text:
Our Office
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The Rise of Apple Picking Nationwide
Recent reports have shown a spike in the theft of mobile phones and other electronic devices. The thieves wipe the devices' memories clean and resell them for hundreds of dollars on the secondary market (an average of roughly $200 for iPhones). Too often, those crimes turn violent, and even deadly.
- Around 113 smartphones are stolen or lost each minute in the U.S.[1]
- More than 1.6 million people had their smartphones stolen last year.[2] According to the Federal Communications Commission, the theft of cell phones makes up 30 to 40 percent of all robberies nationwide.
- Top ten worst cities for smartphone theft are (in order of placement) are: Long Beach, Calif., Newark, N.J., Detroit, Cleveland, Baltimore, New York and Boston.[4]
- Lost and stolen cellphones cost consumers more than $30 billion last year.[5]
- Chicago police say there are more than 30 robberies of electronic devices on Chicago Transit Authority trains every month in the Belmont Area alone. Most of the thefts involve iPhones, which can sell for over $300 on the black market.


text:
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text:
Colon (punctuation)
This article's lead section may not adequately summarize key points of its contents. (July 2012) |
The colon is a punctuation mark consisting of two equally sized dots centered on the same vertical line. A colon is used to explain or start an enumeration. A colon is also used with ratios, titles and subtitles of books, city and publisher in bibliographies, business letter salutation, hours and minutes, and formal letters.[1]
In Unicode, it is encoded at U+003A : colon (HTML: :
The most common use of the colon is to inform the reader that what follows the colon proves, explains, defines, describes, or lists elements of what preceded it. In modern American English usage, a complete sentence precedes a colon, while a list, description, explanation, or definition follows it. The elements which follow the colon may or may not be a complete sentence: since the colon is preceded by a sentence, it is a complete sentence whether what follows the colon is another sentence or not. Some writers prefer to capitalize the first letter after the colon; others do not. Both are correct in American English usage.
- colon used before list
- Williams was so hungry he ate everything in the house: chips, cold pizza, pretzels and dip, hot dogs, peanut butter and candy.
- colon used before a description
- Jane is so desperate that she'll date anyone, even Tom: he's uglier than a squashed toad on the highway, and that's on his good days.
- colon before definition
- For years while I was reading Shakespeare's Othello and criticism on it, I had to constantly look up the word "egregious" since the villain uses that word: outstandingly bad or shocking.
- colon before explanation
- I had a rough weekend: I had chest pain and spent all Saturday and Sunday in the Emergency room.
Some writers use fragments — incomplete sentences — before a colon for emphasis or stylistic preferences (to show a character's Voice in literature), as in this example:
- Dinner: chips and beer. What a well-rounded diet I have.
Writers often also do that in social media such as Tweets because the number of characters is limited and they are trying to say as much as possible in as few characters as they can while maintaining somewhat correct grammar usage. Please note that a colon (:) and a semi-colon (;) are not interchangeable in grammar and that the usage of both has changed over the last couple hundred years. This is the contemporary usage of a colon in expository writing or literature: older literature such as novels or plays may use it differently.
The Bedford Handbook describes several uses of a colon. For example, one can use a colon after an independent clause to direct attention to a list, an appositive or a quotation, and it can be used between independent clauses if the second summarizes or explains the first. In non-literary or non-expository uses, one may use a colon after the salutation in a formal letter, to indicate hours and minutes, to show proportions, between a title and subtitle, and between city and publisher in bibliographic entries.[2]
Luca Serianni, an Italian scholar who helped to define and develop the colon as a punctuation mark, identified four punctuational modes for it: syntactical-deductive, syntactical-descriptive, appositive, and segmental.[3] Although Serianni wrote this guide for the Italian language, his definitions apply also to English and many other languages.
Business Letter Salutation[edit]
One of the ways used for salutation in a letter other than to use comma "," is to use colon, though more common practice is to use the comma.
- Hello Mr. XYZ:
- It's great to have your confirmation for the upcoming event.
The colon introduces the logical consequence, or effect, of a fact stated before.
- There was only one possible explanation: the train had never arrived.
In this sense the colon introduces a description; in particular, it makes explicit the elements of a set.
- I have three sisters: Daphne, Rose, and Suzanne.
Similarly, the syntactical-descriptive colon separates chapter and verse numbers in citations of passages in widely-studied texts, such as epic poetry, religious texts, and the plays of William Shakespeare.[4]
- John 3:14–16 or John III:14–16 refers to verses 14 to 16 of chapter three of the Gospel of John.
Syntactical-descriptive colons may separate the numbers indicating hours, minutes, and seconds in abbreviated measures of time.[5]
- The concert begins at 21:45.
- The rocket launched at 09:15:05.
British English, however, more frequently uses a full stop for this purpose:
- The programme will begin at 8.00 pm.
- You will need to arrive by 14.30.[4]
The colon introduces an appositive independent clause. In other words, the sentence after the colon is in apposition (grammatically parallel) to the one before the colon. Please note that this could also be simply considered an explanation of why Bob could not speak, and written without the capital He after the colon. Both would be technically correct.
- Bob could not speak: He was drunk.[6]
- Bob could not speak: he was drunk.
An appositive colon also separates the subtitle of a work from its principal title. In titles, neither needs to be a complete sentence as it is not expository writing.
Like a dash or quotation mark, a segmental colon introduces speech. The segmental function was once a common means of indicating an unmarked quotation on the same line. The following example is from the grammar book The King's English:
- Benjamin Franklin proclaimed the virtue of frugality: A penny saved is a penny earned.
This form is still used in written dialogues, such as in a play. The colon indicates that the words following an individual's name are spoken by that individual.
- Patient: Doctor, I feel like a pair of curtains.
- Doctor: Pull yourself together!
Use of capitals[edit]
Use of capitalization or lower-case after a colon varies. In British English, the word following the colon is in lower case unless it is a proper noun or an acronym, or is normally capitalized for some other reason (e.g. see segmental use hereinbefore). However, in American English, many writers capitalize the word following a colon if it begins an independent clause, i.e. a clause that could stand as a complete sentence. This follows the guidelines of some modern American style guides, including those published by the Associated Press and the Modern Language Association. The Chicago Manual of Style,[7] however, requires capitalization only when the colon introduces a direct quotation or two or more complete sentences.[8]
In many European languages the colon is usually followed by a lower-case letter (unless the upper case is required for other reasons, such as for a proper noun). However, usage differs from this in German, where an upper-case letter may be used only if the sentence after the colon could stand alone without the preceding sentence (otherwise one may judge freely according to the relative independence of the two assertions[clarification needed]),[9] and in Dutch, where an upper-case letter must be used if the colon is followed by a quotation or an enumeration of complete sentences, although in all other cases a lower-case letter should be used.[10]
In print, a thin space is traditionally placed before a colon and a thick space after it. In modern English-language printing, no space is placed before a colon and a single space is placed after it. In French-language typing and printing, the traditional rules are preserved.
One or two spaces may be and have been used after a colon. The older convention (designed to be used by monospaced fonts) was to use two spaces after a colon.[11]
English colon is from Latin colon (plural cola), itself from Greek κῶλον "limb, member, portion", in rhetoric or prosody especially a part or section of a sentence or a rhythmical period of an utterance.[12][13] In palaeography, a colon is a clause or group of clauses written as a line.
The OED cites William Blades' The life and typography of W. Caxton (1882), p. 126:
"The Greek grammarians […] called a complete sentence a period, a limb was a colon, and a clause a comma."
Use of the : symbol to mark the discontinuity of a grammatical construction, or a pause of a length intermediate between that of a semicolon and that of a period, was introduced in English orthography around 1600.
John Bullokar's An English expositor (1616) glosses Colon as "A marke of a sentence not fully ended which is made with two prickes."
John Mason in An essay on elocution (1748) prescribes "A Comma Stops the Voice while we may privately tell one, a Semi Colon two; a Colon three: and a Period four."
IPA Diacritical usage[edit]
A special triangular colon symbol is used in IPA to indicate that the preceding sound is long. Its form is that of two triangles, each a little larger than a point (dot) of a standard colon, pointing toward each other. It is available in Unicode as modifier letter triangular colon, Unicode U+02D0 (ː). A regular colon is often used as a fallback when this character is not available, and in the practical orthography of some languages which have a phonemic long/short distinction in vowels.
If the upper triangle is used without the lower one, it designates a "half-long" vowel.[14]
Word-medial separator[edit]
In Finnish and Swedish, the colon can appear inside words in a manner similar to the apostrophe in the English possessive case, connecting a grammatical suffix to an abbreviation or initialism, a special symbol, or a digit (e.g., Finnish USA:n and Swedish USA:s for the genitive case of "USA", Finnish %:ssa for the inessive case of "%", or Finnish 20:een for the illative case of "20").
In Swedish, the colon is used in contractions, such as S:t for Sankt (Swedish for "Saint"), e.g. in the Stockholm metro station S:t Eriksplan. This can even occur in people's names, for example Antonia Ax:son Johnson (Ax:son for Axelson). The colon was also used to mark abbreviations in early modern English.[15][16]
The colon is also used as a grammatical tone letter in Budu in the Democratic Republic of the Congo, in Sabaot in Kenya, in some Grebo in Liberia, and in Papua New Guinea: Erima, Gizra, Go꞉bosi, Gwahatike, Kaluli, Kamula, Kasua, Kuni-Boazi, and Zimakani.[17] The Unicode character used for the tone letter U+A789 ꞉ modifier letter colon is different from the punctuation (U+003A), as well from IPA's triangular colon U+02D0.
Mathematics and logic[edit]
The colon is used in mathematics, cartography, model building and other fields to denote a ratio or a scale, as in 3:1 (pronounced "three to one"). When a ratio is reduced to a simpler form, such as 10:15 to 2:3, this may be expressed with a double colon as 10:15::2:3; this would be read "10 is to 15 as 2 is to 3". Unicode provides a distinct character U+2236 ∶ ratio for mathematical usage.
The notation |G:H| may also denote the index of a subgroup.
The notation ƒ: X → Y indicates that f is a function with domain X and codomain Y.
The combination with an equal sign, ≔ , is used for definitions.
In mathematical logic, when using set-builder notation for describing the characterizing property of a set, it is used as an alternative to a vertical bar (which is the ISO 31-11 standard), to mean "such that". Example:
- (S is the set of all x in (the real numbers) such that x is strictly greater than 1 and strictly smaller than 3)
In type theory and programming language theory, the colon sign after a term is used to indicate its type, sometimes as a replacement to the "∈" symbol. Example:
Some languages like Haskell use a double colon (::) to indicate type instead.
A colon is also sometimes used to indicate a tensor contraction involving two indices, and a double colon (::) for a contraction over four indices.
This section needs additional citations for verification. (November 2011) |
In computing, the colon character is represented by ASCII code 58, (HTML :) and is located at Unicode code-point U+003A (colon). Scripts comprising wide characters, such as kanji, use a full-width equivalent, located at Unicode code point U+FF1A : fullwidth colon.
Several programming languages use the colon for various purposes.
A number of programming languages, most notably Pascal, and Ada use colon immediately followed by an equality sign, :=
in which case the colon and the equality sign are considering to compose to an independent assignment sign; this can be represented in Unicode as U+2254 ≔ colon equals.
Labels — targets for jumps, notably goto, but also some switch statements — are general formed of a label name followed by a colon. These include C, and DOS batch files.
For the double colon used in computer programming, see the scope resolution operator, and class member access of C++.
The colon is also used as part of the ?: conditional operator in C and other languages.
In a number of languages, including JavaScript and Python, colons are used to define name-value pairs in a dictionary or object.
var obj = { 'name': 'Charles', 'age': 18, }
The colon is also used in many operating systems commands. It is often used as a single post-fix delimiter, signifying a token keyword had immediately preceded it or the transition from one mode of character string interpretation to another related mode. Some applications, such as the widely used MediaWiki, utilize the colon as both a pre-fix and post-fix delimiter.
The colon is quite often used as a special control character in URLs,[18] computer programming languages, in the path representation of several file systems (such as FAT, following the drive letter, as in C:\Windows\
, and HFS).
In an IPv6 address colons (and one optional double colon) separate up to 8 groups of 16 bits in hexadecimal representation.[19] In a URL a colon follows the initial scheme name (like http), and separates a port number from the hostname or IP address.[18]
Other languages[edit]
In BASIC, it is used as a separator between the statements or instructions in a single line, which is represented in other languages via the semicolon.
In Forth, colon precedes definition of a new word.
Haskell uses a colon (pronounced as "cons", short for "construct") as an operator to add an element to the front of a list:[20]
"child" : ["woman", "man"] -- returns ["child","woman","man"]
while a double colon ::
is read as "has type of" (confer scope resolution operator):[21]
("text", False) :: ([Char], Bool)
The ML languages (including Standard ML and OCaml) have the above reversed, where the double colon (::
) is used to add an element to the front of a list; and the single colon (:
) is used for type guards.
MATLAB uses the colon as a binary operator that generates vectors, as well as to select particular portions of existing matrices.
In Python, which uses indentation to indicate blocks, the colon is used in statements to indicate that the next line is the start of an indented block.
- to introduce a control structure element. In this usage it must be the first non-blank character of the line.
- after a label name that will be the target of a
or a right-pointing arrow (Note: this style of programming is deprecated and programmers are encouraged to use control structures instead. - to separate a guard (boolean expression) from its expression in a dynamic function. Two colons are used for an Error guard (one or more error numbers).
- Colon + space are used in class definitions to indicate inheritance.
In the esoteric programming language INTERCAL, the colon is called "two-spot" and is used to identify a 32-bit variable - distinct from a spot (.) which identifies a 16-bit variable.
Internet usage[edit]
On the Internet, a colon, or multiple colons, is sometimes used to denote an action or to emote[original research?], similarly to asterisks. In this use it has the inverse function of quotation marks, denoting actions where unmarked text is assumed to be dialogue. For example:
- Tom: Pluto is so small; it should not be considered a planet. It is tiny!
- Mark: Oh really? ::drops Pluto on Tom's head:: Still think it's small now?
Colons may also be used for sounds, e.g. ::click::, though sounds can also be denoted by asterisks or other punctuation marks.
Colons can also be used to represent eyes in emoticons.
- U+003A : colon (HTML:
- U+FF1A : full-width colon (HTML:
- U+02D0 ː ipa triangular colon (HTML:
- ^ "Semicolon & Colon Rules". Georgia College Writing Center. Retrieved 17 April 2013.
- ^ Hacker, Diana (2010). The Bedford Handbook. Boston-New York: Bedford/St. Martin's. pp. 384–387. ISBN 0-312-65269-0.
- ^ Serianni, Luca; Castelvecchi, Alberto (1988). Grammatica italiana. Italiano comune e lingua letteraria. Suoni, forme, costrutti (in Italian). Turin: UTET. ISBN 88-02-04154-7.
- ^ a b Trask, Larry (1997). "The Colon". Guide to Punctuation. Retrieved 28 July 2011.
- ^ {{{title}}}
- ^ Example quoted in An Educational Companion to Eats, Shoots & Leaves by Lynne Truss
- ^ "Chicago Style Q&A: Capitalization". Chicagomanualofstyle.org. Retrieved 2011-11-08.
- ^ "Capital Community College: Guide to Grammar and Writing". grammar.ccc.commnet.edu. Retrieved 2011-11-08.
- ^ Duden Newsletter vom 24.08.2001
- ^ "Hoofdletter na dubbele punt". taaladvies.net. Retrieved 2011-11-08.
- ^ Paterson, Derek (2009-11-19). "How many spaces after a colon?". Absolute Write forums. Post 4. Retrieved 2012-11-04. "Back in the typewriter day, when fading ink ribbons could result in commas being mistaken for periods and vice versa, typists were taught to insert 2 spaces after the period to differentiate between the two. The same happened with colons and semicolons: 2 spaces were left after a colon; 1 space after a semicolon."
- ^ "colon". Online Etymology Dictionary.
- ^ κῶλον. Liddell, Henry George; Scott, Robert; A Greek–English Lexicon at the Perseus Project.
- ^ "The International Phonetic Alphabet". Weston Ruter. 2005. Retrieved 27 October 2011.
- ^ Ioppolo, Grace (2006). Dramatists and their manuscripts in the age of Shakespeare, Jonson, Middleton and Heywood. Psychology Press. p. 73.
- ^ Mueller, Janel; Scodel, Joshua, eds. (2009). Elizabeth I: translations, 1544-1589. University of Chicago Press. p. 460.
- ^ Peter G. Constable, Lorna A. Priest, Proposal to Encode Additional Orthographic and Modifier Characters, 2006.
- ^ a b Berners-Lee, T.; Fielding, R.; Masinter, L. (January 2005). Uniform Resource Identifier (URI): Generic Syntax IETF. STD 66, RFC 3986.
- ^ Hinden, R.; Deering, S. (Februari 2006) IP Version 6 Addressing Architecture. IETF. RFC 4291.
- ^ Real World Haskell by Bryan O'Sullivan, Don Stewart, and John Goerzen
- ^ "Learn You a Haskell for Great Good! - Types and Typeclasses". Learnyouahaskell.com. Retrieved 2011-11-08.
- ^ "Dyalog APL Language Reference Manual". Retrieved 2012-02-14.
External links[edit]
- "Using the Colon". On-line Writing Lab. Northland Community and Technical College. Retrieved 2 December 2013. .


text:
Campus Activities
Campus Activities is a student-run programming board that strives to create a more active campus life. We work together to create and coordinate a diverse range of social, educational, and recreational programs throughout the year for the students at Webster University.
Program Managers
Program Managers are student staff members who coordinate, execute, and evaluate programs for the students of the Webster University home campus. They also come up with ideas for new programs. Program Managers maintain office hours, attend all Campus Activities retreats and events and report to the Graduate Assistant of the University Center and Student Activities.
Graduate Assistant
The GA oversees the Program Managers and advises them on programming ideas, advertising, and budgeting.
How to get involved?
Any student is welcome to be a part of Campus Activities. All you have to do is contact us by phone at 314-246-7708, e-mail us at firstname.lastname@example.com, or talk to any of the Program Managers or the GA.
In addition to helping plan events, we need volunteers to help on the day of the events, which will ensure that the event runs smoothly. If you are interested in helping with these events, please let us know and we will be glad to have your help.
Upcoming Events
Connect with Us
St. Louis Home Campus
470 East Lockwood Ave.
St. Louis, MO 63119-3141 USA
(314) 246-7105
- Department of Student Activities
- Campus Activities
- Commuter Council
- Student Organizations
- Meet the Staff


text:
Package: libhttp-access2-ruby1.8 (126.96.36.199-2) [universe]
Links for libhttp-access2-ruby1.8
Ubuntu Resources:
Download Source Package libhttp-access2-ruby:
- [libhttp-access2-ruby_184.108.40.206-2.dsc]
- [libhttp-access2-ruby_126.96.36.199.orig.tar.gz]
- [libhttp-access2-ruby_188.8.131.52-2.diff.gz]
Please consider filing a bug or asking a question via Launchpad before contacting the maintainer directly.
Original Maintainers (usually from Debian):
- Ryan Niebur
- Debian Ruby Extras Maintainers (Mail Archive)
- Gunnar Wolf
It should generally not be necessary for users to contact the original maintainer.
External Resources:
- Homepage [dev.ctor.org]
Similar packages:
HTTP accessing library for ruby (transitional package)
This is a dependency package on libhttpclient-ruby1.8.
Other Packages Related to libhttp-access2-ruby1.8
- dep: libhttpclient-ruby1.8
- HTTP client library for ruby (ruby 1.8 version)
Download libhttp-access2-ruby1.8
Architecture | Package Size | Installed Size | Files |
all | 2.4 kB | 32.0 kB | [list of files] |


text:
Separation Anxiety: Must Candidates Avoid Talking About Separation Of Church And State?
Has the separation of church and state become the constitutional principle that dare not speak its name?
That seems to be the view of at least one consultant to the Democratic Party. In a recent New York Times article, Mara Vanderslice admitted that she told some candidates not to use the phrase "separation of church and state" while campaigning. Read more


text:
Thread: Playtest Update
Tuesday, 26th June, 2012, 03:01 AM #71
Judging from the playtest, I wouldn't buy 5e. Between racial features, class features, feats, backgrounds, themes, etc., there are way too many fiddly bonuses and rule exceptions built into each character. Keep the core simple, please.
- EN World
- has no influence
- on advertisings
- that are displayed by
- Google Adsense
Tuesday, 26th June, 2012, 04:05 AM #72
Core rules need to be simple, yes, but also interesting. Complaining about races, themes, classes, and backgrounds is pretty pointless when there's already an established option to remove themes and backgrounds and nobody has a gun to their head to play a non-human.
Odd thing, though, Wizards and Clerics have spell lists that are basically nothing but a giant pile of hyper-specialized fiddledy bits.
- Marty Lund
Tuesday, 26th June, 2012, 04:14 AM #73
Gallant (Lvl 3)
- Join Date
- Dec 2002
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- Midwood, Brooklyn, NY
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ø Ignore stevelabnyThe fact that most people seem to like the advantage/disadvantage mechanic tells me that either I'm broken or that most people will just like anything that involved rolling more dice and aren't looking deeper.
Its a simple mechanic that singlehandedly undoes so many other things. It makes crits boring, it makes mobs of like creatures tedious, it is so big a swing that it has to be used sparingly which in turn makes it pointless, it removes advantage stacking, and it takes the excitement away from watching the die on an important roll.
And I simply don't think that the impact of most of these things will be felt in one or two playtest sessions.
Oh well.
Tuesday, 26th June, 2012, 05:03 AM #74
Tuesday, 26th June, 2012, 05:14 AM #75
They are modules in the sense that they can be safely removed without bringing the rest of the Core rules crashing down and leaving an unplayable game. They are simply modules that are included in the default assumptions for further modules to be added.
If you're worried about "fidgety bits" like races and backgrounds most PC-related modules aren't going to be designed for your play style anyway. "Basic" is an easy optional configuration for the spartan niche, though probably not a very effective intro tool compared to pre-gens with at least fixed backgrounds.
- Marty LundLast edited by mlund; Tuesday, 26th June, 2012 at 05:22 AM.
Tuesday, 26th June, 2012, 06:51 AM #76
Scout (Lvl 6)
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- Jan 2012
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ø Ignore Consonant DudeThe percentage of people liking the direction of the next edition is not that important. What's more important is how WotC responds to the feedback they get and the most important thing of all is what the new edition will look like when we get the chance to buy the final product.
So being pessimistic or optimistic about the percentage at this point in time is irrelevant and a supremely pointless exercise in wasting time.
As for the article, I'm personally worried. Mearls says the most frequent praise they got was fans telling them how faster and streamlined it was. He then proceeds to say they're gonna add a bunch of clutter and useless details and "options" that those same fans are claimoring for.
It's becoming a running gag when designing new editions of DnD or knockoffs like Pathfinder. Everyone starts by being fed up with clunky, slow systems and starts from the basics. Then they add and add and add until it is just as pointlessly clunky or worse.
Is it that hard to get that DnD needs to be simple to be accessible and successful in the long term?
Note to fans and designers who want a faster, simpler game as well as a gazillion useless detailed options: You can't get both. It's one or the other.
Tuesday, 26th June, 2012, 08:30 AM #77
You are making an assumption here that if 60% of the survey respondents said they liked the current direction of D&D Next, then the other 40% said that they didn't like the current direction. But that doesn't correctly represent all of the the survey options. Perhaps the remaining 40% were split between just 5% who disliked the direction of D&D Next, and 35% who were simply neutral or undecided?
Tuesday, 26th June, 2012, 08:53 AM #78
Waghalter (Lvl 7)
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ø Ignore CasvalRemDeikunIn this economy, people tend not to buy stuff that makes them go "meh". And ultimately, in this case, the neutrals are still not happy with the direction the game is going, they just aren't unhappy either. Which ultimately means the game has not drawn them in yet, which after only one playtest is probably to be expected. We have no way of determining how Mike arrived at the number he did, for all we know, neutral was included in his 60% or was taken out entirely. Still, bottom line, 40% of people are NOT happy with the way the game is headed, whether it is because they haven't developed an opinion yet, or they flat out don't like it.
Tuesday, 26th June, 2012, 04:19 PM #79
Magsman (Lvl 14)
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ø Ignore Fifth ElementBut realistically the adv/dis mechanic is replacing the recent-edition tendency of many bonuses. It's +2 from this and +3 from that and another +1 from over there. Did I forget any? No? Okay, I'll roll. Darn it, missed by one. Who's next? Wait! I forgot the other +1! So I made it.
Besides that, of course, a bonus makes you able to accomplish things you otherwise couldn't, whereas advantage only increases your chances of success, without changing what you can accomplish.
I'm assuming that with your "less dice" position that you want to get rid of damage rolls as well?
Tuesday, 26th June, 2012, 05:20 PM #80
Defender (Lvl 8)
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ø Ignore Mercutio01
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text:
Natural 12 inch long reeds tied in bundles of 12 with a little piece of raffia.
Use reeds to make ever popular reed diffusers. Not only are they safer than candles they are so much easier to make! Learn how here!
Reeds have special spaces that run the length of the reed which allow the fragrance to wick all the way up the reed. Helping the fragrance to scent the room more effectively than regular sticks or bamboo skewers.


text:
Classic cars were on display on Sunday, Sept. 23, in the inaugural Boston Cup at Boston Common. Proceeds benefited the Fund for Boston Parks & Recreation and the Downtown Boston Business Improvement District.
This McLaren MP4 was one of the vehicles in the Parkman Bandstand area. Check out the others.


text:
The Gleason Score: A Significant Biologic Manifestation of Prostate Cancer Aggressiveness On Biopsy
By Gerry J. O'Dowd, Robert W. Veltri,
M. Craig Miller, UroCor, Inc., Oklahoma City, OK;
and Stephen B. Strum, Prostate Cancer Research Institute,
Los Angeles, CA
Reprinted from PCRI Insights January 2001 v4.1
Tumor grading of prostate cancer (PC) is a fundamental determinant of disease biology and prognosis. Tumor grading is defined as a property of cancer independent of tumor location found in either biopsy or radical prostatectomy specimens. Prognosis refers to the expected biologic aggressive potential of a patient's PC to spread to other organs. The Gleason score, the most widespread method of prostate cancer tissue grading used today, is the single most important prognostic factor in PC.1-7 It is one determinant of a patient's specific risk of dying due to prostate cancer.2,8 Hence, once the diagnosis of prostate cancer is made on biopsy, tumor grading, especially the Gleason score, strongly influences decisions regarding options for therapy.9
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The diagnostic quality of prostate biopsies is really a team effort between the urologist and the pathologist (an expert physician trained in the study of disease) working on a patient's case. A correct prostate cancer diagnosis and Gleason score are possible only when the biopsy is both performed and interpreted correctly by the urologist and pathologist respectively. Incomplete biopsy sampling of the prostate is one reason why the "predicted" Gleason score on biopsy does not always correlate with the actual "observed" Gleason score of the prostate cancer in the gland itself. Hence, the accuracy of Gleason scoring is dependent upon not only on the expertise of the pathologist reading the slides, but also on the completeness and adequacy of the prostate biopsy sampling strategy.10
Currently no clinical standard for transrectal ultrasound biopsy is used by practicing urologists that specifies a particular strategy of systematic sampling of the prostate gland. We know that extending biopsy strategy beyond that of the standard sextant approach will increase the yield of positive biopsies for PC and improve the sensitivity of the transrectal ultrasound technique.11,12 However, given the data from a number of studies showing the unique diagnostic contribution by biopsies from each of 11 separately labeled prostate sites and given commonly observed variations in biopsy quality, we strongly urge urologists to place each biopsy core in an individual container, clearly labeled with the anatomic location or prostate gland site of each biopsy taken.9,13,14,15
Systematic prostate biopsy labeling provides additional clinical information of value in the risk assessment of the patient.16 Anatomic, site specific, biopsy labeling or "prostate biopsy mapping" allows for (1) determination of the total percentage of separate biopsy samples involved by cancer (i.e. often referred to as "the percentage of positive cores"),17-21 (2) the measurement in mm's of the amount (or the percentage) of linear involvement by PC present in each positive biopsy core at a particular biopsy site,22-25 and (3) the anatomic region or zone of origin (transition zone vs. peripheral zone) of PC involvement.26-33
The Gleason scoring system is based on microscopic tumor patterns assessed by a pathologist while interpreting the biopsy specimen. When PC is present in the biopsy, the Gleason score is based upon the degree of loss of the normal glandular tissue architecture (i.e. shape, size and differentiation of the glands) as originally described and developed by Dr. Donald Gleason in 19741-4. The classic Gleason scoring diagram shows five basic tissue patterns that are technically referred to as tumor "grades". The subjective microscopic determination of this loss of normal glandular structure caused by the cancer is abstractly represented by a grade, a number ranging from 1 to 5, with 5 being the worst grade possible (See Figure 1). The Gleason score (GS) and the Gleason sum are one and the same. However, the Gleason grade and the Gleason score or sum are different. The biopsy Gleason score is a sum of the primary grade (representing the majority of tumor) and a secondary grade (assigned to the minority of the tumor), and is a number ranging from 2 to 10. The higher the Gleason score, the more aggressive the tumor is likely to act and the worse the patient's prognosis. Figure 2 provides classical photomicrograph examples of Gleason grade 3, 4, and 5 prostate cancers in needle core biopsy tissue sections.
Here's how it goes:
The Primary Gleason grade has to be greater than 50% of the total pattern seen (i.e. the pattern of the majority of the cancer observed). The Secondary Gleason grade has to be less than 50%, but at least 5%, of the pattern of the total cancer observed. The sum of the primary and secondary Gleason grades is shown as the Gleason score or sum (i.e. primary grade + secondary grade = GS; i.e. 4+3 or 3+4 = GS 7).
The defects in this scoring system are as follows:
1) Gleason grading and scoring is largely subjective and the range of Gleason scores diagnosed has narrowed to where almost all patients today present with a Gleason score of 6, 7, or 8,34-39 Gleason scores 2-4 should not be made on transrectal prostate biopsies40, and Gleason scores 9 and 10 are uncommon.
2) The medical expert responsible for the grading and scoring (i.e. the pathologists) are not all equally proficient in reading Gleason grades, especially on the small thin needle core tissue samples obtained at biopsy.41,42
3) The Gleason score is not the only key statistic available from the patient's biopsy, especially in today's changing pattern of pathologic presentation of PC. GS 7 cancers are a prognostically heterogeneous group of tumors that can be sub-stratified by the amount of Gleason grade 4 or 5 disease present. The proportion of grades 4 and 5 appears to have significant value in the determination of a patient's prognosis.43-45
4) Analysis of the correctness of this important diagnostic call has been made by correlating the predicted Gleason score of the biopsy with that observed in the radical prostatectomy surgical specimen. Unfortunately errors in the predicted biopsy Gleason score are common and most often result in under-grading (by greater than or equal to 1.0 grade level) of the actual tumor.7,35,46-48
The above limitations of GS indicate the clinical need to avoid under-grading GS 6 and to substratify GS 7 tumors in some clinically useful way. Under-grading of the predicted Gleason scores of prostate cancers on biopsy under estimates the potential risk of disease progression and may significantly impact the success or failure of the chosen primary treatment modality (surgery, radiation therapy, cryosurgery, or watchful waiting). Undergrading will especially affect the success of " watchful waiting", and the observed efficacy of some of the newer treatment modalities like brachytherapy, and it also will conceal the need for adjuvant therapy in high risk patients who need it the most.
As the title of this article indicates, the Gleason score is not the only key prognostic factor available from your biopsy, especially in today's changing pattern of pathologic presentation for PC. As previously noted, the Gleason score can be anywhere from 2-10, since the Gleason grades range from 1-5 for the primary grade and 1-5 for the secondary grade. Table 1 illustrates the distribution of Gleason score readings for 54,200 patients with PC that were processed and diagnosed between 3/94 and 9/98 by a single central expert reference laboratory. This table also demonstrates the correlation between Gleason scoring and the patient's age, the number of positive cores, and the total percent of linear tumor involvement.34
Table 1 shows the analysis of 54,200 prostate biopsies containing prostate cancer from over 151,000 prostate biopsy cases collected over a four year period. The majority of men present with either GS 6 (48%) or GS 7 (33%) prostate cancer. There are a relatively small number (2%) of men with low Gleason score (GS) cancers (i.e. GS 2 – 5). This table also shows that as you get older, you are more likely to have a more aggressive cancer (i.e. higher GS, more positive cores, and a greater volume of tumor). The "Total % Involvement" column is the sum of the % involvement of all positive cores, and can be a number anywhere from 0.5% up to 1,200% (if you have 12 positive cores with 100% involvement) and beyond. This number can be viewed as an indicator of tumor volume. Lastly, this table shows that as the GS increases, the volume of the tumor also increases (i.e. increasing number of positive cores and % tumor involvement). |
We know through the excellent work of McNeal and Stamey that the amount of Gleason grades 4 and 5 relate to the overall prognosis of the patient.43-45 This is not a final verdict, but is usually a strong and important factor regarding the outcome of the patient. A quantitative interpretation of today's biopsies should also include the percentage of positive biopsy samples, the zonal origin of the biopsy specimen with cancer if possible (transition zone vs. peripheral zone), the notation of the presence or absence of invasion of the pericapsular fat49 (fatty tissue around the capsule of the prostate) and the perineural invasion50-53 (invasion of nerve radicles) by the cancer. It should also include the quantitative amount of cancer present on each positive tissue core presented in the biopsy. The latter information has been shown to be related to the PC's aggressive nature as well as the relative tumor size, both of which have prognostic value.10,16,19,20,22-24,30,32,35,50,54
Some alternatives to the classic Gleason scoring system have been proposed. One involves the conversion of the Gleason grading system to one that is more objective and quantitative using new methods of image analysis that would mathematically convert the Gleason grade to a continuous quantitative variable. This type of effort has been published but remains in the research and development stage.55-58
Another approach would be to use supplemental testing to sub-stratify Gleason score 6 and 7 cases. One example of this approach would be the use of DNA ploidy image analysis to identify abnormal DNA ploidy cases.59-60 DNA ploidy uses expert-selected cancer cell nuclei from a PC biopsy specimen to determine the amount of DNA present in the cells. The cells are stained with a Feulgen stain that binds to the DNA of the cell in a way that permits direct quantitation of the DNA using a special microscope interfaced with a computer, a digital camera, and a software program to analyze the DNA content of the nuclear images. However, a study by Carmichael et al indicated that ploidy analysis on tissue sections was more predictive of recurrence post-radical prostatectomy than ploidy done on individual cell nuclei.59 A poor prognostic DNA ploidy result is represented as aneuploid or tetraploid, whereas a good prognostic result is interpreted as diploid. These interpretations actually refer to the relative numbers of chromosomes (amount of DNA) present in the cells (usually about 125- 150 cells) that were analyzed. A normal amount of chromosomes would be 22 pairs (maternal and paternal sets) plus a pair of sex chromosomes, for a total of 46.
Table 2 illustrates the relationship between DNA ploidy results and Gleason scores for 35,391 prostate cancer biopsies analyzed from 3/94 to 9/98. Please note that even cases of Gleason score 6 have a large group that have abnormal DNA ploidy (38%), which would suggest a poorer prognosis than the tumor grade would imply. Also, note the direct correlation between increasing Gleason score and the percentage of cases with abnormal DNA ploidy. Gleason Grade 4/5, the amount of tumor involvement, the perineural invasion status in the biopsy, and DNA ploidy allow for a more comprehensive patient disease profile to guide treatment decisions. In other words, it is a significant contribution to the risk assessment of the patient.
Table 2 shows a comparison of the DNA ploidy analysis result and the Gleason scores in 35,931 prostate biopsies collected over a four year period. The majority of low GS tumors (i.e. GS 2-5) have a normal DNA ploidy, which indicates a less aggressive tumor and a good prognosis. Conversely, most of the high GS tumors (i.e. 8 – 10) have an abnormal DNA ploidy (i.e. aneuploid and/or tetraploid), indicating an aggressive tumor and a poor prognosis. This table also shows that approximately 1/3 of the GS 6 tumors have an abnormal DNA ploidy and are probably more aggressive than they appear, and that the same amount of GS 7 tumors have a normal DNA ploidy and possibly have a fairly decent prognosis. |
Finally, based in part on the tumor volume and grading measurements of radical prostatectomy specimens by Stamey et al,43 Dr. Stephen Strum has proposed to pathologists like Dr. David Bostwick and urologists such as Dr. Alan Partin the use of Gleason Differential (GD). The GD would give us the breakdown of the relative proportions or amounts of primary and secondary GG. This is how it would look: Patient "A" has a GS of 7 that is a (4+3). This means that the GG 4 can range anywhere from 51% to 95%. A better expression of information would be to show the patient's GS and GD as (4+3)[%GG 4/ %GG 3]. If patient "A" had 70% GG4 and 30% GG3, this would be shown as (4,3)[70/30].
The prognostic value of estimating or measuring the quantity of Gleason Grade 4 and 5, however, has been demonstrated only in RP specimens and has not been proven in biopsies as of this time. Studies need to be conducted to assess the prognostic value of quantitative Grade 4 and 5 measurements in biopsy specimens for patient outcomes. Notwithstanding the lack of patient outcomes data based on biopsy grading results, there is growing support for this biopsy grading concept. Stamey has proposed that the Gleason sum be followed by the % Grade 4 and/or 5. These figures should be used in evaluating the role of the GS with the breakdown of the GD.
Gleason Score or GS = two numbers representing: a) the predominant pattern and b) the next most predominant pattern seen by the pathologist when examining prostate cancer tissue. Gleason Grade or GG = Gleason Differential or GD = |
Additional Data On Value Of Gleason 3/4 Grading:
In the November issue of Urology, Sakr et al38 reported findings on 534 patients with GS 7 at RP. Patients with GS 4+3 had more advanced clinical and pathological stages, larger tumor volumes, higher preoperative PSA levels, older age and a higher proportion were African-American men compared to GS 3+4 patients. Differences in tumor volumes are shown in Table 3.
Table adapted from Sakr et al 38
In the same issue of Urology, Chan et al39 presented an assessment of the prognostic value of Gleason score (3+4) versus (4+3) at RP. The findings are summarized in Table 4.
Table adapted from the paper by Chan et al 39
Clearly, relative proportion of high Gleason grades in a given tumor is more critical than the Gleason score by itself, especially as noted in studies of radical prostatectomy cases for which long-term follow-up is available. However, the published literature has confirmed the value of accurate Gleason grading on thin needle biopsies as well as the added value of capturing and reporting information such as the percentage of positive biopsy specimens, the amount of Gleason grade 4/5 tumor, presence of perineural invasion, pericapsular fat invasion, and abnormal ploidy within the subset of Gleason score 6 or 7 biopsies.10,18-20,43,49,59
Our Words of Advice on the GS
In summary, an accurate prognosis is not just a Gleason score — it is a complete and thorough interpretation of all the pathological and clinical information available from the prostate biopsy material! Throughout our counseling of men with PC, we continue to strongly advise that the Gleason score be read by either an experienced uropathologist of acclaimed expertise or a laboratory known for its focus on urology and having a high level of accuracy in its pathologic interpretation of prostate biopsies. In this regard, Dr. Strum has appended the following message to thousands of email postings and consultations and continues to apply it as a basic principle in the management of PC.
"Because the Gleason score is such a critical piece of information, I would want to have an expert pathology opinion. This should be obtained from a prostate cancer pathology expert. The ones that I am most familiar with include:
List omitted – a list of suggested Pathologists can be obtained by emailing firstname.lastname@example.com
A second opinion on the pathology is usually covered by insurance but if not, runs about $150. A copy of the original pathology report with the actual slides or recuts from the tissue paraffin block is sent to the outside reviewer. A copy of the insurance information is usually sent along with this. Either you or your primary care doctor or specialist can initiate such a second opinion."
Editor's Note: Since the posting of this message the costs of second opinions on pathology specimens has increased. The Medicare allowable for such a service is now $300. In addition, a few changes have been made to the list of PC pathology experts.
1. Gleason D. Classification of prostate carcinomas. Cancer Chemother Rep 50:125-128, 1966.
2. Baillar J, Mellinger G, Gleason D: Survival rates of patients with prostatic cancer, tumor stage and differentiation- a preliminary report. Cancer Chemotherap Rep 50:129-136, 1966.
3. Gleason DF, Mellinger GT, and the Veterans Administration Cooperative Urological Research Group: Prediction of prognosis for prostatic adenocarcinoma by combined histologic grading and clinical staging. J Urol 111:58-64, 1974.
4. Gleason DF and The Veteran's Administration Cooperative Urologic Research Group: Histologic grading and clinical staging of prostatic carcinoma, in Urologic Pathology: The Prostate (Tannenbaum M., ed.), Lea & Febiger, Philadelphia, pp. 171-197, 1977.
5. Hodge K, McNeal JE, Terris MK, et al: Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 142:71-74, 1989.
6. Gleason DF. Histology grading of prostate cancer: a perspective. Hum Path 23:273-279, 1992.
7. Allsbrook Jr WC, Mangold KA, Yang X, et al: The Gleason grading system: an overview. J Urologic Path 10:141-157, 1999.
8. Albertsen PC, Hanley JA, Gleason DF, et al: Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 280:975-980, 1998.
9. D'Amico AV, Whittington R, Malkowicz SB, et al: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969-974, 1998.
10. Stamey TA: Making the most out of six systematic sextant biopsies. Urology 45:2-12, 1995.
11. Norberg M, Egevad L, Holmberg L, et al: The sextant protocol for ultrasound- guided core biopsies of the prostate underestimates the presence of cancer. Urology 50:562-6, 1997.
12. Eskew LA, Bare RL, McCullough DL: Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol 157:199-203, 1997.
13. Presti JC, Chang JJ, Bhargava V, et al: The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial. J Urol 163:163-168, 2000.
14. Bauer JJ, Zeng J, Weir J, et al: Three dimensional computer simulated prostate models: lateral prostate biopsies increase the detection rate of prostate cancer. Urology 53:961-967, 1999.
15. Babaian RJ, Toi A, Kamoi K, et al: A comparative analysis of sextant and an extended 11-core multisite directed biopsy strategy. J Urol 163:152-157, 2000.
16. Terris MK, Haney DJ, Johnstone IM, et al: Prediction of prostate cancer volume using prostate-specific antigen levels, transrectal ultrasound, and systematic sextant biopsies. Urology 45:75-80, 1995.
17. Presti J, JR, Katsuto S, Bacchetti P, et al: Positive fraction of systematic biopsies predicts risk of relapse after radical prostatectomy. Urol 52:1079-1084, 1998.
18. D'Amico AV, Whittington R, Malkowicz SB, et al: Clinical utility of the percentage of positive prostate biopsies in defining biochemical outcome after radical prostatectomy for patients with clinically locallized prostate cancer. J Clin Oncol 18:1164-1172, 2000.
19. D'Amico AV, Whittington R, Malkowicz SB, et al: Utilizing predictions of early PSA failure to optimize patient selection for adjuvant systemic therapy trial. J Clin Oncol 18:3240-3246, 2000.
20. D'Amico AV, Whittington R, Malkowicz SB, et al: Combination of the preoperative PSA level , biopsy Gleason Score, percentage of positive biopsies and MRI T stage, to predict early PSA failure in men with clinically localized prostate cancer. Urol 55:572-577, 2000.
21. Sebo TJ, Bock BJ, Cheville JC, et al: The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomy. J Urol 163:174-178, 2000.
22. Badalament RA, Miller MC, Peller PA, et al: An algorithm for predicting non organ confined prostate cancer using the results obtained from sextant core biopsies with prostate specific antigen level. J Urol 156:1375-1380, 1996.
23. Egan AJ, and Bostwick DG: Prediction of extraprostatic extension of prostate cancer based on needle biopsy findings. Perineural invasion lacks significance on multivariate analysis. Am J Surg Path 21:1496- 1500, 1997.
24. Veltri RW, O'Dowd GJ, Orozco RF, et al: The role of biopsy pathology, quantitative nuclear morphometry, and biomarkers in the preoperative prediction of prostate cancer staging and prognosis. Semin Urol Oncol 16:106-117, 1998.
25. Rubin MA, Bassily N, Sanda M, et al: Relationship and significance of greatest percentage of tumor and perineural invasion on needle biopsy in prostatic adenocarcinoma. Am J Surg Path 24:183-189, 2000.
26. Terris M, Pham TQ, Essa MM, et al: Routine transition zone and seminal vesicle gland biopsies in all patients undergoing transrectal ultrasound guided prostate biopsies are not indicated. J Urol 204-206, 1997.
27. Liu PD, Terris M, McNeal J, et al.: Indications for ultrasound guided transition zone biopsies in the detection of prostate cancer. J Urol 153:1000-1003, 1995.
28. Keetch DW and Catalona WJ: Prostatic transition zone biopsies in men with previous negative biopsies and persistently elevated serum prostate specific antigen values. J Urol 154:1795-1797, 1995.
29. Chang JJ, Shinohara K, Hovey RM, et al: Prospective evaluation of systematic sextant transition zone biopsies in larger prostates for cancer detection. Urology 52:89-93, 1998.
30. Hammerer P and Huland H: Systematic sextant biopsies of 651 patients referred for prostate evaluation. J Urol 151:99-102, 1994.
31. Dyke CH, Toi A, Sweet JM: Value of random US-guided transrectal prostate biopsy. Radiology 176:345-349, 1990.
32. Billebaud T, Villers A, Astier L, et al: Advantage of systematic random ultrasound-guided biopsies measurement of serum prostate-specific antigen levels and determination of prostate volume in the early diagnosis of prostate cancer. Eur Urol 21:6-14, 1992.
33. Daniels GF Jr, McNeal JE, Stamey TA: Predictive value of contralateral biopsies in unilaterally palpable prostate cancer. J Urol 147:870-874, 1992.
34. Orozco RF, O'Dowd GJ, Kunnel B, et al: Observations on pathology trends in 62,537 prostate biopsies obtained from urology practices in the United States. Urology 51:186-195, 1998.
35. O'Dowd GJ, Veltri RW, Orozco R, et al: Update on the appropriate staging evaluation for newly diagnosed prostate cancer. J Urol 158:687- 698, 1997.
36. Epstein JI, Lecksell K, and Carter HB. Prostate cancer sampled on sextant needle biopsy: Significance of cancer on multiple cores from different areas of the prostate. Urology 54:291-294, 1999.
37. O'Dowd GJ, Miller MC, Orozco R, et al: Analysis of repeat biopsy results within one year following a non-cancer diagnosis. Urology 55:553- 559, 2000.
38. Sakr WA, Tefilli MC, Grignon DJ, et al: Gleason score 7 prostate cancer: a heterogeneous entity? Correlation with pathologic parameters and disease-free survival. Urology 56:730-734, 2000.
39. Chan TY, Partin AW, Walsh PC, et al: Prognostic significance of Gleason score 3+4 versus Gleason score 4+3 tumor at radical prostatectomy. Urology 56:823-827, 2000.
40. Epstein JI: Gleason score 2-4 Adenocarcinoma of the prostate on needle biopsy. A diagnosis that should not be made. Am J Surg Path 24:477- 478, 2000. 41. Allsbrook W, Lane R, Lane C, et al: Interobserver reproducibility of Gleason's grading system: urologic pathologists. Mod Pathol 11:75A, 1998.
42. Steinberg DM, Sauvageot J, Piantadosi S, et al: Correlation of prostate needle biopsy and radical prostatectomy Gleason grade in academic and community settings. Am J Surg Pathol 21:566-576, 1997.
43. Stamey TA, McNeal JE, Yemoto CM, et al: Biological determinants of cancer progression in men with prostate cancer. JAMA 281:1395-400, 1999.
44. McNeal JE: Cancer volume and site of origin of adenocarcinoma in the prostate: relationship to local and distant spread. Hum Path 23:258- 266, 1992.
45. Noguchi M, Stamey TA, McNeal TA, et al: Preoperative prostate specific antigen does not reflect biochemical failure rates after radical prostatectomy in men with large volume cancer. J Urol 164:1596-1600, 2000.
46. Epstein JI: The diagnosis and reporting of adenocarcinoma of the prostate in needle biopsy specimens. Cancer 78:350-356, 1996.
47. Spires SE, Cibull ML, Wood DP, et al: Gleason histologic grading in prostatic carcinoma: correlation of 18-gauge core biopsy with prostatectomy. Arch Pathol Lab Med 118:705-708, 1994.
48. Bostwick DG: Gleason grading of prostatic needle biopsies: correlation with grade in 316 matched prostatectomies. Am J Surg Pathol 18:796- 803, 1994.
49. Ravery V, Boccon-Gibod LA, Dauge-Geffroy MC, et al: Systematic biopsies accurately predict extracapsular extension of prostate cancer and persistent/recurrent detectable PSA after radical prostatectomy. Urology 44:371-6, 1994.
50. Rubin MA, Bassily N, Sanda M, et al: Relationship and significance of greatest percentage of tumor and perineural invasion on needle biopsy in prostatic adenocarcinoma. Am J Surg Pathol 24:183-9, 2000.
51. Endrizzi J and Seay T: The relationship between early biochemical failure and perineural invasion in pathological T2 prostate cancer. BJU Int 85:696-8, 2000.
52. de la Taille A, Rubin MA, Bagiella E, et al: Can perineural invasion on prostate needle biopsy predict prostate specific antigen recurrence after radical prostatectomy? J Urol 162:103-6, 1999.
53. Bastacky SI, Walsh PC, and Epstein JI: Relationship between perineural tumor invasion on needle biopsy and radical prostatectomy capsular penetration in clinical stage B adenocarcinoma of the prostate. Am J Surg Path 17:336-341, 1993.
54. Peller PA, Young DC, Marmaduke DP, et al: Sextant biopsies: a histopathologic correlation with radical prostatectomy specimens. Cancer 75:530-538, 1995.
55. Veltri RW, Partin AW, Epstein JE, et al: Quantitative nuclear morphometry, Markovian texture descriptors, and DNA content captured on a CAS-200 Image analysis system, combined with PCNA and HER-2/neu immunohistochemistry for prediction of prostate cancer progression. J Cell Biochem Suppl 19:249-58, 1994.
56. Partin AW, Steinberg GD, Pitcock RV, et al: Use of nuclear morphometry, Gleason histologic scoring, clinical stage, and age to predict disesefree survival amaong patients with prostate cancer. Cancer 70:161-168, 1992.
57. Veltri RW, Miller MC, Partin AW, et al: Ability to predict biochemical progression using Gleason score and a computer-generated quantitative nuclear grade derived from cancer cell nuclei. Urology 48:685-91, 1996.
58. Wojno K, Schwab ED, Consolino CM, et al: Fractal analysis of the Gleason grading system. Mod Pathol 9:86a, 1996.
59. Carmichael MJ, Veltri RW, Partin AW, et al: Deoxyribonucleic acid ploidy analysis as a predictor of recurrence following radical prostatectomy for stage T2 disease. J Urol 153:1015-1019, 1995.
60. Ross JS, Sheehan CE, Ambros RA, et al: Needle biopsy DNA ploidy status predicts grade shifting in prostate cancer. Am J Surg Path 23:296- 301, 1999.


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Industry Forum 38: Carpal Instability Management
Industry Forum 39: Clavicle Fixation in 2012: Who, Why, How?
Industry Forum 40: Surgeon Training (Cadaveric) on Uniportal Endoscopic Carpal, Cubital and Trigger Finger Release Utilizing the Clear Cannula System
Presented by: A.M. Surgical, Inc.
Industry Forum 41: Cancelled
See NEW IF41, presented by Biomet on Thursday, September 6, listed above.
The views and techniques presented are not necessarily those of the ASSH or its members. The ASSH assumes no responsibility or liability for the use or misuse of any information, materials or techniques described and makes no warranty, guarantee or representation as to the absolute validity or sufficiency of any information provided.


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Love my Dyson!
By Debbie
from Mississauga, Ontario
As soon as it arrived I felt like a child at Christmas!! Most of the vacuum already comes put together but there is 3 easy quick steps to attach the entire model together. I started using it right away. I was amazed! The amount of power behind this vacuum is incredible! When I saw how much it actually captured in its canister .. I was amazed! Best buy ever .. And worth every penny. How did I ever live without a Dyson before!


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Someone/something that acts out of custom or normality. Monstrous in form, practice, or belief.
I am an avid lover of Nature, and all things natural. I am of Pagan faith, and I don't appreciate bigotry or discrimination.
I like to post a lot about the elements, especially fire, and about Paganism in general. I have done an ample amount of research, and aim to educate all those who are willing to lend their ears (eyes)!
I also aim to learn from all who share my faith, and even from those who do not. I like to see myself as an open-minded person. So...TALK TO ME! (:
2 years ago / 83,193 notes Tags: #vw bus


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Simple Meals at Way Cool Cooking School
Date: Saturday 2 March 2013
Time: 9:30 am – 11:30 am
Registration Closes:
Online registration
Begin to think like a chef and create an amazing meal of your own. Step up your cooking skills with a real pro, practice a variety of culinary tricks, and learn how ingredients can change a recipe. Get inspired to cook up something delicious to show off to your family and friends! Badge included. Girls complete majority of steps. Details for badge completion available at the event. These events will use a variety of ingredients. If any event participants have dietary needs or allergies, please be sure to indicate that when signing up.
Registration closes at 10:59pm on Feb 14.


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*HORF*: Meat Cakes Are A Little Too Realistic
This is a slab of bacon. In cake form. I know, I thought it was eel too. Anyway, I'm gonna have to admit I'd have a hard time driving that into me. Mostly because there's no steering wheel or pedals! *zing!* How about airline food, amirite? First time I've ever had to use a barf bag in the back of my pants. Thank you, thank you -- you all have been great, don't forget to tip your bartenders, I'm gonna steal their tip jars after the show. Woops -- did I say that out loud? I have a gun.
Hit the jump for an eerily realistic Spam cake and an unbelievable bacon & eggs one.
Bacon and Spam Cakes Look Delicious [walyou]
This is a video of a couple jackasses shooting a model rocket made of meat. It was an interesting experiment from a purely scientific standpoint, but a terrible waste of resources. It does get funny at the end though because SPOILER ALERT: the rocket crashes through the kitch... / Continue →
This is a $16 elemental bacon shirt. It spells 'BaCoN' through the clever placement of three periodic elements: barium, cobalt and nitrogen. And I think we can all agree: bacon would be a lot less popular if it actually were barium, cobolt and nitrogen. And not just because ... / Continue →
A bunch of French Canadians (you sound so funny!) decided to cover their friend in $37 of raw bacon and film it with the hopes of being featured on Geekologie. And, because I'm basically a super handsome 'Make a Wish' foundation, here it is. Per babelfish translation: We had... / Continue →


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this year the Deemack wrestling team proved they are a team up and coming .. last year they were not only a young team with little experience but this year was a different story. they brought home thier first piece of hardware placing in the eureka tourny and sent four guys off to state sectionals .way to go guys keep up the good work ..
deemack wrestling great season
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From ErfWiki
Book (LIAB)
Page by page (40)
Panel by panel (40:6)
Page Info
Description | [edit] |
In the foreground, the white figurine can be made out; it wears white armor set off by the same black and maroon that Gobwin Knob uses. In the midground, the table with the model city is visible; a few figurines rest on the tower, with one white or pink; at the lead of the red flyers in the hex opposite them, are a white and purple. In the background, Parson has turned his back on the planning table; Maggie reaches out a hand to him.
Text | [edit] |
Parson Gotti: C'mon.
Maggie: Lord?
Parson Gotti: Armory.


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SHAKIRA MADISON SQUARE GARDEN NEW YORK TICKETS: Columbian born entertainer Shakira is a jack of all trades when it comes to her talent. A talented singer, writer, dancer, and even a producer, Shakira is recognized across the world. Now you can order your tickets to see Shakira live in New York, NY at Madison Square Gardenn downtown as she jet-sets on her 5th tour so far. This eight-time Latin Grammy award winning artist is only a click away! Contact us for your Shakira New York tickets today!
Shakira New York, NY tickets are accessible below. If they are currently unavailable, sign up and be among the first who are notified once they are. By providing your name and e-mail address below, you will be added to our Shakira priority mailing list!
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ORDERING SHAKIRA NEW YORK TICKETS MADISON SQUARE GARDEN: - To order your tickets online, simply click "view tickets" next to the show you want to attend from our list above. - You may also order your tickets over the phone by calling us today
SHIPPING: - All tickets are shipped via FedEx. Saturday deliveries must be requested at the time of your ticket purchase and will carry an extra charge. -You may also arrange to pick-up your tickets in person. Please inquire with one of our reps.
About Us: Thank you for shopping with BarrysTickets.com! For nearly a quarter of a century we have been working hard to bring you the absolute best in all sports, concert, and theater tickets. Contact us for tickets to the next Shakira MSG New York show today!


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The Annette Caldwell Simmons School of Education and Human Development offers teacher education programs at the graduate, post-baccalaureate, and undergraduate levels where students can become world-class scholars and teacher leaders. Our faculty members are outstanding educators who combine years of classroom experience with a deep knowledge of research-based practices to create a high-quality learning environment. Our programs offer students a comprehensive curriculum of theory, research, cross-disciplinary studies, and practicum. Our goal is to improve teacher effectiveness and we are committed to raising the bar in teacher education.
We design our classroom experience to meet the needs of all students and pride ourselves on being responsive to diverse learners. Many of our faculty are actively involved in the local education community and work in schools, focusing on dyslexia, ESL, mathematics, and special education.
The Annette Caldwell Simmons School of Education and Human Development is a place of great value, we deliver a high caliber education with a cost comparable to other education programs in the surrounding area. We are so pleased that you are considering joining our team and we invite you to explore our diverse range of programs. We can work together to change minds!
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Join us for a graduate study information session on Tuesday, March 25th and learn more about our graduate and non-degree programs. There are excellent scholarship opportunities and by attending the information session, you will be able to discuss your educational goals with graduate education faculty. Find more details here.
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Dr. Candace Walkington, assistant professor and mathematics educator, has uncovered the importance of personalizing algebra instruction for struggling students. Her research made the cover of Education Week in 2012 and was most recently featured on "Mindshift," a National Public Radio affiliate. Read more here...
The Fairess Simmons Scholarship Program was created to provide merit scholarship to pre-service or practicing teachers interested in pursuing coursework in Master of Bilingual Education (MBE) program. In order to be considered, applications must be received by the priority deadline of April 15. Read more here...
SMU's Master of Education with Certification program is tailor-made for the individual who would like to teach and already has a bachelor's degree, but who does not have the appropriate certification credentials. This full-time program is a summer start program. Priority application deadline is April 15. Read more here...


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You can also call the appointment center to schedule, change or cancel an appointment or ask questions.
Stuttering is a sudden, intense breakdown in the fluent production of speech. In early childhood, it appears as word or syllable repetitions that often resolve. More severe silent hesitations, sound prolongations or muscle tremors may develop into more resistant behaviors.
While there is growing scientific evidence that stuttering is a physically-based disorder of speech muscle control, there are no known causes or cures. There are, however, a variety of promising early childhood and adult treatment programs that do provide excellent fluency results.
Beaumont's Stuttering Center helps children and adults who stutter to develop fluent speaking patterns. The center's clinicians help establish new fluency patterns as well as provide coping skills for patients and their families.
Is stuttering hereditary?There is growing evidence that stuttering tends to occur in families who have a history of stuttering in previous generations.
Can stuttering be caused by physical or psychological trauma?Trauma to the head can cause temporary speech dysfluency or stuttering. This usually resolves within weeks or months. Psychologic trauma can also cause temporary stuttering. Both of these conditions are rare.
Does early childhood stuttering resolve without treatment?A large portion of children (75 percent) who begin to stutter at three to five years of age stop stuttering without treatment.
When should a parent seek help for their child who stutters?As early as three years of age if the child exhibits muscle tremors, spasms or expresses anxiety about their speech.
Is there one speech technique that works best for children or adults who stutter?No. There are several treatment strategies that have proved very successful. They include stuttering modification and fluency initiating programs.
NIDCD - StutteringNational Association of Young People Who StutterNational Stuttering AssociationStuttering Foundation of America
For more information, please contact us at 248-551-2100 or 248-551-0003.
Copyright © 2013 Beaumont Health System. All Rights Reserved. Privacy Policy | Site Map


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Dr. Martens Rylee Oxford
Sorry, this item is sold out!
Looks like you've got more shoe shopping to do - have fun!
Looks like you've got more shoe shopping to do - have fun!
Item # 242023
A classic brand with modern style, Dr. Marten's brings us the Rylee Oxford. This shoe combines the comfort and design for which Dr. Marten's is known for, but also adds a bit of edge to your everyday look.
- Greasy lamper suede upper is coated to give you a waxy feel
- Ankle pull tab for easy on/off
- Cushioned footbed
- Slip resistant sole that is cemented to the base of the upper
- Imported
- Online Exclusive!


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Published Sept. 24, 2013 By Meredith Boggs, KNDU TV
More than 100 teenage girls experienced some hands on training Tuesday as they were introduced to the world of manufacturing.
The annual student event is hosted by TRIDEC and Columbia Basin College to showcase specific career opportunities in the manufacturing industry for women. Female industry professionals were also on hand to inspire the young women at Tuesday's event.
the real purpose behind this is to show the girls what's behind all of the products and the things they make and do. What is the process it takes to come up with the things that they make and use everyday, so their technology, their electronics, aerospace, transportation," said Kayla Pratt with TRIDEC. Pratt says the event is so popular that they had to turn away some students this year. However, she says they will be looking to expand in the future.


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Assessing the Link Between Smoke Carcinogen Biomarkers and Lung Cancer Risk - 1
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Lung cancer is the leading cause of cancer death in the United States. Currently it remains impossible to predict which smokers will get cancer. Each puff of a cigarette delivers a mixture of over 60 known carcinogens. Biomarkers that quantify carcinogen levels and metabolism are a useful tool and available to use. The purpose of this study is to assess the link between tobacco smoke carcinogen biomarkers and the risk of developing lung cancer.
Condition | Intervention |
Tobacco Use Disorder |
Other: Non-intervention |
Study Type: | Observational |
Study Design: | Observational Model: Case Control Time Perspective: Retrospective |
Official Title: | Prostate, Lung, Colon, and Ovarian Cancer (PLCO) Screen Trial |
- Lung cancer [ Time Frame: Cumulative incidence ] [ Designated as safety issue: Yes ]
Enrollment: | 200 |
Study Start Date: | September 2005 |
Study Completion Date: | December 2007 |
Primary Completion Date: | December 2007 (Final data collection date for primary outcome measure) |
Groups/Cohorts | Assigned Interventions |
Lung cancer cases diagnosed prior to 2007 among baseline smokers in the PLCO
Other: Non-intervention
Measured total NNAL and PheT as biomarkers of exposure
Other Name: NNAL-glucuronide, phenanthrene tetraol
Subjects without lung cancer among smokers at baseline in the PLCO study
Other: Non-intervention
Measured total NNAL and PheT as biomarkers of exposure
Other Name: NNAL-glucuronide, phenanthrene tetraol
Detailed Description:
Lung cancer is the leading cause of cancer death in the United States. Approximately 90% of lung cancer is caused by cigarette smoking. While most lung cancer cases occur in smokers or ex-smokers, only 15-25% of smokers will get lung cancer. Currently it remains impossible to predict which smokers will get cancer.
Each puff of a cigarette delivers, along with nicotine, a mixture of over 60 known carcinogens. Most of these carcinogens require metabolic activation before they can negatively affect cell DNA and cause cancer. Biomarkers that quantify carcinogen levels and metabolic activity of carcinogens are a useful tool and available to use. The purpose of this study is to assess the link between tobacco smoke carcinogen biomarkers and the risk of developing lung cancer.
This observational case-control study will involve a random selection from a group of smokers who are participating in the Prostrate, Lung, Colon, and Ovarian Cancer (PLCO) Screen Trial. The chosen cases will include 300 incident lung cancer cases and 300 controls (participants who have had no diagnosis of lung cancer). Demographic and baseline data from the PLCO database will be obtained. Prior baseline blood samples from the PLCO trial will be obtained as well. Based on age, sex, and smoking history, participants will be grouped into triplets in order to pool their blood samples. These samples will then be analyzed to determine whether distributions of biomarker levels in lung cancer participants differ from those in non-lung cancer participants. This study will not involve recruitment of any participants, as data and samples from the PLCO trial will be used and no new blood samples will be obtained.
Ages Eligible for Study: | 55 Years to 74 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Non-Probability Sample |
Case-control study nested within the Prostate Lung Colorectal and Ovarian Cancer Screening Trial. Subjects consisted of screening arm subjects who were smokers at baseline and who contributed biorepository samples at the first screening visit.
Inclusion Criteria:
- Screening arm participants in the Prostate, Lung, Colon, and Ovarian Screen Trial (PLCO)
- Reported smoking on baseline questionnaire of PLCO
- Contributed biorepository samples
Exclusion Criteria:
- Unstable physical or mental health
United States, Minnesota | |
University of Minnesota | |
Minneapolis, Minnesota, United States, 55455 |
Principal Investigator: | Dorothy Hatsukami, Ph.D. | University of Minnesota - Clinical and Translational Science Institute |
No publications provided
Responsible Party: | Timothy R. Church, PhD, University of Minnesota |
ClinicalTrials.gov Identifier: | NCT00218179 History of Changes |
Other Study ID Numbers: | NIDA-13333-1, P50-13333-1, DPMC |
Study First Received: | September 16, 2005 |
Last Updated: | April 23, 2009 |
Health Authority: | United States: Federal Government |
Additional relevant MeSH terms:
Tobacco Use Disorder Substance-Related Disorders Mental Disorders |
ClinicalTrials.gov processed this record on March 13, 2014


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These TCI flexplate safety shields are designed to protect both drivers and spectators from the effects of flexplate or starter ring failure. Mandatory in many classes of the NHRA, IHRA, and IMCA, each flexplate shield is manufactured from high-strength steel and certified to SFI specifications.
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1br, Bay Ridge and Fort Hamilton, Brooklyn, $1,450
Amenities: Bicycle Room, Elevator, Laundry, Wheelchair Access, Dining Room, Eat In Kitchen, Hardwood, High Ceilings, Light, Renovated, Shares OK, Walk In Closet, Original Details Description: Bay Ridge Massive 950 Square Foot 1 Bedroom situated in an elegant Pre-War Elevator Building! This sprawling apartment is located in the epicenter of Bay Ridge within 1 block of markets, grocery stores, Rite Aid Pharmacy, banks, shopping, entertainment, and public parks. The apartment features an XXL foyer with three huge closets (including 1 walk in cedar closet), a huge renovated eat-in kitchen with brand new appliances (coming soon), a tremendous great room with 3 additional large closets, a renovated white tile bathroom with new sink vanity, extremely high ceilings, original pre-war crown & baseboard moldings, restored original herringbone floors, and extra large windows boasting both Northern and Western exposures. The building boasts a large laundry room, 2 elevators, and a live-in super for all your maintenance concerns. This newly renovated unit will not last long! Call today to schedule a showing of this amazing apartment! ***photos are of a similar unit, and accurately represent finishes and room sizes***
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Results 1 to 3 of 3
Thread: Rough idle!
- Join Date
- May 2012
- Location
- Ontario, Canada
- Posts
- 2
Rough idle!
Hey guys and gals,
I recently purchased a 2008 Silverado LT 5.3L V8 with 52,000km. After getting comfortable with the ride, I noticed a rough idle, in gear, while stopped. The rpms fluctuate between 400 and 750, it never stalls but I get a bogged out feel. During the fluctuation, the oil pressure drops slightly, lights dim/flicker, and, annoying vibration.
Plugs are original, runs in 87 octane.
Could anybody lead me in a certain direction as to what could be the cause? any feedback is appreciated!Stay Classy, Wear a Bowtie!
05-03-2012, 05:39 PM #2Try injector cleaner and then a plug change if that does not help. I have had good results with Lucas products and I it did more good than the Sea Foam treatment did.
2000 GMC YUKON SLT, 5.3L tow pkg, G80 rear/w 3.73 gear
05-03-2012, 05:55 PM #3I would have the alternator checked out. I was having a similar issue with my 03 and it turned out to be the alternator and battery.
1995 Silverado 4x4
6" BDS Suspension Lift-3" Body Lift-Add A Leaf in rear -Trailmaster SSV Shocks-Duel Steering Stabilizer Kit -AirAid Cold air intake-
4.56 Gears with Detroit Auburn Locker-Pro-Comp Traction Bars with duel shocks-Aluminum Skid Plate Kit-38.5" x 16.5" Mickey Thompson Baja Claws-Constant Dropping fuel gauge
2005 Yukon XL Jet Power Programmer, Bilstein Shocks, Bilstein rear springs, Helwig Anti-sway bars, EGR Window Visors, EGR Hood Shield, Denali Headlights, Headlight harness upgrade, GE NightHawk Bulbs, White Night Rear lighting system http://www.gmtruckclub.com/forum/sho...5-GMC-Yukon-XL
2002 Silverado ext cab 2wd (Sold)
2003 Yukon XL (Totaled)
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Impact Instrumentation is pleased to announce the partnership with EMSA, Oklahoma's national leader in pre-hospital health care. EMSA has decided to equip their fleet of ambulances with the AEV® CPAP/Bi-Level ventilator from Impact®.


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Catalogue Number: 533-4158
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Recognised for the superb quality of their products, Telford Hot Water Cylinders are one of the biggest names in the industry. This Stainless Steel Unvented Horizontal Hot Water Cylinder is just one of the products that will show you the great craftsmanship that go into these builds.All of the domestic unvented cylinders are now formed from 2304 Duplex Stainless Steel. The Tornado units are finished with a wipe-clean, white coated steel casing, and only using some of the finest materials, the heat loss is cut down to a minimum making these units more economical to run.Telford are so confident about there Horizontal cylinder range that they are even offering a lifetime guarantee with them, as well as a 2 year guarantee on parts .Product Details...
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by Peachpit
This definitive guide shows readers how to exploit raw image formats using Adobe Photoshop Camera Raw.
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The definitive guide to mastering Photoshop's essential features, this award-winning guide has been completely updated for CS4
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The ultimate guide for getting the most from the new black and white conversion tools in Photoshop CS3 and Photoshop Lightroom!
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A truly unique guide to the creative side of Photoshop, showcasing phenomenal artwork by one of the world's best.
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This intermediate-level guide takes up where the Photoshop CS4, Volume 1: Visual QuickStart leaves off.


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Welcome to NCR. Our newsroom provides you with the latest news and information about our company. NCR's news releases and resources will keep you updated on NCR's business around the world. Use our resources area to help you filter for specific content or collateral by each of our industries.
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TNS is a global provider of
Data Communications and Interoperability Solutions
Transaction Network Services (TNS) is a leading global provider of data communications and interoperability solutions. By combining innovation, advanced technology, experience and service excellence, TNS delivers managed communications solutions to service providers and enterprises on a global scale. Thousands of companies from the retail, banking, financial markets and telecom industries count on TNS to build and manage their mission critical communications platforms, improving their ability to communicate and transact efficiently and effectively.
TNS operates some of the largest real-time community-based networks in the world, enabling industry participants to simply and securely interact and transact with other businesses, while connecting to the data and applications they need over highly available platforms.
Retail Business Technology Expo
TNS is exhibiting at the upcoming Retail Business Technology Expo (RBTE) event in London, UK. The event is being held at Earls Court from 11th March to 12th March.
To learn more about TNS' products and solutions, come by and see the team at stand number 524 or book an appointment by completing the form below. Click here for further details.