text:
See the 2010 TREATMENT GUIDELINES for the most recent treatment information.
Hepatitis C
On this Page
Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States; approximately 2.7 million persons are chronically infected (204). Although HCV is not efficiently transmitted sexually, persons at risk for infection through injection-drug use might seek care in STD treatment facilities, HIV counseling and testing facilities, correctional facilities, drug treatment facilities, and other public health settings where STD and HIV prevention and control services are available.
Persons newly infected with HCV typically are either asymptomatic or have a mild clinical illness. HCV RNA can be detected in blood within 1–3 weeks after exposure. The average time from exposure to antibody to HCV (anti-HCV) seroconversion is 8–9 weeks, and anti-HCV can be detected in >97% of persons by 6 months after exposure. Chronic HCV infection develops in 60%–85% of HCV-infected persons; 60%–70% of chronically infected persons have evidence of active liver disease. The majority of infected persons might not be aware of their infection because they are not clinically ill. However, infected persons serve as a source of transmission to others and are at risk for CLD or other HCV-related chronic diseases for decades after infection.
HCV is most efficiently transmitted through large or repeated percutaneous exposure to infected blood (e.g., through transfusion of blood from unscreened donors or through use of injecting drugs), although less efficient, occupational, perinatal, and sexual exposures also can result in transmission of HCV.
The role of sexual activity in the transmission of HCV has been controversial. Case-control studies have reported an association between acquiring HCV infection and exposure to a sex contact with HCV infection or exposure to multiple sex partners. Surveillance data also indicate that 15%–20% of persons reported with acute HCV infection have a history of sexual exposure in the absence of other risk factors (204,208). Case reports of acute HCV infection among HIV-positive MSM who deny injecting-drug use have indicated that this occurrence is frequently associated with other STDs (e.g., syphilis) (209,210). In contrast, a low prevalence (average: 1.5%) of HCV infection has been demonstrated in studies of long-term spouses of patients with chronic HCV infection who had no other risk factors for infection, and multiple published studies have demonstrated the prevalence of HCV infection among MSM who have not reported a history of injecting-drug use to be no higher than that of heterosexuals (211–213). Because sexual transmission of bloodborne viruses is more efficient among homosexual men compared with heterosexual men and women, the reason that HCV infection rates are not substantially higher among MSM compared with heterosexuals is unclear. Overall, these findings indicate that sexual transmission of HCV is possible but inefficient. Additional data are needed to determine whether sexual transmission of HCV might be increased in the context of HIV infection or other STDs.
Diagnosis and Treatment
Anti-HCV testing is recommended for routine screening of asymptomatic persons based on their risk for infection or based on a recognized exposure (see Hepatitis C, Prevention). For such persons, testing for HCV infection should include the use of an FDA-cleared test for antibody to HCV (i.e., immunoassay, EIA, or enhanced chemiluminescence assay and, if recommended, a supplemental antibody test) (214).
Persons counseled and tested for HCV infection and determined to be anti-HCV positive should be evaluated (by referral or consultation, if appropriate) for presence of active infection, presence or development of CLD, and for possible treatment. Reverse transcriptase polymerase chain reaction to detect HCV RNA may be used to confirm the diagnosis of current HCV infection, and an elevated alanine aminotrans-ferase (ALT) level is biochemical evidence of CLD. Combination therapy with pegylated interferon and ribavirin is the treatment of choice for patients with chronic hepatitis C. Because of advances in the field of antiviral therapy for acute and chronic hepatitis C, clinicians should consult with specialists knowledgeable about management of hepatitis C infection.
No vaccine for hepatitis C is available, and prophylaxis with immune globulin is not effective in preventing HCV infection after exposure. Reducing the burden of HCV infection and disease in the United States requires implementation of both primary and secondary prevention activities (208). Primary prevention reduces or eliminates HCV transmission; secondary prevention activities reduce liver and other chronic diseases in HCV-infected persons by identifying them and providing appropriate medical management and antiviral therapy, if appropriate.
Persons seeking care in STD clinics or other primary-care settings should be screened to identify those who should be offered HCV counseling and testing. In STD clinics and other settings that serve large numbers of persons at high risk for bloodborne infections (e.g., correctional settings), the major risk factor for which to screen for HCV infection is injection of illegal drugs. In addition, for clinical management issues, all persons with HIV infection should also be offered HCV counseling and testing. Other risk factors for which routine HCV testing is recommended include persons
- who had a blood transfusion or solid organ transplant before July 1992,
- who received clotting factor concentrates produced before 1987,
- who have been on long-term dialysis, and
- those with signs and symptoms of liver disease (e.g., abnormal ALT).
Persons who test positive for anti-HCV (see Diagnosis and Treatment) should be provided information regarding 1) how to protect their liver from further harm, 2) how to prevent transmission to others, and 3) the need for medical evaluation for CLD and possible treatment.
- To protect their liver from further harm, HCV-positive persons should be advised to avoid alcohol and taking any new medicines (including OTC and herbals) without checking with their doctor.
- To reduce the risk for transmission to others, HCV-positive persons should be advised to 1) not donate blood, body organs, other tissue, or semen; 2) not share any personal items that might have blood on them (e.g., toothbrushes and razors); and 3) cover cuts and sores on the skin to keep from spreading infectious blood or secretions. HCV-positive persons with one long-term, steady sex partner do not need to change their sexual practices. They should discuss the low but present risk for transmission with their partner and discuss the need for counseling and testing. HCV-positive women do not need to avoid pregnancy or breastfeeding.
- HCV-positive persons should be evaluated (by referral or consultation, if appropriate) for presence of development of CLD, including assessment of liver function tests, assessment for severity of liver disease and possible treatment, and determination of the need for hepatitis A and B vaccination.
Persons who test negative for anti-HCV who had an exposure previously should be reassured that they are not infected.
Regardless of test results, persons who use or inject illegal drugs should be counseled to
- stop using and injecting drugs;
- enter and complete substance abuse treatment, including relapse prevention;
- take the following steps to reduce personal and public health risks, if
they continue to inject drugs:
- never reuse or share syringes, water, or drug preparation equipment;
- use only syringes obtained from a reliable source (e.g., pharmacies);
- use a new, sterile syringe to prepare and inject drugs;
- if possible, use sterile water to prepare drugs; otherwise, use clean water from a reliable source (e.g., fresh tap water);
- use a new or disinfected container ("cooker") and a new filter ("cotton") to prepare drugs;
- clean the injection site before injection with a new alcohol swab;
- safely dispose of syringes after one use; and
- get vaccinated for hepatitis A and B.
Postexposure Follow-Up
No PEP has been demonstrated to be effective against HCV. Testing to determine whether HCV infection has developed is recommended for health-care workers after percutaneous or permucosal exposures to HCV-positive blood and for children born to HCV-positive women.
Special Considerations
Routine testing for HCV infection is not recommended for all pregnant women. Pregnant women with a known risk factor for HCV infection should be offered counseling and testing. Patients should be advised that approximately five of every 100 infants born to HCV-infected woman become infected. This infection occurs predominantly during or near delivery, and no treatment or delivery method is known to decrease this risk. The risk is increased by the presence of maternal HCV viremia at delivery and also is greater (2–3 times) if the woman is coinfected with HIV. Breastfeeding does not appear to transmit HCV, although HCV-positive mothers should consider abstaining from breastfeeding if their nipples are cracked or bleeding. Infants born to HCV-positive mothers should be tested for HCV infection and, if positive, evaluated for the presence of CLD.
Because of the high prevalence of HIV/HCV coinfection and because of critical
clinical management issues for coinfected persons, all HIV-infected persons
should be tested for HCV. Because a small percentage of coinfected persons
fail to acquire HCV antibodies,
HCV RNA should be tested in HIV-positive persons with unexplained liver
disease who are anti-HCV negative. The course of liver disease is more
rapid in HIV/HCV coinfected persons, and the risk for cirrhosis is nearly
that in persons with HCV infection alone. Treatment of HCV in coinfected
persons might improve tolerance to highly active antiretroviral therapy
(HAART) for HIV infection because of the increased risk for hepatotoxicity
from HAART with HCV infection. However, anti-HCV treatment in coinfected
persons is still investigational, and based on ongoing clinical trials,
more data are needed to determine the best regimens.
Contact Us:
- Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333 - 800-CDC-INFO
TTY: (888) 232-6348 - Contact CDC-INFO


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David Tomlinson, PGA
Main Address:
Swamp Fox Golf Club
193 Golf Rd
Greeleyville, SC 29056-9114
(843) 382-3436
193 Golf Rd
Greeleyville, SC 29056-9114
(843) 382-3436
David Tomlinson is a PGA Professional in Greeleyville, SC. The PGA of America comprises 27,000 men and women professionals with one singular goal in mind - to make the game of golf more enjoyable for you.
Services Offered:
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Professional has not entered award information.
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text:
Game over man by Jack Teagle.
Now available in grey,and to 'celebrate' we're going to give one away in a either white or grey.
Just REBLOG (THIS) TO WIN and in a couple of days we will pick one winner (maybe even two if we get enough posts) who'll get one of these sent out to them, anywhere in the whole big bad world.
Get Reblogging. Good luck. All that stuff.
this episode fucked me up.


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text: Malachy McCourt is a writer and actor who has had numerous featured roles on stage, television, and screen, including such films as The Devil's Own, She's the One, and Bonfire of the Vanities. He is happily married, the father of five children, and the grandfather of three. He lives in New York City.


text:
Quick Facts
- NAME: Gordon Gould
- OCCUPATION: Physicist
- BIRTH DATE: July 17, 1920
- DEATH DATE: September 16, 2005
- EDUCATION: Union College, Yale University
- PLACE OF BIRTH: New York, New York
- PLACE OF DEATH: New York, New York
Best Known For
Gordon Gould contributed to the invention of a Laser that uses visible light and the first use of the acronym LASER, in 1959.
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"." 2014. The Biography Channel website. Mar 12 2014, 01:39 http://www.biography.com/people/gordon-gould-9316783.
"," The Biography Channel website, 2014, http://www.biography.com/people/gordon-gould-9316783 [accessed Mar 12, 2014].
"," The Biography Channel website, http://www.biography.com/people/gordon-gould-9316783 (accessed Mar 12, 2014).
[Internet]. The Biography Channel website; 2014 [cited 2014 Mar 12] Available from: http://www.biography.com/people/gordon-gould-9316783.
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. The Biography Channel website. 2014. Available at: http://www.biography.com/people/gordon-gould-9316783. Accessed Mar 12, 2014.
Native New Yorker and physicist Gordon Gould, born in 1920, garnered fame for his work on the visible light laser and the first use of the acronym, LASER, along with the subsequent battle for its patent. Although it took Gould nearly 30 years to win his patent battles, in the end the significant expansion of lasers meant his later patents became much more valuable than the original.
But certainly the laser proved to be what I realized it was going to be. At that moment in my life I was too ignorant in business law to be able to do it right, and if I did it over again probably the same damn thing would happen.
Early Life and Work
Physicist, inventor and manufacturer Gordon Gould was born on July 17, 1920, in New York City, New York. He studied at Union College in New York before completing graduate work in physics at Yale. He later left to work on the atomic bomb for the Manhattan Project during World War II.
Developing the LASER
In his post-war years, he worked for various private engineering firms while teaching at different institutions, including City College of New York (1947–'54), Columbia University (1954–'57) and Brooklyn Polytechnic Institute (1967–'74). While working at Columbia with Charles Townes and others, he contributed to the development of the laser. He would claim greater credit for the laser than others have been willing to grant him, but he was named inventor of the year in 1978 by the Patent Office Society for his laser amplifier.
Later Years and Death
He also held patents on many of the laser devices used for industrial and medical applications. In 1974 he founded Optelecom Inc, which specializes in optical communications, retiring from the firm in 1985. Gould died on September 20, 2005, in Manhattan at age 85.
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Best meal I ever ate:
Most amazing: French Laundry
My current drink of choice:
Great Lakes Blackout Stout
I really wish I could:
Eat for a living :)
My favorite comfort food:
My top 5 favorite restaurants:
Too many - just can't list like that!
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By Michael Gioia
05 Oct 2012
The 5 PM event, which will also be live-streamed at TheGreenSpace.org, features Rob McClure, who leads the cast as Charlie Chaplin; Jenn Colella, who stars as gossip columnist Hedda Hopper; and Tony Award winner Thomas Meehan, who co-wrote the musical's book alongside Christopher Curtis.
Here's how the new Broadway musical is characterized: "From the slums of London to the heights of Hollywood, Chaplin is the showbiz Broadway musical about the silent film legend the world couldn't stop talking about – Charlie Chaplin. The brand new 24-person musical reveals the man behind the legend, the undeniable genius that forever changed the way America went to the movies."


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Quality keeps coming for Sky Sports customers
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Check out all the latest transfer news
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Sunderland's Steven Fletcher is hoping he can soon recapture his goal-scoring touch after returning from injury.
Sunderland boss Gus Poyet believes Steven Fletcher's injury problems have been the reason behind his struggle for form.
Sunderland striker Steven Fletcher is in a race to be fit for the Capital One Cup final against Manchester City.
Gus Poyet is still hoping Sunderland striker Steven Fletcher will be fit for the Capital One Cup final in March.
Sunderland boss Gus Poyet admits Steven Fletcher's Achilles injury is a cause for concern as surgery may be required.
Gus Poyet has explained Steven Fletcher's initial absence as Sunderland battled back for a point against Southampton.
Sky sources understand that Sunderland are yet to receive a bid for Steven Fletcher.
Celtic manager Neil Lennon has rebuffed speculation linking the club with Scotland international Steven Fletcher.
Gus Poyet is sure Steven Fletcher can get the goals to haul Sunderland out of trouble.
Steven Fletcher was happy to get on the Sunderland scoresheet once again as he aims to fire the Black Cats to safety.
Gus Poyet says Steven Fletcher needs more ammunition from his team-mates as he chases his first goal in eight matches.
Sunderland striker Steven Fletcher says that he expects to score more goals for the club.
Steven Fletcher says belief and confidence have been returned to the Sunderland squad under manager Gus Poyet.
Scotland boss Gordon Strachan has confirmed goalkeeper Matt Gilks has pulled out of the squad to face Norway.
Sunderland boss Gus Poyet has backed Steven Fletcher to go on a goalscoring run once he is back to full fitness.
Kilmarnock striker Kris Boyd has been pleasantly surprised at his recall to the Scotland squad.
Scotland defender Grant Hanley reckons confidence is prevalent throughout the squad since Gordon Strachan's arrival.
Steven Fletcher has praised Jozy Altidore and is confident that his Sunderland team-mate will soon start scoring.
Gordon Strachan says there is no need to rush Sunderland striker Steven Fletcher back into the Scotland team.
Steven Fletcher hopes the victory over local rivals Newcastle has repaid the Sunderland fans for sticking by the team.
Watch every goal from every game in the Football League


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text:
Stage I Testicular Cancer
Stage I Seminoma
Stage I Nonseminoma
Current Clinical Trials
Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)
Stage I SeminomaStage I seminoma has a cure rate of greater than 95% regardless of whether or not postorchiectomy adjuvant therapy is given.
Standard treatment options:
- Radical inguinal orchiectomy with no retroperitoneal node radiation therapy followed by periodic determination of serum markers, chest x-rays, and computed tomographic (CT) scans of the abdomen and pelvis (surveillance). These studies are typically performed every 4 months for the first 3 years, then every 6 months for 3 years, and then annually for an additional 4 years.
Results of multiple clinical series, including more than 1,200 patients with stage I seminoma managed by postorchiectomy surveillance, have been reported.[1-8] The overall 10-year tumor recurrence rate is 15% to 20%, and nearly all patients whose disease recurred were cured by radiation therapy or chemotherapy. Thus, the overall cure rate is indistinguishable from that achieved with adjuvant radiation therapy or carboplatin chemotherapy. Relapses after 5 years are unusual but can occur in as many as 4% of patients.[5] Independent risk factors for relapse include tumor size greater than 4 cm and invasion of the rete testis.[1] The 5-year risk of relapse is about 10% without either risk factor, 16% with one risk factor, and 32% with both risk factors.
- Radical inguinal orchiectomy followed by either one or two doses of carboplatin adjuvant therapy.
In a large randomized controlled equivalency trial comparing para-aortic (or dog-leg field, if clinically indicated) radiation to a single dose of carboplatin (concentration-versus-time curve [AUC] × 7) after radical inguinal orchiectomy, relapse-free survival (RFS) and overall survival (OS) rates were equivalent after a median follow-up of 4 years.[9][Level of evidence: 1iiA][10] Three-year RFS was 94.8% with carboplatin versus 95.9% with radiation therapy. In this trial, AUC dosing was based on radioisotope measurement of glomerular filtration rate; dosing based on calculations of creatinine clearance is not equivalent, has not been validated in this setting, and is discouraged.
Phase II studies, including several with more than 4 years median follow-up, have consistently reported lower relapse rates (0%–3.3%) when two doses of carboplatin were administered either 3 or 4 weeks apart and dosed either at 400 mg/m2 or at an AUC of 7.[2,3,11-15] Administration of two doses of carboplatin has never been compared to a single dose nor to radiation therapy in a randomized trial.
- Removal of the testicle via radical inguinal orchiectomy followed by radiation therapy is an approach that is associated with a 5-year relapse-free survival of 95% to 96% and a 5-year disease-specific survival in excess of 99% in multiple large series and randomized controlled trials.[16-22]
Two treatment fields are commonly used: a para-aortic strip covering the retroperitoneal nodes or a dog-leg field that includes the ipsilateral iliac lymph nodes as well as the retroperitoneum. The dose ranges from 20 Gy to 26 Gy. Relapse rates and toxic effects were studied in a randomized comparison of para-aortic radiation therapy alone versus para-aortic radiation therapy with an added ipsilateral iliac lymph node field.[18] Three-year RFS rates were virtually identical (96% vs. 96.6%) as were OS rates (99.3% vs. 100%). Pelvic RFS rates were 98.2% versus 100%; the 95% confidence interval (CI) for the difference in pelvic RFS rates was 0% to 3.7%. A statistically significant increase was observed in leukopenia and diarrhea associated with the ipsilateral iliac radiation therapy. In a randomized trial (MRC-TE18), radiation to 20 Gy over 10 daily fractions was clinically equivalent to 30 Gy over 15 fractions after a median follow-up of 61 months in both RFS and OS. Patient-reported lethargy and ability to perform normal work were better in the lower-dose regimen.[19][Level of evidence: 1iiA]
Stage I nonseminoma is highly curable (>99%). Orchiectomy alone will cure about 70% of patients but the remaining 30% will relapse and require additional treatment. The relapses are highly curable, and thus post-orchiectomy surveillance is a standard treatment option, but some physicians and patients prefer to reduce the risk of relapse by having the patient undergo either a retroperitoneal lymph node dissection (RPLND) or one or two cycles of chemotherapy. Each of these three approaches has unique advantages and disadvantages, and none has been shown to result in longer survival or superior quality of life.
Standard treatment options:
- Radical inguinal orchiectomy followed by a regular and frequent surveillance schedule.
Typically, patients are seen monthly during the first year, every 2 months during the second year, every 3 months during the third year, every 4 months during the fourth year, every 6 months during the fifth year, and annually for the subsequent 5 years.[23-25] At each visit, the history is reviewed, a physical examination is given, determination of serum markers are performed, and a chest x-ray is obtained (sometimes at alternating visits). An additional key aspect of surveillance involves abdominal or abdominopelvic CT scans, but the preferred frequency of such scans is controversial.
A randomized controlled trial (MRC-TE08) compared a schedule that used only two scans at 3 months and 12 months to a schedule that used five scans at 3, 6, 9, 12 and 24 months.[26] With over 400 randomly assigned patients and a median follow-up of 40 months, all relapsing patients had either good- or intermediate-risk disease, and there were no differences in the stage or extent of disease at relapse between the two arms. No deaths were reported. Nonetheless, some organizations recommend CT scans every 3 to 4 months during the first 3 years of follow-up and continuing but less-frequent CT scans thereafter. While this study would appear to indicate that scans at 3 and 12 months are adequate during the first year, longer follow-up will be needed to assess whether discontinuing scans after 12 months is safe.[26][Level of evidence: 1iiA] With regard to chest imaging, disease recurrence is rarely detected by chest x-ray alone, so chest x-ray may play little or no role in routine surveillance but is nonetheless included in the mainstream surveillance schedules.[23]
The need for long-term follow-up has not been adequately investigated. Surveillance series with long follow-up have reported that fewer than 1% of clinical stage I patients relapse after 5 years.[27,28] Late relapses often occur in the retroperitoneum when they do occur. Hence, some schedules discontinue CT scans after 12 months, while others recommend at least annual scans for 10 years.
The option of a radical inguinal orchiectomy followed by a regular and frequent surveillance schedule should be considered only if:
- CT scan and serum markers are negative.
- The patient accepts the need for and commits to frequent surveillance visits. Children are adequately followed by serum markers alpha-fetoprotein (AFP), chest x-rays, and clinical examination.[29]
- The physician accepts responsibility for seeing that a follow-up schedule is maintained as noted.
- Removal of the testicle through the groin followed (in adults) by RPLND.
A nerve-sparing RPLND that preserves ejaculation in virtually every patient has been described in clinical stage I patients and appears to be as effective as the standard RPLND.[30-32] Surgery should be followed by monthly determination of serum markers and chest x-rays for the first year and every other month determinations for the second year.[23]
Men undergoing RPLND who are found to have pathological stage I disease have a roughly 10% risk of relapsing subsequently, whereas men with pathological stage II disease (i.e., those who are found to have lymph node metastases at RPLND) have as much as a 50% risk of relapse without further treatment.[33]Two cycles of post-RPLND chemotherapy using either bleomycin, etoposide, and cisplatin (BEP) or etoposide plus cisplatin (EP) lowers the risk of relapse in men with pathological stage II disease to about 1%.[34,35] The vast majority of reported patients in studies of RPLND underwent the operation at a center of excellence with a urological surgeon who had performed hundreds of such operations. The ability of less-experienced urologists to achieve similar results is unknown.
In patients with pathologic stage I disease after RPLND, the presence of lymphatic or venous invasion or a predominance of embryonal carcinoma in the primary tumor appears to predict for relapse.[36-38] In a large Testicular Cancer Intergroup Study, the relapse rate among men with pathological stage I disease was 19% in those with vascular invasion versus 6% in those without vascular invasion. One study reported that the relapse rate for men with pathological stage I disease was 21.2% (18 of 85 men relapsed) if their tumors were predominantly embryonal carcinoma and 29% if there was a predominance of embryonal carcinoma plus lymphovascular invasion, versus 3% (5 of 141 men relapsed) if there was not a predominance of embryonal carcinoma.[36,37]
Among pathological stage II patients, the relapse rate was 32% among men with embryonal carcinoma-predominant tumors compared with15.6% in the other stage II patients. The risk of metastatic disease (i.e., either pathological stage II disease or relapsed pathological stage I disease) in men with tumors showing a predominance of embryonal carcinoma plus lymphovascular invasion was 62% compared with 16% in men with neither risk factor.
These data have shown that high-risk patients undergoing RPLND have a substantial risk of subsequently receiving chemotherapy. Data from one institution have shown that about half of men with stage I pure embryonal carcinoma undergoing RPLND will subsequently receive cisplatin-based chemotherapy.[39]
Retroperitoneal dissection of lymph nodes is not helpful in the management of children, and potential morbidity of the surgery is not justified by the information obtained.[29] In men who have undergone RPLND, chemotherapy is employed immediately on first evidence of recurrence.
- Adjuvant therapy consisting of one or two courses of BEP chemotherapy in patients with clinical stage I disease.
A randomized controlled trial compared a single cycle of BEP chemotherapy to RPLND in 382 patients. The 2-year recurrence-free survival rates were 99.5% with chemotherapy versus 91.9% with RPLND (absolute difference = 7.6%; 95% confidence interval, 3.1%–12.1%). There were no treatment-related or cancer-specific deaths in either arm of the study.[40]
A Swedish and Norwegian study reported results of a risk-adapted therapy protocol in which patients with nonseminomas with lymphovascular invasion underwent postorchiectomy chemotherapy with one or two cycles of BEP chemotherapy, while those without lymphovascular invasion underwent either surveillance or a single cycle of BEP.[41] The study included 745 patients and, with a median follow-up of 4.7 years and 2-year follow-up of 89% of patients, there were no deaths from testicular cancer, although one patient died of a stroke immediately after completing chemotherapy for relapsed disease. Overall survival and cause-specific survival were 98.9% and 99.9%, respectively. Both of these studies were conducted at community-based hospitals and demonstrated that postorchiectomy chemotherapy could be delivered at a regional or national level without depending on centers of excellence.
Several phase II studies and case series reporting the results after two cycles of BEP in intermediate- or high-risk patients have reported relapse rates ranging from 0% to 4% (average = 2.4%).[42] Fewer than 1% of patients in these series died of testicular cancer. While chemotherapy produces the lower relapse rate and a comparable disease-specific survival rate compared to RPLND or surveillance, it is unknown whether a brief course of chemotherapy results in late toxicity or an increased risk of late relapse. Longer follow-up is awaited.
There is no consensus about the optimal management of men with stage I nonseminomas, but each of the three strategies above produces a disease-specific survival rate of about 99%. Some clinicians have advocated a risk-adapted approach such that low-risk patients undergo surveillance, while others undergo either RPLND or chemotherapy. The goal of such an approach is to minimize the side effects of treatment, but risk-adapted therapy has never been demonstrated to result in better outcomes. Some experts prefer a surveillance strategy generally so as to minimize unnecessary treatment. Others prefer RPLND to obtain more accurate staging, to reduce the risk of needing chemotherapy (and hence chemotherapy's side effects and toxicity) and to, theoretically, reduce the risk of late relapse. At the same time, many experts reject RPLND as insufficiently effective at lowering relapse rates and prefer chemotherapy. Surveillance and chemotherapy have been tested at the regional and national level with excellent results, whereas the limited data concerning RPLND in the regional setting have shown higher than expected in-field relapse rates but no deaths.[40,41]
With regard to risk stratification, data suggest that relapse rates are higher in patients with histologic evidence of lymphatic or venous invasion or a predominance of embryonal carcinoma.[17,27,36,37,43] Tumors that consist of mature teratoma appear to have a lower relapse rate.[44]
Current Clinical TrialsCheck for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I malignant testicular germ cell tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
References- Warde P, Specht L, Horwich A, et al.: Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 20 (22): 4448-52, 2002. [PUBMED Abstract]
- Aparicio J, García del Muro X, Maroto P, et al.: Multicenter study evaluating a dual policy of postorchiectomy surveillance and selective adjuvant single-agent carboplatin for patients with clinical stage I seminoma. Ann Oncol 14 (6): 867-72, 2003. [PUBMED Abstract]
- Aparicio J, Germà JR, García del Muro X, et al.: Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol 23 (34): 8717-23, 2005. [PUBMED Abstract]
- Choo R, Thomas G, Woo T, et al.: Long-term outcome of postorchiectomy surveillance for Stage I testicular seminoma. Int J Radiat Oncol Biol Phys 61 (3): 736-40, 2005. [PUBMED Abstract]
- Chung P, Parker C, Panzarella T, et al.: Surveillance in stage I testicular seminoma - risk of late relapse. Can J Urol 9 (5): 1637-40, 2002. [PUBMED Abstract]
- Daugaard G, Petersen PM, Rørth M: Surveillance in stage I testicular cancer. APMIS 111 (1): 76-83; discussion 83-5, 2003. [PUBMED Abstract]
- Horwich A, Alsanjari N, A'Hern R, et al.: Surveillance following orchidectomy for stage I testicular seminoma. Br J Cancer 65 (5): 775-8, 1992. [PUBMED Abstract]
- von der Maase H, Specht L, Jacobsen GK, et al.: Surveillance following orchidectomy for stage I seminoma of the testis. Eur J Cancer 29A (14): 1931-4, 1993. [PUBMED Abstract]
- Oliver RT, Mason MD, Mead GM, et al.: Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 366 (9482): 293-300, 2005 Jul 23-29. [PUBMED Abstract]
- Oliver RT, Mead GM, Rustin GJ, et al.: Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol 29 (8): 957-62, 2011. [PUBMED Abstract]
- Dieckmann KP, Brüggeboes B, Pichlmeier U, et al.: Adjuvant treatment of clinical stage I seminoma: is a single course of carboplatin sufficient? Urology 55 (1): 102-6, 2000. [PUBMED Abstract]
- Krege S, Kalund G, Otto T, et al.: Phase II study: adjuvant single-agent carboplatin therapy for clinical stage I seminoma. Eur Urol 31 (4): 405-7, 1997. [PUBMED Abstract]
- Oliver RT, Boublikova L, Ong J, et al.: Fifteen year follow up of the Anglian Germ Cell Cancer Group adjuvant studies of carboplatin as an alternative to radiation or surveillance for stage I seminoma. [Abstract] Proceedings of the American Society of Clinical Oncology 20: A-780, 196a, 2001.
- Reiter WJ, Brodowicz T, Alavi S, et al.: Twelve-year experience with two courses of adjuvant single-agent carboplatin therapy for clinical stage I seminoma. J Clin Oncol 19 (1): 101-4, 2001. [PUBMED Abstract]
- Steiner H, Höltl L, Wirtenberger W, et al.: Long-term experience with carboplatin monotherapy for clinical stage I seminoma: a retrospective single-center study. Urology 60 (2): 324-8, 2002. [PUBMED Abstract]
- Bamberg M, Schmidberger H, Meisner C, et al.: Radiotherapy for stages I and IIA/B testicular seminoma. Int J Cancer 83 (6): 823-7, 1999. [PUBMED Abstract]
- Classen J, Schmidberger H, Meisner C, et al.: Para-aortic irradiation for stage I testicular seminoma: results of a prospective study in 675 patients. A trial of the German testicular cancer study group (GTCSG). Br J Cancer 90 (12): 2305-11, 2004. [PUBMED Abstract]
- Fosså SD, Horwich A, Russell JM, et al.: Optimal planning target volume for stage I testicular seminoma: A Medical Research Council randomized trial. Medical Research Council Testicular Tumor Working Group. J Clin Oncol 17 (4): 1146, 1999. [PUBMED Abstract]
- Jones WG, Fossa SD, Mead GM, et al.: Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I Testicular Seminoma: a report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328). J Clin Oncol 23 (6): 1200-8, 2005. [PUBMED Abstract]
- Logue JP, Harris MA, Livsey JE, et al.: Short course para-aortic radiation for stage I seminoma of the testis. Int J Radiat Oncol Biol Phys 57 (5): 1304-9, 2003. [PUBMED Abstract]
- Oliver RT, Mason M, Von der Masse H, et al.: A randomised comparison of single agent carboplatin with radiotherapy in the adjuvant treatment of stage I seminoma of the testis, following orchidectomy: MRC TE19/EORTC 30982. [Abstract] J Clin Oncol 22 (Suppl 14): A-4517, 386, 2004.
- Santoni R, Barbera F, Bertoni F, et al.: Stage I seminoma of the testis: a bi-institutional retrospective analysis of patients treated with radiation therapy only. BJU Int 92 (1): 47-52; discussion 52, 2003. [PUBMED Abstract]
- van As NJ, Gilbert DC, Money-Kyrle J, et al.: Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse. Br J Cancer 98 (12): 1894-902, 2008. [PUBMED Abstract]
- Krege S, Beyer J, Souchon R, et al.: European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): part I. Eur Urol 53 (3): 478-96, 2008. [PUBMED Abstract]
- National Comprehensive Cancer Network.: NCCN Clinical Practice Guidelines in Oncology: Testicular Cancer. Version 2.2009. Fort Washington, PA: National Comprehensive Cancer Network, 2009. Available online. Last accessed October 25, 2013.
- Rustin GJ, Mead GM, Stenning SP, et al.: Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197--the National Cancer Research Institute Testis Cancer Clinical Studies Group. J Clin Oncol 25 (11): 1310-5, 2007. [PUBMED Abstract]
- Colls BM, Harvey VJ, Skelton L, et al.: Late results of surveillance of clinical stage I nonseminoma germ cell testicular tumours: 17 years' experience in a national study in New Zealand. BJU Int 83 (1): 76-82, 1999. [PUBMED Abstract]
- Shahidi M, Norman AR, Dearnaley DP, et al.: Late recurrence in 1263 men with testicular germ cell tumors. Multivariate analysis of risk factors and implications for management. Cancer 95 (3): 520-30, 2002. [PUBMED Abstract]
- Huddart SN, Mann JR, Gornall P, et al.: The UK Children's Cancer Study Group: testicular malignant germ cell tumours 1979-1988. J Pediatr Surg 25 (4): 406-10, 1990. [PUBMED Abstract]
- Foster RS, McNulty A, Rubin LR, et al.: The fertility of patients with clinical stage I testis cancer managed by nerve sparing retroperitoneal lymph node dissection. J Urol 152 (4): 1139-42; discussion 1142-3, 1994. [PUBMED Abstract]
- Donohue JP: Evolution of retroperitoneal lymphadenectomy (RPLND) in the management of non-seminomatous testicular cancer (NSGCT). Urol Oncol 21 (2): 129-32, 2003 Mar-Apr. [PUBMED Abstract]
- Heidenreich A, Albers P, Hartmann M, et al.: Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the German Testicular Cancer Study Group. J Urol 169 (5): 1710-4, 2003. [PUBMED Abstract]
- Williams SD, Stablein DM, Einhorn LH, et al.: Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med 317 (23): 1433-8, 1987. [PUBMED Abstract]
- Behnia M, Foster R, Einhorn LH, et al.: Adjuvant bleomycin, etoposide and cisplatin in pathological stage II non-seminomatous testicular cancer. the Indiana University experience. Eur J Cancer 36 (4): 472-5, 2000. [PUBMED Abstract]
- Kondagunta GV, Sheinfeld J, Mazumdar M, et al.: Relapse-free and overall survival in patients with pathologic stage II nonseminomatous germ cell cancer treated with etoposide and cisplatin adjuvant chemotherapy. J Clin Oncol 22 (3): 464-7, 2004. [PUBMED Abstract]
- Hermans BP, Sweeney CJ, Foster RS, et al.: Risk of systemic metastases in clinical stage I nonseminoma germ cell testis tumor managed by retroperitoneal lymph node dissection. J Urol 163 (6): 1721-4, 2000. [PUBMED Abstract]
- Sweeney CJ, Hermans BP, Heilman DK, et al.: Results and outcome of retroperitoneal lymph node dissection for clinical stage I embryonal carcinoma--predominant testis cancer. J Clin Oncol 18 (2): 358-62, 2000. [PUBMED Abstract]
- Sesterhenn IA, Weiss RB, Mostofi FK, et al.: Prognosis and other clinical correlates of pathologic review in stage I and II testicular carcinoma: a report from the Testicular Cancer Intergroup Study. J Clin Oncol 10 (1): 69-78, 1992. [PUBMED Abstract]
- Stephenson AJ, Bosl GJ, Bajorin DF, et al.: Retroperitoneal lymph node dissection in patients with low stage testicular cancer with embryonal carcinoma predominance and/or lymphovascular invasion. J Urol 174 (2): 557-60; discussion 560, 2005. [PUBMED Abstract]
- Albers P, Siener R, Krege S, et al.: Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I Nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group. J Clin Oncol 26 (18): 2966-72, 2008. [PUBMED Abstract]
- Tandstad T, Dahl O, Cohn-Cedermark G, et al.: Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: the SWENOTECA management program. J Clin Oncol 27 (13): 2122-8, 2009. [PUBMED Abstract]
- Choueiri TK, Stephenson AJ, Gilligan T, et al.: Management of clinical stage I nonseminomatous germ cell testicular cancer. Urol Clin North Am 34 (2): 137-48; abstract viii, 2007. [PUBMED Abstract]
- Heidenreich A, Sesterhenn IA, Mostofi FK, et al.: Prognostic risk factors that identify patients with clinical stage I nonseminomatous germ cell tumors at low risk and high risk for metastasis. Cancer 83 (5): 1002-11, 1998. [PUBMED Abstract]
- Alexandre J, Fizazi K, Mahé C, et al.: Stage I non-seminomatous germ-cell tumours of the testis: identification of a subgroup of patients with a very low risk of relapse. Eur J Cancer 37 (5): 576-82, 2001. [PUBMED Abstract]


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17 CFR 275.204(b)-1 - Reporting by investment advisers to private funds.
Reporting by investment advisers to private funds on Form PF.
If you are an investment adviser registered or required to be registered under section 203 of the Act (15 U.S.C. 80b-3), you act as an investment adviser to one or more private funds and, as of the end of your most recently completed fiscal year, you managed private fund assets of at least $150 million, you must complete and file a report on Form PF (17 CFR 279.9) by following the instructions in the Form, which specify the information that an investment adviser must provide. Your initial report on Form PF is due no later than the last day on which your next update would be timely in accordance with paragraph (e) if you had previously filed the Form; provided that you are not required to file Form PF with respect to any fiscal quarter or fiscal year ending prior to the date on which your registration becomes effective.
Electronic filing.
You must file Form PF electronically with the Form PF filing system on the Investment Adviser Registration Depository (IARD).
Note to paragraph (b):
Information on how to file Form PF is available on the Commission's Web site at
When filed.
Each Form PF is considered filed with the Commission upon acceptance by the Form PF filing system.
Filing fees.
You must pay the operator of the Form PF filing system a filing fee as required by the instructions to Form PF. The Commission has approved the amount of the filing fee. No portion of the filing fee is refundable. Your completed Form PF will not be accepted by the operator of the Form PF filing system, and thus will not be considered filed with the Commission, until you have paid the filing fee.
More frequently, if required by the instructions to Form PF. You must file all updated reports electronically with the Form PF filing system.
If you have unanticipated technical difficulties that prevent you from submitting Form PF on a timely basis through the Form PF filing system, you may request a temporary hardship exemption from the requirements of this section to file electronically.
Complete and file in paper format, in accordance with the instructions to Form PF, Item A of Section 1a and Section 5 of Form PF, checking the box in Section 1a indicating that you are requesting a temporary hardship exemption, no later than one business day after the electronic Form PF filing was due; and
Submit the filing that is the subject of the Form PF paper filing in electronic format with the Form PF filing system no later than seven business days after the filing was due.
The temporary hardship exemption will be granted when you file Item A of Section 1a and Section 5 of Form PF, checking the box in Section 1a indicating that you are requesting a temporary hardship exemption.
Assets under management means the regulatory assets under management as determined under Item 5.F of Form ADV (§ 279.1 of this chapter).
Private fund assets means the investment adviser's assets under management attributable to private funds.
[76 FR 71174, Nov. 16, 2011]
Title 17 published on 2013-04-01
no entries appear in the Federal Register after this date.


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Shin Megami Tensei Persona (PSP)
Manufacturer: Atlus Part number: PS-60009-0
$59.90 at 1 online store
- CNET Editor rating: Not yet rated
- Average user rating: 0 stars No reviews, write one!
- More product information:
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- Description:
- The rumor around St. Hermelin High is that by playing the "Persona" game, you can get a glimpse of your future self. When the protagonist and his friends try it out on a lark, nothing seems to happen. But then the protagonist and his friends all share a common dream after blacking out, in which they meet a mysterious man ... Read more
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| In stock Get free shipping on orders over $35.00 | Enter zip code to get total price: Price +Tax +Shipping =Total price | as of 03/16/2014 |
*Total price for the Shin Megami Tensei Persona (PSP) are estimated and may vary slightly based on exact tax, shipping, manufacturer rebate or any sale/promotion on the merchant site.


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Vivitar 58mm Neutral Density Filter
Ways to Save
Why Adorama?
Easy Returns, Fast Shipping, Trusted for over 35 years.Need help? Call 800-223-2500 212-741-0052
Get the best value shopping our selection of used gear.
Shop UsedWe Pay top dollar for your used photo & video equipment.
Get A QuoteNeed help? Call 800-223-2500 212-741-0052
The Vivitar 58mm Neutral Density Filter is manufactured from high-quality solid optical materials. The filter is heat-treated to avoid any rare movement or distortion. The ND8 filter allows you to shoot 4 F-stops lower in brightly lit conditions.
This Neutral Density filter reduces intensity of all wavelengths or colors of light equally, giving no changes in hue or color rendition. The purpose of standard photographic neutral density filters is to allow the photographer greater flexibility to change the aperture, exposure time and/or blur of subject in different situations and atmospheric conditions. Instead of reducing the aperture to limit light, the photographer can add a ND filter to limit light and can then set the shutter speed according to the particular motion desired and the aperture set as needed.
Filter Size | 58mm |


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UNCA announces:
Read the full article
Registration is now open for UNC Asheville's Super Saturday program for creative, highly motivated and/or academically gifted students in grades 3-8. Classes begin on March 17, with topics including chess, photography, wildlife exploration, creative writing, foreign language, theatre, and martial arts. More than 12,000 children from across Western North Carolina have explored their special interests through hands-on learning at Super Saturdays on the UNC Asheville campus.
The 22 courses offered range from "Spanish for Beginners" and "Sketchbooking," to "Art in Science, Science in Art" and "Improv for the Theatre." Budding scientists can explore plants, insects, and bones in "Icky Sticky Fun Biology," or lasers and holograms in "Physics is Phun." "World of Wildlife" and "Movie Making and Animation" are also likely to be popular.
Super Saturday classes are taught by UNC Asheville faculty members, upper-level students, experienced artists and other professionals.
Super Saturday classes meet from 9 a.m. to noon Saturdays from March 17-April 28. The mail-in registration deadline is March 9 and online registration closes March 11. Tuition is $69 for each six-week course. A limited number of need-based scholarships are available.
For more information or to register, call UNC Asheville's Cultural Events and Special Academic Programs at 828.251.6558 or visit the Super Saturday web page.
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It has been more than a hundred years since California wine pioneer Jean Laurent quarried stone from the base of Glass Mountain in Napa Valley to build his wine cellar. That cellar stands today and serves as both a literal and figurative link to the past and Laurent's guiding principles of quality and values.
Glass Mountain wines are crafted using a careful selection of choice grapes from the top winemaking regions to produce exceptional wines true to their character. The concept is driven by a simple philosophy – "Place Quality First."
Glass Mountain wines focus on rich, pure flavors of the best vineyards. Offered as a tremendous value wine for consumers, Glass Mountain represents a vision to provide quality wines at accessible prices, while delivering an outstanding value wine for your enjoyment.


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Can't wait for flowers to bloom and robins to chirp?
Since that's unlikely to happen any time soon, why not enjoy the great escape of music?
Musicians--instrumentalists and vocalists at the Nyack School of Music--have a wonderful selection of spring concerts scheduled, starting Tuesday, February 8 on the Rockland County campus in Nyack.
Admission for most events is free or a modest donation will be received to benefit upcoming programs.
Click here for a complete listing. For additional details, please phone the Music Office at 845.67.4687.


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This holiday shopping season, retailers are witnessing first-hand just how important mobile has become to their businesses.
And they're not alone. According to Nielsen's Social Media Report 2012, mobile is now crucial to social media as it is driving the growth of the most popular social networks.
Read more...
by Patricio Robles 04 December 2012 16:05pm 1 comment


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Early Bird Special
Customers who evolve before the Triassic get a free pair of wings (followed by extinction).Original release date: September 12, 2011
This design from the BustedTees Archive will be custom printed just for you and therefore cannot be returned or exchanged. It will also ship separately from other BustedTees products.
Unfortunately, no coupons may be applied to this item.


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1"Remember, in the month of Abib you must celebrate Passover to honor the Lord your God. It was that night in Abib when the Lord your God brought you out of Egypt. 2You must go to the place the Lord your God will choose to be the home for his name. There you must offer the Passover sacrifice to honor the Lord. You must offer the cattle and goats. 3Don't eat bread that has yeast in it with this sacrifice. You must eat unleavened bread for seven days. This bread is called 'Bread of Trouble.' It will help you remember the troubles you had in Egypt. Remember how quickly you had to leave that country. You must remember that day as long as you live. 4There must be no yeast in anyone's house anywhere in the country for seven days. And all the meat you sacrifice on the evening of the first day must be eaten before morning.
5"You must not sacrifice the Passover animal in any of the towns that the Lord your God gives you. 6You must sacrifice the Passover animal only at the place that the Lord your God will choose to be the home for his name. There you must sacrifice the Passover animal in the evening when the sun goes down. This is the festival when you remember that God brought you out of Egypt. 7You must cook the meal and eat it at the place the Lord your God will choose. The next morning you may go back home. 8You must eat unleavened bread six days. On the seventh day you must not do any work. On this day the people will come together for a special meeting to honor the Lord your God.
Festival of Harvest
9"You must count seven weeks from the time you begin to harvest the grain. 10Then celebrate the Festival of Harvest for the Lord your God. Do this by bringing him some special gift you want to bring. Decide how much to give by thinking about how much the Lord your God has blessed you. 11Go to the place the Lord will choose to be the home for his name. You and your people should enjoy yourselves together there with the Lord your God. Take all your people with you—your sons, your daughters, and all your servants. And take the Levites, foreigners, orphans, and widows living in your towns. 12Remember, you were slaves in Egypt. So be sure to obey these laws.
Festival of Shelters
13"Seven days after you have gathered your harvest in from your threshing floor and from your winepress, you should celebrate the Festival of Shelters. 14Enjoy yourselves at this festival—you, your sons, your daughters, all your servants, and the Levites, foreigners, orphans, and widows living in your towns. 15Celebrate this festival for seven days at the special place the Lord will choose. Do this to honor the Lord your God. The Lord your God blessed your harvest and all the work you did, so be very happy!
16"Three times a year all your men must come to meet with the Lord your God at the special place he will choose. They must come for the Festival of Unleavened Bread, the Festival of Harvest, and the Festival of Shelters. Everyone who comes to meet with the Lord must bring a gift. 17Each man should give as much as he can. He should decide how much to give by thinking about how much the Lord has given him.
Judges and Officers for the People
18"Choose men to be judges and officers in every town that the Lord your God gives you. Every tribe must do this. And these men must be fair in judging the people. 19You must always be fair. You must not favor some people over other people. You must not take money to change your mind in judgment. Money blinds the eyes of wise people and changes what a good person will say. 20Goodness and Fairness! You must try very hard to be good and fair all the time. Then you will live and keep the land that the Lord your God is giving you.
God Hates Idols
21"When you set up an altar for the Lord your God, you must not place beside the altar any of the wooden poles that honor the goddess Asherah. 22You must not set up special stones for worshiping false gods. The Lord your God hates them.
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My eyes hurt so I thought I should check the screen refresh rate, but I couldn't find it.
Where is it? (in Ubuntu 12)
Compiz looked like it worked. But it didn't work. So the solution to this is the following.
Alright. Then all you have to do is add the command to Startup Applications and be done. |
open your terminal and type this
then type compiz in your unity dash , it will list you compiz settings manager .Open compiz and at general options click at composite and there you have untick the detect refresh rate then you can manually set the value you want . . and two know allowed refresh rates for the resolution you can use the second row are allowed refresh rates with respect to the resolutions . so by depending on resolutions you have set , you can change the refresh rate by using the above methods . |
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Community Supported Agriculture: Welcome
Note: Parking for CSA
The CSA delivery vehicles now use the parking lot that served the former Dreyfus Building. The farmers are easily visible from East Institute Drive. If you arrive by car from East Institute Drive, you can park anywhere in the large lots next to Buildings 3, 5, and 9.
Fresh Products Direct from the Farm
to You
RTI International is proud to host the Community Supported Agriculture (CSA) Program in the heart of the Research Triangle Park.
If you work in the Park or live nearby, you can pick up local vegetables, fruits, eggs, free-range and organic meats, and North Carolina seafood weekly at RTI.
How CSA Works
Our participating farmers grow and sell a wide variety of wholesome food items. One vendor supplies fresh seafood from the North Carolina coast and estuaries.
You sign up with the supplier of your choice. For farm products, you agree to purchase one or more "shares" (see Participating Farmers). A share represents your part of that session's harvest—usually enough to supply one household. For seafood, you sign up to receive regular notices about the available catch and then place orders from week to week.
Once a week, on Thursday afternoons between 4 and 6 p.m., you come to RTI and pick up your deliveries (see Map and Directions). It's that simple. You and your family enjoy a bounty of high-quality, fresh products; in return, our participating farmers and our seafood vendor are assured of a continuing level of purchases.
RTI's employees have enjoyed the advantages of community-supported agriculture since 2003. We invite you to join us and share the goodness.
These pages explain more about the community supported agriculture concept, and give sign-up details, the CSA schedule for the year, and directions to the location where you will pick up your food shares.
If you have additional questions, please contact Karen Lauterbach at 541-5960 [firstname.lastname@example.com] or Jamie Wescott at 485-5573 [firstname.lastname@example.com].
Walk-Up Sales
Fruit, vegetables, meat, and seafood are available each week for walk-up customers.


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Sandy Pines Resort
- 2731 Raven Lane NW, Backus, MN 56435 | Get Directions
- Phone: 218-947-4467
- email@example.com
- Visit Website
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Year-RoundCheck out our New Cabin.
We offer 11 Beautiful Cabins from 2 - 5 bedrooms. These cabins are well spaced throughout 5 acres of land with 500 feet of amazing sandy beach, cabins right next to the crystal clear lake and lots of beautiful trees and green grass. Watch the peaceful loons next to the dock, and enjoy the beautiful sunsets. Each cabin offers a fire ring, charcoal grill, picnic table, and plenty of relaxation. We have designated swimming area with slide, raft and a NEW Water Trampoline. We have a large playground equipment, Game Room, horseshoe pits, volleyball net, and much more to offer.
New: Kids weekly Pirate Hunt & other organized kids activities.
Our RV Park has 23 beautiful wooded sites, 18 seasonal. 1 Open spots for 2013. Situated in the park is the common grounds, shower house and laundry facilities.
Our rental inventory includes 16' Crestliner Deluxe, 14' Alum. boats, mercury 4 stroke motors, a NEW 20' Pontoon w/Mercury 4 stroke motor, canoe, kayaks, paddle boats & other misc. equipment. The resort also offers bait, tackle, gas, some groceries, ice, pop, firewood, & other misc. items.
So come and enjoy a relaxing stay up in the beautiful Northwoods of Minnesota here at Sandy Pines Resort.
On-Site Facilities & Services
- Located on a Lake or River
- High Speed Internet Available
- Children's Programs (scheduled, supervised)
- Grocery/Supply Store
- Laundry Facilities
On-Site Recreation
- Swimming Beach
- Fishing Boats Available
- Canoes or Kayaks Available
- Lake/River Access (Boat Ramp)
- Dock Space/Slips/Mooring Buoys
- Fishing Boat Motors Available
- Pontoon Boat(s) Available
- Playground
- Ice Fishing Houses
- Snowmobile Trail (groomed)
- Snowmobile Rental
Indoor Lodging Amenities
- Accessible to disabled
- Pets allowed in Indoor Unit(s)
- Open in Fall
- Open in Winter
- Kitchen/Kitchenette(s)
- Fireplace in Room(s)
- Air Conditioned Units Available
- Discount Packages Mid-Week
Accommodations Policies
- Open to the general public, no membership required
- Unit(s) that accommodate groups of 10+ people
Resort Plans
- Housekeeping
Green Practices
- Waste Reduction/Reuse/Recycling
Lodging Capacity
- Number of cabins: 11
- Number of cabins available in winter: 2
- TOTAL number of indoor lodging units: 11
- TOTAL indoor lodging units available in winter: 2
Length of Stay
- Weekend Rental Available
- Weekly Rental Available
- Split Weeks Available
- Extended Stay Facility
- Seasonal site rental
Campground Features
- Electric
- Water
- Sewer
- Pets allowed in campsite
- 50 amp
- Flush toilets in campground
- Hot showers in campground
Number/Type of Campsites
- Number of RV/Trailers Only: 22
- TOTAL number of campsites: 22


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Summer Break UK
Summer time!
Enjoy a Summer Break in the UK this year! With the warmer weather now upon us there's not a better time to enjoy a Summer Break at the 4 Star Abbey Hotel in Worcestershire, UK.
Summer Break UK Packages
Escape this summer with a relaxing summer UK break at the 4 star Abbey Hotel, Golf & Spa in Worcestershire, Midlands. Fantastic summer break deals are now available.
Our Summer Break UK is priced FROM only £38.00 per adult/per night based on a minimum 2 night stay
For your little Sunshines this Summer Break UK
Travelling with children this summer break UK? We go out of our way to make visiting us with children is as easy and enjoyable as possible. Valid on our summer break UK we offer the following.
Add some Summer Sparkle to your Summer Break UK
Enhance your summer break UK even further with the following treats:
Summer Break UK Terms and Conditions
* Summer Break UK terms and conditions - Summer break uk offers are subject to availability and based on two guests sharing a standard bedroom for a minimum of two consecutive nights. The offer price is a from price and is available on selected nights for stays between 3rd June 2013 and 22nd September 2013. Up to 2 Children aged 12 and under stay and eat breakfast for free when staying in a family room with their parents. Children over 12 will be charged an additional £5.00 per child/per night when sharing their parents rooms. Please note children hours in our swimming pool are restricted.


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Iterative Software Development, Part 1
With this blog post, I'm officially kicking off a new long-running screencast series! Yay! I really am excited about this, but first let me give a big shout-out to Near Infinity, which is a great place to work. Awesome benefits, smart and talented people, and very interesting work.
So, what's this screencast series going to be about? The main theme is iterative software development - I'll be building a 2D game library iteratively, one feature per screencast. I won't be teaching Java syntax, but I will be teaching you how to keep your code organized and flexible so that you can go whatever direction you need to.
I'll be using an architecture called "Component, Entity, System" for this project. There's lots of great information out there about this, but I'll go ahead and define the terms here for convenience:
- Component - A chunk of related data, such as a point (with an x and y value). Little-to-no logic
- Entity - An ID list of components. Little-to-nothing else, including logic.
- System - Logic (finally!) that acts on a set of entities.
That's enough of an intro for now. You can find the github repository here. Please email me feedback; I will be happy to take it into account. I'm hoping to release a video or two each week, so tell me what you want to see! Here's the first video:
(Note: Opinions expressed in this article and its replies are the opinions of their respective authors and not those of DZone, Inc.)


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Savory Omelet Cups Recipe
I replaced the pastry portion of this recipe with a light crepe-like cup. Baked in tiny oven-proof dishes, they're filled with cheese, leeks, scallions, olives and sun-dried tomatoes. My son, a vegetarian, always asks for them. —Joan Churchill of Dover, New Hampshire
- 1/4 cup sun-dried tomatoes (not packed in oil)
- 1/2 cup water, divided
- 3 eggs
- 6 egg whites
- 2 tablespoons minced fresh cilantro
- 4 teaspoons butter, melted
- 1/2 teaspoon salt
- 1/4 teaspoon pepper
- 1/3 cup shredded provolone cheese
- 1 cup chopped leeks (white portion only)
- 2 green onions, chopped
- 1 tablespoon olive oil
- 2 tablespoons chopped Greek olives
- 2 teaspoons minced fresh oregano or 1/2 teaspoon dried oregano
- 1/4 cup grated Parmesan cheese
- 1 tablespoon honey
- Place tomatoes in a small bowl. Cover with 1/4 cup water; let stand for 30 minutes. Meanwhile, in a large bowl, whisk the eggs, egg whites, cilantro, butter, salt, pepper and remaining water.
- Heat an 8-in. nonstick skillet coated with cooking spray; pour about 1/2 cup egg mixture into center of skillet. Lift and tilt pan to evenly coat bottom. Cook for 1-1/2 to 2 minutes or until top appears dry; turn and cook 30-45 seconds longer or until set.
- Remove from pan and press into a 1-cup baking dish or ramekin coated with cooking spray. Repeat with remaining egg mixture, making three more omelet cups (coat skillet with cooking spray as needed). Sprinkle provolone cheese into cups.
- Drain tomatoes; chop and set aside. In a large nonstick skillet, saute leeks and onions in oil until tender. Stir in the tomatoes, olives and oregano; cook over medium heat for 2-3 minutes. Spoon into omelet cups. Sprinkle with Parmesan cheese; drizzle with honey.
- Bake at 350° for 10-12 minutes or until heated through. Yield: 4 servings.
Originally published as Savory Omelet Cups in Light & Tasty
February/March 2006, p37
Reviews for Savory Omelet Cups(1)
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Reviewed Jul. 20, 2010
Wonderful recipe, my family was very impressed with the presentation. I substituted monterey jack for the provolone, since I already had some on hand. I omitted the tomato/olive mixture on my children's omelet cups, but I loved it! But I think the crowning item in this recipe is the drizzle of honey. I was skeptical, but it gave this savory dish a hint of sweetness!
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< Return To Hearing
Commissioner Sylvester JohnsonJuly 5, 2006
I am here today to discuss our local law enforcement, its relationship to federal immigration law, and our needs in this area.. It is simply not in best interests of the communities we serve to require local police to enforce federal immigration law. This is true for many reasons, including the importance of community trust and cooperation, the current social climate, a general deficiency in all types of resources at the municipal level, limited local authority under state law, and the complexity of federal immigration law and the correspondent high risk of civil liability. The primary reason to refrain from making local enforcement of immigration law mandatory is that it undermines the basic function of local police. As officers, we must engender trust within the communities we serve. A significant portion of that population includes both documented and undocumented persons. Meeting public safety objectives is only possible when the people trust their law enforcement officials. Fear of negative consequences or reprisal will undermine this important element of successful police work. It will also undercut homeland security efforts among immigrant communities, in that those who that may know persons who harbor knowledge of terrorist activities will no longer be willing to come forward to any law enforcement agency for fear of reprisal against themselves or their loved ones. Crime does not discriminate. Requiring immigration enforcement by local Departments will create distrust among persons from foreign lands living in the United States. Undocumented immigrants will not report victimization or cooperate in solving crimes or testifying for fear of deportation. A culture of trepidation regarding public officials, which often must be dissipated among certain immigrants groups to begin with, will become ingrained among legal immigrants too. Undoubtedly, a substantial group of legal immigrants will avoid contact with police for fear that they or their friends and family may be subject to immigration enforcement or profiling. We would be creating a self-imposed underclass when it comes public safety, an absolutely unacceptable and decidedly un-American outcome. Of course, undocumented immigrants, like any person, may also be perpetrators of crimes which are currently investigated by local law enforcement. Philadelphia police investigate all reported criminal activity. Cultivating relationship with federal agencies regarding the criminal activity of illegal immigrants could prove beneficial to public safety. A second concern is that local departments do not have the resources necessary to successfully enforce immigration laws. In Philadelphia, we are working within tight budgetary constraints, have a substantially reduced police force and have greater responsibilities. Though the overall crime rate in the City is slightly down, like many urban areas, we are also dealing with an increase in shootings and murders. Additionally, federal funding for major city departments has steadily decreased. Despite these challenges, our Department has been doing more with less. Mandatory enforcement of immigration law would tax our department. The number of personnel, the facilities and the equipment needed would overwhelm our current resources, and the resources of other city agencies. With no clear promise of federal funding, the cost of such an effort would be prohibitive. Our enforcement of local and state laws, as well as our current Homeland Security duties, would be compromised. Additionally, federal immigration law is complex, with civil and criminal aspects that are often difficult to distinguish. Currently, specific personnel in a limited number of federal agencies are trained and tasked to deal with immigration enforcement. This highly specialized focus indicates the complexity of immigration issues. Local departments, which are simply unequipped to take on such a task, would be required to spend a tremendous amount of time training their officers in this area. In a time of shrinking Departments and a rising trend in violence, our citizenry could not afford the loss of manpower on the streets. Moreover, charging local police departments with immigration enforcement fundamentally changes our underlying law enforcement objectives. Traditionally the police enforce the criminal provisions of the law. In Philadelphia, even city attorneys are delegated either civil or criminal duties, depending on whether they work for the District Attorney's Office or the Law Department. Local law enforcement is often primary agencies enforcing state law issues, and federal law enforcement entities often take the lead on federal law issues. In addition, state and local laws mandate the responsibilities of officer within a state, and also set limits on the activities permitted by police personnel in the pursuit of fighting crime and maintaining public safety. Such limitation must be considered before determining the effectiveness of local immigration enforcement. Lastly, all Police Departments are susceptible to civil litigation as a result of civil rights suits. The police must attempt to minimize civil liability for many reasons. First, I have often said that we will not break the law to enforce the law. As a matter of principal and policy, we do not want our officers to violate people's constitutional rights. Additionally, time in court on a civil suit equates to fewer officers of our streets and settlements, court costs, and Plaintiff's rewards all cost all citizens precious resources. With questionable federal law authority to enforce such immigration laws, and with a precedent of local police being sued for assisting in the enforcement of immigration law, the probability of civil suits against local departments as primary enforcers is a major concern. The problem of illegal immigration is substantial and has not gone unnoticed by the chiefs of local police departments. The Major City Chiefs, an organization consisting of fifty-seven Chiefs of Police across the United States have convened a committee to research immigration issues and have come to several conclusions and possible solutions to mitigate the current problem. In addition to many of the above conclusions, they have created a list of items that will help to decrease illegal immigration. These include securing our borders, enforcing laws prohibiting the hiring of illegal immigrants, consulting, involving and sharing intelligence with local police agencies and the having local law enforcement continue to commit resources against criminal violators regardless of their immigration status. Clarification of authorities allowing local police to enforce immigration law, the limitation of liability for such, the removal of civil immigration detainers from the NCIC system and an incentive based system of full federal funding instead of a reduction or shifting approach would also be beneficial. Local law enforcement is the first line of defense in protecting our communities. We have witnessed the atrocities that can occur when people put nationality, race and ethnicity before humanity. The Philadelphia Police Department will not let this happen. We will do everything within our authority to protect and serve everyone who enters our City. Though illegal immigration is a serious problem, it is in the best interest of everyone involved to allow those with the expertise, experience and resources to concentrate on solving issues related to immigration. It is in the best interest of the entire country to allow local law enforcement to maintain the relationships with the immigrant community we have worked so hard to build, and to allow us to protect and serve our communities. |


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Cognitive architectures: Research issues and challenges (2002)
Download Links
Citations: | 51 - 8 self |
author = {Pat Langley and John E. Laird and Seth Rogers},
title = {Cognitive architectures: Research issues and challenges},
institution = {},
year = {2002}
Years of Citing Articles
In this paper, we examine the motivations for research on cognitive architectures and review some candidates that have been explored in the literature. After this, we consider the capabilities that a cognitive architecture should support, some properties that it should exhibit related to representation, organization, performance, and learning, and some criteria for evaluating such architectures at the systems level. In closing, we discuss some open issues that should drive future research in this important area. Key words: cognitive architectures, intelligent systems, cognitive processes 1


text:
Biferno is a new generation, Cross Platform Web Scripting Language that allows developers the rapid implementation of dynamic Web applications and of Web sites that offer a high degree of user interactivity.
Biferno is an Open Source Project distributed under the GNU GENERAL PUBLIC LICENSE, its current version is 1.6.0.
Biferno is a Web server add-on module that allows dynamic generation of HTML pages. The result of the processing of the Biferno code by the server determines the page content. A Biferno script is therefore a server-side script, i.e. the Web server is tasked with code processing.
Biferno is currently implemented as an interpreted language.
Biferno is also a "HTML-embedded" language. Scripts can be written in pure Biferno language, but can also contain HTML code segments between Biferno code blocks.
The Biferno code is always delimited by special tags that allow separation from the rest of the code (HTML or whatever).
The following tags can be used to delimit a Biferno script:
<? // Biferno code ?> <?biferno // Biferno code ?>
The alternative opening tag <?biferno is necessary when integrating Biferno and XML code, or when using certain HTML development tools that are compatible with embedded scripting languages.
During page processing the Biferno interpreter executes only the text (code) delimited by the <? and ?> tags, ignoring the rest of the text, which is returned with the output page to the client (nevertheless an exception to this behavior exists). An example is:
  An example of Biferno code embedded in a HTML page
 The current Biferno version is <? print(biferno.version) //Print Biferno version ?>

The example above produces the following HTML output
   An example of Biferno code embedded in a HTML page
 The current Biferno version is 1.6.0

The Biferno code has been replaced by the result of its processing, which is the current version of Biferno. This information has been obtained by calling the biferno.version method and sending its result in output using the print function. The HTML code generated by this mechanism produces the following result in the browser window:
An example of Biferno code embedded in a HTML page


text:
Paul J. Gough
Paul J. Gough is digital producer at the Pittsburgh Business Times. Contact him at firstname.lastname@example.com or 412-208-3827. You can also follow him on Twitter.
412-208-3827 | Email | Twitter | LinkedIn | Google+ | Paul J. Gough feed
Latest by Paul J. Gough
Mar 7, 2014, 8:20 am EST
5 things to know: Medicaid provision removed ... Greene County pizza giveaway .... Health dept. hires director ... Disney cuts ... Not every state worker gets pay raise (Video)
Mar 6, 2014, 8:10 am EST
5 things to know Thursday ... Oil/gas law battle ... slot machine revenue down ... Coal mine controversial ... DEP spill ... Staples could close 225 stores (Video)
Mar 5, 2014, 8:04 am EST
NSF granting CMU prof $600K award to boost data-center energy efficiency
Mar 5, 2014, 7:00 am EST
5 things to know: Jones Lang LaSalle changes name ... Mr. Rogers honored with historical marker ... A slowdown in the Utica shale? ... Pittsburgh-region stocks up ... (Video)
Mar 4, 2014, 9:41 am EST
Radio Shack to close up to 1,100 stores
Mar 4, 2014, 8:46 am EST
Radio Shack to close 1,100 stores (Video)
Mar 4, 2014, 8:09 am EST
Road salt shortage critical in McKeesport
Mar 4, 2014, 7:35 am EST
Corbett urges National Guard cuts to be rescinded
Mar 4, 2014, 7:25 am EST
Mine Safety Appliances to change name to MSA Safety Inc.
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I won't tweet about the weather. I won't tweet about the weather. I won't tweet about the weather.
7 Mar
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I'm amazed there's a second day to the monocle story. I was ready for it to be over about 1 hour after Mr. Peanut responded.
7 Mar
PBT_PaulPaul J. Gough
@PortaBeer I love the shot of the two structures together!
7 Mar


text:
JOPLIN, Mo. —
When Dan O'Connor first saw what the tornado did to the exterior of St. John's Regional Medical Center, he thought there was a possibility it could be restored.
Then he went inside.
"There was no way they could make it back the way it was," he said. "The damage inside was unbelievable."
Then, he thought it would take more than a year to bring it down.
"We started on March 1," he said. "We'll have it done on Sept. 30. We are on target to meet that deadline. The weather is no problem. We like it when it rains because it helps keep the dust down."
O'Connor is the project manager on the demolition project for Northstar Management, of St. Louis. It is the largest demolition project on which O'Connor has worked for Northstar.
But it is more than a demolition job. It could well be the single largest recycling project in the history of Joplin.
O'Connor estimates that 40 percent of the former medical center will be recycled. What's not recycled will go to the Prairie View Landfill near Lamar and to the landfill operated by the city of Galena, Kan.
"We'll even recycle the concrete as fill to prepare this site for the new school and the other projects that are planned here," he said. "There is no need for this stuff to be taking up space in a landfill."
Some of the concrete will be used by the Missouri Department of Natural Resources to plug abandoned mine shafts and cave-ins that are being reclaimed in the region by the department, O'Connor said. Even the asphalt parking lots will be lifted and recycled.
The metal in the medical center is being sorted for recycling. O'Connor estimates the copper alone will be worth $1.5 million. Other metals that are being recycled include aluminum, structural steel, red iron and cast-iron pipe. A security team monitors the site around the clock.
The demolition started with the outlying buildings south of the medical center. The focus now is on the towers. Small earthmovers called Bobcats were lifted by a crane to the top floors. The Bobcats demolish the interior walls of each floor and push them to exterior openings on the south side of the medical center. From there, the material falls to the ground, where it is sorted for recycling. About 35 people are working on the project. They were hired locally.
Once the floors are cleared, the structure will be brought down by a machine that will cut through the concrete and steel supports that hold up the floors. That will bring the towers down in sections.
O'Connor said it is too risky to implode the building and have it fall all at once because of the mining that took place in the area. The concern is not the St. John's property.
"It's the potential for damage off site by having all of that weight come down at once," he said. "The impact would be felt out beyond our property lines that could open other sinkholes."
A mining subsidence on the east side of the towers forced the medical center a couple of years ago to bring down an elevated parking garage.
The medical center itself was built on piers that reach down to solid bedrock.
The demolition of an outlying building uncovered a prospect hole. A concrete bridge with piers was constructed over the hole so that it could carry the weight of the structure that was built on top of it, O'Connor said.
Mining maps from the 1800s have been used to show where the mining took place in relation to the new structures that are planned for the site.
The primary hazard at the site was asbestos, which has been fully removed. The May 2011 tornado did not cause any nuclear lab material to be released.
As the demolition has progressed, artifacts have been saved, including much of the artwork, the stained glass from the chapel, the main desk on the first floor, pavers with engravings, time capsules, statues and even the letters from the main entrance.
"A lot of things were hidden by newer construction," O'Connor said. "We have found plaques and cornerstones. A lot of historical things — old photos and memoirs — were recovered from a library on the second floor."
Crews also have found evidence of the power of the storm and things that are hard to explain. Pieces of wood in a mechanical room had pierced metal that was a half-inch thick. On the eighth floor, solid-core wood doors that were nearly 2 inches thick "were split like paper," O'Connor said.
"The offices on the east side of the tower were completely destroyed," he said. "But you could find coffee cups and personal pictures on desks that were untouched.
"When people have come here to retrieve personal items, they act tough like they can handle what they're about to see. When they get inside, you can see the emotion overcome them."
THERE WERE 189 PEOPLE in St. John's Regional Medical Center when the tornado struck. Five patients on life support died when an air handler on top of the building was blown off and fell onto the hospital's emergency generators. One visitor to the hospital was killed that day.


text:
News & Publications
New Event at St. John's- Naval Academy Croquet Match Includes Chance to Bid on Free Parking in Downtown Annapolis
FOR RELEASE: March 31, 2010
CONTACT: Patricia Dempsey, 410-626-2539
Bring the family to St. John's College in historic Annapolis for an annual rite of spring: the 28th annual St. John's-Naval Academy croquet match –and a new event, a silent auction fundraiser. The croquet match between St. John's and Navy takes place this year on Saturday, April 17, at 1 p.m. Rain date: Sunday, April 18. This family event is free. The match is a lively mix of spirited intercollegiate competition for the Annapolis Cup and a festive lawn party where watching the spectators is as much a sport as croquet.
This year, while spectators enjoy champagne and croquet, they can bid on silent auction items like free parking in downtown Annapolis for a month. Free parking is one of several items offered during the silent-auction fundraiser, a new event at the annual croquet match. The auction will be held in the "Mind- Body Challenge Tent" on the college's front lawn, on Saturday, April 17, from noon to 4 p.m. Proceeds help fund renovations for the college's 100-year-old gymnasium, Iglehart Hall.
Spectators can also bid on items such as: lunch with St. John's College President Christopher Nelson; tickets to the Renaissance Festival, complete with a two-night stay at the Hampton Inn and Suites, Annapolis; and an "Ultimate St. John's College Croquet Package" that includes a portable director's chair, water bottle, two t-shirts, and a St. John's College tote bag stuffed with goodies.
This silent auction is a part of the Mind-Body Challenge; the goal is to raise $500,000 for Iglehart Hall and support the intramural athletics program. For more information, visit the Mind-Body Challenge page.
Please note: Guest tents may be set up only in the designated areas (in front of the Greenfield Library). No tents larger than 20-by-20 feet will be permitted on campus. Guests will not be permitted to set up their spaces before 8 a.m. on the morning of the match. All tents and other personal items must be removed from the front campus by 8 p.m. on the day of the match or they will become the property of St. John's College.
For more information on the 28th annual St. John's-Naval Academy croquet match and directions, visit the Croquet page.


text:
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Healthcare clinics, along with education and housing projects, are commonly supported by impact investors.
Funds that promise to put money to work for the good of society are growing fast, as investors look for alternatives to traditional assets.
So how does it work? Individuals invest in funds or organizations with a specific social or environmental purpose, such as building schools, hospitals or affordable housing - and they're rewarded with a financial return.
Fund managers say the unique selling point of this kind of investing is an intentional, measurable social benefit. This sets impact investing apart from its older cousins -- ethical or socially responsible investing, which try to avoid doing harm by excluding tobacco or arms companies from their portfolios.
And it appears to be catching on.
JPMorgan (JPM, Fortune 500), which invest in several funds dedicated to social causes, says its clients weren't aware of impact investing just three years ago.
Now they're coming to the bank to pump money into socially conscious investment vehicles. A survey by the firm found investors plan to commit $9 billion this year.
World leaders are also throwing their weight behind the sector, agreeing at a G8 summit this year to create a task force aimed at expanding the market.
The global financial meltdown, financial scams and Wall Street misconduct have left many people disillusioned with traditional investments.
And growing awareness of inequality and diminishing natural resources is also fueling a hunger to do good with finance, particularly among young people.
Related: Find out if a company shares your values
So what about the return on your investment?
The market is still in its infancy and tends to be weighted to private equity or longer-term funds, meaning lots of projects haven't yet had time to bear fruit.
Counting the number of jobs supported by a loan, or the amount of small businesses helped by micro-finance is straightforward.
Self-proclaimed "profit with purpose" private equity firm LeapFrog Investments says 11 million people have benefited from its investments in emerging markets.
Calculating the longer-term social impact, such as a drop in crime or reduced welfare dependency, is much harder.
Social impact bonds are designed to show more clearly how finance can generate lasting benefits.
Launched three years ago in the U.K., and now also available in the U.S., Australia and Canada, this type of bond has been used to fund school mentors, for example. It pays out if truancy rates fall.
Related: Rebalance your portfolio or not?
Getting involved is getting easier, for large and small players alike.
The Calvert Foundation offers impact investments from just $20. The group, which uses most of its capital to support projects in the U.S., has been paying returns to investors for years.
Its one-year fixed income product currently pays 0.5%. This rises to 1% over 3 years, and 3% on a 10-year term.
It won't make you rich, but beats parking money in the bank.
Investments can be made via MicroPlace, an online brokerage platform for social investing, where organizations seek backers for a variety of causes.
Calvert Foundation chief executive Jennifer Pryce says investors still need to do their homework, as fund managers are increasingly touting social investments without measurable benefit.
"They see it as a way to grow their business, by saying they do impact investing," she said.
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