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Hollywood Will Lure You In With an Adaptation of The Piper
by Ethan Anderton
December 2, 2009
One thing that I'm constantly shocked and astounded by are some of the morbid and morally questionable fairy tales, fables, nursery rhymes and legends that children hear at such a young age. Stories like Hansel and Gretel, Three Blind Mice or even the Dr. Seuss story of The 500 Hats of Bartholomew Cubbins are surprisingly dark and grim. But now as an adult, I love when someone has the creativity to take these twisted stories and make them even more vicious. Such is the case with THR's report on an adaptation of the comic book The Piper, a twisted, contemporary take on the classic legend of The Pied Piper of Hamelin.
The comic centers on a bullied high school band student who unintentionally channels the spirit of the mysterious Pied Piper and triggers terrifying consequences of his actions beyond his control. Sounds like Carrie meets Bully, and I'm just fine with that. But I'm hoping this won't strike the wrong chord with certain organizations who might be worried for the sake of children whose delicate sensibilities might be affected by violence in schools from bullied kids. Incidents like Columbine and the like are tragedies, and there's no denying the necessity for the safety of our kids, but attempting to shield them from true violence in the world, let alone a fictional comic book scenario would be irresponsible.
Sorry if that was a little too political or deep for an article concerning a comic book adaptation, but I can just hear the complaints already. Anyway, the search is on for writers, so we've got some time to sit on this one for awhile, but you can be sure we'll be highlighting this as the project develops, so stay tuned for updates.
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Monique Bryher joins the CalBRE Commissioner's Real Estate and Mortgage Loan Advisory Panel
Press Release:
I was recently invited by Real Estate Commissioner Wayne Bell to be a member of the Commissioner's Real Estate and Mortgage Loan Advisory Panel and have accepted.
The Commissioner for the California Bureau of Real Estate ("CalBRE") and its employees occasionally reach out to industry members or to subject matter experts or specialists for advice, expertise, guidance, information, ideas, perspectives or feedback on various real estate and/or mortgage topics or issues.
It is indeed an honor to be a contributor to this group of real estate and mortgage industry professionals.
–Monique Bryher

subset: commoncrawl


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African Football News
AFCON 2017 Qualifiers Roundup: Wins For Tunisia, Morocco, Swaziland
Tunisia and Morocco opened their 2017 African Cup of Nations qualification campaign with home wins while Swaziland upset the form book in defeating Guinea.
Tunisia 8-1 Djibouti
Yassine Chikhaoui's early hat-trick set the Carthage Eagles to a cruising start in group A. He opened his account with a penalty after nine minutes and completed his treble after just 25 minutes. Ferjani Sassi scored one more before the break to end the game as a contest.
Minnows Djibouti pulled a goal from the penalty spot through Liban but Tunisia responded with ruthlessness; scoring another four through, Tunisian Ligue 1 topscorer, Saber Khalifa, Fakhreddine Ben Youssef, Hannanchi and Touzghar.
Togo and Liberia, the other teams in the group, meet on 14th June.
Morocco 1-0 Libya
Morocco dominated the entire game but only manage to score one goal in the all-North African showdown in Agadir.
El Kadouri scored the crucial goal at the 50th minute mark in Morocco's first official match in almost two years. Hachim Mastour confirmed his allegiance for the Atlas Lions senior team in this fixture.
Cape Verde and Sao Tome and Principe are the other sides in this group.
Guinea 1-2 Swaziland
Guinea, playing their home matches in neutral venues due to the Ebola situation, got stunned in their group L opener by underdogs Swaziland.
Swaziland took the lead in the 18th minute and it took until the 68th minute for Guniea to equalise.
Thulani Tsabedze scored in the 84th minute beating slotting past goalkeeper Kamano to give Swaziland the vital three points.
The group is completed by Malawi and Zimbabwe, the latter having had issues prior to the game over unpaid bonuses.
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Roda JC vs Groningen 2017 Dutch Eredivisie: Match Preview and Prediction
Fixture: Roda JC vs Groningen
Competition: Dutch Eredivisie 2016-17
Date: Sunday, 12th March, 13:30 GMT
Stadium: Parkstad Limburg Stadion.
Roda JC vs Groningen: Preview
Roda JC vs Groningen match is going to be held on 12th March at Parkstad Limburg Stadion. It's an important football clash between two Dutch football clubs where they will try to give their best efforts to win this match. Roda JC suffered a 4-0 away defeat against PSV and Groningen held a 1-1 home draw against Ajax in their previous league matches.
At the moment, Roda JC is performing poor and they have secured 3 wins, 11 draws and 11 defeats along with 17th position in Dutch Eredivisie 2016/17 season. In other side Groningen performing average with 6 wins, 10 draws and 9 defeats along with 10th position in Dutch Eredivisie table. Groningen will start the match as favorite against Roda JC in their crucial fixture of Dutch Eredivisie at Parkstad Limburg Stadion.
Roda JC vs Groningen: Head-to-Head Stats
- Both teams have played 42 matches against each other in all the competitions. Roda JC has registered 19 wins, 10 draws and 13 defeats against Groningen. Groningen has scored 54 goals against Roda JC and concedes 78 goals against them.
- Groningen registered a 2-0 home win against Roda JC in their last meetings in the match of Dutch Eredivisie on 10th Dec, 2016.
Roda JC vs Groningen: Prediction
Roda JC will try their best to secure at least a home draw from this match and Groningen is ready to secure an away win from the fixture. Groningen is better side to compare with Roda JC when they will play against each other at Parkstad Limburg Stadion.
Predicted result will be a draw or away win for Groningen.
Roda JC vs Groningen: Betting Tips
Draw No Bet: Groningen at 1.66


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Massage is a form of physical communication, a touch of love, of caring. Touch nourishes the body and the soul. Sensual massage begins with learning to touch yourself. Appreciate touching the things around you. Learn to relax. Let go and enjoy. Get below your mind and into your senses. In this program, we will cover preparing for a massage, back massage, and front massage. Learn the secrets of sensual loving touch that will leave you and your partner invigorated. Follow our program and discover new ways to touch and give each other pleasure. Learn about creating the perfect setting, using massage oils, arousing all five senses, and relaxing the entire body to find new erogenous zones. This one-hour program covers:
©2005 Alexander Institute
"Listen while doing"
This could make for a good listen but by the time one goes to apply everything they learned, they're likely to forget much of the advise given. My suggestion, listen to this audio book while you are actually giving the massage!
Report Inappropriate Content
If you find this review inappropriate and think it should be removed from our site, let us know. This report will be reviewed by Audible and we will take appropriate action.


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Hyperbilirubinemia management guidelines
Assistance with the AAP 2004 guidelines for the management of hyperbilirubinemia in newborns 35 or more weeks of gestation.
Risk factors:
- isoimmune hemolytic disease
- G6PD deficiency
- asphyxia
- significant letheragy
- temperature instability
- sepsis
- acidosis
- albumin < 3 g/dL
Based on
- Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation, Pediatrics 2004, 114:297
Script by Joe Chou, 2014-04
The User acknowledges and agrees that this tool will be used only as a reference aid, and that the information contained in the product is not intended to be (nor should it be used as) a substitute for the exercise of professional judgement.
In view of the possibility of human error or changes in medical science, the User should confirm the information in the product through independent sources. This product is provided without warranties of any kind, express or implied, and the author disclaim any liability, loss, or damage caused by it or its content.
By continuing to use this product, you have indicated your acceptance of these terms.


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German artist Gregor Hildrebrandt has a labyrinthine exhibition at the Almine Rech gallery in Paris until 25 February. In his new works, he continues to explore his fascination with music and its recording media. He cuts up and reassembles magnetic tapes and vinyl records to invent a new, impenetrable, sinuous musical grammar that reflects the collective memory that humanity has assembled over the years.
His massive floor juxtaposed chessboards is part of a heady reflection on duality and his title painting Alle Schläge sind erlaubt is inspired by the pattern on the drapes of a New York hotel. We asked Gregor Hildebrandt to decipher his new works for us, and to tell us about his passion for music and his fascination with chessboards.
NEWS OF THE ART WORLD – Can you tell us what you find interesting about recording media such as cassettes and records?
Gregor Hildebrandt – What most interests me is the music that the media contains and the imaginary world evoked by the song. What also impresses me is the transformation of multi-coloured audio cassettes that end up as big black paintings.
I discovered the moulded vinyl records at a second-hand sale in Berlin in 2003. I instantly liked these objects, and what they represented: music as a container. I was very excited and I immediately bought several for myself to use as fruit bowls and to store onions, and as birthday gifts.
I made my first piece from the moulded vinyl records in 2005. I asked the seller where I bought the bowls to mould a vinyl record for me. It was Jacques Brel's Ne me quitte pas, which my mother had given me. What I like about the paintings that I am making at the moment in cut-out vinyls is that the grooves are very much like brush strokes.
What is the starting point for your works? In your latest exhibition, you can see that it can be anything from a photo, a song, or a hotel room, etc.
The starting points are always very different, but generally I can say that they are always things that are around me and that I like. Then, the things come together and cross over, like, for example, the view from a window, a song on the radio, or what might be running through your mind at some point.
You started working with cassette tapes in the 1990s. At the time, they were used a lot. Like vinyl records, they fell out of favour, before coming back into fashion… Do these changes in perception influence the way you think about your art? Or he way people who view your art perceive it?
I don't necessarily think about it when I'm working. I have simply noticed that cassettes have become rarer and more expensive. They are like paint for painters.
How do you collect the records, cassettes and video tapes that act as the records medium for your work? Does what is recorded on them contribute any meaning to the final work?
I buy audio cassettes on eBay. What is recorded on them does not matter, because they are all recorded over when I make the painting – in most cases with a single song per painting that is repeated over and over again.
That said, I am not sure that as a spectator you need to know the songs to understand the pieces. I think that even without hearing them you feel something of them. Maybe even my enthusiasm for them.
What is your relationship with music when you work?
I like to listen to music and when I really like a song I play it over and over again, continuously. I do it at work, when I'm driving my car, or when I'm smoking, which I have not done for some time, sadly.
Could you talk to us a little more about your work Burning from the Inside (a wall of audio cassettes), one of the most imposing works in your exhibition at Almine Rech, and the way you imagined it?
It is the only figurative piece in the exhibition. In fact, initially, I did not want to have a Kassettensetzkasten (cassette cabinet) in the exhibition, because I already had a really beautiful in my recent exhibitions, but I found that it worked wonderfully with the Hirnholzparkett cassette tape floor in front of it. That piece – Hirnholzparkett – is sort of my Babylon. In the room, I wanted to create with Burning from the Inside a more concentrated zone that you come to like a kind of oasis in the centre of the exhibition. The title Kassettensetzkasten refers to the album of the same name by Bauhaus, which I adore. The motif also refers to the album cover, but its colours and atmosphere also refer to the cover of Faith by The Cure.
The entire exhibition is imagined as a labyrinth and your works are themselves labyrinths that lead from one groove to another, from one tape to another. Are you obsessed by this shape?
Yes, it's true. I have transformed the whole gallery through the labyrinthine structure of the main room. The small rooms that give onto the courtyard no longer seem so small.
I proposed and created a viewing order, but through that process I also made it possible for the works to be seen in an ideal fashion. The room was divided according to them. It offers several viewing angles and front-on situations that create the feeling that sections of wall that are actually small are much bigger and more imposing than they really are. That also made it possible for me to show more works, because sometimes the more there are, the better it is!
You work a lot with black and white. In the exhibition, there is a superb, very bright turquoise blue work. What is your relationship to colour?
I generally try to not use colour. My paintings are almost all black, because the audio cassette tape is fairly black, and white, because the paintings are prepped with a white primer. There are also brown cassette tapes, but I don't like them as much. My coloured pieces, such as the blue mäandern ins Blaue painting, which is in the first part of my exhibition at Almine Rech, are composed exclusively of the guard bands at the beginning and end of the cassette tapes. Before the song starts or ends.
For Hirnholzparkett we used over 30,000 audio cassettes and since you cannot see the precious coloured guard bands in the piece, I asked if we could collect them with a view to making some coloured paintings. In my opinion, the tape is reminiscent of a beginning and an end that are repeated endlessly.
At the end of the exhibition there is a chessboard floor. Can you tell me what you found interesting about the sets?
It was the star piece of my Ich möchte weiterhin verwundbar bleiben exhibition at the Grieder gallery in Zurich. I absolutely love chess. That is why, originally, I wanted to create a piece with chess pawns. With that idea in mind, I bought lots of chess sets and they all had chessboards. I laid the boards side by side and I really liked the effect.
A while earlier, in the Morne-à-l'Eau cemetery in Guadalupe, I found some tombs that were covered in a chequerboard pattern. That made me think of my "rip-off" paintings. They are paintings that I explore and that show a pattern and its negative. (You can have a predominantly black painting and a predominantly white painting, Ed.) So, I reproduced part of the cemetery in the paintings in my exhibition in Zurich. I was inspired by their spatial organization: each painting refers to a tomb, to which I added the chequerboard floor.
When we were talking about my piece Das Schachspiel (2008), Tina Sauerländer has remarked on the relationship between the black and white duality of the game and my "rip-offs", which always comprise a version that is predominantly white and another version that is predominantly black. They often mirror each other.


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Sunday, May 29, 2016
Sadly many churches have already accepted homosexuality or openly gay pastors. It looks like the United Methodist church is on the same path. They just delayed the decision by two years. It is one of the more liberal denominations so this is not surprising.
8 comments:
Ok Methodist, get out your Bibles and turn to Romans chapter 1. The decision has ALREADY been made. - Don
- May 29, 2016 at 2:06 PM
- Bible Believer said...
I agree. the Decision has been made, they are ready to jump on the world's bandwagon.
- May 29, 2016 at 8:57 PM
Why are they even having this conversation? The true bride of Christ would reject all laws that are not in scripture. We don't see a redeemed church anymore, only an unrepentant one.
- May 30, 2016 at 8:10 PM
- Grammy G said...
They made decisions over 12 years ago to become liberal in policy making by diluting down abortion policies and women in the pulpit. There was also a movement of Diana worship in our area for quite sometime led by our woman pastor. More and more they are looking like the Catholic Church with mystical practices being implemented. I went to a conference being put on by the Methodist Church on healing and it was all mysticism. I fled! So sad for the once conservative denomination to be coming out like this. Read another article on the number of gay pastors in the denomination finally coming out in the last few months. Wolves in sheep's clothing, leading the herd astray. Pray people!
- May 31, 2016 at 5:26 AM
- Grammy G said...
Completely agree! Unrepentant!
- May 31, 2016 at 7:03 PM
Galatians 1:10 10 For do I now persuade men, or God? or do I seek to please men? for if I yet pleased men, I should not be the servant of Christ.
We as believers are under liberty not bondage. We are of the free woman not the slave woman. Coming under men preaching a false gospel is coming under bondage and will enslave us. We are servants of the Lord, not wicked masters who lead us into the pit of hell. The problem is true believers who are being deceived have already ingested bits of poison so they are ready to digest greater amounts of it. Rather than being appalled, they applaud diabolical teachings being introduced. The flesh loves to be catered to and pampered. It will cry over deprivation of any sort. So these ministers of hell know just how to do that.
- June 1, 2016 at 2:53 PM
- Bible Believer said...
The United Methodist church is lost and even its more conservative offshoots have gone over the bend. So I agree with you Grammy, yes there is another article about gay Methodist pastors coming out. Last anon, this is about the flesh and rejecting God's Word to please man and they are the ministers of hell, making sinful things seem "right" and "acceptable". What is there to decide? Either follow God's Word or be a church that is a fake.
- June 4, 2016 at 5:08 PM
- Sweet Celebrations Cakes for all Occassions said...
Lord have mercy, this describes the UMC in Erin to T. I pray for God to restore that congregation to a true biblical church. Liberalism has ruined it.
- January 26, 2017 at 10:01 AM


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A decade of rapid growth in Barrow and Jackson counties fueled a retail boom that increased the counties' sales tax revenues by about 70 percent before the recent economic downturn temporarily reversed the trend.
Through sales tax extensions that voters will consider today, county officials hope a healing economy means the revenue will start growing again.
"We've got the rooftops, and businesses are recognizing that we've got the rooftops now," said Tommy Jennings, director of the Barrow County Chamber of Commerce. "That's why our sales tax revenue has gone up (over the past decade)."
Voters in Barrow and Jackson counties will go to the polls to decide whether to extend two local sales taxes, one for Barrow County and city governments, and one for Jackson County schools. Both taxes would renew a current 1 percent tax on goods and services and primarily will go toward paying down debt taken on by the county, cities and school systems over the past six years.
While the economic downturn hurt sales tax collections over the past three years, revenue grew each of the seven years before the downturn. More retail businesses in both counties means that more sales tax revenue is on the horizon, Jennings said.
Over the past decade, Barrow and Jackson counties saw exponential growth in residential neighborhoods, but only started to attract new retail businesses since 2007. Publix and Kroger grocery stores opened locations in Jackson County, and Target, Belk, Home Depot and other large retailers staked their claim along Georgia Highway 316 in Barrow County.
Neither county has seen the full effect of the new business, as their openings coincided with the beginning of the recession.
In Barrow County, the tax would begin in July 2012 and bring in about $10 million a year. Barrow County's dedicated sales tax collections grew from $5.5 million in 2000 to $9.49 million in 2007. However the county only collected $7.72 million in 2010, according to statistics kept by the Georgia Department of Revenue.
The current six-year sales tax, which took effect in 2006, was projected to raise $68 million, but it's only brought in $40 million so far.
In Jackson County, officials believe the tax on today's ballot could raise as much as $100 million. The current sales tax, which went into effect in March 2007, has raised just $35.8 million.
Madison County voters also will consider whether to renew a 1 percent education sales tax that school leaders will use to make improvements to existing school buildings, including media centers at Comer Elementary and Madison County High schools.
Winterville residents will go to the polls to pick a city councilman to finish out the last nine months of a term started by Rob McNiff, a councilman who resigned in November. Candidates Bob White and Kenny Hodges are running to fill the remainder of McNiff's term.
Local election managers don't expect high turnout in any of the special elections today.
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By being friends with a female. If you see a girl you like, start a conversation with her. What do you have in common? If she is doing something you can relate to, talk about it. Find someone from a class, choose someone from work, even pick someone from the street.
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Well, having run Linux on and off on my main machine (which has been a laptop since about 2003) and having run Linux on my desktop machines for several years, I've decided to switch back to Ubuntu on my primary machine, Pigmeyer, an HP Pavilion dv2000 which shipped with Vista, that unlike Gertrude, the low-end, but decent Gateway I bought Provazolezec, could actually run it at a usable, if not snappy, speed. However, after a couple months of utter annoyance and frustration at having to change so many ways of doing things to accomodate Vista's arbitrary and caprious restrictions I finally broke down and bought another XP license (Microsoft wins again by selling two licenses for one computer). Migrating from Windows 3.1 to Windows 95 was never that kind of hassle. Migrating to NT 3.51 a couple months later when I realized how worthless 95 was wasn't a hassle. Nor was migrating to NT 4, 2000 or XP, but Vista was just an unending stream of little annoyances, frustrations and plain old pains-in-the-butt. The camel-breaking straw came when I needed to reboot after a single update and it took 7 minutes for Vista to start up. 7 minutes while I had to sit there like a moron, waiting to log on to an online session with friends. I don't think I've ever seen a computer take so long to start up.
I'd run Ubuntu before on this machine, but having a 64-bit AMD processor, I'd installed the 64-bit version of the OS. Unfortunately, certain pieces of software don't work too well on the 64-bit version (yes, I'm talking to you, Adobe). Wireless, which has always been a bit of an issue with Linux was also a real problem for me, thanks in large part to the manufacturers who insist on keeping their drivers closed-source for reasons that benefit no one, especially them. I also had a lot of trouble with Java, but I don't know if that's because of using the 64-bit version of the OS, or because everything having to do with Java is like working with a Soviet-style bureaucracy. I can't imagine why anyone would want to develop under such a grotesquely byzantine platform. At the AOL developer's conference I attended while working there, I attended a presentation on some of the allegedly neat Java stuff they were doing, and why it's so easy and fun to get things done with Java. I went into the presentation rather optimistically only to be totally and utterly turned off by anything to do with Java (except ant... which seems like a really cool make tool). Most of the presentation consisted of the insane amount of hoops they needed to jump through just to get everything configured correctly, and we're not talking configuration scripts here. We're talking using some kind of hideous-looking IDE (including the long and tedious story of finding just the right version of the IDE that was actually compatible with the libraries and tools they wanted to use), with an utterly ridiculous string of cookbook "drag-and-drop" procedures needed to get everything set up correctly. "Write-once-run-everywhere" is clearly a joke from all my experience with Java. I've seen Java software that won't even run unless you had the exact same version of the JRE that it's expecting. Who knows what you're supposed to do if you're already running something newer, which at the time I was? And of course, after 10 years, it would be nice to see a Java program (besides Azureus) that doesn't look like XWindows circa 1994 (i.e., butt-ugly and primitive).
Ironically, I've found that one of the things Microsoft used to excel at is something almost everyone now does better than they: playing videos. The Windows Media Player, which spent about 6 years getting nothing but bigger, uglier and harder to use now utterly fails at so many video formats that it's not even worth having any more. On Windows, using Media Player Classic is the only way to watch movies without getting that useless "Codec not found" error (that doesn't tell you which one it needs), and a message asking if WMP should look for a codec. Has that ever actually worked? I've been using Windows Media Player since it first came out and I've never seen it actually find a codec it was missing. I suspect it only looks for Microsoft stuff, which is almost certainly already installed on any Windows system. The fact that it can't play MPEG-2 out of the box is beyond ridiculous. Or at least it wouldn't for me, and there's no point in trying to "fix" WMP since it's confusing and frustrating (and seldom worth the effort) to do and MPC "just works" right out of the box... including QuickTime and Real with the "Alternative" packages. (Why, oh, why does Real still exist? They are possibly the only company that hates their customers more than Microsoft and are far more incompetent.)
Anyhow, I noticed recently that Windows XP is showing little thumbnails of videos in Explorer, a very nice new feature (that KDE has had forever under Linux) which seems to have been part of SP3, because it only showed up recently. However, shortly afterwards, I started finding that Explorer (possibly the buggiest mainstream application in the history of software for 13 years running, no wait, that would be Word on the Mac, or possibly IE5, or IE6...) started crashing every time it would try to show a thumbnail of H.264-encoded movies. I only found this out by loading it into the debugger because all you would see is a crash dialog for "Explorer" and clicking on anything would restart Explorer, even though Explorer itself would continue working just fine, except you had this System Modal dialog box you couldn't get rid of. It turns out what was crashing was an ActiveX control that had something to do with H.264, according to its name. Smooth move, Microsoft. I wonder if that could even be fixed without reinstalling the OS.
Anyhow, I knew that the only way to eliminate this ridiculous problem would be to either use an Explorer replacement (practically anything is better) or just give up saddling myself with the stink of Microsoft's hatred and failure and just move over to Linux again, now knowing that sticking to a 32-bit distro would make life a lot easier.
Now of course, lots of people will point out correctly that Linux has its own shares of hassles, and I'm not going to deny it. There are plenty of pains, problems and utter stupidities in the Linux world, too. But given that most open-source software is developed not by one of the largest, richest and most powerful companies in the world with ten figures of capital and tens of thousands of employees to throw at any problem, but rather by small groups of dedicated people who are interested in making software that works and is useful, as opposed to locking users in a software prison. Also, when you have a weird problem under Linux, you can almost always find the exact solution you need with Google. The software discussion forums and documentation for various Open Source software are almost always 10 times more useful and informative than anything Microsoft provides.
Microsoft's utter arrogance and contempt for users by releasing Vista, after 5 years of development, long before it should have seen the light of day, and then prematurely killing XP, even though there is still a huge demand for it is a primary reason why I don't want to do business with them. Microsoft's biggest competitor for XP for years was Windows 2000, and the biggest competitor for Vista has always been XP. Being true to their monopolistic nature, since they can't, or won't, compete with XP (or anything else) on quality and performance, they will simply kill the competition. Fortunately for them, they don't even need to break the law to do it this time (for a change). Of course, customer demand and satisfaction never enter the equation. Watcha gonna do? Buy a MAC?! HAW HAW HAW! (I would recommend it. Macs are quite good.)
Meanwhile, Windows 7 is being hyped (albeit a lot less hyperbolically than Longhorn-cum-Vista was) and is now set to be released in 2010. Since every advanced feature Vista was supposed to contain was removed before it was released, and the only improvements were more ham-fisted security improvements (basically either disabling things, or making the user responsible for every tiny security decision, not so much to put more control in his hands, but to shift the blame), Vista offers nothing over XP except perhaps minor usability improvements and a bunch of meaningless (and ugly, IMO) eye candy. All this at a massive performance hit. I think the biggest reason for Vista's whole existence is to set the stage for ever more arbitrary and capricious control over what the users can and cannot do with their computers. Microsoft knew Vista was a total boat anchor, but since they have completely given up on competing on features, performance and usability, they have to devote all their energies into locking users in to their vicious cycle of upgrades and further restrict their ability to consider alternatives by their heinous refusal to open their document standards (ironically by releasing said standards which are so hideously and deliberately complex and equivocal that Microsoft themselves cannot implement them correctly or consistently) and interoperating with other systems by rarely implementing any standards without compatibility-breaking "extensions".
Regardless of the quality of Microsoft software, and I've consistently said that XP was overall a decent product, it's getting harder and harder to justify dealing with a company, however tangentially, that has never played fair, and is increasingly being forced, by sheer inertia, to rely exclusively on unfair practices to maintain its very existence.
And besides, Linux is really cool.
Wednesday, June 25, 2008
Becoming Microsoft free...
Posted by ConceptJunkie at 10:25 AM
2 comments:
- Page said...
I also have a DV2000. It's a great Linux machine, except for the broadcom wireless chip. I had the hardest time getting that working, and broadcom simply doesn't care about Linux users. (the new b43 firmware or b43xx legacy firmware from b43xx-fwcutter will get it working) It took me 6 months to figure that out...
- saskboy said...
I too have an HP with Ubuntu and 64bit AMD. I tried 64 bit, and found it too difficult, in part to Adobe.
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text:
|Publication number
|Publication type
|Application number
|Publication date
|May 16, 2000
|Filing date
|Apr 1, 1998
|Priority date
|Apr 1, 1998
|Fee status
|Publication number
|John R. Trachtenberg
|Original Assignee
|Trachtenberg; John R.
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (8), Referenced by (37), Classifications (9), Legal Events (3)
|External Links: USPTO, USPTO Assignment, Espacenet
This application claims benefit of Provisional application Ser. No. 60/076,619 filed Mar. 3, 1998.
Not Applicable
The present invention relates generally to an apparatus and method for performing a thermal therapy patient treatment protocol. More particularly, the invention relates to a novel apparatus and method for physically separating organs to enable aggressive thermal therapy to be administered safely and relatively comfortably, on an outpatient basis, if desired.
Thermal therapy has been proven to be an effective method of treating various human tissues. Thermal therapy includes tissue freezing, thermotherapy, hyperthermia treatment and various cooling treatments. Thermotherapy treatment is a relatively new method of treating cancerous, diseased and/or undesirably enlarged human prostate tissues. Hyperthermia treatment is well known in the art, involving the maintaining of a temperature between 41.5 degrees Celsius through 45 degrees Celsius. Thermotherapy, on the other hand, usually requires energy application to achieve a temperature above 45 degrees Celsius for the purposes of coagulating the target tissue. Tissue coagulation beneficially changes the density of the tissue. As the tissue shrinks, forms scars and is reabsorbed, the impingement of the enlarged tissues, such as an abnormal prostate, is substantially lessened. Further, tissue coagulation and its beneficial effects are useful for treating cancerous tissue, because cancer cells are particularly susceptible to abnormal temperatures. Cancer cells can be treated in accordance with the present invention with temperatures in excess of 100 degrees Celsius without damage to the therapy applicator or discomfort to the patient.
The higher temperatures required by thermotherapy require delivery of larger amounts of energy to the target prostate tissues. At the same time, it is important to protect nontarget tissues from the high thermotherapy temperatures used in the treatment. Providing safe and effective thermal therapy, therefore, requires devices and methods which have further capabilities compared to those which are suitable for hyperthermia.
Although devices and methods for treating prostate cancer and benign prostatic hyperplasia have evolved dramatically in recent years, significant improvements have not occurred and such progress is badly needed. As recently as 1983, medical textbooks recommended surgery for removing cancerous or impinging prostatic tissues and four different surgical techniques were utilized. Suprapubic prostatectomy was a recommended method of removing the prostate tissue through an abdominal wound. Significant blood loss and the concomitant hazards of any major surgical procedure were possible with this approach.
Perineal prostatectomy was an alternatively recommended surgical procedure which involved gland removal through a relatively large incision in the perineum. Infection, incontinence, impotence or rectal injury were more likely with this method than with alternative surgical procedures.
Transurethral resection of the prostate gland has been another recommended method of treating benign prostatic hyperplasia. This method required inserting a rigid tube into the urethra 15. A loop of wire connected with electrical current was rotated in the tube to remove shavings of the prostate at the bladder orifice. In this way, no incision was needed. However, strictures were more frequent and repeat operations were sometimes necessary.
The other recommended surgical technique for treatment of benign prostatic hyperplasia was retropubic prostatectomy. This required a lower abdominal incision through which the prostate gland was removed. Blood loss was more easily controlled with this method, but inflammation of the pubic bone was more likely.
With the above surgical techniques, the medical textbooks noted the vascularity of the hyperplastic prostate gland and the corresponding dangers of substantial blood loss and shock. Careful medical attention was necessary following these medical procedures.
The problems previously described led medical researchers to develop alternative methods for treating prostate cancer and benign prostatic hyperplasia. Researchers began to incorporate heat sources in Foley catheters after discovering that enlarged mammalian tissues responded favorably to increased temperatures. Examples of devices directed to treatment of prostate tissue include U.S. Pat. No. 4,662,383 (Harada), U.S. Pat. No. 4,967,765 (Turner), U.S. Pat. No. 4,662,383 (Sogawa) and German Patent No. DE 2407559 C3 (Dreyer). Though these references disclosed structures which embodied improvements over the surgical techniques, significant problems still remain unsolved.
Recent research has indicated that cancerous and/or enlarged prostate glands are most effectively treated with higher temperatures than previously thought. Complete utilization of this discovery has been tempered by difficulties in protecting rectal wall tissues from thermally induced damage. While shielding has been addressed in some hyperthermia prior art devices, the higher energy field intensities associated with thermotherapy necessitate devices and methods having further capabilities beyond those suitable for hyperthermia. For example, the microwave-based devices disclosed in the above-referenced patents have generally produced relatively uniform cylindrical energy fields. Even at the lower energy field intensities encountered in hyperthermia treatment, unacceptably high rectal wall temperatures have limited treatment periods and effectiveness.
The prostate lies immediately above the rectum. The two structures are separated only by a thin fascial plane called the Denonvillier's fascia. This is composed of two layers which are in close contact. To kill prostate cancer cells within the prostate, the entire prostate, including the peripheral zone, must be included in the thermal window. However, because the rectum lies in intimate contact with the prostate, if one were to direct enough noxious agents, in most methods heat, to the periphery of the prostate sufficient to kill the cancer cells, one risks additionally damaging the adjacent rectum. This is the problem that the previously known methods have, which leads either to failure of treatment or morbidity.
In addition, efficient and selective cooling (for heat-based treatments) or warming (for freezing treatments) of the devices is rarely provided. This substantially increases patient discomfort and increases the likelihood of healthy tissue damage during benign prostatic hyperplasia treatments. These problems have necessitated complex and expensive temperature monitoring systems along the urethral wall. Satisfactory ablative prostate cancer therapy using extremely high or low temperature treatments cannot be undertaken without effective thermal control of the therapy device including effective cooling of exterior portions of the therapy device.
It would therefore be useful to utilize a method of treatment which enables the physician to both protect the adjacent rectum while still enabling the physician to direct enough heat to sufficiently kill the cancer cells.
According to the present invention, a hydrodissection apparatus is utilized for treating the prostate of a patient by moving the prostate away from the rectum and then applying sufficient heat to the prostate to kill the cancer cells while protecting the rectum. Also included in the present application is a method of treating the prostate of a patient using the apparatus. Further included is a method of providing thermal therapy to prostate tissue of a patient by providing a fluid flow which thereby causes a physical separation of the prostate from the rectum.
Other advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings wherein:
FIG. 1 illustrates a front view of a human prostate and rectum in accordance with conventional medical knowledge;
FIG. 2 shows a front view of the prostate and rectum of FIG. 1 physically separated by a fluid;
FIG. 3 illustrates a side view of a prostate and rectum physically separated by a fluid;
FIG. 4 shows a front view of the prostate and rectum of FIG. 2 showing a device for providing the fluid and a fluid temperature sensor;
FIG. 5 shows a front view of a delivery system constructed in accordance with one form of the invention.
FIG. 1 illustrates a front view of a human prostate 12 located immediately above a human rectum 14 in accordance with well-known anatomical observations. The prostate and the rectum 14 are separated by a thin fascial plane called "Denonviller's fascia" or a "biplane fascial layer" 16. Denonviller's fascia is composed of two layers of fibrous membrane tissue in close contact. To kill prostatic cancer cells within the prostate 12, the entire prostate 12 must typically be subjected to the thermal therapy, regardless of whether heating or cooling techniques are utilized. Because the rectum 14 naturally lies in intimate contact with the prostate 12 and the biplane fascial layer 16, if one subjects the periphery of the prostate 12 to intense thermal therapy to kill all living tissue within, one risks damaging the portions of the rectum 14 close to the prostate 12. Such damage can lead to severe complications such as urethral or vasicle-rectal fistulae.
The present invention can use ultrasound or magnetic resonance or other imaging modalities to direct the percutaneous (through trans-perineal techniques or others) instillation of fluid flow 18 under pressure into the biplane fascial layer 16 (Denonvillier's fascia) to create a real space 20 from the pre-existing virtual space, thereby physically separating the rectum 14 from the prostate 12. Extremely low fluid pressures (i.e., gravity-fed flows) can be used in accordance with the invention if desired. The fluid flow 18 tracks into this fascial plane, physically and thermally isolating the rectum 14 from the prostate 12, and isolating the prostate 12 from lateral and inferior lying structures (e.g., the perineal diaphragm, sphincteric mechanism and neurovascular bundles). Fluid flow 18 can be continuously instilled to cool (or warm, as desired) and separate this space 20 and protect adjacent structures. Thermoprobes can be placed into the periphery of the prostate to ensure adequate temperatures to ablate cancer cells while temperature sensors 22 and pressure monitors in the fluid space can dictate the amount of fluid flow necessary to adequately protect adjacent structures. Conventional intermittent trans-rectal ultrasound can also help ensure adequate continuing separation of vital tissues by the instilled cooling fluid flow 18.
In accordance with one preferred embodiment of the invention, a needle 24 is inserted at a location near or between the prostate 12 and rectum 14 to infuse a fluid flow 18 for cleaving or providing a space 20 physically separating the prostate 12 and rectum 14. It will be apparent that all of the organ separation methods described herein can be practiced from a variety of entry ports: transperineally, transrectally, transurethrally, suprapubically and others. The fluid flow 18 can be a cooling solution (ionic or nonionic), an insulating medium (as in energy absorption), an energy reflecting medium for use with some trans-urethral therapy applications, a warming solution, air or a gas, or some type of gel. Infusing these types of agents essentially provides a space 20 to either help insulate the rectum 14 from the therapy or can provide a means to either augment the therapy or to provide the actual therapy itself.
The fluid flow 18 can be bolused in or continuously infused to provide proper maintenance of the space 20 between the organs and proper temperature of the fluid flow 18. The fluid flow 18 can also be recirculated into and out of the space 20 by the use of a multilumen catheter or by use of multiple catheters. For heat treatments, the fluid flow 18 can be cooled to provide cooling to the rectum 14. Alternatively, the fluid flow 18 can be maintained at a minimally therapeutic temperature. Therefore, monitoring of the fluid flow 18 temperature within the space 20 or in the delivered and returned solution temperature can be used to guide or enhance the treatment effectiveness. For cooling or freezing treatments of the prostate 12, the fluid flow 18 can be warmed to ensure that the rectum 14 is provided a safety cushion such that the therapy inside the prostate 12 can be as aggressive as possible.
This space 20, once created, can also be used to provide a window within which to now deliver therapy, feedback regarding the extent of the treatment by providing more localized control or for various types of imaging (e.g., ultrasound). Further details for implementing those functionalities are described hereinbelow. This technique can be especially useful for prostate cancer which develops predominantly in the posterior and lateral edges of the prostate 12. The close proximity of the thermally sensitive rectum 14 to those commonly afflicted areas of the prostate 12 limits the effectiveness of conventional treatments. By utilizing the space 20 or window to now provide a means for directly treating these regions of the prostate 12 in a directional way, the rectum 14 can be protected from thermal damage, and the location of the cancer can be extremely aggressively treated in a safe and relatively comfortable manner. Therapy elements (energy sources) capable of providing desirably asymmetric energy patterns include, without limitation, laser, microwave (especially with some type of shielding (e.g., air) to avoid heating the rectum 14), cryosurgery, ultrasound (focused or diffuse) and diagnostic ultrasound. The diagnostic ultrasound and the therapeutic ultrasound can be combined into the same probe if desired.
The therapeutic element 36 can be directional, shielded or simply conventional. The element 36 can then be used to effectively treat the outer portions of the prostate 12. This approach can be used in conjunction with another form of treatment, either drug or device, and can be used with interstitial or intraluminal treatments. If needed, a conventional endoscope or similar device can be inserted to guide the application of the treatment under direct visualization.
The therapeutic element 36 can incorporate a locating means 40 whereby the location of the treatment can be confirmed, adjusted or maintained throughout the treatment. This locating means 40 can include, without limitation, a helium neon laser pointer for direct vision or a mechanical/ultrasound opaque (i.e., metal) indicator on the probe itself. It can also comprise an ultrasound imaging device capable of monitoring the therapeutic effect in the tissue itself.
While prostate treatment uses of the present invention are described herein for illustrative purposes, it will be readily apparent that the present invention can also be used to treat other anatomical structures including, without limitation, structures inherent or attached to the rectum 14 itself (e.g., treating the wall of the rectum 14 or tumors associated with the rectum 14).
Thermal therapy delivery systems 50 can also be used as mechanical separators 28. The delivery system 50 can take a number of forms, such as the one described in copending U.S. patent application Ser. No. 07/976,232, the Detailed Description of Preferred Embodiments which is incorporated herein in its entirety. The delivery system 50 can include the ability to provide degassed and temperature regulated water flow into the delivery system 50 adjacent tissue to be treated. An example of such a suitable delivery system 50 is a single or multiple lumen device which circulates fluid, gas, gel and the like under pressure within a closed environment. The delivery system 50 is intended to be inserted into body cavities or interstitially. The delivery system 50 can be inserted into the body (organ) targeting a specific treatment site. The delivery system 50 can house a therapeutic element 36 such as laser, microwave, therapeutic or diagnostic ultrasound or simply a temperature sensor 22. The fluid flow 18 or infused agent can be recirculated under pressure or can remain static. This form of the invention can deliver therapeutic energy to internal body structures through a minimally invasive procedure.
The delivery system 50 is preferably small in diameter, being 9 French and under. Delivery systems 50 as small as 6 French have been used satisfactorily and are being further miniaturized. The delivery system 50 incorporates 360 degree radial cooling (or warming) which is essential for this intensive thermal therapy, especially for interstitial therapy, because it greatly reduces the potential for exit wounds which could result from both thermal or freezing technologies.
The delivery system 50 can be made out of extremely thin polymers, such as PET, which permits the use of very thin wall thicknesses, thereby minimizing the overall device size. This type of material is essentially nondistensible and can withstand high pressures without failure. This permits passage of fluid flow 18 or other media under pressure to provide flow without compromise of the structure. The delivery system 50 can also be made from typical catheter material with the size increasing due to the need for larger wall thicknesses.
The delivery system 50 can have a rigid structure that aids in insertion or could be made so thin that it essentially has no rigidity. The latter design can be inflated to provide the handling and insertion stability required. This has the advantage of permitting extremely thin wall thicknesses to be used, thereby maximizing throughput flow and/or minimizing overall size. The rigidity of the delivery system 50 can also be used in conjunction with a conventional sharpened tip at one end of the delivery system 50. The sharpened tip enables interstitial insertion of the delivery system 50.
The circulating fluid flow 18 could be either a cooling agent or a warming agent, whichever is required for the particular thermal therapy being utilized. For example, microwave therapy benefits from a cooled device whereby the cooling of the antenna provides a substantial increase in efficiency. The delivery system 50 preferably incorporates the therapeutic elements 36 with complete cooling or warming (via submersion) along the therapeutic element's 36 entire length. This configuration is the most efficient use of space, thereby resulting in a smaller profile.
The outer structure (lumen) 52 of the delivery system 50 can be made either nondistensible or moderately to fully distensible. A distensible outer lumen diameter can be changed even during a treatment to maintain desired contact with the surrounding tissue. This is important for therapies that benefit from intimate contact between the applicator and the tissue for efficient transmission of energy such as microwave, laser, ultrasound and the like.
The change in lumen 52 diameter can be accomplished via an active increase in the internal pressure of the delivery system 50. The pressure can be increased (inflated), decreased or otherwise controlled automatically (or manually) and triggered via the recording of reflected or lost power transmission which can be monitored real time. A conventional pump 60 or other inflation system can be controlled electronically for this purpose. This can be a feedback circuit to improve the efficient transmission of energy throughout the duration of the treatment. In this way, intimate contact between the delivery system 50 and the surrounding tissue can be maintained throughout the treatment, increasing the efficiency of the energy transmission.
Pressurization can also be a useful feature of the delivery system 50 for: clearing the pathway of air or impurities; cooling or warming; and reducing or eliminating modifications in the environment resulting from the treatment. For example, in microwave treatments, the cooling medium is typically a deionized solution such as distilled water. With the application of microwave energy, the microbubbles are produced along the antenna resulting in an increase in reflected power. This can develop into an almost total stoppage of emitted energy into the tissue. Pressurization desirably changes the degassing characteristics of the medium and can minimize the effect of microbubbles out of the energy emitting pathway. Air will block the transmission of most energy sources such as microwave and ultrasound. Laser will also see this as another interface which can result in overheating of the delivery system 50 in that region, possibly resulting in delivery system 50 or laser malfunction. Pressurization can therefore reduce or eliminate reflected power and can be varied throughout a treatment to compensate for changes in the reflected power levels that may occur.
Reflected power will also change according to the matching/mismatching characteristics of the environment surrounding the delivery system 50. This is especially true for microwave energy. Therefore, the measurement of reflected power can be used to correlate with tissue changes in the surrounding tissue. This measurement can, therefore, be used as a feedback mechanism for the progression of a treatment or for a regulating mechanism during a treatment. It can be used as a surrogate measure of tissue temperature or tissue destruction, and can also be used to determine if the treatment is being applied too aggressively. For example, if the therapy is too aggressive, the interface between the delivery system 50 and the surrounding tissue may change (e.g., dehydrate) which will impact the matching between the two entities. The severity of the mismatch will be reflected in an increase in the reflected power. This mismatch clinically results in a less effective administered treatment. By reacting to the change in the reflected power, the aggressiveness of the treatment can be modified to manage this event. Reflected power will change with changes in the temperature of the environment surrounding the delivery system 50. Accordingly, this measure can be used to estimate the temperature of the environment. This is the same for actual physical changes in the surrounding environment (e.g., denaturization, carbonization, dehydration, etc.); therefore, this measure can also estimate effects of a treatment upon the surrounding environment.
While preferred embodiments have been illustrated and described, it should be understood that changes and modifications can be made therein without departing from the invention in its broader aspects. Various features of the invention are defined in the following claims.
The above discussion provides a factual basis for the use of a method of providing thermal therapy to the prostate tissue of a patient. The methods used with and the utility of the present invention can be shown by the following non-limiting examples and accompanying figures.
The patient is administered prophylactic antibiotics on call to the operating room. In the operating room, the patient is placed on the cystoscopy table and a general anesthetic is administered. The suprapubic area and the perineum of the patient is then prepped and draped in the dorsal lithotomy position. The scrotum of the patient is secured to the anterior abdominal wall. The bladder is drained and a 16 French Foley catheter is then placed in the urethra 15. A transrectal ultrasound transducer is then placed in the rectum and the volume and configuration of the prostate 12 is confirmed. The Foley catheter is visualized in the urethra 15 in the sagittal plane.
The position and number of interstitial microwave antenna assemblies (MAA) to be inserted is based upon the volume and configuration of the prostate 12 which will be determined and planned using pretreatment transrectal ultrasound. The actual number of interstitial microwave assemblies (MAA) used will be determined based upon the volume and shape of the gland, as specified below:
45 to 75 cc gland 4 MAA
35 to 45 cc gland 3 MAA
25 to 35 cc gland 2 MAA
The treatment zone locations and number will be determined as to yield complete therapeutic heating of the prostate 12. The sites are plotted on a treatment map during pretreatment planning prior to insertion to achieve efficient isothermic heating of the tissue.
Placement of the intra-prostatic MAA is preceded by repeat topical antibacterial preparation of the perineum. In order to place the MAA, a needle and sheath assembly is first inserted, this assembly is a peel-away assembly. The needle and sheath assembly will be placed transperineally into the left lateral lobe of the prostate 12. The needle will be advanced along an axis 1.5 centimeters away from (as close as medically feasible) and roughly parallel to the prostatic capsule, adjacent to the bladder neck. The position is confirmed using transrectal ultrasound and the needle is repositioned as necessary. The MAA will be inserted into the lumen of the peel-away needle and sheath assembly and advanced until the distal tip reaches the end of the sheath. Proper MAA placement is confirmed when the MAA reaches the sheath hub. The peel-away sheath is then removed, leaving the MAA in place. This procedure is repeated until the predetermined MAA therapy plan has been accomplished. Using a similar technique, a 2-sensor thermosensor array will be inserted at a three or nine o'clock position laterally inside the gland at the capsule. Another 2-sensor array will be placed at the five or seven o'clock position. A single thermosensor array will be placed at the posterior mid line (recto-prostate interface) margins of the prostate 12.
The recto-prostatic interface will be delineated by transrectal ultrasound. A needle and sheath assembly will be guided with transrectal ultrasound into this space. The rectum will be separated from the prostate 12 by hydrodissection within the recto-prostatic space. This will be accomplished by inserting a needle and sheath assembly into the recto-prostatic space and connecting a continuous saline solution drip infusion. The hydrodissection will be confirmed by transrectal ultrasound. A single array thermosensor will be inserted via a Y-connector through the needle and sheath assembly into this space. The temperature within the hydrodissection space will be continually monitored. The infusion flow rate will be adjusted to maintain a maximum temperature of 43.5 degrees Celsius within the space. If the monitored temperature rises above 45 degrees Celsius, the flow rate will be increased. If the increased flow rate does not decrease the temperature below 45 degrees, the power of the respective treatment zone(s) will be turned down as described below. A rectal probe with two thermosensors spaced two centimeters apart in length will be placed in the patient's rectum. A transrectal ultrasound transducer with the same two thermosensor array may be used to monitor rectal temperatures and hydrodisection.
A urethral cooling assembly will be coated with sterile lubricant and inserted into the urethra 15 with the anchor balloon inside the urinary bladder. The anchor balloon will be inflated with 7 cc of sterile water and traction will be applied to ensure that the applicator is in the proper position. The proper position will be with the proximal side of the anchor balloon seated against the urinary bladder neck. Either a rectal probe or a transrectal ultrasound transducer will be inserted into the rectum 14. The rectal probe or transrectal ultrasound transducer will have a two sensor thermosensor array spaced by two centimeters. It is preferred to use the transrectal ultrasound transducer/thermosensor array to visually monitor the hydrodissection space. During the procedure, MAAs, thermosensor fiber arrays, and water connections for the urethral and rectal cooling devices will be attached to the respective system connectors and the treatment program will be initiated.
Power Ramp-Up Procedure
The microwave power will be initiated at 5 watts. The power will be manually increased in 5 watt increments every two minutes to a maximum of 25 watts.
Time: Wattage:
0-2 minutes 5 watts
2-4 minutes 10 watts
4-6 minutes 15 watts
5-8 minutes 20 watts
8-10 minutes 25 watts
The power of the respective treatment zone will be turned down in 2.5 watt increments when the interstitial thermosensor reaches 75 degrees Celsius. The power will be lowered 2.5 watts every one minute until the interstitial temperatures within the respective treatment zone(s) are stabilized within the target treatment temperature range, 55 to 75 degrees Celsius.
The treatment time will start when all interstitial thermosensors have reached the treatment range, 55 to 75 degrees Celsius. A minimum temperature of 55 degrees Celsius must be attained to start the treatment clock. The treatment will be 15 minutes at temperatures within the treatment range. If the treatment range is not attained, the treatment will be 20 minutes in length plus the 10 minute power ramp-up time, or 30 minutes total.
The rectal temperature limit will be 43.5 degrees Celsius as measured on the surface of the cooled rectal probe or ultrasound transducer/thermosensor array. If the rectal temperature limit is exceeded, the power will be decreased as described above.
The target intraprostatic temperature during treatment is 75 degrees Celsius for 15 minutes within the target temperature zone to 0.5 centimeters of the margin of the prostate 12. A gradient of 75 to 45 degrees Celsius within this lateral heating zone of the prostate 12 has been calculated. The target temperature zone is a cylinder of tissue extending the length of the prostate 12, roughly parallel with and centered 0.2 centimeters lateral to the urethra 15, extending outward to the prostatic capsule. The urethral cooling assembly consists of a 9 French catheter which inflates to 18 French during treatment. This assembly constantly circulates 30 degrees Celsius cooled water to cool the urethral mucosa. Similarly, the rectal probe contains two thermosensors in a linear array designed to interrupt the treatment and shut down the microwave power if the rectal mucosa temperature exceeds 43.5 degrees Celsius. Additionally, the operator will be alerted via a "pop-up" dialogue box on the treatment screen prior to interruption of treatment. The rectal probe is cooling and protecting the rectal mucosa. Furthermore, the rectal mucosa has been separated by hydrodissection from direct contact with the heated prostate 12 and the created hydrodissection from direct contact with the heated prostate, and the created hydrodissection space is actively cooled via a saline infusion.
The location and size of the target temperature zone will allow for glandular asymmetry and normal anatomic variation in the angle and curvature of the urethra 15 through the prostate 12. The thermosensor's readings will be visually monitored throughout the therapy treatment. At the moment any of the intra-prostatic thermosensors reach 75 degrees Celsius, the microwave power will be lowered at 2.5 watt increments every one minute until the intra-prostatic temperatures are stabilized within the treatment range, 55 to 75 degrees Celsius. Due to the variable heat transfer rates in tissue, some overshot and lag response in temperature beyond the 75 degree Celsius limit is expected and the operator must take each patient's response characteristics into consideration when adjusting the microwave power levels. If the intra-prostatic temperature continues to fall after the microwave power has been decreased, the procedure described for lowering the power will be reversed to maintain the intra-prostatic temperatures within the treatment range.
Throughout this application, various publications are referenced by author and year. Full citations for the publications are listed below. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains.
The invention has been described in an illustrative manner, and it is to be understood that the terminology which has been used is intended to be in the nature of words of description rather than of limitation.
Obviously, many modifications and variations of the present invention are possible in light of the above teachings. It is, therefore, to be understood that within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.
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Effective date: 20040516


text:
Did you feel it?
Yes. Lots of rattling from the kitchen cabinets and clanging from the hanging pots and pans.
A major earthquake while having subzero temperatures would be devastating for many who are unprepared.
The P and S waves were merged into one long rolling motion. HAd to grab the TV to keep it from falling over - haven't anything rock our place like that in years... Live out buy Russian Jack, the soil is mostly gravel.
Glad the power stayed on, it was below zero and getting colder....
Sure did....at work in west Anchorage. A little hint as I walked to my desk, lots of folks saying, "Did you feel that"? Just sat down and the monitors on my desk really started dancing. It was sort of rolling....different.
At home, east Anchorage...nothing fell down.


text:
GraphicRiver Celestial Sphere 8826784
GraphicRiver Celestial Sphere 8826784
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Celestial Sphere is a professional Lightroom presets. This quality preset is necessary for any digital artist – photographer, graphic or web designer. By using this you can convert your ordinary photos into great images.
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- Please select a date to see the proper prices!
- Meal can be requested on the spot
Best offer
69 € / person / night, no meal
Description of the accommodation:
Rooms, services Lloyd's Baia Vietri sul Mare is offering 132 nicely furnished rooms to stay in to those seeking accommodation in Vietri sul Mare. If you feel like having a meal not included in your chosen type of catering, you can always taste local dishes in the restaurant of the hotel. Parking is availably nearby for those arriving by car. Car rental service is available to discover all must-sees and highlights of the area. Upon preliminary notice airport transfer can be requested. The café and the bar are an ideal location for a personal meeting and a relaxing evening talk. You may secure your valuables in the safe. At the hotel you may go online via wireless Internet connection (WiFi). The exact list of services available at Lloyd's Baia Vietri sul Mare (including those for an extra fee) and the exact list of equipment in a room can be found on the information sheet below.
Payment Depeding on the selected room, date and price, you may be asked to provide credit card guarantee or to pay by credit card in advance.
Arrival, opening hours The earliest time to arrive is 14:00, the latest time to leave the rooms is 11:00. Italian and English languages are spoken by the personnel.
Lloyd's Baia Vietri sul Mare rooms Rooms
- Please select a date to see the proper prices!
Accommodation services
Free WiFi in shared places
Car rental nearby
Default services: Bar, Cafe, Elevator, Safe deposit box
Airport transfer
Own restaurant
Bathrobe, Hairdryer, Desk in the room, Mini-bar


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Online Class
Patternmaking Basics: The Bodice Sloper
with Suzy Furrer
Joe is a fine looking Crow that likes to sit around and keep you company! he is fairly quick to make and because he has something reasonably weighty inside he perches well on shelves etc. He looks great in bright black as that is a colour crows know well! BASIC SKILLS NECESSARY You should know how to use your sewing machine and how to cut shapes and stuff. SIZING / FINISHED MEASUREMENTS Approx. 7" tall plus legs


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Event Information
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- Family Fireworks Event at The Cricket Ground, Horsham Sports Club
Last year's annual fundraising firework evening was a sell out success and we hope this year will be just as popular!
Gates open at 4:30pm and there is plenty to keep the family busy until the firework display at 7:30pm.
We have a Fairground with rides for all ages, a great variety of food stalls and a large Beer Tent as well as the Club Bar.
Following the display (by Aurora Fireworks) we'll have 80's cover band 'Cinnamon Street' playing live in the clubroom.
The first 1000 tickets are on sale at only £4 each!!!
After that, tickets are still only £6 each until Midday on the day of the event.
All tickets will be £9 on the gate.
Don't forget that U5's go free!
Please note that if you do buy your tickets online then a booking fee is payable- this is passed onto Eventbrite and not the Club. To avoid paying any fees you can of course pop down to the club office or bar and buy your tickets in person. Alternatively visit M&J News, at the top of Denne Road , to purchase them.
More details about the event and any updates can be found on our website www.horshamsportsclub.com or on our Horsham Fireworks Night Facebook page.
Are there ID requirements or an age limit to enter the event?
U14's must be accompanied by an adult.
What are my transport/parking options getting to the event?
There is no parking at the venue- we do have a limited number of disabled parking spaces for blue badge holders. These are available on a first come first serve basis. The nearest car parks are in the town centre, Waitrose or at Sainsburys, all of which are only a 5-10 minute walk from the club. The Hop Oast PArk and Ride is also open until 11pm.
What can/can't I bring to the event?
Please note that no alcohol or fireworks/sparklers can be brought into the event. Dogs are also not permitted.
Where can I contact the organiser with any questions?
You can check the club website www.horshamsportsclub.com for other FAQs about the event and any updates- if you can't find the answer to your question on there then please do give us a ring on 01403 254628
Is my registration/ticket transferrable?
Yes- if you have a ticket and no longer require it and want to give it away, or want to buy it on behalf of someone else then that is absolutely fine. We cannot hold tickets on the gate except in exceptional circumstances, so make sure you distribute tickets to everyone in your group in advance, or arrange to meet them near the entrance, as everyone needs a ticket to get into the event except for under 5's.
Do I have to bring my printed ticket to the event?
Ideally yes, as we can scan the printed ticket. We are looking at using a barcode scanning facility directly onto your mobile device too this year so watch this space!
What is the refund policy?
Sorry, there are no refunds in the event of a cancellation of the event. In the event of extreme bad weather (usually high winds) we would have to cancel the event on the advice of the company doing the Firework display due to health and safety concerns. Otherwise just dress appropriately for the weather on the night- we won't be cancelling if it's raining unless the ground is flooded!! Any updates will be posted onto the website.
There are no refunds if you are unable to attend for any other reason.
Will I definitely get to see the band in the clubroom after the display?
We can't guarrantee you'll get it as we have a number limit in the clubroom- so it'll be on a first come basis. But we'll have the doors open too so you'll be able to enjoy it from outside while you have something to eat from one of our lovely food stalls and enjoy a drink from the beer tent... The band this year will be 80's cover band 'Cinnamon Street' and they will be playing as soon as the firework display finishes.
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MOVIE SYNOPSIS [ General Audiences ] Being a creation directed by Edward James Anderson, this film in English (subtitles) was presented in 2015. The film, a creation of Edward James Anderson, was produced in USA. You can watch Death: A Love Story online on TV cable or theaters with original audio in English at different dates. This film premiered in theaters in 2015.
Rating: 5 by 10 users./
Runtime: 77 minutes
Jill Evyn, Louis C. Oberlander, Aidan Bristow, Matt O'Neill, Victoria Stevens, Donna Swensen, Noriko Sato, Ariane Ryan, Daniel Lucio, Jamie Josephs, Nic-Nac The Clown, Colin Friend and Philip Bacotti.
Terror, Thriller.
77-minute film (full movie) directed by Edward James Anderson.
The original audio of Death: A Love Story has dialogues in Dolby Digital, it was produced in USA.
It premiered in cinemas or television in 2015.
Screenplay written by Edward James Anderson.
John Kesl and Erik Shirai.
Edward James Anderson, Andrew E. Hwang, Tamara Sayiner and David Rey.
Composed by Pancho Burgos-Goizueta.
Without commercial breaks, the full movie Death: A Love Story has a duration of 77 minutes; the official trailer can be watched in streaming on the Internet. You can watch this full movie free in EnglishDolby Digital in movie TV channels, renting the DVD or with VoD services (Video On Demand player, Hulu) and PPV (Pay Per View, Netflix).
See the page of this full movie, Death: A Love Story in FULLTV Movies.


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About Estiatorio VOLOS
Fresh, healthy flavours and emphasis on beautiful presentation please both the appetite and eyes at Volos. Modern twists on traditional Greek dishes and Greek twists on local Canadian ingredients create a contemporary culinary experience rooted in authenticity. The restaurant sources the highest quality local produce, superior quality cuts of meat and the best fish, delivered daily. Like the menu, the interior plays with different Greek elements and motifs. Natural wood and stone combined with artful and ambient lighting lend a seductive and comfortable atmosphere.
We invite you to enjoy the Volos experience.
Toronto, ON M5H 2L3
Dining Style:
Casual Elegant
Seafood, Greek, Mediterranean
Hours of Operation:
Monday - Wednesday: 11:30am - 10:00pm
Thursday - Friday: 11:30am - 10:30pm
Saturday: 5:00pm - 10:30pm
Sunday: CLOSED
Cross Street:
York Street
Dress Code:
Smart Casual
Price Range:
CAN$30 and under
Payment Options
AMEX, MasterCard, Visa
Phone Number:
(416) 861-1211
Parking Details:
Valet parking is available adjacent to the restaurant at the Hilton and Sheraton hotels. Public lots are also adjacent to the restaurant at the Four Seasons Centre for Performing Arts, 150 York Street & Richmond-Adelaide Centre. Street parking is available on York Street.
Public Transit:
SUBWAY: Osgoode Station (Volos is 1 block south & 1 block east) and Queen Station (Volos is 1 block south & 2 blocks west).
STREETCAR: Exit at York Street from either Queen Street (Volos is 1 block south) or King Street (Volos is 2 blocks north)
Executive Chef:
Reza Persia
Banquet, Bar Dining, Bar/Lounge, Beer, Chef's Table, Full Bar, Gluten-free Menu, Happy Hour, Non-Smoking, Private Room, Wine
Special Events & Promotions:
Restaurant Photos
New Year's Eve Special Menus & Offers
Sunday, December 31, 2017
New Year's Eve Special Menus & Offers
Sunday, December 31, 2017Details
Take a trip to Greece this New Year's Eve with an extra special evening filled with friends, family and fine Greek cuisine.
Estiatorio VOLOS Ratings and Reviews
We dined at Volos to celebrate my mother-in-law's birthday and we had an excellent experience! We enjoyed great food and great recommendations by Dave, our wonderful server. Our favourite was the saganaki! We had a wonderful dinner and we look forward to dining here again!
I had heard about Volos through my network and was blown away with the culinary creations and the ambiance. The food was particularly tasty and unique. While the name of the restaurant is indicative of Greek cuisine, the food is not traditional. Rather, it combines traditional Aegean ingredients and turns them into spectacular experiences that delight every taste bud. The ambiance is warm yet upper scale which is not the easiest to achieve for any dining establishment. Our waiter was very attentive and pleasant. I would note that the management of the restaurant has done a great job in aligning the appropriate ratio of servers to tables. We had the pleasure of meeting the restaurant manager, Tom, and his authenticity and personal attention to introducing himself to all patrons in a way that was not intrusive but, rather, showed that the restaurant cares about everyone who dines there stood out to us. I would give this restaurant 5 stars on every rating scale.
We have dined at Estiatorio Volos on three separate occasions now (a late lunch for two; a wedding dinner for twelve at the Celebration Table; and, most recently a Birthday dinner for five) and every occasion has been a very enjoyable, pleasant and delicious experience. The friendly, busy ambience and knowledgeable staff are outstanding. Without fail, they have been consistently courteous, friendly and attentive to the care and detail of our dining experience. And then there is the delicious Greek dishes and wines on their menu. Everything we and our guests have ordered from the menu has been outstanding - our meals were delicious and very satisfying. Everything was prepared and presented perfectly. The seafood is excellent! We look forward to returning to Volos many times in the future and recommend it enthusiastically! They are busy so don't forget to make reservations. We extend our best wishes to Estiatorio Volos! Thanks for adding to three of our memorable occasions by making them even more enjoyable for us!
Went to with my sister and fiancé for a celebratory dinner for her new job promotion. The ambiance was great as well as the service from our server and his trainee. We ordered the octopus which was phenomenal as well as the flambé Greek cheese. The spicy sausage was as expected and forn entrees we ordered two Fishermans stew and one swordfish. The stew and the swordfish had amazing flavoured broth absolutely perfect however the temperature of both stews was quite cool and the mussels were not of the best quality and were mostly uneadible. The rest of the meal and service was perfect and topped with them bringing out a complimentary dessert that said congratulations.
Went to Volos for dinner before going to the theatre. Have been before. Food was excellent. Enjoyed the cod and my business associated enjoyed the rack of lamb. We shared appetisers -calamari and octopus. The octopus was cooked to perfection but the calamari were not up to the standard of my last visit ( a bit overcooked).
I have been to this restaurant on three previous occasions and decided to take friends visiting from out of town there tonight. From the minute we walked into the restaurant, something was 'off'. We could barely step foot into the restaurant as there were large groups blocking the entryway. It took about 15 mins before we were able to tell the hostess we had arrived for our reservation. Once seated, service was slow. The food was, as usual amazing. We ordered some dessert and coffee and the coffee arrived but after 25 mins it was clear our waiter neglected to put in our dessert order. After he came over to give us our bill (that we didn't ask for) he realized the dessert never arrived. No apology no removing the dessert from our bill...nothing!! When I went to speak to the apathetic manager I felt like my lips were moving but he couldn't care less. He basically attributed it to the fact 'we usually get 130 on a Friday night and tonight we have over 200' no sincerity, no empathy, just a blank look. After we paid our bill our waiter mustered an apology and offer for drinks. ..seriously? What an insult. In a city that has MANY great restaurants, I know this was my last visit to this particular one.
Great overall, but I know the wine I was served had been opened a while (I had the same wine a few days earlier). The waitress said the wine had been opened that morning at first...and then changed that to be I opened on front of her that evening. Umm.....nope.
The food was good but service was pretty poor mainly because the waitress did not come even 45 minutes after our arrival and we had to ask an employee to send her take our order. We seriously considered to go across the street. No water was offered to us as we sat. Once we got her attention, service was good.
Overall disappointing. Second time dining here, first time was a treat this time, we were very disappointed. The feta cheese on the entrée tomato salad was smeared over a salad and looked like it had been sitting there for quite some time. We both had the crusted salmon on the risotto. Not only was the main quite salty, but the risotto to be perfectly sincere, was simply quite awful. I don't think will be coming back, perhaps there has been a change in the kitchen?
I organized a business meal here, and the food and service did not disappoint. Our table was ready when we arrived, but the hostess advised us that if we could wait ten minutes, she could get us a table with a little more room. We waited at the bar, where the manager sent over some complementary sparkling wine for the wait- a very nice touch. Our server was friendly and made some great wine recommendations. The appetizers and mains were well-paced, and everything was really fresh and healthy. We will definitely return.
A failed attempt on high end Greek food. We had lamb shank, seabass which were all average. Appetizers of octopus, calamari and flaming cheese were nothing special either. Better off head to Greek town proper for same level of food for less $. So disappointed. Oh yeah and bread was stale, how can you mess that up.
Went to Volos for a dinner with old friends. We were warmly welcomed and the man serving us gave great friendly service. We were able to get the pre-theatre menu which is great value, plus we shared the octopus appetiser. Great value ad well prepared greek food.
Took my fussy mother for dinner before Plan Opera and we both felt the meal, service and ambiance were excellent. Impressed with the value and quality. Nice to experience fine dining with a Greek flair. I will definitely return soon and recommend to friends.
Food was good although I thought the salmon was slightly over cooked (but I still enjoyed). Service staff is nice enough but not very attentive. Took a while for them to bring over menus, to proactively refill our wine glasses (we had to ask, and we had bought a pretty nice bottle). Overall good food and decent experience, I wouldn't bring a special client or loved one here if you're looking for an extra special experience.
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Long Island man rescued near brink of Niagara Falls
NIAGARA FALLS – A 33-year-old Long Island man who was rescued after he jumped into the rapids in the Niagara River about 40 yards above the brink of the cataracts, was undergoing examination Wednesday night in the psychiatric ward of Niagara Falls Memorial Medical Center, according to State Parks Police.
The man, whose name cannot be made public under New York State mental health laws, spent about six hours on a rock above the rapids near the brink after making a 911 call early Tuesday, just after midnight, saying he planned to kill himself.
After the 911 call, the man climbed over a railing and remained on a rock as rescuers kept trying to talk him into rethinking his intentions. Another potential suicide victim had been talked out of jumping into the swift current about two weeks ago.
At about 7 a.m. Tuesday, the Long island man, still sitting on a rock above the rapids leading to the brink of the falls, jumped backwards into the rapids.
Two Niagara Falls firefighters wearing harnesses with ropes and State Parks Police officials running along the shore made a stab at saving the man. As he got to about 20 yards from the brink, he turned toward the shore and the firefighters and State Parks Police Lt. Patrick Moriarty grabbed him and pulled him to safety.
They said he did not speak as he was put into an ambulance for the trip to the hospital.
email: firstname.lastname@example.com


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Mr. McLamb and Mrs. Hyde took the National Young Readers Week principal challenge and read to all of the classrooms at MRES. They dressed up as Pete the Cat, and Pippi Longstockings which made the students smile and giggle. The challenge was not only to inspire young readers but to also help win all our students a Kate DiCamillo book to take home during winter break.
Published by Cyntrea Moore on November 10, 2016
Hurricane Matthew Relief – School Supply Drive
The students of Rockfish Elementary and Morganton Road Elementary are joining together to help students at St. Pauls Elementary School in neighboring Robeson County. Hurricane Matthew caused flood damage and loss to the school, as well as many of the students' homes. In an effort to assist these students, our schools are coming together to conduct a school supply drive. We are asking students at each grade level to bring designated items listed below.
MRES as well as Rockfish Elementary did an amazing job collecting supplies to help St. Pauls Elementary school..........................................................................................................................................
Published by Cyntrea Moore on October 31, 2016
MRES had a great turn out for our Grandparents' lunch, on Monday, Tuesday, and Wednesday. Thank you to all of the grandparents that came out to eat with their student..........................................................................................................................................
Published by Cyntrea Moore on September 15, 2016


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Foundational Analytics enables insights by using specific metrics to measure past performance to guide business planning. It can answer questions like "What happened", "When? "Who?" and "How Many?" and helps to inform decisions in various vertical markets around key business drivers:
ICC delivers targeted reporting metrics with interactive, custom dashboards and creates other UX visualization tools and applications so clients can interpret analytic findings and effectively apply that knowledge to their business.


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Marc Jacquinet
Personal Details
213 540 121
213 540 124
Rua Fernão Lopes, no 9, 1o Esq., 1000-132 Lisboa
RePEc:edi:douabpt (more details at EDIRC)
+351 289 244 406
Campus de Gambelas, 8005-139 Faro
RePEc:edi:cialgpt (more details at EDIRC)
This author is featured on the following reading lists, publication compilations or Wikipedia entries:
- Porfírio, José & Jacquinet, Marc & Carrilho, Tiago, 2009. "The Concept of Agricultural District and the Question of Rural Development," Spatial and Organizational Dynamics Discussion Papers 2009-3, CIEO-Research Centre for Spatial and Organizational Dynamics, University of Algarve.
- Marc Jacquinet, 2004. "La question de l'accès au droit dans le cadre de la réforme de la justice : Vers une méthode comparative," Law and Economics 0405004, EconWPA.
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The Cross LIVE ! - Prince 1988 Tour
Description:One of the greatest songs the man has ever written. "Sign o' the Times" is one of the greatest albums of the 80's. My #1 artist ever!I absolutely love this song and enjoy this LIVE version.
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The Indians have announced that 3B Jack Hannahan will begin a rehab assignment for the Columbus Clippers tonight. The Clippers are at home for a series against Charlotte.
Hannahan is batting .276 with 3 home runs and 18 RBI this season. 772 OPS and .345 SLG.
According to manager Manny Acta, he will need four or five rehab games before being recalled. The most interesting question might be who gets sent back to Columbus after his rehab stint is finished. Smart money will be on Lonnie Chisenhall.


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Efficient Secure Group Communication in Cloud Computing Environment
Cloud Computing has been envisioned as the next-generation architecture of IT Enterprise. In the authors' day today life they are using many web applications. Many of the users know to create web application which is very useful for their society. After creating their web application they don't know how to deploy their web application in cloud computing environment. Cloud provide different kind of services to the user such as Software as a Service (SaaS) which uses a provider's applications over a network and Platform as a Service (PaaS) which deploys customer-created applications to a cloud and Infrastructure as a Service (IaaS) which rents processing, storage, network capacity, and other fundamental computing resources.