comments (28)
Christopher Snowdon on nicotine and the prohibitionist's dilemma:
In scenario number two, you are a journeyman public health advocate picking up a nice, steady wage from the government every month. You hold lots of meetings and you go to lots of conferences. You and your colleagues developed a plan of incremental prohibition in the early 1980s and you have it all mapped out… And then something comes along that you didn't expect. A new product that gives smokers a way to enjoy nicotine without the health risks of smoking cigarettes. You didn't come up with the idea. The government didn't come up with the idea. It came from the private sector, and private businesses are making money out of it. Worse still, after a few years of monitoring the market, the tobacco industry buys up a few companies and now they're making money out of it. Sure, lots of people are giving up smoking as a result, but not in a way that was part of The Plan. Where does this leave you?
Brendan O'Neill on a popular conceit:
The idea that there is a… culture of hot-headed, violent-minded hatred for Muslims that could be awoken and unleashed by the next terror attack is an invention… The thing that keeps the Islamophobia panic alive is not actual violence against Muslims but the right-on politicos' ill-founded yet deeply held view of ordinary Europeans, especially those of a working-class variety, as racist and stupid. This is the terrible irony of the Islamophobia panic: The fearers of anti-Muslim violence claim to be challenging prejudice but actually they reveal their own prejudices, their distrust of and disdain for those who come from the other side of the tracks, read different newspapers, hold different beliefs, live different lives.
Thomas Sowell on milking pretentious guilt:
Our schools and colleges are laying a guilt trip on those young people whose parents are productive, and who are raising them to become productive. What is amazing is how easily this has been done, largely just by replacing the word "achievement" with the word "privilege."
And again, on the equality racket.
And Daniel Hannan chats with some unhappy, scowling socialists:
Don't make the mistake of judging socialism as a textbook theory but judging capitalism by its necessarily imperfect outcomes. Judge like with like. In the real world, you find me a functioning socialist country that has delivered more than a free-market alternative.
As always, feel free to share your own links and snippets in the comments. It's what these posts are for.
Posted at 07:14 in Academia, Politics, Religion | Permalink
Comments (34)
Daniel Greenfield learns of more racism that's invisible to the sane:
Are there not enough black people who build ships in bottles? There must be something racist about it. It couldn't possibly be that black people aren't as interested in building ships in bottles.
Remember this?
Roger Kimball on that pernicious little tool in the White House:
Just yesterday, the president of the United States… stood before the United Nations and heaped praise on Sheikh Abdallah Bin Bayyah, a Muslim cleric who has endorsed a fatwa calling for the murder of U.S. soldiers. Yep, Bin Bayyah is Obama's candidate of the week for the prize of being a "moderate Muslim."
And Heather Wilhelm weeps at the suffering of "Goodwill Ambassador for U.N. Women," Ms Emma Watson:
While Watson, to her credit, did give a few shout-outs to actual oppression around the globe — child brides and uneducated girls in Africa, specifically, along with an admission that "not all women have received the same rights I have" — her speech [to the U.N.] was an unfortunate reflection of the "we're all victims," zero-sense-of-proportion mishmash that makes up modern Western feminism. If you don't believe me, here is what Emma Watson, Hollywood actress, actually complained about before a body of 192 member states, some which have more terrifying dictatorships than others: 1. She was called "bossy" as a child; 2. She was sexualised by the media as a young movie star; 3. Many of her girlfriends quit their sports teams because they didn't want to grow muscles.
Now, if, for instance, Ms Watson had directly addressed the representative of each member country in which women really are treated appallingly – and listed that country's sins in graphic detail – I'd have been more than happy to applaud. But that didn't happen, and was never going to happen. What we got instead was a piece of flimsy theatre that we're expected to applaud anyway. It's the U.N., after all. But it seems to me that if you're going to use a U.N. gathering to shame backward cultures and their various representatives – shame them into change - it's best not to appear clownish and morally frivolous while you're attempting it. And if you want to highlight real oppression in the world – say, women being disfigured by Muhammadan savages – it's probably best to avoid moaning about having once been called "bossy."*
Ms Watson's feminist credentials have been noted here previously.
*Added via the comments. Feel free to share your own links and snippets below.
Posted at 14:36 in Politics, Religion, The Deep Wisdom of Celebrities | Permalink
Comments (38)
Meanwhile, in where-to-go-on-that-foreign-holiday news:
One of the most senior members of the Turkish government sparked an outcry on Tuesday, after declaring that women should not laugh loudly in public. The deputy prime minister, Bülent Arinc, one of the co-founders of the ruling Islamic Justice and Development party (AKP), made the comment while lamenting the moral decline of modern society. "A man should be moral but women should be moral as well, they should know what is decent and what is not decent," Arinc said in a speech on Monday, in the western Bursa region for the Bayram holiday that marks the end of Ramadan. "She should not laugh loudly in front of all the world and should preserve her decency at all times," he added.
Mr Arinc also shares his wisdom on other matters.
He denounced the excessive use of cars, saying that if even the "river Nile was filled with petrol" there wouldn't be enough to go around. Arinc also slammed the excessive use of mobile phones in Turkish society, with women "spending hours on the phone to swap recipes."
An equally pious Guardian reader adds this,
Right up there with… keeping [women] barefoot and pregnant, oh wait, that's only in America.
Any forcibly barefoot American women are welcome to respond.
Posted at 07:41 in Anthropology, Religion, Travel | Permalink
Comments (17)
This Scientology promo video - complete with "floating tone arms" and wildly upbeat mad people - may not be online for long, so watch it while you can.
Via MeFi, via Anna.
Posted at 09:28 in Anthropology, Psychodrama, Religion | Permalink
Comments (44)
The mighty headwear of Nihang Sikhs, Punjab, photographed by Mark Hartman.
Via Mick Hartley.
Posted at 08:14 in Anthropology, Not Often Seen, Religion, Travel | Permalink
Comments (11)
Tim Blair quotes Mark Steyn:
The gentleman had called the Female Genital Mutilation Helpline thinking it was a helpline set up by Her Majesty's Government to help you find someone to genitally mutilate your daughters.
And no, he's not joking.
Posted at 15:11 in Anthropology, Department of Irony, Modern Savagery, Religion | Permalink
Comments (13)
Via TDK, Theodore Dalrymple on rhetorical leverage and 'progressive' self-flattery:
Professor Lakoff uses the term 'progressive' freely. Now there is a framing metaphor if ever there was one. What person of goodwill could possibly be against progress, that is to say betterment of the human condition? So if you are a person in favour of progress – in short, a progressive – only the malevolent could disagree with you.
However, there is a rather large question begged here, namely 'What is progress?' There is rarely gain without loss, and loss can easily exceed gain. Human action has unintended and unforeseen consequences, sometimes beneficial, often not. Progress in society is not the same as progress in internet speeds… It is possible for reasonable people to disagree… Yet Professor Lakoff seems to use the term 'progressive' as if those he calls progressives brought about progress ex officio, as it were, merely by virtue of their self-designation. This is a form of magical thinking.
I'm reminded of the modesty of Mr George Monbiot, a man who also deploys the word 'progressive' as if it were a talisman, and who dismisses his political opponents as dullards struggling with "low intelligence" and racial phobias.
BenSix on learning to be mute and befuddled:
These posters and drawing hardly seem to be the stuff of Voltairian pamphlets. They do not renew the liberal flames in me. What should inspire one, though, is the response to them. It is alarming that our national media feels that it cannot publish a drawing of a cartoon man for fear of violent reprisals. If people are scared to show innocuous cartoons, how might they react to a novel that may provoke controversy, or to academic research that might inspire outrage? …If, indeed, Rory Bremner is scared to joke, or Grayson Perry to make art, how many commentators, novelists and scholars have allowed their thoughts to be repressed?
And Jonah Goldberg on hammers, sickles and not saying certain things:
In its opening video for the Olympic Games, NBC's producers drained the thesaurus of flattering terms devoid of moral content: "The empire that ascended to affirm a colossal footprint; the revolution that birthed one of modern history's pivotal experiments. But if politics has long shaped our sense of who they are, it's passion that endures." To parse this infomercial treacle is to miss the point, for the whole idea is to luge by the truth on the frictionless skids of euphemism.
As usual, feel free to share your own links and snippets in the comments.
Posted at 09:45 in Academia, History, Politics, Religion | Permalink
Comments (32)
Chris Snowdon on booze, sponsorship and publicly subsidised temperance zealots:
With tiresome predictability, Alcohol Concern says this must all be done for the sake of "children." There is, it seems, no interference into adult pastimes that cannot be justified in the name of those who are prohibited from engaging in them. For the moral busybody, all the world is a crèche.
Peter Wood ponders the bean-counting world of campus gender equity:
To be "representative of the student body," approximately 55% of the 52 Title IX Coordinator positions should have been held by women. But in our sample, 83% are held by women. Likewise, women appear overrepresented in the staff positions of the relevant campus offices, but the level of overrepresentation was less than for the top positions (73.1 percent of the positions are held by women). Considering that the overwhelming preponderance of sexual harassment allegations are directed by women at men, the disproportion of women to men in the positions charged with interpreting and enforcing the sexual harassment rules is a legitimate concern. Are male students who are accused of sexual harassment likely to receive fair-minded treatment in these offices?
Mark Bauerlein* on do as I say not as I do:
When white male President Mills pledges to press for race-based affirmative action, the right reply is this: "Well, then, sir, you must resign your post immediately and call for Bowdoin to hire a racial or ethnic minority in your place." Keep it simple and direct. Every white male board member of the ACE should receive a message to step down. Let's ask white male campus leaders to stand up for their own principles and do the thing they want everybody else to do. When white women acquire a disproportionate number of jobs in campus leadership, yet still call for more diversity, they, too, should be asked to withdraw. This is the logic of affirmative action, and if diversity proponents who are white follow it to its conclusion, they should relinquish their positions as soon as possible.
Jennifer Kabbany notes the difficulties of gendered nouns:
The University of Leipzig has voted to adopt the feminine version of the word for 'professor' as its default. In German, professorin refers to a female professor while professor is the male equivalent. Under the new measures, written documents will use the term Professorinnen when referring to professors in general. A footnote is to explain that male professors are also included in the description. Physics professor Dr Josef Käs suggested the change as a joke because he was becoming weary of extended discussions about gendered language. To his surprise, the university board voted in favour of the idea.
And Theodore Dalrymple on jihad, entitlement and Michael Adebolajo:
It is not true that the society in which he lived offered him no opportunity for personal betterment. Adebolajo was for a time a student at Greenwich University, graduation from which, whatever the real value of the education it offered him, would have improved his chances in the job market, especially in the public sector. But it was at the university that he encountered radical Islam, that ideology that simultaneously succours people with an existential grudge against the world and flatters their inflated and inflamed self-importance. It also successfully squares the adolescent circle: the need both to conform to a peer group and to rebel against society.
As usual, feel free to share your own links and snippets in the comments. [ *Added, via Rafi in the comments. ]
Posted at 08:12 in Academia, Food and Drink, Politics, Psychodrama, Religion | Permalink
Comments (38)
Mark Steyn notes a standard media narrative:
The killer of French schoolchildren and soldiers turns out to be a man called Mohammed Merah. The story can now proceed according to time-honoured tradition. Stage One: The strange compulsion to assure us that the killer is a "right wing conservative extremist," in the words of NRO commenter ExpatAsia. […] The insistence that the killer was emblematic of an epidemic of right-wing hate sweeping the planet is, regrettably, no longer operative. Instead, the killer isn't representative of anything at all.
So on to Stage Two: Okay, he may be called Mohammed but he's a "lone wolf." Sure, he says he was trained by al-Qaeda, but what does he know? Don't worry, folks, he's just a lone wolf like Major Hasan and Faisal Shahzad and all the other card-carrying members of the Amalgamated Union of Lone Wolves. All jihad is local. On to Stage Three: Okay, even if there are enough lone wolves around to form their own Radio City Rockette line, it's still nothing to do with Islam. […]
And then, of course, Stage Four: The backlash that never happens. Because apparently the really bad thing about actual dead Jews is that it might lead to dead non-Jews: "French Muslims Fear Backlash After Shooting." Likewise, after Major Hasan's mountain of dead infidels, "Shooting Raises Fears For Muslims In US Army." Likewise, after the London Tube slaughter, "British Muslims Fear Repercussions After Tomorrow's Train Bombing." Oh, no, wait, that's a parody, though it's hard to tell.
Oh, and don't forget the Guardian's contribution.
George Will on the size and scope of government.
James Q. Wilson, America's preeminent social scientist, has noted that until relatively recently, "politics was about only a few things; today, it is about nearly everything." Until the 1930s, or perhaps the 1960s, there was a "legitimacy barrier" to federal government activism: When new policies were proposed, the first debate was about whether the federal government could properly act at all on the subject. Today, there is no barrier to the promiscuous multiplication of programmes, because no programme is really new. Rather, it is an extension, modification or enlargement of something government is already doing.
The vicious cycle that should worry [economic adviser, Larry] Summers is the reverse of the one he imagines. It is not government being "cut back" because of disappointments that reinforce themselves. Rather, it is government squandering its limited resources, including the resource of competence, in reckless expansions of its scope. "There has been," Wilson writes, "a transformation of public expectations about the scope of federal action, one that has put virtually everything on Washington's agenda and left nothing off." Try, Wilson suggests, to think "of a human want or difficulty that is not now defined as a 'public policy problem.'"
And related to the above, Tim Worstall on Zoe Williams and her suggested jobs of choice:
When the desirable jobs are spending other peoples' money, reporting on spending other peoples' money and lobbying to spend other peoples' money, then you know that the society is fucked.
Feel free to add your own.
Posted at 08:00 in Media, Politics, Religion | Permalink
Comments (26)


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subset: commoncrawl


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The link "KRISPY KREME DOUGHNUTS INC Files SEC form 8-K, Entry into a Material Definitive Agreement, Termination of a Material" makes an interesting point about KKD. Agree? http://volatile-stocks.com/KKD
Btw, I dont think it was any accident that this was filed/announced/arranged for the first day of the new FY. My bet is that they want the 'benefit' of the new facility (lower int exps) to show in this new year for that much better YoY improvements in the forward quarters. Not a dumb move, necessarily, just the timing is purposeful in that regard.With a stated estimated savings as $3.1million or so for the new FY, it'll have about 4c EPS impact on earnings for the year. Well, actually, maybe 2-3c since there was a charge to redo the financing.Regardless, this deal along just added at least 2 or maybe 3c per share earnings for this new FY.That implies about a 75c benefit to the stock price (3c * 25 PE). So, seeing how the stock has only jumped some 20c in price since the announcement, I'd say its slightly undervalued by ~50c for the immediate valuation.Hope that makes sense.
Redoing their debt facility was a smart move. It lowered their interest rates/expenses going forward. That said, they should continue paying down their debt since it is a floating rate debt. And WHEN (not IF) rates rights, they will find themselves in a bit of a cashflow pickle.


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STATEN ISLAND, N.Y. -- He lived large on bribes and, now, a one-time Consolidated Edison engineer from Prince's Bay will pay large -- more than $6.5 million in forfeitures, as well as possible prison time.
Sassine Razzouk, who turns 56 this month, has been ordered to make the hefty payback under an agreement unsealed Monday in Brooklyn federal court.
He had previously pleaded guilty to bribery and tax-evasion charges, according to other court documents.
Two years ago, federal prosecutors charged Razzouk, a Central Engineering Unit section manager, with accepting millions of dollars in kickbacks from a contractor between January 2008 and May 2010.
Court papers said MDM Capital Inc., a shell company incorporated by Razzouk, received 157 payments totaling $4 million from the head of a Queens-based engineering and design firm.
Razzouk oversaw various projects within Con Edison's electrical generating plants and substations to include planning and designing new electrical control systems and maintaining existing systems. A source said he was so well thought of that he was a lead engineer in the reconstruction of Con Edison's substation at 7 World Trade Center after the Sept. 11, 2001, terrorist attacks.
Court papers said MDM Capital disbursed the money to Razzouk directly, to his relatives and to pay for personal items, including $75,000 for Mercedes-Benzes for his wife and himself. MDM also directed $200,000 to another company owned by Razzouk, called Heavenly American Yogurt, paid $56,000 in property taxes on the suspect's second home in Marlboro, N.J., and shelled out $65,000 for Razzouk's personal income taxes. Razzouk also made $234,000 in mortgage payments on his Prince's Bay residence, and paid $115,000 in credit card bills, court papers said.
According to court papers, Razzouk under-reported more than $5.1 million in income for the calendar years 2007 through 2009. He owes more than $1.7 million in taxes, said those records.
Razzouk was fired shortly after his arrest, a Con Ed spokesman said Monday.
Under the original charges, Razzouk potentially faced up to 10 years behind bars and a fine of up to $250,000.
A sentencing date has not been set, said a spokesman for Loretta E. Lynch, U.S. attorney, for the Eastern District of New York, whose office is prosecuting the case.
Razzouk's lawyer, E. Scott Morvillo, could not immediately be reached for comment.
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EDUCAUSE President and CEO Diana Oblinger to Retire in 2015 After a Career Advancing Education Technology Issues
|For Release:
April 3, 2014
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EDUCAUSE President and CEO Diana Oblinger to Retire in 2015 After a Career Advancing Education Technology Issues
The association's Board of Directors will launch a leadership search this month
Washington, DC (April 3, 2014)—EDUCAUSE announced today that President and CEO Diana G. Oblinger will retire in March 2015. Dr. Oblinger has led the association for a decade, first as a vice president then as president.
Dr. Oblinger joined EDUCAUSE, a higher education technology association with 2,400 member colleges, universities, and corporations, in 2004 as a vice president and was named as president in 2008. Under her leadership, the association has seen sizable growth in membership, new programs, and influence.
"Each year since Diana came onboard, EDUCAUSE has expanded, most notably in the program offerings for members. Over the past few years there have been several new professional development programs, millions of dollars in grants that support transformative programs, new publications, more and better research, and a massive amount of outreach to the higher education community," said Debra Allison, chair of the EDUCAUSE Board of Directors. "Thanks to Diana and her team, EDUCAUSE is well-known and highly respected. We are in a great position to build on the recent achievements and continue to advance thought leadership on technology in higher education."
Dr. Oblinger started EDUCAUSE's first online events, which reach approximately 20,000 participants per year and created the EDUCAUSE Learning Initiative (ELI). An early focus of ELI was on millennial students and how information technology could be used to enhance their learning. Dr. Oblinger's work with learning spaces continues to shape how colleges and universities think about formal and informal spaces. As a result, ELI has developed a reputation as the source for innovation in learning.
Dr. Oblinger also launched the Next Generation Learning Challenges (NGLC), a program supported by many organizations, including the Bill & Melinda Gates Foundation and the Hewlett Foundation. NGLC provides grants for transformational technology-mediated programs in post-secondary and secondary institutions. The program has awarded nearly $55M in grants. Dr. Oblinger's most recent book, "Game Changers: Education and Information Technologies," offers a transformative vision for how online learning, learning analytics, and degree pathways can make higher education more successful, for all students.
Dr. Oblinger began her career as a faculty member, and then moved into university administration. She changed career paths in the late 1980s to focus on how technology could improve education. With a background in academia and the corporate world, she was well suited to lead a non-profit at the intersection of technology and higher education. After a successful career in higher education, Dr. Oblinger is retiring from EDUCAUSE to focus on her family.
"One of the wonderful qualities Diana has brought to the job is her appreciation and deep understanding of the diversity of the higher education community. She has a remarkable ability to work across all organization types—from research universities to community colleges to corporations. Diana understands our membership; she has been and is one of us. She listens, she is innovative, and she gets the right things done," said David Lassner, former chair of the EDUCAUSE Board of Directors and interim president of the University of Hawaii. "Her efforts have greatly advanced the mission of EDUCAUSE and positioned the association to better meet the needs of its members and the entire higher education community."
Dr. Oblinger will continue to forward the organization's strategic goals and activities for 2014-15 as planned. The EDUCAUSE Board of Directors will announce a search for the new president later this month. Information will be available on the EDUCAUSE website.
About EDUCAUSE
EDUCAUSE is a higher education technology association. The organization has an estimated 60,000 active members in over 40 countries. The EDUCAUSE annual conference is considered one of the best technology conferences in higher education. EDUCAUSE holds over 20 face-to-face events each year that reach approximately 11,500 individuals, with thousands more involved in online events. The association produces monthly publications for its members including the EDUCAUSE Review with a circulation of 22,000, and EDUCAUSE Review Online, which receives 100,000 unique monthly views. Both are both award-winning publications. For more information, visit www.educause.edu.


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Obama Visit
Crowd to Reagan: 'Four More Years'
(WBNG Binghamton) The announcement of President Obama's tour stop at Binghamton University has been received with mixed reaction, especially on social media. But 28 years ago -- when things like Facebook and Twitter were decades from even being concepts -- the world watched as President Ronald Reagan brought people, democrat and Republican alike, together on a September afternoon in Endicott.
White House: College should be available for everyone, not a luxury
(WBNG Binghamton) President Barack Obama's agenda for his two-day tour of New York and Pennsylvania will focus on how to make a college education available for everyone, not a luxury.
Traffic pattern for the president
Vestal, NY (WBNG Binghamton) A portion of the Vestal Parkway will be shut down for around 20 minutes in two intervals when President Barack Obama rolls into town.
Binghamton University an example of success, Obama advisor says
Vestal, NY (WBNG Binghamton) Obama administration praises Binghamton University on its success the day before the president's arrival.
Obama outlines affordable education plan in Buffalo, Syracuse
(WBNG Binghamton) President Barack Obama embarked Thursday on his two-day bus tour through New York and Pennsylvania.
President Obama visits Buffalo: Complete coverage
(WBNG Binghamton) Click inside to check out coverage of the President's visit to Buffalo from Granite Broadcasting sister station WKBW.
Speaking to reform education
(WBNG Binghamton) The president's two-day bus tour through New York and Pennsylvania has one goal in mind: Make higher education more affordable.
Fact Sheet on the President's plan to make college more affordable: A better bargain for middle class families in New York
President kicks off his two-day bus tour that is making stops in New York and Pennsylvania.
Obama visits Vestal: How to watch
(WBNG Binghamton) Action News will provide live coverage of President Barack Obama's visit to Binghamton University and a town hall on college costs.
Lawmakers looking forward to Obama visit
(WBNG Binghamton) Excitement is building for President Barack Obama's visit to the Southern Tier, especially with area lawmakers.


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Estradiol Therapy Combined With Progesterone and Endothelium-Dependent Vasodilation in Postmenopausal Women
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Background—Epidemiological studies indicate that estrogen replacement therapy decreases the risk of cardiovascular events in postmenopausal women. Estrogen may confer cardiovascular protection by improving endothelial function because it increases endothelium-dependent vasodilation. It is not known whether progesterone attenuates the beneficial effects of estrogen on endothelial function.
Methods and Results—Seventeen postmenopausal women with mild hypercholesterolemia were enrolled in a placebo-controlled, crossover trial to evaluate the effect of transdermal estradiol, with and without vaginal micronized progesterone, on endothelium-dependent vasodilation in a peripheral conduit artery. Brachial artery diameter was measured with high-resolution B-mode ultrasonography. To assess endothelium-dependent vasodilation, brachial artery diameter was determined at baseline and after a flow stimulus induced by reactive hyperemia. To assess endothelium-independent vasodilation, brachial artery diameter was measured after administration of sublingual nitroglycerin. During estradiol therapy, reactive hyperemia caused an 11.1±1.0% change in brachial artery diameter compared with 4.7±0.6% during placebo therapy (P<0.001). Progesterone did not significantly attenuate this improvement. During combined estrogen and progesterone therapy, flow-mediated vasodilation of the brachial artery was 9.6±0.8% (P=NS versus estradiol alone). Endothelium-independent vasodilation was not altered by estradiol therapy, either with or without progesterone, compared with placebo. There was a modest decrease in total and LDL cholesterol during treatment both with estradiol alone and when estradiol was combined with progesterone (all P<0.001 versus placebo). In a multivariate analysis that included serum estradiol, progesterone, total and LDL cholesterol concentrations, blood pressure, and heart rate, only the estradiol level was a significant predictor of endothelium-dependent vasodilation.
Conclusions—The addition of micronized progesterone does not attenuate the favorable effect of estradiol on endothelium-dependent vasodilation. The vasoprotective effect of hormone replacement therapy may extend beyond its beneficial actions on lipids.
Epidemiological studies indicate that estrogen replacement therapy decreases the risk of cardiovascular death in postmenopausal women.1 2 3 Yet, many postmenopausal women require the use of progesterone in addition to estrogen to reduce the risk of endometrial cancer.4 A recent observational report from the Nurses Health Study, which included >63 000 women, suggested that progesterone, when added to estrogen replacement therapy, decreases the risk of cardiovascular events, as does estrogen replacement therapy alone.5 Other, smaller studies have found that progesterone in combination with estrogen had no adverse effect, compared with estrogen alone, on the risk of myocardial infarction and stroke.6 7 8
An important postulated mechanism whereby estrogen may confer cardiovascular protection is by improving the function of vascular endothelium, specifically by increasing the bioavailability of endothelium-derived nitric oxide.9 Nitric oxide may slow atherogenesis and limit the adverse effects of atherosclerosis by modulating vascular tone; by inhibiting platelet aggregation, synthesis of monocyte chemotactic factors, and monocyte adhesion to the endothelial surface; and by reducing vascular smooth muscle cell proliferation.10 11 12 13 Indeed, estrogen administration improves endothelium-dependent vasodilation in coronary and peripheral vessels of ovariectomized animals and postmenopausal women.14 15 16 17 18 19 20 21 22 Addition of medroxyprogesterone acetate decreases the beneficial effects of estrogen on endothelium-dependent vasodilation in atherosclerotic coronary arteries of cynomolgus monkeys.23 It is not known whether progesterone diminishes the favorable endothelial effects of estrogen on the endothelium in postmenopausal women. A counterregulatory action would be inconsistent with the available epidemiological studies.
Oral estrogen also may decrease cardiovascular risk by lowering LDL cholesterol and lipoprotein (a) levels and by raising HDL cholesterol.24 25 The Postmenopausal Estrogen-Progesterone Intervention (PEPI) trial found that neither medroxyprogesterone acetate nor oral micronized progesterone significantly changed the beneficial effects of conjugated equine estrogen on LDL cholesterol levels.26 Transdermal administration of estradiol, with or without micronized progesterone, however, has not been shown to significantly alter plasma lipoprotein composition.24 27
The objective of this study was to determine whether progesterone, when added to estrogen replacement therapy, attenuates the favorable effects of estrogen on endothelium-dependent vasodilation in postmenopausal women with mild hypercholesterolemia. Specifically, we studied the effect of chronic transdermal estradiol treatment alone and in combination with vaginal micronized progesterone, each administered to achieve physiologically relevant premenopausal levels, on peripheral endothelium-dependent vasodilation in a placebo-controlled, crossover trial.
Seventeen postmenopausal women 48 to 75 years old (mean, 60 years) with mild hypercholesterolemia were recruited via advertisement for participation in the study. Menopause was confirmed by follicle-stimulating hormone levels >40 IU/L and absence of menses for at least 1 year. Exclusion criteria included hypertension, diabetes, cigarette smoking, clinical manifestations of atherosclerosis (coronary artery disease, peripheral artery disease, and cerebrovascular disease), venous thromboembolism, liver disorders, unexplained vaginal bleeding, and personal or family history of breast cancer. All subjects provided a medical history and underwent a physical examination, including gynecological evaluation, and mammography before enrollment. This study was a substudy of a larger trial evaluating the metabolic effects of the restoration of premenopausal hormone levels in postmenopausal women and was approved by the Human Research Committee of Brigham and Women's Hospital. Each subject gave written informed consent.
Randomization to Treatment
This was a double-blind, crossover trial in which subjects received 2 therapeutic regimens, each for a duration of 14 weeks. Nineteen women were enrolled; 17 participated in the vascular reactivity studies. Eight women were randomized to placebo treatment first and received 14 weeks of placebo therapy followed by a 1-month washout period. Then, they crossed over to receive active therapy for 14 weeks. This included estradiol alone for the first 8 weeks, followed by estradiol in combination with 2-week cycles of progesterone during weeks 9 to 10 and 13 to 14. The other 9 women received the opposite treatment order. Estradiol was administered as 0.2 mg estradiol transdermal (two 0.1-mg patches, Estraderm, CIBA-Geigy) placed 2 times per week or corresponding placebo (CIBA-Geigy). The transdermal route of estrogen administration was selected to minimize changes in lipid levels.24 27 Progesterone was given daily as 300 mg vaginal micronized progesterone (Upjohn) in a nonliquefying base (Unibase, Warner Chilcott Laboratories) to achieve sustained physiological levels.28 The vaginal route of administration was chosen to administer natural progesterone. Patch and creme medications were administered in the evening, and vascular reactivity studies were performed in the morning. Review of treatment effects was undertaken at each visit by 1 of the authors (B.W.W.). Treatment effects were not made known to the individuals performing and analyzing the vascular reactivity studies.
Vascular Reactivity Studies
Vascular reactivity was evaluated during placebo treatment (week 8), during estradiol therapy (week 8), and during estradiol plus progesterone therapy (week 10). Subjects were evaluated at the same time of day for each study in a quiet, temperature-controlled room after resting supine for 15 minutes. To assess vascular reactivity, high-resolution ultrasonography of the brachial artery was performed with a Toshiba 270 SSA ultrasound machine equipped with a 7.5-MHz linear array probe. In brief, as previously described and validated,21 29 30 31 32 the brachial artery was imaged longitudinally at a site just proximal to the antecubital fossa, with the arm abducted 80° from the body and the forearm semipronated. The transducer position was adjusted to obtain optimal images of the anterior and posterior intima. The image was recorded on x-ray film to ensure that the brachial artery was imaged at the identical site and position for each study. All images were recorded on super VHS videotape. After baseline images were recorded, a sphygmomanometric cuff on the upper arm was inflated to suprasystolic pressures for 5 minutes. To determine endothelium-dependent vasodilation, the brachial artery was imaged during reactive hyperemia 1 minute after cuff release. Brachial artery blood flow typically increases 5- to 10-fold during reactive hyperemia, and this is followed by peak brachial artery vasodilation.20 Flow-mediated vasodilation of the brachial artery is largely an endothelium-dependent process, mediated by nitric oxide and inhibited by the nitric oxide synthase antagonist NG-monomethyl-l-arginine.30 Moreover, flow-mediated, endothelium-dependent vasodilation of the brachial artery correlates with endothelium-dependent vascular responsiveness of the coronary arteries to acetylcholine in individuals who have undergone both types of testing.31 After a minimum of 10 minutes from the time of cuff release and reestablishment of baseline conditions, including baseline diameter, the brachial artery was imaged again. Then, to determine endothelium-independent vasodilation, subjects received 0.3 mg of sublingual nitroglycerin. The brachial artery image was recorded 3 minutes later, a time corresponding to peak vasodilation to nitroglycerin. Forearm blood flow during reactive hyperemia was measured by venous occlusion plethysmography with calibrated mercury-in-Silastic strain gauges as previously described.33
Biochemical Assays
Serum 17β-estradiol, progesterone level, and lipid concentrations were measured during each treatment period on the day of the vascular reactivity study. An enzymatic method was used to determine total cholesterol and triglyceride levels (Dax 96 analyzer, Bayer). HDL cholesterol was measured by precipitation of apoB-containing lipoproteins by the addition of phosphotungstic acid and magnesium ions. After centrifugation, only HDL cholesterol remained in the supernatant. The cholesterol concentration of the supernatant was measured by the enzymatic method. LDL cholesterol was calculated according to the Friedewald formula.34 Estradiol and progesterone concentrations were determined by chemiluminescent immunoassays (Bayer).
Image Analysis
For each condition (baseline, reactive hyperemia, repeat baseline, nitroglycerin) during each treatment period, 3 end-diastolic frames were selected and digitized for subsequent analysis. Each image was assigned a code. Subject name, date, and time were then removed from the image. Image analysis of the coded frames was then performed by 2 blinded investigators using software that searched for the shortest distance between the points on the arterial wall as previously described.20 29 This resulted in ≈20 paired measurements along a 10- to 15-mm length of artery. Arterial diameter was measured from the intima-lumen interface along the posterior wall to the media-intima interface of the anterior wall. Pixels were converted to millimeters by use of calibration factors from real-time ultrasonography. The average of 3 measurements was used for each determination of brachial artery diameter.
Statistical Analysis
All data are reported as mean±SEM. The effects of estrogen alone and combined with progesterone were analyzed by repeated-measures ANOVA. Post hoc comparisons between the different treatments were made with the Student-Newman-Keuls test. Side effects during treatment were evaluated with the McNemar test. The Spearman rank correlation coefficient was determined for endothelium-dependent vasodilation and total and LDL cholesterol levels. A stepwise multivariate analysis was performed with flow-mediated, endothelium-dependent vasodilation as the dependent variable and 17β-estradiol, progesterone, total cholesterol and LDL cholesterol levels, age, heart rate, and blood pressure as independent variables. Statistical significance was accepted at the 95% confidence level (P<0.05).
The effect of treatment with placebo, estradiol, and estradiol combined with progesterone on heart rate, blood pressure, and serum estradiol and progesterone is described in Table 1⇓. The serum estradiol concentration rose significantly and comparably during both drug treatment periods. The serum progesterone level increased significantly only during the period in which micronized progesterone was administered. Neither heart rate nor blood pressure was altered by active treatment.
During placebo therapy, total cholesterol was 223±7 mg/dL, LDL cholesterol was 141±6 mg/dL, HDL cholesterol was 62±4 mg/dL, and triglycerides were 97±12 mg/dL. Estradiol therapy alone decreased total cholesterol by 6.7±1.8% (P<0.001) and LDL cholesterol by 10.9±2.7% (P<0.001). Estradiol therapy combined with progesterone decreased total cholesterol by 5.8±1.7% (P<0.001) and LDL cholesterol by 8.4±2.4% (P<0.001). Estradiol treatment alone or combined with progesterone did not significantly alter HDL cholesterol or triglyceride concentrations.
There were no significant differences in the degree of symptoms or side effects between placebo, estradiol alone, and estradiol with progesterone therapy. Breast tenderness was noted by 9 subjects during estradiol therapy, by 7 subjects during estradiol with progesterone therapy, and by 5 subjects during placebo therapy. Vaginal bleeding was reported by 4 subjects during estradiol therapy, by 5 subjects during estradiol plus progesterone therapy, and by 2 subjects during placebo therapy. Hot flashes were present in 5 subjects during placebo therapy and were reported by 2 subjects during estradiol therapy. One or 2 subjects reported fatigue, mood change, leg cramps, headache, rash, sweating, insomnia, nausea, urinary frequency, and insomnia during each of the 3 treatment periods.
Effect of Hormonal Treatment on Vascular Reactivity
The baseline brachial artery diameter was 3.61±0.80 mm during placebo treatment, 3.59±0.70 mm during estradiol treatment, and 3.62±0.90 mm during the estradiol plus progesterone treatment (each P=NS versus placebo). Peak reactive hyperemic forearm blood flow, the stimulus for brachial artery flow-mediated vasodilation, was similar for each treatment period (19.5±1.4, 19.7±1.6, and 24.0±1.8 mL · 100 mL−1 · min−1 during placebo, estradiol alone, and estradiol plus progesterone treatment periods, respectively, P=NS). Flow-mediated, endothelium-dependent vasodilation was greater during estradiol therapy than during placebo therapy. During estradiol therapy, reactive hyperemia caused an 11.1±1.0% increase in brachial artery diameter compared with 4.7±0.6% during placebo therapy (P<0.001) (Figure 1⇓). Flow-mediated endothelium-dependent vasodilation of the brachial artery also was greater during combined estradiol and progesterone treatment (9.6±0.8%) than during placebo treatment (P<0.001 versus placebo) (Figure 1⇓). Progesterone combined with estradiol did not change the magnitude of endothelium-dependent vasodilation compared with treatment with estradiol alone (9.6±0.8 versus 11.1±1.0%, P=NS). Endothelium-independent vasodilation to sublingual nitroglycerin was not affected by treatment (Figure 2⇓). The change in brachial artery diameter after nitroglycerin was 12.7±1.3% during placebo treatment, 12.1±1.0% during estradiol treatment alone, and 11.3±1.2% during the combination of estradiol and progesterone (P=NS).
Factors Associated With Endothelium-Dependent Vasodilation
Stepwise multiple logistic regression was performed with flow-mediated, endothelium-dependent vasodilation as the dependent variable (Table 2⇓). Estradiol concentration was the only significant predictor of endothelium-dependent vasodilation. A significant correlation between the change in total cholesterol or LDL cholesterol and flow-mediated, endothelium-dependent vasodilation was not detected by rank correlation testing.
The novel observation made in this study is that the addition of micronized vaginal progesterone to transdermal estradiol does not diminish the benefits of estradiol on endothelium-dependent vasodilation in postmenopausal women. This effect of estradiol therapy, with or without progesterone, on vascular reactivity appears to be independent of its lipid-lowering effect.
Estrogen and Endothelium-Dependent Vasodilation
The beneficial effect of estrogen on endothelium-dependent vasodilation was initially elucidated in animal models and subsequently confirmed in postmenopausal women. Replacing estrogen after ovariectomy restores endothelium-dependent relaxation of arteries isolated from rabbits, dogs, and cholesterol-fed swine.14 15 35 Short-term and long-term estrogen administration also improves endothelium-dependent vasodilation of coronary arteries to acetylcholine in vivo in cholesterol-fed ovariectomized monkeys.16 17 23 In postmenopausal women, acute administration of estrogens increases endothelium-dependent vasodilation of coronary arteries and forearm resistance vessels,18 19 21 22 and chronic oral estradiol administration increases flow-mediated vasodilation of the brachial artery.20 Studies in animal models have examined the effect of progestin on endothelial function. Miller and Vanhoutte35 studied canine coronary artery rings and reported that progesterone combined with estrogen attenuated the improvement in endothelium-dependent relaxation seen with estrogen alone. Williams et al23 found that medroxyprogesterone acetate diminished the endothelium-dependent vasodilator effect of conjugated equine estrogen by up to 50% in coronary arteries of cholesterol-fed monkeys. Recently, Miyagawa et al36 compared the effects of 2 types of progestin on coronary vasoreactivity in ovariectomized monkeys. Intracoronary administration of serotonin and a thromboxane mimetic induced coronary vasospasm in monkeys treated with 17β-estradiol and medroxyprogesterone acetate but not in monkeys treated with 17β-estradiol and progesterone.36 Taken together, these studies suggest that the vascular effects of progestins combined with estrogen may be different between synthetic and natural progesterone.
The present study demonstrates that the addition of micronized vaginal progesterone, in a dose that achieved physiological serum concentrations of progesterone, does not attenuate the beneficial effects of estradiol on endothelium-dependent vasodilation in postmenopausal women. Our findings are consistent with those observed in premenopausal women, in whom similar enhancement of endothelium-dependent vasodilation of the brachial artery occurred during the follicular and luteal phases of the menstrual cycle compared with the time of menses.37 In our study, we achieved estradiol and progesterone levels during active treatment comparable to those found in the follicular (estradiol administration) and luteal (estradiol plus progesterone administration) phases of the menstrual cycle.38 The use of micronized progesterone, which is less androgenic than medroxyprogesterone acetate, and/or species differences may explain, in part, the findings in women compared with those seen in experimental studies.
Lipoprotein Effects
The decrease in total and LDL cholesterol concentrations with both active treatments in this study was modest. This differs from a previous study in which transdermal estradiol concentration used at a lower dose (0.1 mg twice each week) had no effect on these lipoprotein measurements.24 We chose to use 0.2 mg twice each week to more closely approximate physiological concentrations of estrogen that occur during the menstrual cycle. The higher dose may account for the disparate results on lipoprotein fraction between these 2 studies.
Lowering LDL cholesterol has been shown to improve endothelium-dependent vasodilation in coronary arteries.39 40 41 42 Therefore, a question has arisen as to whether the effect of estrogen on endothelium-dependent vasodilation is indirect and related to its lipid-lowering properties.43 If so, this approach would be less appealing than the use of moderate lipid-lowering drugs, which are more potent and more free of side effects. Our findings suggest that improved endothelium-dependent vasodilation with transdermal administration of estradiol is independent of the change in lipid concentration. In a multivariate analysis, reduction in total and LDL cholesterol did not correlate with improvement in brachial artery endothelial function. Moreover, in previous studies, intracoronary or intravenous estrogen restored endothelium-dependent vasodilation in the coronary arteries in a matter of minutes, a time duration in which lipid changes could not have occurred.17 18 19 21 22
The addition of micronized vaginal progesterone does not attenuate the improvement in endothelium-dependent vasodilation that occurs with estradiol treatment. These findings suggest that the increased bioavailability of endothelium-derived nitric oxide achieved with estradiol therapy is not reduced by progesterone. This observation provides insight into a mechanism whereby hormone replacement therapy reduces the risk of cardiovascular events in postmenopausal women and may allay fears about abrogating cardiovascular risk reduction with the addition of progesterone. Moreover, the vasoprotective effects of estradiol and progesterone replacement therapy appear to extend beyond its favorable actions on lipids. Therefore, hormone replacement and lipid-lowering therapies may be complementary, a concept that needs to be explored in future studies.
This research was supported by a grant from the National Institutes of Health (NIH R01-HL-50890) as well as a National Institutes of Health Program Project Grant in Vascular Biology and Medicine (HL-48743). Dr Gerhard is a recipient of a Harvard/MIT Health Sciences and Technology–Beth Israel fellowship and the Cardiac Care Award of Excellence from the Alpha Phi Foundation. The authors gratefully acknowledge Dr Arnold Barnett for assistance with statistical analysis and Joanne Normandin for expert assistance in the preparation of this manuscript.
Reprint requests to Mark A. Creager, MD, Vascular Medicine and Atherosclerosis Unit, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
- Received January 30, 1998.
- Revision received May 6, 1998.
- Accepted May 16, 1998.
- Copyright © 1998 by American Heart Association
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- Estradiol Therapy Combined With Progesterone and Endothelium-Dependent Vasodilation in Postmenopausal WomenMarie Gerhard, Brian W. Walsh, Ahmed Tawakol, Elizabeth A. Haley, Shelly J. Creager, Ellen W. Seely, Peter Ganz and Mark A. CreagerCirculation. 1998;98:1158-1163, originally published September 22, 1998http://dx.doi.org/10.1161/01.CIR.98.12.1158
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- Estradiol Therapy Combined With Progesterone and Endothelium-Dependent Vasodilation in Postmenopausal WomenMarie Gerhard, Brian W. Walsh, Ahmed Tawakol, Elizabeth A. Haley, Shelly J. Creager, Ellen W. Seely, Peter Ganz and Mark A. CreagerCirculation. 1998;98:1158-1163, originally published September 22, 1998http://dx.doi.org/10.1161/01.CIR.98.12.1158
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- Hormones, genetic factors, and gender differences in cardiovascular disease
- Endothelial function, vascular reactivity and gender differences in the cardiovascular system
- Effects of acute hormone therapy on recurrent ischemia in postmenopausal women with unstable angina
- Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: A report of the International Brachial Artery Reactivity Task Force
- Coronary flow: how far can we go with echocardiography?
- Hormone Replacement Therapy and Endothelial Function: The Exception That Proves the Rule?
- Gender differences in wall shear-mediated brachial artery vasoconstriction and vasodilation
- Acute and mid-term combined hormone replacement therapy improves endothelial function in post-menopausal women with angina and angiographically normal coronary arteries
- Protective effects of estrogen on gender-specific development of diet-induced hypertension
- Effect of Medroxyprogesterone Acetate on Endothelium-Dependent Vasodilation in Postmenopausal Women Receiving Estrogen
- Repeated thermal therapy improves impaired vascular endothelial function in patients with coronary risk factors
- Relationship between the angiotensin-converting enzyme genotype and the forearm vasodilator response to estrogen replacement therapy in postmenopausal women
- Vascular Effects of Synthetic or Natural Progestagen Combined With Conjugated Equine Estrogen in Healthy Postmenopausal Women
- Attenuation of endothelin-1 induced vasoconstriction by 17{beta} estradiol is not sustained during long-term therapy in postmenopausal women with coronary heart disease
- Effect of Oral Postmenopausal Hormone Replacement on Progression of Atherosclerosis : A Randomized, Controlled Trial
- Endothelial Dysfunction and Oxidative Stress During Estrogen Deficiency in Spontaneously Hypertensive Rats
- The Phytoestrogen Genistein Produces Acute Nitric Oxide-Dependent Dilation of Human Forearm Vasculature With Similar Potency to 17{beta}-Estradiol
- Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women
- Differential Effects of Oral and Transdermal Estrogen Replacement Therapy on Endothelial Function in Postmenopausal Women
- Cardiovascular Effects of Droloxifene, a New Selective Estrogen Receptor Modulator, in Healthy Postmenopausal Women
- Mechanisms Responsible for Endothelial Dysfunction Associated With Acute Estrogen Deprivation in Normotensive Women
- Pharmacodynamics of Oestrogens and Progestogens
- The roles of gender, the menopause and hormone replacement on cardiovascular function
- Chronic Estrogen Treatment Increases Levels of Endothelial Nitric Oxide Synthase Protein in Rat Cerebral Microvessels Editorial Comment
- Raloxifene Acutely Relaxes Rabbit Coronary Arteries In Vitro by an Estrogen Receptor Dependent and Nitric Oxide Dependent Mechanism
- Assessment and treatment of endothelial dysfunction in humans
- Cholesterol Lowering : Should It Continue to Be the Last Thing We Do?
- Individual and combined effects of estrogen/progestin therapy and lovastatin on lipids and flow-mediated vasodilation in postmenopausal women with coronary artery disease
- The 1998 Nobel prize in Medicine: clinical implications for 1999 and beyond
- The Impact of Gender on Infrainguinal Arterial Occlusive Disease
- Hormone Therapy and Endothelium Function
- Hormone Therapy and Endothelium Function
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my birthday cake! :) my birthday is this saturday and i didn't trust my mother... so i made my cake! first time working with real fondant (satin ice). other than it tearing just a little... which i covered up ... i'm really happy with it! raspberry cake made with jello.
CakeCentral.com is the world's largest cake community for cake decorating professionals and enthusiasts.
(if this is a private computer)
Yes please, register now!


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Austin , TX
Capital Cruises was established in 1991 as the only all-electric boat fleet on the Highland Lakes. Nestled on the shores of beautiful Lady Bird Lake at the Hyatt Regency Hotel (208 Barton Springs Rd, Austin, TX), we are proud to offer lunch and dinner cruises, wedding events, internationally famous bat watching excursions, party boat services and the ultimate alternative for group and corporate outings.
Nightly, 30 minutes before sunset.
All orders are subject to credit card approval and billing address verification. The billing address will be verified with your credit card company so you must use the exact address that your statements are sent to.
Print at Home ticket orders are available immediately and accessible via your confirmation email. All tickets are non-refundable/non-returnable.
We are unable to issue exchanges or refunds after a purchase has been made including but not limited to lost, stolen, damaged or destroyed tickets.
Ticket package and prices are subject to change without notice.


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Your Shopping Bag 0
Christmas Gifts for the one you love or great savings for a treat for you!
Extra value on these fantastic Kerastase products
Legendary oils for smooth, shiny looking, purely divine hair.
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Kerastase is a luxury haircare brand established in 1964 in France. Beauty Flash own and operate Cocoon Hair & Beauty based in Reading, Berkshire an authorised Kerastase salon. Help and advice is available from our Kerastase specialists.
Kerastase products offer a luxury hair care experience with technologically advanced formulas and ingredients. The range is made up of rituals, which are specifically designed to address the needs of different hair types and conditions, working out how to achieve the optimum hair condition.
This hair care programme deeply transforms the hair at a structural level, targeting the core and working outward; using bio-regulating care to improve the scalp's health and appearance.
Customer Services 0118 975 8806
Privacy Policy | Terms & Conditions | Conditions of Sale
Beautyflash.co.uk is owned and operated by LDLP Ltd. LDLP Ltd is a registered company in the UK and 04757113 is our company number. All prices include VAT at the current rate and our VAT number is 837787468.


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NEW YORK — At a few minutes before 9 p.m., as the umpires met to discuss whether the pouring rain at Citi Field was strong enough to send this game to a rain delay, Anthony Recker stood at home plate and had a singular thought.
As the rain drops fell, the Mets held a one-run lead and Patrick Corbin, the Diamondbacks' young ace was reeling. Recker was the next in line and he did not want another ounce of intrigue to add to an already critical situation.
"Please don't do this right now," he told himself. "Bases loaded, nobody out, you're going to make me sit for a while."
His protest, kept to himself, was an empty hope. At 8:54, the game was paused. For nearly two hours, the Mets stewed. When it resumed, and the rain drops were no longer falling and the fans no longer as numerous, it only took them 11 minutes to score more runs than they had in eight days and seven games — all for a 9-1 victory.
And for 101 minutes, Recker waited, his patience never turning to anxiety.
He paced around, hoping to keep himself active so that he would not tighten up. He took several swings to keep himself loose. He even ate a snack.
Mostly, he kept walking and talking and waiting. The Mets had endured five-plus hours of baseball the night before but at least that had been continuous. Tuesday night came in chapters.
Twenty minutes before the game would restart, Recker came out to the dugout for a third time during this delay. He looked into Arizona's bullpen and saw two right-handers, Will Harris and Brad Ziegler. Harris was the lone Diamondbacks pitcher not to throw Monday night. Ziegler was the sidearming, groundball specialist.
Recker knew who he would face. He and Zeigler had been teammates in Oakland and he had plenty of experience with his repertoire. Enough that only a few snippets of video would suffice as preparation.
"Obviously, I knew his game," he said.
On the third pitch, an 86-mph sinker, Recker sent a ground ball single through the right side of the infield. It was the breaking point.
The next five batters would reach, four on hits, and a tense one-run game had suddenly wilted into blowout. By the inning's end, the Mets would score seven runs. The rain delay had brought upon a levity to a long two day stretch. By 11:17, they had won two consecutive games over nearly 10 hours.
"I'm not sure they know what's going on," Mets manager Terry Collins said. "They're all tired."
The outburst came in support of starter Jeremy Hefner (3-6, 3.54 ERA), who pitched seven innings to earn the win. He had thrown only 97 pitches before being lifted because of the delay.
He and Corbin had set a quick tempo before it was halted.
Hefner moved through Arizona's lineup with impunity. He allowed just a run over seven innings. His mistake came on a solo home run by Martin Prado in the seventh.
Corbin was similarly successful for six innings, giving up only a solo home run to Recker. But in the seventh he found trouble, allowing three consecutive hits to break the 1-1 tie. After walking Andrew Brown, the game paused. When it resumed, the Mets supplied Hefner with all the support he needed.
"I know we haven't scored a lot of runs in this ballpark so seven is pretty good," Collins said. "It just took an hour and a half to get them."


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Infamous New Zealand noise-rock trio the Dead C certainly isn't for everybody. Some music fans find the band's chaotic lo-fi din unlistenable, while others derive hypnotic bliss from the clamorous dirges created by Bruce Russell, Michael Morley, and Robbie Yeats. Morley often contributes keening, haunted vocals, and in recent years, the band has ventured into more experimental, droning realms using two guitars, drums, and occasional electronics. To a degree, it's metamusic, with the band deliberately deconstructing notions of what "songs" should sound like. In any case, its distinctive noise is a compelling auditory experience.
"The way I see it, the Dead C are like a white man's blues," says Ben Goldberg of the Ba Da Bing label, which released the band's most recent album, Secret Earth, and the illuminating two-CD overview Vain, Erudite and Stupid. "While there's very little groove in their music, there's a whole lot of soul, mostly around the anguish of living in the modern day. It's a sophisticated angst which cuts right to your bones, stripping you down to a complete self-awareness of your own despair." Yikes!
Indeed, there is no other band that holds the same weird power and harrowing, riveting energy. If you surrender yourself to it, you'll find the same transporting magic the group's rabid followers discovered. Secret Earth, for example, is a more accessible return to the band's rockish early days. There are four tracks ranging from seven to 16 minutes in length; the first, "Mansions," launches with a roar and then settles into something resembling Sonic Youth channeling dark, folksy blues. This tone carries throughout the album as a pervasive minor-key melancholy gets layered with obstreperous guitar. Given the chance, the disc is oddly moving and beautiful.
For more immediate Dead C exposure, check out the YouTube video of the trio's single television appearance in 1999. It's a rendition of "Sky" on a New Zealand variety show called Ground Zero. The trio blasts out a hair-raising sonic monster; Russell turns in a blistering display on guitar, making quick use of feedback, a screwdriver, and some enigmatic spinning gizmo. It's a powerhouse performance that's over within three minutes. (Reportedly, the TV crew was most worried that the band would break something.)
The Dead C members often state that they're more interested in pleasing themselves than worrying about their listeners, and in an e-mail from New Zealand, Russell reiterates this sentiment. "In the early days we didn't have any audience, so it was never a worry," he says. "As time has gone on, we've continued doing stuff that pleases us, even when we know that parts of our audience don't like it." He adds that he sees the rock music tradition as dead, and his band's music is a response to that: "It's over; there's no juice in the corpse."
The Dead C's output serves to point out the wreckage, even as Russell understands that his approach is as alienating as it is inviting. "If people are interested in sound as opposed to 'music,' and if they have a critical perspective on art and culture and its place in society, then they may find something of worth in our work," he says. "Otherwise, I wouldn't recommend it." That said, performances by The Dead C are singularly impressive; the group doesn't come here often. Just consider yourself warned.


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Most of the time I feel like I am still trying to figure things out. Making progress but I still have a lot of unknowns.
In the summer I enjoy camping, going to the beach or cottage and almost any outdoor activity.
In the winter I enjoy xc skiing, downhill skiing out west, snowshoeing and when it's really cold...staying in and watching Netflix.
Most HBO shows
Plus too many to list, better to discuss in person.
Running Shoes
Delicious Food
Interesting People
I find excellent grammar and punctuation very attractive.


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This bundle includes Borderlands 2: Ultimate Vault Hunters Upgrade Pack 1 & 2!Read full description
This bundle includes Borderlands 2: Ultimate Vault Hunters Upgrade Pack 1 & 2 !
Take Borderlands 2 to the next level. The Ultimate Vault Hunter's Upgrade lets you get the most out of the Borderlands 2 experience.
Ultimate Vault Hunter's Upgrade Pack 1 includes:
The Ultimate Vault Hunter Upgrade Pack 2 includes:
Digistruct Peak Challenge adds 11 more levels of character growth
New legendary gear
"Raid on Digistruct Peak" map offering even more high-level play.
For players who want to get the most out of their Borderlands 2 experience, the first Ultimate Upgrade Pack and Ultimate Upgrade Pack 2 can be combined for a max level cap of 72 , even more legendary gear, and new over-leveled modes!
Borderlands 2 is required to play this DLC.
Initial installation requires one-time internet connection for Steam authentication software installations required (included with the game) include Steam Client, DirectX 9, Microsoft .NET 4 Framework, Visual C++ Redistributable 2005, Visual C++ Redistributable 2008, Visual C++ Redistributable 2010, and AMD CPU Drivers (XP Only/AMD Only)
© 2012 Gearbox Software, LLC. All rights reserved. Borderlands, Gearbox, and the Gearbox Software logos are registered trademarks, and the Borderlands logo is a trademark, all of Gearbox Software, LLC and are used here under license. Borderlands 2 is published and distributed by 2K Games, a subsidiary of Take-Two Interactive Software, Inc. 2K Games, Take-Two Interactive Software and their respective logos are trademarks and/or registered trademarks of Take-Two Interactive Software, Inc.
User score
I'm not exactly sure who's the target audience for this particular DLC. Let's approach this from a "customer" point of view, alright? "Level with me" (apologies for such a cheap pun), as I go through the possibilities here: Let's say, you don't have Borderlands 2, but would like to buy the game for some reason. You can choose between getting the default game or the GOTY edition ( which you totally should ). The GOTY has both of these levelcaps, so if went with that option, you're NOT going to buy this pack. If you bought the default game, you've played around with it a little, and now have an opinion about it. If that opinion is negative, you're not going to buy anything related to the game, so you're NOT going to buy this pack. If that opinion was positive, you may start to look around for additional content to purchase, and all signs will point towards buying the Season Pass. Now, purchasing the Season Pass means you'll get one of the "Vault Hunter Upgrade Packs" (the first one, to be precise), which means you're NOT going to buy this pack, because you'd be paying for something you already own, twice! So now we've concluded, that purchasing this pack is not beneficial for anyone, and that it is, in fact, a "noobtrap". Get the most out of your wallet and stay away from this as much as possible!
This is a pack of two DLC's for borderlands 2. Each pack contains its own goods. The first one lets you get up on a higher level with new equipment that it offers. Yes that's it, but it gets better. With the other levels you get new skills and so we get to the second pack. The second one includes even more levels and yet again new gear, better than any before. This one is different by the other with that it includes a new map that you can play which i think it is worth it, a total of 72 levels with new gear will make sure to bring your enemies to their knees.
All reviews are moderated and may not appear on the site staight away
Thank you for your patience whilst we complete this process.


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For the more information about the geologic resources of the National Park Service, please visit http://www.nature.nps.gov/geology/.
White-Nose Syndrome
White-Nose Syndrome Video Series
Watch the WNS video series to learn more about white-nose syndrome, the efforts different parks are making to respond and minimize the spread of this deadly diease, and ways you can help protect these wonderful creatures for future generations to enjoy.
White-nose syndrome (WNS) is a disease of cave-hibernating bats caused by a fungus, Pseudogymnoascus destructans. After being discovered in New York in the winter of 2006-2007, white-nose syndrome has spread to 29 states and five Canadian Provinces devastating the populations of bats in its path.
The mission of the National Park Service is to preserve, protect and share the legacies of America's natural resources. In meeting this mission, the NPS exercises its mandate for wildlife management in all national parks to help protect bats from this deadly disease.
What is at risk?
The National Park System contains over 400 national parks. One in four of these national parks have caves and one in three contain mines that can provide habitat for bats and other organisms. Over 50 species of bats have been documented in national parks.
White-nose syndrome (WNS) is threatening bat populations and conservation, as well as visitor use of recreational caves and the enjoyment of bats in national parks. Bats also play an important role in keeping the ecosystem and us healthy by eating insects, pollinating plants, and dispersing seeds.
Parks in 28 states are currently affected by WNS.
Click image to enlarge.
Click image to enlarge.
How is NPS addressing WNS?
National parks welcome over 270 million visitors per year. Some national parks such as Mammoth Cave and Carlsbad Caverns have caves as their primary attractions. With WNS posing a threat to parks and visitor enjoyment, the NPS is taking steps to address this issue.
Parks with caves are updating their Cave Management Plans, or using other means to identify and implement actions to minimize the risk of WNS spreading into uninfected parks. These actions include: providing extensive WNS education and materials; screening visitors and gear; disinfection; and when necessary, closure of cave resources.
White-nose syndrome has not been shown to affect humans. No human illnesses to date have been associated with contact or exposure to WNS-infected bats or caves. Additionally, the fungus that causes the disease only grows at cold temperatures, well below human body temperature.
Last Updated: August 16, 2016