text:
... Flood Watch remains in effect through Friday afternoon...
The Flood Watch continues for
* portions of western Washington... including the following
counties... Skagit... Whatcom... King... Lewis... Mason... Pierce...
Snohomish... Thurston... .
* through Friday afternoon
* heavy rain began falling overnight in the Olympics and the
Cascades from roughly the Snohomish basin northward... with much
of the area receiving a half inch to one and a half inches of
rain. Another 3 to 5 inches of rain is likely in this same area
today through Friday. The Cascades south of the Snohomish basin
will probably receive 2 to 4 inches of rain... but much of that
will fall on Friday. The snow level will be 5500 to 7500 feet
today and tonight... then fall slowly Friday.
* Flooding is possible on the Skokomish River... which flows off
the southeast slopes of the Olympics... and it could begin this
* Rivers flowing off the west slopes of the Cascades from the
Snohomish basin northward could flood... including the
Nooksack... Skagit... stillaguamish... Skykomish... tolt...
Snoqualmie... and Snohomish rivers. These rivers flooded or came
close to flooding in the past couple days... and they are still
running high. Flooding on these rivers could begin tonight or
* There is also a threat of flooding on rivers that flow off the
west slopes of the Cascades south of the Snohomish basin. That
includes the Green River... The Reach of the Puyallup river near
Orting... the Carbon... upper Nisqually... Deschutes... upper
Cowlitz... and reach of the Skookumchuck river near Bucoda.
Several rivers in this area flooded recently as well... and they
are running high. Flooding on these rivers... if it does
occur... would most likely begin on Friday.
* A major flooding episode is unlikely... but many of the flood-
prone Cascade rivers could have minor to moderate flooding.
* A cold front will move southeast of western Washington Friday
night... with cold and drier weather this weekend. Rivers should
then recede and the flood threat will end.
Precautionary/preparedness actions...
A Flood Watch means that flooding is possible but not occurring.
Monitor the weather and be ready to act quickly if flooding is
observed or flood warnings are issued.
... Warm and wet weather will give way to much colder conditions
and possible lowland snow late Friday night into Saturday...
... Cold and windy conditions are expected to develop in the north
interior late Friday night into Saturday...
Big changes in the weather will begin to take place on Friday
morning as a strong cold front moves southeast across the region.
This front will be accompanied by locally heavy rainfall and windy
conditions. Temperatures will start off mild in the early morning
hours... in the lower 50s in most areas... but will fall through
the 40s during the afternoon hours and into the 30s Friday
A modified Arctic front will move south through the area Friday
night into early Saturday. Snow levels will fall below 1000 feet
Friday night and to near sea level Saturday morning. It is too
early to tell how much snow will fall in The Lowlands late Friday
night or Saturday morning. Most areas will likely see light
snowfall amounts... but some weather forecast models show up to a
few inches in the interior from north of Seattle into the northern
Windy conditions will develop late Friday night into Saturday over
the San Juan Islands and in western Whatcom County. These areas
may see northeast winds increase to 25 to 40 mph with gusts to 55
mph. The windy conditions will be accompanied by temperatures in
the 20s to around 30.
Stay tuned to the latest updates from the National Weather Service
in Seattle.


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Google May Buy New York Office Building
Google's big buy by the New York Post reports Google may shell out $2 billion to buy the New York office building they currently rent a portion of.
The building is well known, previously the home of the Port Authority, with space of about 2.9 million square feet. It fills an entire city block, from Eighth and Ninth avenues from 15th and 16th streets. It has several addresses, commonly 76 Ninth Avenue or 111 Eighth Ave and is one of the largest buildings in New York City.
In January, we reported Google is looking to expand their New York offices from the two or three floors they currently rent in that building. Buying the whole building may solve that problem.
I personally toured the building when they first moved in late 2006. Back in 2006, it looked like a ghost town. Since then, I have been there several more times and every time I go, the office gets stuffier and stuffier.
DON'T MISS OUT! The agenda for Search Engine Land's SMX West search marketing show is now up. Search marketing is the biggest area of digital marketing. You can't afford to get it wrong! SMX has practical tips & techniques for those experienced with SEO & SEM plus a welcoming environment for beginners. Learn more!
(Some images used under license from Shutterstock.com.)
Get the best search news, tips and resources, delivered each day.

subset: commoncrawl


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Finally have become a member! After constantly checking search engines, and always getting hits to this site, I always find the best information from members. Thank you all so much for sharing your experiences and findings. It has been very helpful. I hope someone will be able to benefit from any insights I may have as well. :)Jul 05 2012 05:48 AM


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A Plus® Personalized Rocking Horse Baby Blanket
Item # WX2-170921
- Google+
This item is shipped directly from the factory. To see the expected shipping date, please add to your Shopping Cart. Sorry, no express shipping available. We are unable to ship factory direct items to Alaska, Hawaii, Puerto Rico or APO or FPO addresses.
This item cannot ship to Canada.
This item cannot ship internationally.
- Details & Specs
A Plus® Personalized Rocking Horse Baby Blanket. Commemorate the happy occasion with a personally embroidered blanket!
Beautiful American craftsmanship and vibrant colors are sure to brighten baby's first few months! Expertly woven with soft 2-ply cotton, this custom embroidered Baby Blanket can be personalized with baby's name and birthdate, to make a one-of-a-kind keepsake that parents will cherish for years.
The Throw features feather-soft multi-colored fringes and a whimsical images of children's toys, including a majestic white rocking horse. The perfect gift for new parents and their baby! Measures 48 x 38". Machine wash / dry. Made in the USA!Personalize yours:
- Line 1 - Color (pink or blue)
- Line 2 - Baby's name, up to 24 characters
- Line 3 - Birth date, up to 8 characters (including dashes... 11-11-09, for example).
A perfectly personal gift for the new parents in your life!
- Reviews
<!--BVSEO|dz:Main_Site-en_US|sdk:v22.214.171.124-n|msg:Error: Request errored out - The remote server returned an error: (403) Forbidden. -->
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2 Racing Horse Hopper BallsBuyer's Club $44.99 Non-Members $49.99


text:
You're leaving Wedding Paper Divas to see the Deal of the Day at our parent site, Tiny Prints.
You won't be able to dismiss this by usual means (escape or click button), but you can close it programatically based on user choices or actions.
"I was very happy with the cards that i got, i had to make some changes and i was upset but i realized that until they email you and press approve final order then they print them, i like that about them because i got to review them one more time and i got to make my changes. The cards are great quality and look exactly the same as the picture on the website! I am very happy with these cards!"
"The quality of our invitations are absolutely beautiful! We are so pleased with them, and we cannot wait to send them out to all of our family and friends! Thank you so much for making one of the most important details of our big day look so great!"
"We got samples from many companies but WPD was by far the best quality. My daughter wanted a vintage yet classy, romantic look and we found it with this design. On the Save the Date, we put a text box on the back to give our guests more info in advance since her wedding is on a holiday weekend and many out of towners will have to book rooms. Can't wait to send them out and get people's reaction to the card. I highly recommend this company. The designer was so easy to work with and able to make many little tweaks to make it perfect!"
"I am so pleased with my purchase and can't wait for our guests to receive our beautiful invitations! The quality of the paper and printing is wonderful and our order was reviewed quickly and even mailed ahead of schedule. We are having a non-traditional wedding in the sense that we are only having 20 guests to our ceremony and dinner, so it was an added bonus that the minimum order was only 10 invitations. A lot of other wedding invitation websites require a much higher minimum order. Will definitely be back to order programs and menus!"
"This card is amazing in the blue and gold option, which I purchased. I used it for my indian engagement ceremony invitations, and it worked perfectly as I could personalize the different text fields to use the language and fonts I preferred. When I couldn't change something to see its look, I used the online chat to get assistance from a rep. I also picked the pearl finish which made it subtly shiny and gorgeous! So happy how it turned out :)"


text:
It seems that Google is backing out of the consumer market with glass and externalizing the hardware problems to other partners and focusing in more on specialized business applications for the dev
It is extremely important to properly track your website traffic and conversion data in order to get the most useful data about your business's website performance.
Analysts reviewing Google's quarterly earnings report, had some hard questions regarding Googles click based revenue model, which is touted as, " ...the best Internet business model ever created" b
Yahoo directory will be coming to a close this December, 2014. It's a sad day, or at least it seems like it is.
A Washington DC area restaurant that became famous for serving lion and bear meat, has closed it's doors after someone apparently edi
Google is now testing a program where they sell domain name registrations to s
We have all seen loads of reports of hijacks of google's knowledge graph like the World Series For St.
Famed technologist, and Google Engineer, Ray Kurzweil, is talking more about Google's plans with Artifical Intelligence.
Finally governments are starting to wake up to how much of a monopoly Google is.
A consumer watchdog group in Canada is saying that Google is violating privacy laws by ret
The heart hand gesture has grown in popularity over the last few years.
Chris Clarke has a very thoughtful piece on how internet is making everything sh*t
This is a major change which is going to affect loads of sites in the UK.
Notorious Ripoff Report has just launched a new "service" - a $89/m subscription to allow business owners NOT to get published on their site.
I will admit that I have a certain soft spot in my heart for digital pirates.
When I first read this about this news, my first thought is this going to be what kills vine...thoughts?
Great piece examining whether it's tougher to run an SMB today than it was, say, 5 years ago. I'd suggest you have to be savvier about online marketing with every passing month, at the very l
The Wall Street Journal has an intersting take on The Yahoo buy out of Tumblr http://online.wsj.com/art
Business Branding for entrepreneurs sometimes is dilluted in the efforts to be noticed and, often, for not staying true to your course when advised to do otherwise.
Link: http://searchenginewatch.com/article/2260667/Scroogled-Rises-Microsoft-Back-on-Attack-as-Google-Faces-New-Antitrust-Complaint
*Active* Threadwatch Editors


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Amazing Fall Special
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Myrtle Beach Golf Package Providers
Planning golf vacations is ALL THESE GUYS DO!
Talk to any of them about your group, travel dates, & the golf trip you're seeking, and they'll recommend places to stay and which golf courses are best for your group.
They can lock in the lowest rates, secure your tee times and accommodations into one "golf package," and let your group focus on what's important: playing golf!


text:
E90Post member cntlaw brings us these amazing photos of the BMW Experience in Hong Kong. Many thanks to one of the most dedicated BMW fans out there!
Read the rest of this article, view the photos and make comments here ==> http://www.e90post.com/forums/showthread.php?t=170784
First off, we were picked up at the Airport by Greenville Marriott. We were treated like Kings, I loved every minute of it. My friend Pat and I were treated to a very nice dinner, inside the Marriott, covered by BMW.
Next morning we wake up, to yet another meal covered by BMW. A great breakfast, with omelets made right in front of us. We were then taken by the Hotel to the BMW Performance center where our day of fun started.
Our Hotel Room
Complimentary copy of BMW Magazine
The Marriott shuttle to … CONTINUED
The psychadelia continues Here are the latest photos of the BMW X1 seen testing on the streets of Munich Germany
Read the rest of this article, view the photos and make comments here ==> http://www.xbimmers.com/forums/showthread.php?t=170850
As per the man himself:
This project started the first week on November. And many of the ideas has been taken from the BMW MOTORSPORT Z4. The things I didnt like on the motorsport version was; The front, so we did our own. And also the huge gap between the wheels.This kit is made of glassfiber and its wided TOT 100mm.
Se www.custommania.se for order and info!
The paint job is done with House Of Kolor Snow white pearl … CONTINUED
The UK M3Post members document their roadtrip to the world famous Nurburgring and take us along for the ride.
Read the rest of this article, view the photos and make comments here ==> http://www.m3post.com/forums/showthread.php?t=169810
Hello from Germany ,
our local dealer got the new E90 and E91 facelift in the last days.
Here are the Pictures
E90 in White and M-Package | E91 in Spacegrey and Xenon
If you wanna save the pictures use the right mouse button.
To scroll forward use the mouse wheel.
I hope you enjoy it!
Best wishes!
P.S.: Our 320xd E91 in white with all possible features and brown leather was built, yesterday. We will get him in the end of september
Read the rest of this article, view the photos and … CONTINUED
BMW knows how to court controversy and this this top-secret X2 is likely to offend purists as much as a long-wheelbase, limo-spec M3. The X2 revealed today in our artist's impression is BMW's riposte to Land Rover's achingly hip LRX coming in 2012: a smaller, funkier 4×4 meets coupe.
The X2 project is part of the new X1 family that we will finally get to see at next month's Paris motor show 2008. A concept X1 will be shown at the Salon de l'Automobile on 2 October 2008 ahead of a … CONTINUED
German luxury car maker targets Porsche Panamera and Mercedes-Benz CLS with a new four-door coupe that is being built by BMW's renowned M division. By JEZ SPINKS.
BMW's M performance division has been commissioned to build a new four-door luxury GT flagship that is set to become the German car maker's new 8 Series.
The new four-door coupe-style gran turismo will be based heavily on BMW's 2007 Shanghai motor show Concept CS, and will launch in 2010 as a rival for the Mercedes-Benz CLS3 AMG as well as the forthcoming Porsche … CONTINUED
Thanks to a friend in Germany, here are the official booklets for the BMW 7 Series that were recently released to dealership in Germany. Great photos!
Read the rest of this article, view the photos and make comments here ==> http://www.7post.com/forums/showthread.php?t=168729
Here are some high resolution wallpaper quality photos of the recently released Alpina B3 based on the facelifted LCI 3-Series cars
Read the rest of this article, view the photos and make comments here ==> http://www.e90post.com/forums/showthread.php?t=168723
Here is the latest in photos of the Z4 which is now only 1-2 months away from full reveal.
I am definitly in big time anticipation of this car, it should be pretty damn sick. Atleast I hope BMW does right by us and gives us a serious performance car ……
Read the rest of this article, view the photos and make comments here ==> http://e89.zpost.com/forums/showthread.php?t=167639
Hey guys found this at Inside Line.This basically confirms what some of my Plant contacts have been saying for the last 18 months or so.BMW is very seriously considering building a large number of 3 Series at the BMW Plant in South Carolina.There is plenty of room to expand even after the X3 begins production in 2010.The weak US dollar is killing BMW on everything they import from Europe to the US.Ill keep you posted.Thanks! PalBay http://www.edmunds.com/insideline/do…ticleId=131370
Read the rest of this article, view the … CONTINUED


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Jessie Davidson is from Lexington, IN and a graduate of Austin High School.Her parents are Melvin and Louise Davidson.
What do you like to do outside of your sport: Spend time with family and friends.
Person who pushes you or makes you better: My Mom and current and former coaches.
Superstitions: Wearing high school state championship ring on game days and wearing a headband while playing.
Favorite class and why: Intro to Kinesiology and Integrative Physiology: Most interesting.
Favorite quote: "Life isn't about waiting for the storm to pass, it's about learning to dance in the rain."


text:
Congress to Fight Obama on Immigration
NBC's Senior Political Editor Mark Murray has more on Obama's plan to take executive action once he returns to D.C. Watch »
Officers Surprised Bushes Didn't Stop W.H. Intruder
Secret Service officers chasing a Texas Army veteran across the White House lawn in September figured they had him... Watch »
Pot-Friendly States Teaming Up on Capitol Hill
Members of Congress from states with legal pot are banding together to tell their colleagues on Capitol Hill not to... Read »
Panel May Vote on Medical Marijuana Regulations
A Maryland panel considering regulations for medical marijuana may finally take a vote. Read »
Sherwood's Notebook: 'There's There There'
A year ago this month, we had the chance to sit down with U.S. Attorney Ronald Machen for an hour-long talk about... Read »
What Md. Residents Say They Want Hogan to Achieve
Maryland Gov.-elect Larry Hogan is thanking voters and veterans alike at a Veterans Day parade in Leonardtown. Read »
Biden: Military Veterans Are 'Spine of the Nation'
Vice President Joe Biden is saluting military veterans, calling them not only the heart and soul, but the spine... Read »
Defense Secretary to Lead Veterans Day Ceremony
Defense Secretary Chuck Hagel is expected to join a Veterans Day ceremony at the Vietnam Veterans Memorial on the... Read »
Herring Announces Donations From Inaugural Funds
Attorney General Mark Herring says his inaugural committee has donated $50,000 in leftover funds to 11 Virginia... Read »
January Special Election for Comstock's Va. House Seat
After Barbara Comstock's win of Virginia 10th District seat in the U.S. House of Representatives, Virginia voters in... Read »
Obama to Congress: Draft Immigration Bill
President Obama is attending an economic summit in Beijing, but ahead of the trip, he spoke out about immigration... Watch »
Bowser to Hold Open House for Transition Office
D.C. Mayor-Elect Muriel Bowser will hold an open house Monday afternoon to officially introduce her transition team... Read »
Va. Senate: Gillespie Concedes to Warner
Challenger Ed Gillespie has conceded Virginia's close Senate race to incumbent Mark Warner, nearly three days after... Watch »
D.C. Mayor-Elect Announces Transition Team
District of Columbia Mayor-elect Muriel Bowser says Marion Barry and three other former mayors are among the group... Read »
Rep. Delaney Wins in Md. Absentee Ballot Count
The Associated Press declared Democratic Rep. John Delaney the winner in Maryland's 6th Congressional District on... Read »
Warner Eager to Return to Senate, No Concession From Gillespie
With the final votes still being counted, Sen. Mark Warner said Thursday he's eager to return to the Senate for... Watch »
Norton: No Reason for D.C. to Worry About GOP Gains
The District of Columbia's delegate to Congress says there's no reason for leaders or residents of the heavily... Read »
Weary Rivals in SoCal House Race Brace for Ballot Count
The long, divisive road to the 52nd Congressional District seat stretches on for its two weary candidates, incumbent... Watch »
Indicted Texas Gov. Perry in Court for Heated Hearing
Indicted Texas Gov. Rick Perry has made his first court appearance on felony abuse of power charges, sitting largely... Watch »
Absentee Ballots Promise Closure in Md. House Race
Montgomery County election officials have begun an absentee ballot count that will likely resolve the tight race for... Read »


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How much would Apple's overseas cash help the U.S. economy?
Mark Garrison
May 21, 2013 Apple's $100 billion in overseas cash is just part of the nearly $2 trillion in U.S. corporate funds that are beyond the reach of the IRS. What difference could that money make if it was brought home?
House Republicans attempt to repeal Obamacare ... for the 37th time
Gigi Douban
May 16, 2013 Republicans in the House are expected to hold a vote today to repeal President Obama's health care initiative. It will be their 37th vote on the issue.
Lobbyists gearing up for fight over tax breaks
Nancy Marshall-Genzer
Mar 26, 2013 As Washington eyes deficit reduction, cherished tax breaks are in the crosshairs.
Can the new OMB chief tame DC's budget monster?
Tracey Samuelson
Mar 4, 2013 President Obama's new budget director will have less leeway to bargain than her predecessors. But it's also a chance to prove her mettle.
Corporate tax reform could help avoid fiscal cliff
Nancy Marshall-Genzer
Dec 12, 2012 President Obama and House speaker John Boehner are still tussling over the details of any fiscal cliff deal. But the Wall Street Journal reports that, now corporate tax rates have entered the discussion.
Starbucks volunteers to pay more taxes
Stephen Beard
Dec 7, 2012 The company is one of a number of big U.S. businesses accused of not paying a fair share of tax on their British operations.
President Obama's secret directive on cyber ops
David Brancaccio
Nov 15, 2012 The president has reportedly signed a directive that could change the way the government could fight cyber terrorism. Also, cell phones that can get a charge from a good shake, and climate change's impact on satellites.
How Obama's campaign used big data to win, and how coke got hacked
David Brancaccio
Nov 9, 2012 To help tap financial donors and to get out the vote, we knew the Obama campaign was crunching big data. But, until now, it wasn't very clear how big.
Obama pushed to recast economic message
David Gura
Jun 14, 2012 Ahead of what's billed as a major speech by Barack Obama in Cleveland, democratic strategists want the president to change his message to acknowledge slow growth.
The Obama interview: The 'recipe for economic growth'
Kai Ryssdal
Interview by
Mar 22, 2012 Yesterday, Marketplace's Kai Ryssdal sat down with President Obama to speak about health care, energy, and the economy at large. Kai asked the president to make the case for why his economic policies have been good for America.


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I had an idea over the weekend. I was flipping through the Northern Brewer catalog, and saw the "Tap-a-Draft" and "Mini-Keg" systems. Esentially, they are just a vessel that you put primed beer into, then use mini CO2 cartriges to keep pressure on for pouring.
Ok, now here's my idea/question. My wife bought be a Beer Machine for X-mas a few years ago. It produced aweful, barely beer-like concoctions (although it led me to real homebrewing). It has been shelved since, and i even thought of putting it on Ebay. However, I was just thinking, it is essentially like these other systems. Its a party-pig with an attatchment for a mini CO2 catridge.
Does anyone see any reason why I couldn't salvage this little beast to use as a minikeg? I figure, fill it with primed beer...let the priming carbonate it fully, then toss it in the fridge with a CO2 cartridge and use like a minikeg? Thoughts?
seems like it would work just fine.
This works just fine and perhaps it is the beermachine's true destiny. Several people I know started with a beermachine, at least one uses it as a secondary for keg conditioning ales. I tried the minikegs a few years back and the dispenser broke first party. The beermachine seems more robust.
Thanks. I figured it should work just fine, and it will finally put the damn thing to good use.
You could rack into the sanitized beer machine, let it carbonate, and then stick it in the fridge. That's what I do. You get about a half-batch in there.
Primary: Lager
Secondary: Sangiovese, Honey Nut Brown, some Pilsner/ale kinda thing that just won't quit...
Tar Sands Porter, Special Dark Bitter,Oaky Red ale, Hammer & Tongs Black Ale, Black Draught, Cooper's Bitter, Baron's Pilsner
Super Saazy Saaz Pilsner Saaz (It's a little green, yet)


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Click the link below for instructions for setting up an Access ACS account. ACS is the Database we use to keep track of your contact information, attendance, giving, etc. Having an account to this database will allow you to view and edit your information, view the pictorial directory, view the church calendar, and in the future, register online for church events.Click Here To Access ACS
Worship Services
9:30am and 10:45am in the Worship Center
Crossroads Children's Ministry
9:30am and 10:45am
Txt180 for Middle and High School
Angel Tree, a program of Prison Fellowship, reaches out to the children of inmates and their families with the love of Christ. This year, we will be purchasing gifts for children in Morgan County who have a parent that is incarcerated. The gifts are not from us but on behalf of the parent. Please take…[Read More...]
What does it really mean to "believe?" Is it an understanding and agreement to a statement of faith? Is it being able to prove what you believe in? Is it something mystical that you can't explain? All of us have had attacks on our beliefs, especially when what we experience in life doesn't seem to…[Read More...]
The Weekend Update is a weekly newsletter with information about all Faith Church events. It shares information for all of ministries, monthly virtues, and calendar highlights. If you do not receive Weekend Updates, please sign up below.[Read More...]


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- Home
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Friday November 28, 2014; 06:09 am EST
The Mark Thompson Show (www.markthompson.org) is coming to Woods Church! The Bible tells us to "rejoice in the Lord always," and "a joyful heart is like a medicine." Often it is humor that draws our hearts together and helps create an atmosphere that is conducive to a good learning experience. Woods is excited to bring to Severna Park, Family Entertainment Minister and Christian comedian, Mark Thompson. For decades now, Mark Thompson and his cast of wacky and zany puppet friends have been thrilling the world over with his enticing blend of ventriloquism, comedy and song. From hilarious audience participation skits to imaginative puppetry, Mark and company promises to leave the crowd laughing for more. This special event is for all ages, and admission is FREE! You won't want to miss this!


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fax: 305-243-7083
Liver Biology and Pathobiology
Paradoxical effects of short- and long-term interleukin-6 exposure on liver injury and repair†
Article first published online: 22 FEB 2006
DOI: 10.1002/hep.21087
Copyright © 2006 American Association for the Study of Liver Diseases
Volume 43, Issue 3, pages 474–484, March 2006
Additional Information
How to Cite
Jin, X., Zimmers, T. A., Perez, E. A., Pierce, R. H., Zhang, Z. and Koniaris, L. G. (2006), Paradoxical effects of short- and long-term interleukin-6 exposure on liver injury and repair. Hepatology, 43: 474–484. doi: 10.1002/hep.21087
- †
Potential conflict of interest: Nothing to report.
Publication History
- Issue published online: 22 FEB 2006
- Article first published online: 22 FEB 2006
- Manuscript Accepted: 24 DEC 2005
- Manuscript Received: 6 MAY 2005
Funded by
- NIH. Grant Number: GM-6360301
- NIH NIDDK. Grant Number: 62314
- Sylvester Comprehensive Cancer Center and Papanicolaou Corps for Cancer Research
- Abstract
- Article
- References
- Cited By
Interleukin-6 (IL-6) is an important mediator of liver regeneration and repair that is also elevated in chronic liver diseases, including fatty liver of obesity and cirrhosis. IL-6 has been reported both to delay and accelerate liver regeneration. We examined the effects on liver injury and regeneration of a continuous administration of exogenous IL-6 to mice by injection of an IL-6–expressing CHO-cell line in athymic nude mice and by osmotic mini-pump delivery of recombinant murine IL-6. Short-term IL-6 administration (1-2 days) accelerated early recovery of liver mass, whereas more long-term administration (5-7 days) markedly impaired liver regeneration. Similarly, short-term IL-6 treatment increased hepatic resistance to the lethal effects of the Fas agonist Jo-2, but on more prolonged IL-6 exposure the Jo-2 resistance vanished. IL-6 administration initially induced expression of the anti-apoptotic proteins Bcl-2 and Bcl-xL, correlating with protection against Fas-mediated cell death. More prolonged IL-6 administration, however, resulted in marked induction of the pro-apoptotic protein Bax. This result coincided with increased activation of the type II or intrinsic, mitochondrial path to cell death, manifested by increased caspase-9 activation and increased cytochrome c release after Jo-2 exposure. These data demonstrate that IL-6 can function acutely to improve hepatic regeneration and repair, but that more chronic exposure not only abolishes the protective effects of IL-6, but actually sensitizes the liver to injury and death. In conclusion, elevated IL-6 in certain chronic liver diseases contributes to an increased likelihood of liver failure after injury. (HEPATOLOGY 2006;43:474–484.)
Interleukin-6 (IL-6) is a multifunctional pro-inflammatory cytokine.1, 2 In the liver, IL-6 is a major inducer of the acute phase response after infection and is secreted in response to tumor necrosis factor.2 As well, IL-6 is required for normal liver repair and regeneration after injury or 70% partial hepatectomy (PH).3 Mice bearing targeted deletions of the tumor necrosis factor type I receptor and IL-6 null (Il6−/−) mice show increased mortality and severely impaired hepatocyte DNA synthesis after PH.4 Moreover, Il6−/− mice display abnormal liver regeneration after other injuries, including carbon tetrachloride, bile duct ligation, and ethanol.5–7 In all cases, acute administration of IL-6 rescues normal liver regeneration in Il6−/− mice. Based on such data, IL-6 has been recognized as an important early signal for liver regeneration after acute injury.
Absence of IL-6 signaling in repetitive injury models also results in increased hepatocyte injury. Il6−/− mice exhibit increased apoptosis after either short-term or prolonged (8 weeks) exposure to the DeCarli-Lieber ethanol diet.8 As well, mice with liver-specific deletion of the IL-6 co-receptor gp130 exhibit increased injury in response to chronic carbon tetrachloride exposure. These reports suggest an important role of IL-6 in acute liver injury and a beneficial effect of IL-6 production in repetitive liver injury.9–13
IL-6 is both pro-mitogenic and anti-apoptotic for hepatocytes. We have demonstrated that prolonged exposure to continuous, supraphysiological levels of IL-6 induces hepatocyte proliferation in vivo.14 IL-6 over-expression from a retroviral vector in primates induced marked hepatocyte proliferation in vivo.15 Administration of an IL-6/soluble IL-6Rα fusion protein16 accelerates hepatocyte regeneration, while IL-6 pretreatment protects mice and isolated hepatocytes from Jo-2–mediated cell death.5
Serum IL-6 is elevated in animal models of and patients with chronic liver diseases.8, 10, 11 In long-term ethanol exposure, the persistently increased serum IL-6 is also associated with an exaggerated production of IL-6 after PH.17, 18 Similarly, leptin-deficient ob/ob mice, which exhibit obesity, diabetes, steatosis, and abnormal liver regeneration after PH, exhibit elevated IL-6 baseline concentrations, an exaggerated IL-6 response to resection, as well as chronic STAT3 nuclear translocation.13, 19 These results suggest similar IL-6 responses to liver injury in alcoholic liver disease and obesity-related liver disease in both humans and mice.9–13 The consequences of chronic IL-6 over-expression and persistent signaling in alcoholic and obesity-related hepatocyte dysfunction are unknown, and the existing data are conflicting. Although administration of IL-6 improved the regenerative response in obese Zucker rats, hyperstimulation with IL-6 administered to transgenic mice expressing soluble human IL-6Rα actually repressed cell cycle progression after hepatectomy, suggesting that IL-6 can inhibit liver growth after injury.20
Thus, whether persistent IL-6 signaling is protective for hepatocytes or contributes to injury is unknown. IL-6 null models do not address the effects of excess IL-6 on liver function. To examine directly the effect of excess IL-6 on liver homeostasis in vivo, we used our previously published CHO-IL-6/athymic nude mouse model and osmotic mini-pumps to continuously deliver recombinant IL-6. This report examines the effects of sustained high-dose IL-6 on liver regeneration after PH or apoptosis induced by administration of the CD95/Fas agonist, Jo2.
Materials and Methods
Reagents and Antibodies.
Reagents were as follows: recombinant murine IL-6 (PeproTech, Rocky Hills, NJ); alpha–minimum essential medium, dialyzed fetal bovine serum (Gibco, Grand Island, NY); Na-deoxycholate, BrdU, methotrexate (amithopterin), sodium orthovanadate, NaF, phenylmethyl sulfonyl fluoride (Sigma, St. Louis, MO); Quantikine human IL-6 assay (R&D Systems, Minneapolis, MN); protease inhibitor cocktail (Roche Diagnostics, Mannheim, Germany); DAKO CSA System, peroxidase (Dako, Carpinteria, CA). Antibodies included anti-Bax, anti-Bad, monoclonal anti-phospho-Bad, anti-Bcl-xL, anti-cleaved caspase-3, anti-Cleaved caspase-7, anti-caspase-9, monoclonal anti-p53, anti-BID, anti-Stat3, anti-phospho-Stat3, anti-cleaved PARP (Cell Signaling Technology, Danvers, MA); anti– apoptosis-inducing factor (AIF), anti-Bcl-2, anti-FLIPS/L, anti redox factor-1 (Ref-1), anti-gp130 (Santa Cruz Biotechnology, Santa Cruz, CA); purified hamster anti-mouse FAS monoclonal antibody (Clone: Jo2), anti-cytochrome c monoclonal antibody (BD Biosciences, San Diego, CA); monoclonal anti-cytochrome c oxidase subunit Vb (COX) (Molecular Probes, Eugene, OR); anti-Bak, monoclonal anti-phospho-epidermal growth factor receptor (EGFR), monoclonal anti-EGFR (Upstate Biotechnology, Lake Placid, NY); monoclonal anti-proliferating cell nuclear antigen, monoclonal anti-beta actin (Sigma); ImmunoPure peroxidase conjugated goat anti-mouse and donkey anti-rabbit IgG, Super Signal West Pico Chemiluminescent Substrate, Coomassie protein assay kit (Pierce Chemical, Rockford, IL).
Cell Lines.
A CHO cell line stably expressing IL-6 as well as a control line (CHO-control) were cultured as described.14
Animal Models.
Mouse experiments were approved by the Institutional Animal Care and Use Committees at both the University of Miami and the University of Rochester Schools of Medicine. Mice received humane care in accordance with NIH publication 86-23 "Guide for the Care and Use of Laboratory Animals." Female athymic nude mice (Harlan, Indianapolis, IN or Charles River Laboratory, Wilmington, MA), 6 to 10 weeks old, were injected in the thigh with 106 cells in 0.1 mL phosphate-buffered saline. Alzet osmotic mini-pumps (Durect Corporation, Cupertino, CA) containing recombinant murine IL-6 in sterile saline or control pumps with saline only were placed intraperitoneally in 6- to 8-week old male C57BL6/J mice (Jackson Laboratory, Bar Harbor, ME) through a midline incision. Athymic nude mice injected with CHO-control or IL-6 cells were subjected to PH or sham surgery as described21 or injected intraperitoneally with hamster monoclonal anti-mouse CD95/Fas antibody.
Western Blotting Analysis.
Liver sections were homogenized in ice-cold modified RIPA buffer (50 mmol/L Tris-HCl, 1% NP-40, 0.25% Na-deoxycholate, 150 mmol/L NaCl, 1 mmol/L EDTA, 1mmol/L phenylmethyl sulfonyl fluoride, 1 mmol/L sodium orthovanadate, 1 mmol/L NaF, protease inhibitor cocktail, pH 7.4). Isolation of mitochondria was performed as described.21 Densitometry and quantitation of protein expression was performed using Kodak 1D software (Kodak, Rochester, NY). Statistical analysis of expression levels was performed by Student's t test using InStat or Prism software (GraphPad). Survival analysis was performed using the log-rank test (SPSS, Chicago, IL).
Immunohistochemical staining for cleaved caspase-3 was performed with the DAKO CSA Peroxidase System using a 1:200 dilution of antibody. Terminal deoxynucleotidyl transferase–mediated dUTP-nick-end labeling (TUNEL) was performed using the in situ cell death detection kit, POD (Roche).
Effects of IL-6 Pretreatment on Liver Regeneration.
Previously we showed that intramuscular injection of CHO cells expressing recombinant human IL-6 (CHO-IL-6) into athymic nude mice results in sustained serum levels of 40 to 80 ng/mL.14 This was associated with massive hepatocyte proliferation, which over a 12- to 15-day period resulted in livers twofold larger than livers of mice injected with a similarly selected control cell line (CHO-control).
To determine whether continuous IL-6 administration would accelerate liver regeneration, we performed PH on athymic nude mice 48 hours after injection of CHO-IL-6 or CHO-control cells. Although starting liver mass (measured as total weight of the resected liver lobes) was not different in IL-6–treated and control mice on the day of PH (data not shown), IL-6 administration clearly accelerated the early recovery of liver mass. IL-6–treated mice exhibited increased accumulation of liver mass at both 24 and 48 hours after PH versus controls; however, by 4 days after hepatectomy, no significant difference was observed (Fig. 1A).
We next sought to determine whether longer-term administration of IL-6 would further increase the rate of regeneration. Mice treated for 5 or 7 days with CHO-IL-6 cells exhibited no decrease in total body weight compared with controls, although total liver weight was increased 20% to 40% at 7 days, and total white adipose tissue weight was decreased. Histological analysis of intact livers from IL-6–treated mice without hepatectomy at 5d after injection demonstrated mitotic figures without evidence of apoptosis, reflecting ongoing hepatocyte proliferation as previously described.14 We hypothesized, therefore, that PH at 5 days in the setting of such active pre-resective hyperplasia would result not only in accelerated regeneration because of enhanced hepatocyte proliferation, but also in shorter time to recovery of starting liver mass because of the larger post-resection remnant liver mass. We found, however, that 5-day or 7-day IL-6–treated mice did not tolerate PH, and most died within 36 hours of the procedure (Fig. 1B). We hypothesized that the markedly increased mortality rate after 5 days' or 7 days' IL-6 exposure and subsequent PH might be attributable to abnormalities of apoptosis, consistent with the abnormal regenerative response elicited by hyper–IL-6.20 TUNEL staining of 5-day control and IL-6–treated livers was performed. We found a marked decrease in TUNEL-positive nuclei in livers pretreated with IL-6 for 2 days; however, after more long-term IL-6 treatment slightly more TUNEL-positive nuclei were observed in the IL-6 versus the control group (Fig. 1C-D). These data suggest that the anti-apoptotic effects of IL-6 were effective only after short-term exposure. We next examined the production of cleaved caspases and consistent with the TUNEL result found that there was less cleaved caspase-7 and 9 after 2-day IL-6 treatment but paradoxically more after longer pretreatment (Fig. 1E-F). No increased caspase-3 production was observed in any livers after PH (data not shown), suggesting that the mechanism for apoptosis involved activation of caspase-7 and 9. Given that liver regeneration involves a complex interaction of both mitogenic as well as anti-apoptotic signals, we were concerned that the increased liver apoptosis likely is only one of many potential factors that are dysregulated in PH after chronic IL-6 exposure. Likely insulin resistance, production and effects of acute phase proteins, and loss of protein and fat stores for the regenerative response also might be contributing to the observed increase mortality. To better understand the specific pathophysiological changes in the liver that are occurring after acute and chronic IL-6 exposure, we sought to examine the anti-apoptotic effects of short (2 days) and longer-term (7 days) IL-6 treatment on a second more targeted model of hepatocyte apoptosis. Thus, we examined the effects of in vivo administration of Jo2 antibody, a direct activator of CD95/Fas.5, 22
Effects of IL-6 on Jo-2–Mediated Apoptosis In Vivo.
Short-term IL-6 exposure is known to increase resistance to apoptotic signals.5, 23–25 As well, we have shown that CHO-IL-6 treatment of mice inhibits liver caspase-3 cleavage and activity.23 Thus, we hypothesized that continuous IL-6 treatment would inhibit apoptosis resulting from Jo2 administration. Indeed, 2 days of IL-6 pretreatment markedly decreased mortality in response to Jo2 administration (0.4 μg/g body weight); however, 7 days of CHO-IL-6 pre-treatment had no significant protective effect against Jo2-mediated death over 2 days of observation (Fig. 2A). Furthermore, we examined the effect of a sub-lethal (low) dose of Jo-2 (0.2 μg/g body weight) on concentrations of the serum markers of liver injury, aspartate aminotransferase and alanine aminotransferase; again a transient anti-apoptotic effect was observed (Fig. 2B). A significant survival benefit was observed after short-term IL-6 exposure but not after more prolonged exposure (Fig. 2C). Of note, 7-day IL-6–treated mice had proportionately larger livers than both 2-day IL-6–treated mice and all CHO-controls. Liver size had increased approximately 20% to 40% over controls; however, the Jo2 dose used was based on body weight. Thus, the Jo2 dose per gram of liver tissue given to the 7-day IL-6–treated mice was lower than that given to the 7-day control mice. In fact, slight increases in dose as would have occurred if dose were calculated proportional to liver mass resulted in substantially increased mortality, suggesting there may even have been increased sensitivity to the lethal effects of Jo2 in the 7-day IL-6–treated mice (data not shown).
Western blotting analysis of liver extracts from Jo2-treated mice showed no induction of caspase-7 as was observed after hepatectomy. Rather, reduced cleaved caspase-3 protein in 2-day IL-6–treated mice versus 2-day controls was observed (Fig. 2D). In stark contrast, cleaved caspase-3 levels in Jo2-treated 7-day CHO-IL-6 livers were comparable to controls, although the 17-kd fragment was more abundant in the IL-6–treated mice than in controls. Histological analysis demonstrated decreased cellular injury and fewer apoptotic figures in the 2-day IL-6–treated group relative to 2-day controls (Fig. 2D). TUNEL-staining for DNA fragmentation and immunohistochemistry for cleaved caspase-3 (the active form of the enzyme) demonstrated fewer TUNEL-positive nuclei and markedly less cleaved caspase-3 immunoreactivity in 2-day IL-6–treated livers over 2-day controls. In contrast, 7-day IL-6–treated Jo2 livers showed similar cellular injury, apoptotic figures, TUNEL staining and cleaved caspase-3 immunoreactivity as the Jo2 controls, consistent with a lack of protection with 7 days of IL-6 treatment.
Sustained IL-6 Administration Inhibits Apoptotic Pathways.
We next examined the effects of continuous IL-6 administration on activation of the gp130/STAT3 signaling pathway and markers of apoptosis. Western blotting analysis showed persistent STAT3 phosphorylation in CHO-IL-6–treated livers as early as 2 days after CHO-IL-6 injection (Fig. 3A). Expression of the IL-6 co-receptor gp130 was increased by CHO-IL-6 treatment at all times examined. Consistent with our previous observations, cleavage of the caspase-3 substrate poly (ADP-ribose) polymerase (PARP) was chronically and progressively reduced by CHO-IL-6 treatment. These results suggest that chronic IL-6 administration led to persistent STAT3 activation, upregulation of the IL-6 signaling pathway, and inhibition of the apoptotic cascade (Fig. 3A).
To determine whether the inhibition of Jo-2–induced apoptosis might be attributable to induction of anti-apoptotic proteins by IL-6 treatment, we performed Western blotting analysis of liver lysates from mice treated with CHO-control or CHO-IL-6 cells. Indeed, both Bcl-2 and Bcl-xL demonstrated a sustained induction of roughly 3-4 fold over CHO-controls on days 2 through day 7 of CHO-IL-6 treatment (Fig. 3B). No induction of either the anti-apoptotic bifunctional endonuclease/redox factor Ref-1 or the caspase-8/10 inhibitor FLIP (FLICE-like inhibitory protein) was observed at any time point (Fig. 3B).25–29 Thus, chronic IL-6 administration led to persistent STAT3 activation and sustained induction of the anti-apoptotic proteins Bcl-2 and Bcl-xL.
IL-6 Induces Bax, Bad, and Mitochondrial Destabilization.
Based on these results, we found no evidence for late downregulation of anti-apoptotic proteins, but rather found evidence for sustained anti-apoptotic signaling in unchallenged, IL-6–treated livers as previously reported.5 Indeed, IL-6 exposure maintained increased Bcl-2 and Bcl-xL levels regardless of duration of exposure. Thus we examined the alternative explanation for the paradoxically increased sensitivity to apoptosis upon more prolonged IL-6 treatment, namely, upregulation of pro-apoptotic proteins. BH3-only members of the Bcl-2 super-family function as upstream sentinels that respond to specific, proximal death and survival signals.30 One of these BH2-only proteins, Bid, is activated by caspase-8 cleavage after engagement of cell surface death receptors. When cleaved, the tBid (truncated Bid) translocates to the mitochondria, where it triggers Bak oligomerization with subsequent mitochondrial damage and activation of the intrinsic path to cell death.30 Western blotting analysis of liver lysates from control and IL-6–treated mice, however, demonstrated no increase in levels of full-length Bid (Fig. 3B). Truncated Bid was undetectable. A second BH3-only protein, Bad, determines life or death for the cell depending on the presence or absence of survival factors and glucose. Growth factors and glucose result in phosphorylation and inactivation of Bad, preventing its activation of the pro-death Bcl-2 family member Bax.30 Although Western blotting analysis showed that IL-6 treatment markedly increased total Bad protein over CHO-controls, total phospho-Bad protein also increased, suggesting that the protein was inactive in the unstimulated, CHO-IL-6–treated livers (Fig. 3B).
BH3-only proteins activate Bak and Bax, causing their dissociation from anti-apoptotic proteins such as Bcl-2, Bcl-xL and MCL-1, and translocation to the endoplasmic reticulum and mitochondrion, triggering cytochrome c release, formation of the apoptosome, and activation of effector caspases to induce apoptosis. Western blotting analysis showed that a tBid target protein, Bak, was not increased by chronic IL-6 treatment versus controls (Fig. 3B). In stark contrast, expression of the Bcl-2 family member death agonist Bax was markedly induced by IL-6 treatment, with expression peaking at later times precisely when CHO-IL-6 mice exhibit both decreased survival after PH and lack of protection from Jo2-induced apoptosis (Fig. 3B-C).
Chronic IL-6 Leads to Increased Jo-2–Mediated Mitochondrial Bax, Cytochrome c and AIF Release, and Activation of Caspase-9.
The observed upregulation of Bax suggested that the cause of chronic IL-6 exposure-associated hepatocyte sensitization to death might be enhanced activation of the intrinsic (mitochondrial) pathway to cell death. If this hypothesis is correct, increased mitochondrial Bax, increased cytochrome c release, and enhanced caspase-9 cleavage would be observed after an extrinsic apoptotic stimulus. We therefore treated mice with CHO-IL-6 or CHO-control cells for 2 or 7 days and analyzed the intrinsic pathway to apoptosis by Western blotting analysis of total and fractionated liver lysates. In the absence of Jo2 administration, liver samples from mice subjected to 7-day CHO-IL-6 treatment demonstrated biochemical features of mitochondrial destabilization (Fig. 4), despite histological evidence of robust hepatocyte mitosis and no apparent apoptosis (data not shown). Specifically, livers from 7-day CHO-IL-6 mice showed substantial mitochondrial Bax association and increased cytosolic apoptosis-inducing factor (AIF),31 a mitochondrial effector of apoptotic cell death. Despite the presence of these two key biochemical features of apoptosis, the intrinsic pathway to cell death was not activated in 7-day CHO-IL-6 livers as indicated by the fact that cytosolic cytochrome c, caspase-9 cleavage, caspase-3 cleavage, and PARP cleavage were actually decreased or unchanged relative to CHO-controls.
Challenge of CHO-control and CHO-IL-6–injected mice with Jo2 resulted in biochemical evidence for inhibition of apoptosis in 2-day CHO-IL-6 mice versus 2-day CHO-controls. Mitochondrial Bax was increased in 2-day CHO-IL-6 mice versus 2-day CHO-controls; however, mitochondrial injury was diminished in 2-day CHO-IL-6 livers. Specifically, Western blotting analysis of cytosolic fractions demonstrated decreased cytochrome c and decreased AIF in 2-day CHO-IL-6 Jo2 livers versus 2-day CHO-control Jo2 livers. Moreover, capase-9 and caspase-3 cleavage in 2-day CHO-IL-6 Jo2 livers were also dramatically reduced over 2-day CHO-control Jo2 livers.
In contrast to the protection against apoptosis produced by 2 days of IL-6 treatment, 7 days of IL-6 treatment did not diminish activation of apoptotic pathways. Analysis of extracts from 7-day CHO-IL-6 Jo2-treated livers demonstrated equivalent caspase-9 activation, similar caspase-3 cleavage, and comparable cytosolic cytochrome c levels as 7-day CHO-control Jo2-treated livers. Strikingly, both mitochondrial Bax and cytosolic AIF were increased in 7-day CHO-IL-6 Jo2-treated livers. Taken together, these results suggest that long-term IL-6 treatment results in increased Bax expression, which tilts the balance of life or death toward apoptosis in the presence of an apoptogenic agent such as PH or Jo2 administration.
IL-6 Administered Through Osmotic Mini-pump Increases Bax.
To confirm that the observed induction of Bax was not a phenomenon of the athymic nude mouse/CHO model system, we also delivered recombinant murine IL-6 (rmIL-6) to immuno-competent C57BL6/J mice through intraperitoneally-implanted osmotic mini-pumps. Control mice were implanted with pumps containing carrier only. The osmotic mini-pumps delivered 10 μg of IL-6 per day for 7 days. Serum rmIL-6 concentrations roughly 80 times normal or carrier-only pump levels were measured at the time of necropsy (2,182 ± 1427 pg/mL vs. 27.35 ± 22.49 pg/mL). Consistent with our previous report of IL-6–induced hepatomegaly, increased liver mass and increased hepatocyte mitotic figures were observed, with no evidence of apoptosis (unpublished data). Western blotting analysis of liver lysates from mice treated for 7 days with rmIL-6 pumps demonstrated sustained STAT-3 phosphorylation, increased gp130 expression, increased proliferating cell nuclear antigen expression, decreased PARP cleavage, and increased Bax expression as compared with carrier-only control livers (Fig. 5 and Table 1). These results confirm in a second model system the pro-mitogenic and anti-apoptotic effects of chronic IL-6 administration, despite the induction of Bax.
|1 ± 0.64
|7.18 ± 2.02
|1 ± 0.05
|0.80 ± 0.16
|1 ± 0.18
|1.39 ± 0.12
|1 ± 0.05
|1.47 ± 0.20
|1 ± 0.08
|0.26 ± 0.08
|1 ± 0.41
|2.12 ± 0.31
|1 ± 0.43
|2.41 ± 0.62
|1 ± 0.41
|2.34 ± 0.87
A number of reports have identified an important role for IL-6 in the hepatic regenerative response after injury or resection.4–7 More recently, investigators have also examined the potential therapeutic application of IL-6 and a linked IL-6 co-receptor complex (termed "super-IL-6") in liver disease.16 As demonstrated herein, exogenous IL-6 may accelerate recovery of liver mass in vivo, consistent with findings that IL-6 may have therapeutic application in the prevention of ischemic injury during organ preservation before transplantation and in amelioration of hepatic steatosis.32–35 The role and effects of the persistently increased IL-6 present in a wide variety of disease states, however, remains poorly defined. Several reports suggest that this chronic signaling may be protective against injury. We and others have reported, however, that IL-6 may alter glucose resistance in vivo and may actually contribute to the insulin resistance observed in diabetes.36, 37
We show that short-term IL-6 exposure is anti-apoptotic and accelerates recovery of liver mass after hepatecomy and confirm the findings of Kovalovich et al.5 that IL-6 decreases hepatic sensitivity to Jo2-induced hepatocyte apoptosis. This resistance is associated with decreased activation of the mitochondrial apoptotic pathway with increased expression of the anti-apoptotic factors Bcl-2 and Bcl-xL. Less impressive induction of FLIP or Ref-1 is observed in our model system than has been reported by others.5, 25 Our data demonstrate that acute IL-6 treatment is associated with decreased cleaved-caspase-9 and cytoplasmic release of mitochondrial proteins. These data support and confirm the potential application of IL-6 as a factor to improve liver preservation.33
The acute effects of IL-6 on the liver in vivo are, however, in apparent conflict with other published reports that IL-6 delayed the regenerative response.20 We initially investigated whether longer-term IL-6 would continue to be beneficial for recovery from liver resection and were surprised to find impaired recovery after injury. We report herein the novel observation that prolonged exposure to IL-6 in vivo is anti-regenerative and pro-apoptotic. Prolonged exposure to IL-6 is associated not only with the continued increased production of multiple anti-apoptotic factors but with the induction of mitochondrial-destabilizing pro-apoptotic protein Bax. The induction of Bax sensitizes hepatocytes to the intrinsic pathway to cell death by tipping the balance between anti- and pro-apoptotic signals toward mitochondrial destabilization and death through increased caspase-9 activation. Induction of these pro-apoptotic factors appears to override the early anti-apoptotic effects of IL-6.
Upregulation of hepatic Bax has been observed in chronic liver disease and in liver dysfunction in late sepsis.38–41 These results suggest persistent abnormal signaling in these conditions, possibly because of chronic IL-6 overproduction, may be mediating some of the cellular deficiencies observed in these chronic states. An association of IL-6 and STAT-3 activation with fatty liver disease has been demonstrated,13 with ob/ob mice exhibiting persistent STAT3 signaling as well as profound steatosis and abnormal liver regeneration.
The cellular pathways involved in chronic IL-6–induced upregulation of Bax are unclear. We have previously demonstrated prolonged IL-6 exposure induced decreased baseline c-met and EGFR expression and phosphorylation, suggesting decreased hepatocyte signaling of the important hepatic mitogens hepatocyte growth factor and EGF, respectively.14 Such growth factor withdrawal/inhibition of growth factor signaling is well known to induce Bad production/activation and mitochondrially mediated apoptosis. As well, we have found that persistent IL-6 signaling results in increased expression of suppressor of cytokine signaling-3 (unpublished observation), which is known to inhibit signaling of multiple pro-mitogenic pathways, including the insulin and EGFR pathways. The degree of suppressor of cytokine signaling-3 induction in our system, however, is perhaps 2- to 3-fold and considerably less than that observed during the liver regenerative response.42 Another intriguing possibility is that organ cross-talk secondary to systemic cachexia may be involved in the hepatic Bax response. Future studies are targeted at determining the molecular pathways altered by chronic IL-6 over-expression.
Finally, we found that the terminal caspase activated by PH and caspase-3 differed. PH activated caspase-7 and Jo-2 activated caspase-3. This was observed also in control mice not treated with IL-6. In both models caspase-9 activation occurred, suggesting that both pathways involve a mitochondrial component to the terminal caspase activation. How these pathways ultimately result in the observed different caspase activation, however, is unclear. As well, although IL-6 pre-treatment resulted in an improved early recovery of liver mass after PH, no improved survival after PH was observed, making the benefit of IL-6 unclear. Other questions also remain, including the contribution of IL-6–induced peripheral insulin resistance and acute phase proteins to the dysfunction after PH or Jo-2. Future studies targeting disruption of hepatic STAT3 and its downstream targets are planned.
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I consider this book mandatory reading for digital and social marketing practitioners – or those general managers wanting to learn more about the field.
This section also distinguishes between a digital strategy and a social strategy, a key difference that very few grasp and can lead to disappointing results.
The case studies are very interesting, ranging from typical tech companies like Twitter and LinkedIn to more traditional ones like American Express and Nike.
This is written in such obtuse English it may as well be written in a foreign language. More examples would help some, but it's essentially incomprehensible.Published 2 months ago by Jeffrey A Miller
I am awarding this book five stars because it is the best all around book on social strategy that I have yet read. Read morePublished 5 months ago by Ben Faw
Finally, a book that makes use of serious sociological theory to study social media. The author analyzes huge amounts of data to make sense of the sociological processes that drive... Read morePublished 5 months ago by M.I. Fernandez-Mateo


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Al Nawras Metal Scrap Trading LLC
based in Sharjah, UAE, UNITED ARAB EMIRATES
We Al Nawras Metal Scrap Trading LLC Based In UAE Since 2007 & Our Parent Company Al Jenaibi General Trading Company LLC Which Was Established In UAE Since 1993..We Are One Of The Exclusive Metal Scrap Buyer, Scrap Dealer, Scrap Merchant, Trader, Yard Owner, Manufacturer, Of All Kinds Of Metal Scrap, Ore`s (Minerals) & Scrap Demolition Vessel`s In UAE (Dubai) & ...
Rite Metals
based in SOUTH AFRICA
Buyer of surplus and excess stainless steel. Buying and recycling services for scrap metals including car batteries, radiators, electric motors, catalytic converters, factory scrap, insulated wires, and bus plug transformers are also available. Industrial pick-up service using flatbed, dry van fleet, and roll-off containers in sizes 20-80 cubic yards is available. Stock ...
Black Country Metals Limited
based in Stourbridge, UNITED KINGDOM
Black Country Metals Limited was formed in 1986 to trade Internationally in ferrous & non-ferrous Recyclable (Scrap) Metals. The company has been approved to ISO 9001 by Bureau Veritas Quality International Limited since February 1991.
Institute of Scrap Recycling Industries, Inc. (ISRI)
based in Washington, DISTRICT OF COLUMBIA (USA)
A Washington, D.C.-based trade association, ISRI represents nearly 1,600 private, for-profit companies operating at more than 7,000 facilities in the United States and 30 countries worldwide that process, broker, and industrially consume scrap commodities, including ferrous and nonferrous metals, paper, electronics, rubber, plastics, glass, and textiles. In addition, ...
Gold Metal Recyclers
based in Dallas, TEXAS (USA)
Gold Metal Recyclers purchases all ferrous and nonferrous material, including aluminum, brass, copper, stainless steel, tin, titanium and steel, as well as some non-metallic items and electronics. Dallas-based and family-owned Gold Metal Recyclers serves the scrap metal recycling needs of industrial manufacturing companies and other recycling companies across the world. ...
Midwest Industrial Metals, Inc.
based in Troy, MICHIGAN (USA)
Midwest Industrial Metals is a full-service metal recycling facility. We purchase all grades of ferrous, non-ferrous, surplus inventory, and electronic scrap. We come in competitive from day one and never become complacent. As market and economic conditions change, we are proactive in making sure that our customers always receive the best pricing available. Most ...
ELG Metals Inc.
based in McKeesport, PENNSYLVANIA (USA)
For over forty years, our business has covered recycling and global trading in raw materials for the stainless steel industry. Currently, ELG has more than forty operational locations, thereby offering you one of the largest networks worldwide. With its competent contact partners, ELG`s network is able to guarantee you individual and prompt service at any time. Our ...
PSC Metals Inc.
based in Mayfield Heights, OHIO (USA)
PSC Metals is one of North America's premier ferrous and non-ferrous scrap processors. With over a century of industry leading performance, we offer full service processing of ferrous and non-ferrous metals. Our success is strategically linked to our view of both supplier and consumer sharing the position as customer. Meeting customer needs each and every day is our ...
European Metal Recycling Ltd
based in Warrington, UNITED KINGDOM
European Metal Recycling is a global leader in recycled products and environmental services, managing over 10 million tonnes a year of materials from consumers, industry and demolition works.


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Forecast more >
A weak cold front will move through our area tonight with temperatures a little cooler for Thanksgiving. A warming trend will begin this weekend with a slight chance of light showers Sunday.
Lakes ...
Search Results
New information released in Thursday's fatal shooting
New information has been released in Thursday's shooting at 11th Street and Laurel.
"At this point we do not feel this was a random act," Sgt. Rob Flores said. "Detectives are working to determine the connection between the victims and the shooter. There is some connection between the two females in the car and the shooter. This did not appear to be a random act."
The young woman killed in the shooting was identified Thursday as 22-year-old Dominique R. Reed of Beaumont.
At about 4:37 a.m. Thursday officers responded to a reported minor vehicle crash at the intersection of 11th Street and Laurel Street. The female caller stated that a man involved in the crash was brandishing a rifle. The caller hung up and when our 911 operators phoned her back, she said that the man had just shot her friend.
Officers converged on the area and located the female caller. She was uninjured. The female shooting victim died at the scene.
Officers also found a second shooting victim at the scene. According to the witness, the suspect shot this second victim, an unrelated passer-by, who had stopped to help at the crash. Beaumont EMS transported the male passerby to St. Elizabeth ER for his gunshot wound. ER personnel admitted him and listed him in stable condition.
Witnesses described the suspect as a Hispanic male, short and heavy-set, with an eye abnormality they described as "cross-eyed." They last saw him fleeing the area immediately after the shooting. He was driving a dark colored, older model pickup truck. He was armed with a rifle.


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Winnipeg Free Press - PRINT EDITION
Missing Sinclair list raises glaring issue
AN inquest into the death of Brian Sinclair in the HSC ER saw videotape Monday of the 34 hours he awaited medical attention, to no avail. It included the man's arrival at the triage desk, where a triage aide came to his side, bent low to speak to the man who had a severe speech impediment, and wrote information on a paper pad.
The quality of the interaction between Mr. Sinclair and the aide has been an important issue — the Winnipeg Regional Health Authority has released the barest of details on what happened from Sept. 19, 2008, when Mr. Sinclair arrived at the ER, until 34 hours later when he was discovered dead by another person in the waiting room. Det.-Sgt. John O'Donovan, who reviewed all ER security videotape in a criminal investigation into the death, noted that the aide's paper pad was kept at the triage desk so that nurses could track those they had yet to assess and place in line to see a doctor. When Mr. Sinclair arrived, another person was speaking to the nurse. As he waited next to that person, the triage aide intercepted him, spoke briefly and then Brian Sinclair went to wait.
But the aide's notes were not available to the police for the investigation. In fact, months after the death, a board member of the WRHA noted publicly they had been destroyed. Why the notes would not have been preserved — despite two internal investigations by the WRHA immediately after the death — is a glaring question.
It defies common sense, and responsible record management, that such key documents would be destroyed. The inquest has yet to hear from the aide, the nurses and other staff on duty over the time Mr. Sinclair sat awaiting help. The video reviewed at the inquest showed that for almost all the 34 hours, Mr. Sinclair sat in pretty much the same spot in the waiting room in front of the TV. He had parked his wheelchair in an aisle that led to vending machines and the washrooms and hospital staff and numerous other people walked past him. (Evidence is that Mr. Sinclair vomited and the tape shows a chrome basin in front of the double-leg amputee's chair.) The missing list of names is evidence the HSC ER had a formal record of Mr. Sinclair's visit. Many questions remain to be answered, but one obvious outcome of the inquest ought to be a recommendation that all documents of patient contact, from the formal chain of triage on, must be treated as official hospital records and maintained as such.
Editorials are the consensus view of the Winnipeg Free Press' editorial board, comprising Catherine Mitchell, David O'Brien, Shannon Sampert, and Paul Samyn.
Republished from the Winnipeg Free Press print edition August 27, 2013 A8
Updated on Tuesday, August 27, 2013 at 9:58 AM CDT: Adds live blog box, tag.
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The time to have started preparing for Black Friday, apparently, was in late October. That's because rushing to line up, ...
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What is the STEM Van?
STEM stands for Science, Technology, Engineering and Mathematics. The STEM Van is a mobile classroom designed to deliver fun, exciting, educational programs on these subjects. It contains a full A/V system, portable generator and enough supplies and equipment to conduct programs on everything from insect study to robotics to rocketry!
Why does the DC Metro Area need the STEM Van?
STEM is becoming an increasingly important skill set for young people entering the workforce.
The STEM Van helps ensure local youth have access to resources on these vital subjects beyond
what their schools may be able to provide.
Who made the STEM Van possible?
The STEM Van is supported by the generosity of local businesses and sponsors.The major sponsors are:Meg & Norm AugustineBSA National FoundationGeneral Dynamics Lincoln Electric
Where does the STEM Van go?The STEM Van will visit schools, county fairs, Scouting events and other community programs
throughout the DC metro area. A large part of its mission is to provide supplementary STEM
programs to underfunded schools that cannot afford all the scientific equipment they need.
11/25/2014Help Get Scouting License Plates in Virginia
11/14/2014Second Chance Popcorn Sale!
12/5/2014 » 12/6/2014
Aquia District - Introduction to Outdoor Leader Skills (IOLS)
Trainers EDGE


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Created: 01/02/2014 11:12 PM KAALtv.com
(ABC 6 News) -- Big changes could soon be coming to an Austin landmark. Although they are still going through negotiations, officials with Kwik Trip confirmed they have placed an offer to buy the Watts Cookin' Restaurant and Gas Station.
They tell us they would build a new truck stop adjacent to the current one, and would also like to bring a hotel and restaurant to the site.
Officials say the current gas station and restaurant would likely stay open only until the new one is built, and would be demolished after that. The new facility would cost upwards of five million dollars and could bring up to 30 jobs to the area.
The owners of Watts previously said the business would close if they couldn't find a buyer. Kwik Trip says they're optimistic a deal can be reached in the next two weeks.
|Car Plows Into Protestors in Minneapolis Following Ferguson Ruling
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|Austin Police Officer Placed on Leave
|Dramatic Video: 1 Hurt after Car Hits Protesters at Mpls. Ferguson Rally
|Winter Storm Warning Out for Portions of Southern Minnesota


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Edward's new book is in the works with Plain View Press, after a very successful Indiegogo Campaign. Thanks to all the patrons who contributed! The book is due out in December 2014 or January 2015. Check out the page on this site dedicated to Everyday Objects.
Edward A. Dougherty is a poet who earned an MFA in Creative Writing from Bowling Green State University and has published 2 collections of poetry and 5 chapbooks, the most recent of which is Backyard Passages (2012, FootHills Publishing).
He has contributed to many publications, as poetry editor at the Mid-American Review and as a contributing editor at the Alehouse Review, Third Wednesday, and Rowboat: Poetry in Translation. In addition to poetry, Dougherty's essays and reviews have appeared in the Cincinnati Review, North American Review, and War, Literature, and the Arts. His essay about learning the craft of poetry (and crafting his life for it) was published in Memoir and reprinted in the second edition of The Working Poet.
One of his recent projects is a collection of emblems which combine a short verse with small calligraphic abstract artwork (see Events).
Another manuscript entitled Under a Secret Zodiac brings together his long interest in poetic images and visual arts. Originally, this interest led to his chapbook The Luminous House, which responds to artwork by Paul Klee, but recently he returned to that collection and expanded it by contemplating Marc Chagall's paintings as well. Under a Secret Zodiac made it into the top 100 in Copper Canyon's open reading period.
Finally, it took over a decade, but Edward's completed 10048, a collection of poems about the World Trade Center. The manuscript has been a finalist and semi-finalist in contests, and was even accepted for publication but editorial differences kept it from going forward.


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Harvard Medical School Psychologist to Speak March 20
Harvard Medical School psychologist Nancy Etcoff will speak at Lebanon Valley College Wednesday, March 20 at 5 p.m. in Zimmerman Recital Hall of Suzanne H. Arnold Art Gallery. Her presentation, titled "Maxims or Myths: Six Ideas about How to Increase Happiness in Daily Life," is sponsored by the HAPPINESS Colloquium Series and is free and open to the public.
During her presentation, Etcoff will consider a half dozen common ideas and discuss whether evidence from positive psychology and other sciences confirms or denies their importance to happiness and well-being. She will focus on college-related topics.
Etcoff is the director of the Program in Aesthetics and Well Being at the Massachusetts General Hospital Department of Psychiatry. She has conducted extensive research on the perception of beauty, emotion, and the brain for over 15 years. Etcoff's book, "Survival of the Prettiest," refutes social origins of beauty in favor of more evolutionary explanations.
"We are thrilled to present Dr. Etcoff because of her psychology background and national reputation as an author and researcher," Dr. Robert Valgenti, LVC associate professor of philosophy, said. "Her record is impressive; she is a really dynamic speaker."
HAPPINESS is a year-long integrated series of guest speakers, roundtable discussions, films and courses that will consider the meaning and importance of happiness as a psychological, physiological, social and cultural phenomenon. It involves presentations by speakers from a number of disciplines who approach the theme from the standpoints of the arts, the wellness of body and mind, the demands of a consumer economy, the expectations and duties of political life, and the broad philosophical questions of human flourishing. For more information visit www.lvc.edu/live-calendar.
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Ventriloquist to Perform Nov. 21 for Lebanon Valley College's Friday Night Comedy Series
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Phi Mu Alpha Sinfonia Presents Reynaldo Rovers Memorial Recital on Nov. 23
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Lebanon Valley College Transforms Technology Room in Blair Music Center
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Lebanon Valley College Jazz Band Performs Annual Fall Concert Nov. 21
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Woodrow "Skip" Dellinger '62 to Contribute to Senior Class Gift Drive
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The Lebanon Valley College Guitar Ensemble to Perform Concert Nov. 20
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Celebrate Day of Philanthropy: Make a Difference, Get an LVC Pennant!
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Lebanon Valley College Presents Symphony Orchestra Concert on Nov. 16
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Lebanon Valley College Presents Art Lecture by Jim Nikas on Nov. 18
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Lebanon Valley College Professors to Participate in Conversational Debate: Does God Exist?
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Lebanon Valley College to Present Small Jazz Ensemble Concert
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First Lieutenant Howard A. Lloyd '36 Honored During Normandy Trip
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Vale Music Industry Conference to Showcase Lebanon Valley College Music Alumni
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Lebanon Valley College Offers "Spanish for Heritage Speakers" for Second Semester
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LVC Music Programs Re-Accredited by National Association of Schools of Music
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"Rio" Voice Star Francisco Ramos Visits Lebanon Valley College Nov. 7 for Friday Night Comedy Series
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Lebanon Valley College®
in Annville, Pa., welcomes 1,600 full-time undergraduates studying more than 30 majors, as well as self-designed majors. Founded in 1866, LVC has graduate programs in athletic training, business, music education, physical therapy, and science education. Annville is 15 minutes east of Hershey and 35 minutes east of Harrisburg; Philadelphia, Washington, D.C., and Baltimore are within two hours.
Lebanon Valley College
101 N. College Avenue
Annville, PA 17003-1400


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P2K Range is a state of the art shooting sports facility located in El Cajon, California. Members and guest enjoy many ranges that cover all shooting disciplines for rifle, pistol, shotgun shooters. P2K features the largest indoor 100 yard climate controlled shooting range on the west coast.
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Seventeen Ways to Blow Your Tax Refund (In One Shot)
Photo 1 of 18 View on One Page
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Seventeen Ways to Blow Your Tax Refund (In One Shot)
Now that tax day is over, many of us can look forward to receiving refunds. Personally, I like to take a cue from Savvy and bank mine. But what if you wanted to blow your refund on beauty products? I've rounded up some over-the-top luxury items that could eat up your entire check — and then some. (This stuff makes Creme de la Mer look inexpensive in comparison!)
Latest Beauty


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Upcoming Events
Holiday ClosingWillard Library will be closed, Thursday, November 27, for Thanksgiving Day.
Brushbots Science
Make a tiny robot from a toothbrush and test your skills in a robot race. Registration is required, call 296-968-8166 etx. 517, ages 8-14.Thursday, November 20
6:00 p.m.
Willard Library Meeting Room
Pout-Pout Fish Costumed Character
Don't miss your chance to meet everyone's favorite fish at the Helen Warner Branch.We can't wait to see if he can turn his frown upside down!Friday, November 213:30-4:00 p.m.Saturday, November 2211:00-11:30 a.m.Helen Warner Branch


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metals recycler,
shredded scrap,
No. 1 busheling,
Chicago market,
Detroit market,
Alabama market,
Pittsburgh market,
price spreads
Lisa Gordon
PITTSBURGH The shrinking spread between prime and obsolete grades of scrap is expected to continue due to a tightness in supply of shredded and cut grades of metal scrap.
"Obsolete scrap remains tight and the short supply will lead to better prices. With prime scrap now very close in price to shred in Detroit, the demand for busheling will increase," one Detroit market source said.
The Detroit and Chicago spreads between No. 1 busheling and shredded auto scrap stood at $45 per gross ton Dec. 1. It now stands at $14, marking a $31-per-ton narrowing over the course of the month.
Other areas are experiencing similar phenomena. In Alabama, the spread has shrunk $5 to $27 per ton, and in Pittsburgh it has dipped $15 in one month to $32 per ton.
Steel mills are expected to step up their purchases of No. 1 busheling and bundles, which results in a higher metallic yield as it becomes more affordable.
The scenario is playing up for an unusual phenomenon, one Chicago source said.
"(Heavy melting scrap) No. 1 and No. 2 will continue to be in very short supply, as those grades are for the most part now being shredded. The spread between prime and shredded will continue to compress to where we could see the two grades on par or even inversed. However, this will cause mills to chase prime more as yields and chemistries are better, and once again open the spread between the two," he told AMM.
The hierarchy of scrap prices went awry in May 2012, with busheling selling at a discount to shredded scrap (amm.com, May 4, 2012).
The narrowing price trend is due to a combination of tight supplies of shredded and cut grades coupled with a relatively healthy manufacturing sector, which is increasing the amount of prime scrap to the market.
The weather is also a factor. "So far it is only December and it appears that we might actually have a real winter this year. Weve been spared for the last couple years, but the cold weather and snow will slow down peddlers," one Birmingham, Ala., scrap processor said.
Peddlers are an important source for obsolete scrap.
"Supply is weak and this is the worst time to try and get material. It is just not available. Ever work outside when its single-digit temps?" one Pittsburgh scrap processor asked.
The pressure on the tight obsolete grades is being felt at the scale houses of auto shredders.
"Some shredders are already behind on their orders because of the slow inbound (deliveries)," the Pittsburgh source said.
"We are hearing that shred will again push the market in January and that some mills are already pushing for January shipments on a (to-be-determined price) basis," the Detroit source added.
All comments are subject to editorial review.
All fields are compulsory.
Every month American Metal Market takes a statistical look inside the marketplace.
We actually don't know who his investors are. At the point when we are ready, we will investigate further. There are just so many things to handle and there are a lot of items to be considered with the project."
-- Charles C. Mitchell, Barstow city manager


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Hope all of you are having a great week! I just returned from a lovely and relaxing vacation in Riviera Maya, Mexico (hence the bronze glow..lol) and it was a much needed vacay. Anywho, the hubby and I went to see one of my favorite singers, Jazmine Sullivan last night in NYC and she was absolutely amazing! She has such a beautiful voice and we truly enjoyed our night on the town! On to what I wore, it seems as though boyfriend jeans and booties have been my go-to as of lately. I find boyfriend jeans to be so comfy yet effortlessly chic when paired with the right top and shoe. They can be styled with booties, a pair of sky high pumps, loafers, a pair of Chuck Taylor's, the possibilities are really endless. Any who, this was my look for the night. Warmth, comfort, and keeping it cute was my M.O. Hope you enjoy! XOXO
Ensemble Deets:
Jacket-Loehmann's and Cotton on
Pearl Earrings-Lord & Taylor


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Dr. Sharon E. Durousseau, MD
Pediatrics, San Leandro Medical Center
- 2500 Merced St MEDICAL STATION 304
San Leandro, CA 94577
- 1 Office Location
- (510) 454-1000
Dr. Sharon E. Durousseau is a practicing physician. Dr. Durousseau practices medicine in San Leandro, CA and specializes in Pediatrics. Dr. Durousseau is affiliated with Kaiser Permanente Medical Center - Roseville.
Gender: Not Available
Years in Practice: Not Available
Languages Spoken: Not Available
Medical School: Not Available
Graduation Date: Not Available
Hospital Affiliations: Kaiser Permanente Medical Center - Roseville
Specialties: Pediatrics


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Au 1195.85 $/oz
Pt 1221.00 $/oz
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A low-cost, inflatable incubator won this year's international James Dyson design award, which aims to encourage and inspire the next generation of design engineers.
The World Bank released its 'Doing Business 2015: Going Beyond Efficiency' report last month and ranked South Africa 43 out of 189 global economies for its ease of doing business, with Singapore topping the rankings.
Air Products South Africa officially launched its R300-million Eastern Cape air- separation unit (ASU), at its new manufacturing facility in the Coega Industrial Development Zone (IDZ), earlier this month. It is the second facility that Air Products launched in South...
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Nov 25 2014
NYIT Architecture Students Design and Build Beach Project
NYIT Architecture Students Design and Build Beach Project
NYIT Celebrates International Education Week
Men's Soccer Wins ECC Championship with 1-0 Victory over LIU Post
Dr. Jerry Balentine New Vice President for Medical Affairs and Global Health
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Job Search Strategies
Head in the Cloud? Protecting Your Privacy in a Mobile World
Give 'Em the Business: Resources for Management Students
"Year of Turkey 2014" - Conference: Sustainability in the Hospitality Industry-A Global Perspective
School of Engineering & Computing Sciences Graduate Info Session
Read detail about this grant here
This grant is funding the Workforce Advancement through Geriatric Education (WAGE) Training program: The multidimensional care and knowledge needed to assist the aging population in optimizing and maintaining their health status requires expertise and continued education for all levels of health care providers.
Older adults, who are living longer with multiple health problems (many of which are chronic) are requiring more health care. This unique NYIT program focuses on increasing the geriatric expertise and competency level of licensed nurses and paraprofessionals who are caring for the aging population.
Advance your career with knowledge about caring for older adults in a fast-track, innovative, 20 hour continuing education geriatric program at no cost to participants.
For details, visit the NYIT Department of Nursing website here.