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Call it a comeback. After nearly two years out of the spotlight, the Diplomats' charismatic founder, Cam'ron, sat down with XXL magazine for his first interview in years. The cover story features Cam finally speaking on his enigmatic hiatus, Diplomats ...Read More
Featured On XXLmag.com
The Latest
Eve Reworks Shelved Disc, Says Album Coming This Year
It looks like the self-proclaimed "pitbull in a skirt," Eve, will be releasing her heavily delayed album after all. In an interview with the New York Post's PopWatch blog, the West Philly MC blamed her disc's repeated setbacks on her "whole music ...Read More
Snoop Dogg, 50 Cent & Lupe Fiasco Among Hip-Hop Acts At Spring Music Fests
The lineups for several big music festivals have been announced and many hip-hop heavyweights including 50 Cent, Snoop Dogg, Lupe Fiasco and Clipse have all been tapped to rock the stage. Billboard reports that Snoop, the Beastie Boys and Erykah ...Read More
50 Cent & Rick Ross: Giving Season
It's not for Killaz, just Hundred Dollar Billaz. As this magnificently unavoidable 50 Cent vs. Rick Ross spat gets super-uglier by the Clear Channel radio shift, I can't help but ponder the true battery in the back of this now full-blown ...Read More
The Beat Goes On…
What up y'all? It's Datwon aka DT and I'm doing the Scratch blog for a minute. My approach is a lil' different than the homie Gooch. No big explanations about what I'll be bringing, just know that some good music ...Read More
Revenge is like the sweetest joy
Props to Fiddy Cent for taking hip-hop beef to a new level, by doing some charity work with Rick Ross' baby's mother, and then letting the world know by making that hilarious video. Sure, Jay-Z once banged Nas' baby's mother in ...Read More
50 Cent/Rick Ross Beef Rages On, Ross Reacts To Fif's Connection With His Baby Mama
The 50 Cent and Rick Ross beef has taken on a new chapter as Fif has brought the mother of Ross' son into the equation, with a shocking video that hit the net yesterday. In light of 50's insolent move, ...Read More
Back Off, Ricky!
Let's keep it funky, here. Rick Ross is outdoing 50 Cent on the musical tip. "Mafia Music" > "Get Up," "Magnificient" > "I Get It In." But while Rick is putting out better material, he's getting absolutely destroyed on the battlefield. ...Read More
Mr. Len "Soylent Green 6″
So you're wondering what other music there is besides what you always hear...... You're WELCOME! ...Read More
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Hip-Hop News
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subset: commoncrawl


text:
Spring 2015
January 5 (Monday): Deadline for Fall 2015 applicants to apply for Ph.D. admission and M.A. Graduate Teaching Assistantships (GTAs). Apply Now
January 7 (Wednesday): Classes begin; Last day of registration.
January 8 – January 11 (Thursday – Sunday): MLA Annual Convention.
January 13 (Tuesday): Last day to drop/add.
January 16 (Friday): Last day to declare intention to take Spring 2015 Doctoral Comprehensive Exams and to submit proposed schedule for taking SRA/SLA exams.(SLA/SRA proposals and reading lists, including committee members' names, are due at least one month prior to the proposed exam date. The ENTIRE committee must approve the proposal/reading list via signature before it's submitted.) Schedule Exams
January 16 (Friday): Last day to submit an M.A. thesis prospectus for a May 2015 degree. Prospectus must be approved at least three months prior to final oral examination. Turn in a hard copy signed by the project director AND departmental reader by 4:00 PM. See graduate program guidelines for more information. Thesis Checklist
February 2 (Monday): Last day to apply for May 2015 degree.
February 27 (Friday): Ph.D. Visitation/ Recruiting Day - Events held in the Cultural Center's Multi-Purpose Room
February 26 - February 28 (Thursday - Saturday): The Louisville Conference on Literature and Culture since 1900 (University of Louisville)
March 4 (Wednesday): General Exam in Rhetoric and Composition. 10:00AM - 4:00PM, various carrels in Ekstrom Library, unless other room arrangements are requested or necessary.
March 8 (Sunday): Daylight Savings Time begins at 2 am. Set clocks 1 hour forward.
March 9 (Monday): Last day to withdraw from a class.
March 16 – 22 (Monday – Sunday): Spring Break Vacation (no classes; offices open)
March 18-21 (Wednesday - Saturday): CCCC Convention
April/May: M.A. Culminating project discussions with your project advisor and members of the Culminating Project Committee. Once your project has been approved by your director, you will have a final discussion with your committee. It is the student's responsibility to schedule a time for this with his or her faculty members and report the time to the Graduate Program Assistant in order to schedule a room.
(TBA): 10:30 AM Registration for Summer 2015 and Fall 2015 opens. (You will NOT be able to register unless you have been advised by Dr. Schneider and your advising hold has been cleared by Annelise)
April 10 (Friday): Last day for a thesis or dissertation Oral Defense for a May degree, submit Oral Examination Schedule form to the Annelise at least three weeks prior to defense.
April 22 (Wednesday): Last day of classes
April 23 (Thursday): Recommended last day for Culminating Project Discussions.
April 23 (Thursday): Reading Day; No classes; offices open. 1st year Ph.D. students meet with graduate committee. 2nd year PhD students meet with comprehensive exams committee.
April 24 – April 30 (Friday – Thursday): Final exams
April 24 (Friday): Last day for graduate students to submit defended theses or dissertations to the Graduate School (Houchens 105) for a May 2015 degree.
Note: you MUST contact Courtney Kerr (502-852-6495) to schedule a review of your paper BEFORE this deadline.
May 12 (Tuesday): Last day to submit an approved M.A. thesis prospectus for an August 2015 degree. Prospectus must be approved by signature of your project director and departmental reader. Prospectus must be approved at least three months prior to the final oral examination. See the Graduate Program Guidelines for more prospectus information.
May 9 (Saturday): Spring 2015 Commencement


text:
My grandma was put on a respirator breathing machine after her wishes was to not be on their at all or to be be resuscitated as she told them.
Two years from the date of death, though your claim doesn't sounds like a wrongful death claim, but more a claim for failing to follow a DNR or Living Will.
If a public hospital the time to file a notice of claim may be as short as 30 days. Sorry for your loss.
Check with a local NJ attorney. The statute of limitations for your claim for wrongful death may depend on what the hospital did at various times.
The facts do not support a wrongful death case. It is best to consult with a NJ attorney about your options.
Does not sound like a wrongful death case, but there may be a case.
Did she have a living will? Avvo has a terrific "find a lawyer" tool to find a top-rated attorney with a low contingency fee.
Schedule a consult with a local personal injury attorney
If she didn't die from an act of neglect, no wrongful death. Sounds like you are making a claim that they violated her DNR instructions. Consult with a local injury lawyer to see if there is a cognizable claim available under your state's law for such a violation.
You have two years to file a wrongful death claim in NJ.
In this case, the alleged malpractice might be the hospital failing to follow the written instructions of your grandmother, or the person who held her medical power of attorney. If that were the case, the claim might be one for prolonged suffering, rather than wrongful death, as your grandmother wanted to pass away, and the claim would have to filed within two years of the date the hospital did not follow the written instructions and direction of your grandmother by placing her on the respirator.
This would be referred to as a survival action, not a wrongful death action, as she survived the alleged negligence of the hospital. Her instructions would have to have been in a signed document
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Welcome to the new website of the Wellington Methodist Church.
Our mission is to:
New Street, Wellington, Telford, Shropshire, TF1 1LU
U.K registered charity No. 1130091
Wellington Methodist Church and Centre Welcome Leaflet
For further details about the churches in the Telford circuit visit the Telford Methodist Circuit website and the Methodist Church website
Latest News
Please check out our other pages for the latest events and courses we currently offer.
Waiting and Longing - A Communion Service for Advent 27 November 2014
Sam's Annual Christmas Charity Concert 29 November 2014
Iona Worship
Photoshop Course starting January 2015
New TCAT Courses
Digital Photography for Beginners - September 2014
IT for Beginners - Mornings September 2014
IT for Beginners - Afternoons September 2014
Resilience Workshop - September 2014
Resistance to World War One - October 2014
Asserting your rights - January 2015
Introduction to Word Processing and the Internet - Mornings January 2015
Introduction to Word Processing and the Internet - Afternoons January 2015
Photoshop for Beginners - January 2015
Photoshop for Improvers - April 2015
Art Group
Craft and Chat
"Neither height nor depth, nor anything else in all creation, will be able to separate us
from the love of God that is in Christ Jesus our Lord.."
-Romans 8:39


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What Do Conservative Girls Want In A Man?
So, what do conservative girls want in a man? Everything. Just kidding, but this article is probably going to sound that way. My dad was raised in south Texas inRead More »
So, what do conservative girls want in a man? Everything. Just kidding, but this article is probably going to sound that way. My dad was raised in south Texas inRead More »
At the very dawn of our republic, John Adams uttered a prophetic phrase that rings through time to the present age. "Our Constitution was made only for a moral and
Southern California law enforcement are currently on the track of a man who has allegedly killed a handful of people on a revenge-seeking killing spree. The spree began last week
The authority to amend the Constitution of the United States is derived from Article V of the Constitution The Constitution provides that an amendment may be proposed either by the
Congress? Do you have the balls to impeach this man before your branch doesn't even receive pay checks? From ABC: In an effort
Former French President Chirac hospitalised after mauling by his clinically depressed poodle :pause: I got nothing. Open thread.
Yes, I am still here and kicking. I am simply needed to take a much needed break. There are many things which are on my mind in the forthcoming 2009
Hello,John McCain is a proven defender of our country. Once he could no longer serve his country in the military he found another way to serve. He has served the
In the year 2056 – the not so distant future – an epidemic of organ failures devastates the planet. Out of the tragedy, a savior emerges: GeneCo, a biotech company
What are the Democrats trying to serve to us now ?Barack Obama is what we call in "the business"—a sleeper.He has been carefully created as a "change agent".They were saving
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Click below to download a Membership Form
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Adobe PDF version
NAS branches in England provide a local hub where parents, carers and people with autism can get help, access services, support each other and meet other people and families in similar situations.
The West Cornwall Branch does this through:
For more information about autism, Asperger syndrome and related diagnoses visit the National Autistic Society main website.
All welcome to come to our monthly drop-in at Gweal-an-top, School Lane, Redruth.
TR15 2ER 6.30pm til 9pm
Refrehments, library and friendly faces.


text:
Bafana have qualified for AFCON 2015. How will they fare at the tournament? Have your say on our Forum!
Get Sport24 on your mobile
Rome - Italian striker Luca Toni says he wants to make his six-month loan move to AS Roma permanent.
Toni has joined Roma from German club Bayern Munich until the end of the season.
"For the moment I am loan, but I will do all I can to stay at Roma," he said in Saturday's edition of La Gazzetta dello Sport.
World Cup winner fell out with Bayern coach Louis Van Gaal earlier in
the season and was relegated to the bench. He hopes increased playing
time with Roma will help him win back a place in the Italy squad.
32-year-old Toni scored twice for Italy at the 2006 World Cup, but has
not played for Marcello Lippi's side since at last year's
Confederations Cup.
"If I return to my best, there's a good
chance I could (be back in the Italy squad)," Toni said. "Winning the
cup again will be hard, but we are good enough to reach the last four.
Of course there are other teams that are stronger than us on paper, but
that was the case in 2006."
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Abhyudaya Co-operative Bank
Banks and T...
Interview Questions
Question 1 of 58
If you had enough money to retire right now, would you?
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Abhyudaya Co-operative Bank Interview Questions and Answers
1. If you had enough money to retire right now, would you?
2. Tell me about a time when you were particularly effective on prioritizing tasks and completing a project on schedule.
3. How would you ultimately describe your work style?
4. What have you done to improve your knowledge in the last year?
5. Give me an example of a time when you had to make a decision without all the information you needed.
6. What is the riskiest decision you have made? What was the situation? What happened?
7. What signs of trust have you demonstrated in the past while working?
8. How many years of cash handling have you had?
9. Some say a bank teller has an easy job, do you get offended by that?
10. How well do you think on your feet?
11. Why are you the best person for this position?
12. If a customer comes with a $12,500 deposit, all in ones, do you roll your eyes to demonstrate your feelings towards his action?
13. If you were CEO of your last banking company, what would you change?
14. Tell me about yourself.
15. How well do you know online banking?
16. A bank teller needs to be very organized, describe to me your organization characteristics?
17. what are your strengths
18. Give me an example of how you keep track of details while engaging in conversation?
19. What is 42 + 37?
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24. Tell me a time when you had to handle something drastic, but no one was around, how did you do it?
25. Explain your greeting and how you handled each transaction at your last bank.


text:
Clay High School honored its late baseball coach Monday night.
Chad Hudnall's number 14 was retired before the Colonials' game against Marian. It stands on the left field fence.
In a nice tribute, Colonial players ran out from the dugout all the way to left field to touch Hudnall's #14 after each player was introduced during starting lineups.
Hudnall passed away last fall after a long battle with cancer. He was diagnosed right around the time he took the head coaching job but never quit on his players--sticking it out and coaching while undergoing treatment. Last season, Hudnall led Clay to a sectional championship.
Chad's family including his widow Cathy and four children were on hand for the touching ceremony. Clay Athletic Director Joe Toth presented Cathy with a #14 jersey.
Former Clay Athletic Director Greg Humnicky, former baseball coach Chip O'Neill and Chad's father also made heart warming speeches, remembers Chad.
Clay lost the game 6-4 to Marian.
Hudnall was a 2-sport star at Clay and a member of the school's 1994 state championship basketball team. His #14 basketball jersey was retired this past season.


text:
Challenge is a not-for-profit organisation that delivers daily support to children and families living with cancer. Since 1983, Challenge has helped over 25,000 children and families, making a real difference to their quality of life from the moment they are diagnosed, through treatment and beyond. Our pledge is that throughout their journey, they will never walk alone.
A special video gives you a look inside the Challenge Family Centre.
Find out about the programs and services available to Challenge families
Robert Allenby has delivered the best golf day in Australia for 22 years and on December 8 the tradition continues.
Find out more about what Challenge does to help children and families living with cancer
Latest News
21 November 2014
Another successful Cops 'N' Kids Camp for Challenge
19 November 2014
There are only 500 tickets available in this very special Challenge Christmas raffle. The winner will be drawn at the Robert Allenby Gala Dinner on Monday December 8.
19 November 2014
Robert and Jarrod Hit off Together
Robert and Jarrod tee off at The Masters and then at the Robert Allenby Golf Day for Challenge.


text:
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The drone ban: Little Jimmy the spy
The very idea of robots surveiling us from the sky is creepy. It sounds like something George Orwell would warn us against if he were alive today - and a Hollywood screenwriter. Yet on Wednesday the House tabled a bill that would have prohibited the use of drones in New Hampshire skies for the purposes of surveilance and attack. Why? Ah, details, details.
House Bill 619. sponsored by Rep. Neal Kurk, R-Weare, the House guardian of personal privacy, had a simple title: "An act prohibiting images of a person's residence to be taken from the air." As introduced by Kurk, it was a simple bill, too. It would have banned the photographing of the exterior of any dwelling if the photograph was taken by or with the assistance of "a satellite, drone, or any device that is not supported by the ground" and revealed "forms identifiable as human beings or man-made objects."
There were some problems with that language, and the House Criminal Justice and Public Safety Committee set about to improve the bill. What it released to the House, alas, was a larger, longer, more complex and hopelessly flawed bill that went way beyond Kurk's simple attempt to protect people's backyard privacy.
The committee defined "drone" as "an unmanned flying machine" capable of recording images or sounds of people on the ground or of firing rays, missiles or weapons. The flaw in that definition would be instantly apparent to any model aircraft enthusiast. The committee had classified all camera-mounted, remote-control aircraft and model rockets as drones.
At Manchester's Derryfield Park, Bedford's Benedictine Park, and numerous other open spaces throughout the state one can find on many dry days kids and adults flying radio-controlled airplanes, helicopters and space ships, or launching model rockets. A growing percentage of those unmanned flying machines carry video cameras.
You can get a remote-controlled helicopter with a video camera for as little as $50. You can get a tiny video camera for less than $30 and put it in your $12 model rocket, as Cub Scouts sometimes do. Were the current version of HB 619 the law of the land, your Cub Scout would be operating an illegal drone.
The House was right to put this half-baked idea back in the oven. Before we go banning kids' toys or legitimate commercial activity (someday soon documentary filmmakers and commercial photographers will start using drones instead of hiring private planes for aerial shots), let's take more time to mull whether we really need a new law just yet.
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Biker Fox, submitted by Matt. Biker Fox is going to save the world! He is a biker TO THE EXTREME! Are you ready for Biker Fox?! I don't think so! You know why? Because that's how Biker Fox baby has gotta have it! Biker Fox is the greatest showman of our time and all times to come. He can do the MOTHERFUCKING BIKER FOX FLIP!!! Do you see your mom or dad doing that? NO! BECAUSE THEY AREN'T BIKER FOX AT ALL NO MATTER WHAT THEY TELL YOU! THEY ARE NOTHING BUT LYING SHITS! KILL THEM!
Biker Fox welcomes you to his website. He is the first and only person IN THE WORLD to perform the BikerFox flip, a complete front flip on a mountain bike. The only way to see the hops, crashes, extreme front flips, safety techniques, and dances for the girls, is to buy the bicycle video. The out-takes are incredible, unbelievable, hilarious, and worth the price of the movie alone!
Ohhhhh Biker Fox, you silly fucker! Please note that I have no idea why he has a picture of a dead animal in a car engine on his web site.
You Will Read This Headline. Then You'll Laugh. Then You'll Realize You Were Wrong All Along.
'We're going to be in trouble!' Little Sister wailed, clutching her favorite book to her chest and sobbing. 'This isn't fun like a story anymore!' But Big Sister was not listening, she was thinking. She grabbed Little Sister's book from her and ran into town, yelling 'Help! A book made me and my sister hurt someone!'
Val Kilmer lures 6 morons into the ultimate death schvitz to prove global warming is real.
The Goons have already started their preparations, because that pitch isn't going to carpet itself!
When it comes to gaming laptops, you can never have too many LEDs or too much bad taste.
Awful Links of the Day spotlights the worst and weirdest websites on the internet. And we're not talking "weird" in a good way either.
Copyright ©2014 Rich "Lowtax" Kyanka & Something Awful LLC.


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Charmin Printable Coupons 2014
Everyday we use the most essential item of everyday living, toilet paper. And with Charmin Printable Coupons 2014 you can save on the most important toiletries in the home. Save on Charmin brand toilet paper and paper towels. Well have even more printable Charmin coupons for 2014. And get up to the minute Charmin coupon alerts when you sign up for email updates.
Updated Printable Charmin Coupons for 2014
- Save $.75 Off on One (1) Charmin Mega Roll (18 ct. or double roll 36 ct. ) – Charmin Mega Roll Toilet Paper Coupon
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UPDATED: Medical certification confusion — and a state by state resource guide for meeting Jan. 30 reporting deadline
Clearing up some of the confusion around self-reporting of CDL holders' medical certifications. Reporting deadline: Jan. 30, 2014; Kansas, Idaho here update their procedures since original story aired.
Bill to overturn hours-of-service rule introduced in Senate, referred to committee
A bill introduced in the Senate last week that, if enacted, would halt the most recent hours-of-service rule change and allow truck drivers to operate under the pre-July 1 rules again, until Congress can review the rule further.
Agency proposes shortening driving experience needed to obtain vision exemption
FMCSA has proposed shortening the amount of driving experience needed for truck drivers to obtain an exemption to drive with "vision deficiency," it announced via the Federal Register Dec. 19.
Split sleeper wishful thinking, redux
Is there hope for a good outcome of FMCSA's apparent focus on split sleep? Utilize 530-408-6423 to leave a message to contribute to a future podcast on the split-sleep subject.
Warning for short haulers: Exceeding distance, time limits makes 30-min. break mandatory
Short haul drivers who exceed the distance or time limits that qualify them as short haul drivers would be subject to complying with the mandatory 30-minute break required by the July 1 hours rule.
Diesel group: Clean diesel tech has lowered truck emissions to near-zero levels
According to a study released this month, emissions from diesel engines have been nearly eliminated by 2010 engine technolgoy — Selective Catalytic Reduction exhaust aftertreatment systems.
Sleeper time flexibility study could be in works as ATA requests, FMCSA says it's planning
FMCSA says it's planning a field study to gather more data on whether split sleeper berth time is an OK alternative for drivers. Separately, ATA proposed this week the agency conduct a 2-year pilot program to study split sleep.
Agency extends comment period for CSA website changes per safety group request
FMCSA has extended the public comment period for proposed changes it plans to make to its Compliance, Safety, Accountability program's Safety Measurement System website to Jan. 21. Here's a look at some of the comments so far.
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Adam Briggs
Adam Briggs Recent Publications
- Scarborough P, Mizdrak A, Briggs ADM, Appleby PN, Travis RC, Bradbury KE, and Key TJ (2014) Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK Climatic Change, 125:179-192.
- Briggs AD (2013) How changes to Irish healthcare financing are affecting universal health coverage. Health policy (Amsterdam, Netherlands), 113:45–49.
- Briggs ADM, Mizdrak A, and Scarborough Sr P (2013) A statin a day keeps the doctor away: Comparative proverb assessment modelling study BMJ (Online), 347.
- Briggs ADM, Mytton OT, Rayner M, Scarborough P, Kehlbacher A, and Tiffin R (2013) Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: Econometric and comparative risk assessment modelling study BMJ (Online), 347.
- Briggs ADM, Mytton OT, Rayner M, Scarborough P, Madden D, and O'Shea D (2013) The potential impact on obesity of a 10% tax on sugar-sweetened beverages in Ireland, an effect assessment modelling study BMC Public Health, 13.
|Contact address
|Rosemary Rue Building, Old Road Campus, Headington, Oxford, OX3 7LF, United Kingdom
|Nuffield Department of Population Health
|Lady Margaret Hall
Adam is an NIHR Academic Clinical Fellow in public health at the University of Oxford. He is currently a third year Specialty Registrar in Public Health at the Oxford Deanery and works for half his time in the BHF Centre on Population Approaches for NCD Prevention and the other half at Oxford University Hospitals NHS trust.
His research interests include in the interactions between nutrition, health, and sustainability, and the role of fiscal interventions in changing eating habits. He is also an expert collaborator for the Global Burden of Diseases, Injuries, and Risk Factors Study 2013 (GBD 2013).
He studied Natural Sciences at Cambridge University and then moved to Oxford University to study Medicine. He has an MSc in Global Health from Oxford University and worked in London and America before returning to Oxford to pursue a career in Public Health. He is a college tutor in clinical medicine at Lady Margaret Hall and teaches on the medical student public health course.


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Team Astana will be riding Specialized bikes this year.
Originally Posted by rogwilco
I just thought you'd want to know what this years TDF winner will be riding.
You really think Vino has a shot?
Originally Posted by Griffin2020
You really think Vino has a shot?
I think Vinos' had many shots.
Brian | 2015 Cannondale Synapse Carbon 3 | 2014 Trek CrossRip Comp | 2013 Cannondale SuperSix (for sale)
Originally Posted by AEO
you should learn to embrace change, and mock it's failings every step of the way.
Originally Posted by gear
I think Vinos' had many shots.
Excellent sir.
Vino 4 Ever....
Forum Rules


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Manufacturing jobs a social equalizer
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|Must Reads
|Thursday, September 27, 2012
Portland's manufacturing jobs pay more, and offer economic equity for minorities.
Read more at OregonLive.com.
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Everyone knows college is expensive, but a look at the numbers brings that into sharp — and painful — focus.
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Friday, October 24, 2014
How does your workplace stack up against competitors? How can you improve workplace practices to help recruit and retain employees? Find out by taking our 100 Best Companies to Work for in Oregon survey!
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Farmers, grocery stores and food processors cash in on kale.
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Wednesday, October 22, 2014
A conversation with Majd El-Azma, president and CEO of LifeWise Health Plan of Oregon, followed by the Healthcare Powerlist.
Read more...
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Is your business ready to join us in the call for action? This opening panel includes Oregon businesses who will discuss why they signed the Oregon Climate Declaration, the investments they are making to reduce carbon emissions, and how their actions are affecting their companies.
Get ready for two days of special events produced with the EPA, Portland Timbers and ISOS before and after the GoGreen Conference on October 16.
Plenty of employers seem "dazed and confused" after the recent vote to legalize marijuana. In light of Measure 91 passing, what are some issues for private-sector Oregon employers to consider?
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More than 400 "Change Makers" will gather to invest in a socially sustainable community.
Sussman Shank LLP is pleased to announce that Dallas G. Thomsen and Victor J. Roehm have become partners of the firm.


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Just spent the day in Memphis as part of a cross country trip. Stayed at the Days Inn Graceland which lives up to every good review you will read, at a very affordable price. The pool was empty but still fun to photograph, but the hotel was very safe feeling and the staff friendly.
We headed into the city with a list of things we might like, but were still basically winging it. Parked the car by the Mississippi River, near the river boats, and walked to Beale Street.
We walked up Beale Street which was awesome. They had a Corvette car show which closed down the whole street. The Corvettes weren't just some toys the owners had picked up, as most of them were show cars that had been modified and arrived with trophies, lights and high heeled girls.
We walked up to Sun Studios where Elvis, Johnny Cash, and Jerry Lee Lewis, to name a few, all recorded albums. It was really cool to check out. We didn't do the tour but it was fun to see the vinyls. As it was Saturday most of Memphis was closed, which was a recurring theme at some of the attractions (Rock of Soul museum was booked in the evening for an event, the top of Peabody was booked, and the factory workers weren't at Gibson.)
After that we got some lunch at Dyers which was a soda-jerky type place, burgers and shakes. The food was amazing, the interesting part was they had a full bar which we then decided they must hand out liquor licenses like Halloween candy around here. While we are on that topic we also noticed that there must not been any open container law in Memphis because people were walking down the street drinking.
After lunch we went to the Gibson guitar factory and took the tour. It was pretty interesting but the plant was closed so we didn't see anyone making guitars. The best part was the tour guide who was exactly what you would expect, an unusual guy who likes guitars and makes weird jokes.
We had about two hours to kill so we decided it was coffee time and find a place to sit down, so we did. After that we went to the Peabody to have a beer and wait for the ducks to walk down the red carpet. We snagged a spot near the jewelry cases as they go into the elevator. The whole production was worth the wait as the Duckmaster was very entertaining…and the ducks put on a little show of their own.
For dinner we went to Rendezvous which the place everyone says you need to check out. It was awesome. Memphis style barbeque and they serve the ribs dry which was interesting but really good. The weirdest part about this place is we think the owner must hire people on the streets to bring you there because over the course of the day at least three people came up to us and tried to bring us there. If we were in Boston we would have snubbed them and ran the other way, just not in our culture to have street people chatting us up.
After dinner we went for a nightcap at the Flying Saucer (a draft beer emporium, also recommended). We had some different beers from around the country (we though that was fitting). Nice place. It is a smoking bar, but it didn't bother me at all.
After a cab ride back to the car (yes it was still there) and a short drive we ended up back at the hotel for the night. On the ride back to the hotel we listened to the Sox and they were winning, we decided that XM radio is one of the best inventions ever. Driving cross country with a standard FM radio would be unthinkable. Today we go to Graceland, but you can read everyone else's post on how great it is going to be!
If you would like the address to the travel blog just shoot me and email at email@example.com..... And hopefully I'll have enough wireless access to keep posting here!
Memphis Trip Report - late April
Just spent the day in Memphis as part of a cross country trip. Stayed at the Days Inn Graceland which lives up to every good review you will read, at a very affordable price. The pool was empty but still fun to photograph, but the hotel was very safe feeling and the staff friendly.
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I too recently visited Memphis, driving through, for just one night. I stayed at the Marriott downtown via Priceline ($65 + $12 parking) - a little far from Beale Street (still walkable) but right on the trolley line. I took that down to the National Civil Rights Museum, which was quite good - better than I expected, very well done.
Since I'm a photographer, I spent some time wandering around by river, trying to find the ideal place to photograph the Hernando de Soto Bridge (I-40 over the river) at night. The ideal location turned out to be from the 15th floor of my own hotel, the Marriott!!! One of the stairs/fire exits is on the river side and it's completely open air, no window there, plenty of room for a tripod...
I did the Sun Studios tour. The tour was decent enough - could have been a bit longer. It was fun to stand in the actual spot where all those greats first recorded. I skipped Graceland entirely.
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Luckyculver, thanks so much for this great trip report! My new hubby and I took this trip (along with Nashville, Atlanta, and the Smokies) two summers ago right after we got engaged. We loved the Sun Studios tour, but I agree with Andrew, it was a bit short. We got a great photo of my DH pretending to be Elvis crooning into the big microphone they have there and used the picture as our engagement announcement. At night on Beale street we sang along at a dueling piano bar, listened to a Johnny Cash impersonator, and then went for a late-night grease fest at Dyers before heading back to the Heartbreak Hotel. Good times!
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Click Here for Articles About GONE GIRL
David Fincher May Helm GONE GIRL Adaptation for Fox
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Acclaimed director David Fincher is considering helming the adaptation of Gillian Flynn's breakaway hit novel GONE GIRL, Deadline has reported.
20th Century Fox acquired the rights to the book in a 7-figure deal, recently. Reese Witherspoon, Bruna Papandrea, and Leslie Dixon of Pacific Standard will produce.
Gone GIRL is officially described as:
"On a warm summer morning in North Carthage, Missouri, it is Nick and Amy Dunne's fifth wedding anniversary. Presents are being wrapped and reservations are being made when Nick's clever and beautiful wife disappears from their rented McMansion on the Mississippi River. Husband-of-the-Year Nick isn't doing himself any favors with cringe-worthy daydreams about the slope and shape of his wife's head, but passages from Amy's diary reveal the alpha-girl perfectionist could have put anyone dangerously on edge. Under mounting pressure from the police and the media-as well as Amy's fiercely doting parents-the town golden boy parades an endless series of lies, deceits, and inappropriate behavior. Nick is oddly evasive, and he's definitely bitter-but is he really a killer?
As the cops close in, every couple in town is soon wondering how well they know the one that they love. With his twin sister, Margo, at his side, Nick stands by his innocence. Trouble is, if Nick didn't do it, where is that beautiful wife? And what was in that silvery gift box hidden in the back of her bedroom closet?"
Flynn drafted the first script of the adaptation.
Fincher recently directed THE SOCIAL NETWORK and THE GIRL WITH THE DRAGON TATTOO. He's also known for helming FIGHT CLUB, SE7EN, and THE CURIOUS CASE OF BENJAMIN BUTTON.
The director is also currently working on pushing a 20,000 LEAGUES UNDER THE SEA film through Disney, with Brad Pitt attached to star.
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I-91 crash sends driver to hospitalStaff Report | July 16,2014SPRINGFIELD - A Hardwick man was injured this morning when the tractor trailer he was driving crashed veered off the road and into a ledge on Interstate 91.
Richard Martin, 50, was taken by ambulance to Springfield hospital for what Vermont State Police said was a hip injury. He was wearing his seat belt.
Martin was driving a 2014 Kenworth tractor trailer which was towing two trailers in the northbound lane of the divided highway when the truck swerved off the road. The truck traveled part way up the ledge then rolled onto its side.
The travel lane of the highway is closed and the truck removal and fuel cleanup at the site is expected to last throughtout the day.
The crash is under investigation, police say.MORE IN This Just InMENS HOCKEY Full StoryMENs BASKETBALL Full StoryWALLINGFORD The Select Board will put the town budget together at their regular meetings from... Full Story
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- RICHARD'S POOR ALMANACK: On this day in 1863, President Abraham Lincoln delivers short speech in Gettysburg, Pa.; in 1984, a Pemex LNG facility destroyed by series of gas explosions, 600 people are killed; in 1998, Senate builds fire under Bill Clinton.
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- RICHARD'S POOR ALMANACK: On this day in 1927, Leon Trotsky is expelled from the Soviet Communist Party, leaving Joseph Stalin in control of the Soviet Union; in 1970, Oregon DOT tries to dynamite a dead whale off a beach with a rather shocking result.
- RICHARD'S POOR ALMANACK: In 1972, Southern Airways Flight 49 is hijacked, the crew and passengers held for ransom. The hijackers want $10 million and passage to Cuba. In 2007, in Santiago, Chile, King Juan Carlos of Spain loses patience with Hugo Chavez.


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Seth Smith
Giants-Padres Preview
in six innings of a 6-0 victory April 29. He's since pitched two innings of scoreless relief versus San Diego. Seth Smith is 2 for 3 with a home run versus Petit and had an RBI double Friday as San Diego (72-81) improved to 4-1 on its
Erlin, Padres bullpen stifle Phillies 7-3
Brown tied it with an RBI single in the fourth. The Padres scored in the bottom half on a sacrifice fly by Amarista. Seth Smith had an RBI single in the fifth for a 3-1 lead. He drove in Jedd Gyorko, who singled with two outs and moved up when
Amarista's homer lifts Padres over Phillies 5-4
expected back before the weekend. Rollins has been out since Sept. 8 because of a strained left hamstring. Padres: OF Seth Smith did not start due to a sore right hamstring, although he walked as a pinch hitter. Smith tweaked his hamstring while
Padres-Dodgers Preview
1 loss in his home debut with Los Angeles. Hernandez has an 8.78 ERA in three career starts at Dodger Stadium. Seth Smith is 4 for 8 in his career versus Hernandez and Alexi Amarista is 3 for 4. Amarista, however, is hitless in his last
Padres trounce Marlins
Hear from Seth Smith after the 9-3 victory over Miami.
Smith on scoring go-ahead-run
Seth Smith believes successive positive at-bats was the key to him scoring the go-ahead run for the Padres.
Hard-hit balls? No thanks, I'll take bleeders
integral pieces of the Padres' competitive roster as soon as 2015. Their most productive offensive player this season is Seth Smith . He's rocking a wRC+ of 148 (better than Robbie Cano or Miggy Cabrera) and will earn a cool $6 million this year
Wainwright, Carpenter lead Cardinals over Padres 7-6
after Trevor Rosenthal walked the bases full in the ninth. First baseman Matt Adams made a nice defensive stop to rob Seth Smith of a game-tying hit for the second out. TRAINER'S ROOM Padres: 3B Solarte has started the last two games after
Wainwright, Carpenter lead Cardinals over Padres
wild relay as the Padres pulled within 5-4 in the sixth. First baseman Matt Adams made a nice defensive stop to rob Seth Smith of a game-tying hit for the second out in the ninth. TRAINER'S ROOM Padres: 3B Solarte has started the last two
Gyorko rips grand slam, Padres defeat Cards in rain-delayed affair
single and rookie Jake Goebbert hit a bases-loaded triple with two down. He had four RBIs in his first 25 games. Seth Smith 's third hit in the eighth drove the Padres' final run. TRAINER'S ROOM Padres: 3B Yangervis Solarte returned to


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Daily two-hour series of evocative, ground-breaking music seamlessly bridges new instrumental, world fusion, new acoustic, impressionistic jazz and inventive vocal styles.
Governor Rick Snyder.
Governor Rick Snyder will approve the state's part of the so-called Grand Bargain Friday. It's the agreement to ease pension cuts for retired Detroit city workers and protect city-owned art works at the DIA. The governor will commit 195-million dollars approved by the Legislature. The museum, Detroit's automakers, and several foundations have also pledged millions to the agreement. Retirees have until July 11th to accept or reject it. The governor tells WDET's Pat Batcheller what the agreement means for the city and the state. Click on the audio link above to hear the conversation.


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pio maya and el paso taqueria: any good?
- j
- james May 16, 2006 05:32 PM
i saw an article on gothamist recently highlighting pio maya, a taqueria down in the village near nyu. although i'm a little skeptical of the review, i do want to check it out to see for myself. that said, i'm wondering if anyone here has tried this place out.
also, one of the people who responded to the article mentioned el paso taqueria (2 locations) in spanish harlem. i have never heard of this place...has anyone been and, if so, is it worth a trip?
here's the article in question:
Pio Maya is excellent. Their chicken soup is particularly noteworthy - not something I usually order in a Mexican restaurant but this is something special. It is the kind of place where you order and pay at the register and they bring you your food...
I'm a big fan of El Paso.. i've been to both locations, and prefer the 104th street location.. it's small, has little ambience, and gets very crowded, especially on the weekends and well into the evening, but it is great.. easy ride on the 6 train to 103rd leaves you a block away.. cheap food, can be a bit slow but very good tacos and other small eats as well as a large assortment of specials, which can vary a bit..
i would recommend el paso. that's where i fell in love with pozole which (at least there) is a very flavorful pork and hominy stew. the tacos are good, i always get al pastor. i go to the one on 94th street, never been to the one further up.
I personally think Pio Maya blows El Paso out of the water. I esp. love the burrito they serve at the former. It's a knife and fork deal, and you have to ask them to put the cheese and guacamole (excellent, btw) insides. But the result is really quite tasty. They also do excellent authentic (i.e., smaller and grilled) tortas.
I always enjoy our food from El Paso (97th St.) My favorite tacos are the carnitas and the al pastor. The tamales are great too. Another delicious thing there (though it's not really the weather for it now) is tortilla soup. Instead of just sprinkling a few tortilla chips on it, they use long tortilla strips as noodles. The broth is rich and filled with smoky, not hot, chilis. Gooey cheese at the bottom....sooooo good. I've been wanting to try the one at 104th because they have cemitas, which the 97th location doesn't seem to have.
Pio Maya is my choice hands down. Great tortas, burritos, and rotisserie chicken. Also, if you get any salad there the dressing is so nice-- light with the perfect amount of aciditiy. El Paso is right around the corner from where I work. Their shrimp burritos are good, but not great (often too much cheese/too heavy, and I much prefer the pinto beans at Pio Maya to the black beans at El Paso). I got turned off to El Paso after they got our order incorrect too many times. But the kicker for me was when I ordered a salad with chicken and it came with what seemed like fake/pre-cooked chicken strips. The quality of Pio Maya is head and shoulders above El Paso (97th Street location).
re: jdream
I agree that the quality of the meat at El Paso is not great. My other gripes from recent trips there are that they no longer give out the little containers of radish, lime, and salsa. They now ask if you want the ($7.25) guacamole when you sit down--divey, cheap, local place no more! The guac is pretty one dimensional, but that one dimension is creamy ripe avocado, so I'm not (really) complaining. Their tamarind juice is still awesome.
Neither of these places are destination worthy. I do agree that the El Paso on 103rd is better than the one on 97th, but I haven't been there in a while to confirm that. I've been to the one on 97th and can tell you that it's not that good. Pio Maya I've tried a couple times and don't quite understand the accolades. These places are good for the neighborhood, but it seems that if you go a little further out of your way, you'll find something better.


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Market Update
US Dollar Index Softens as Jobless Claims Rise to Near 3-Month High
The greenback retreated for a third consecutive session on Wednesday, ahead of the Thanksgiving holiday on Thursday. The Labor Department reported on Wednesday that initial jobless claims increased by 21,000 to a seasonally adjusted 313,000 for the week ended November 22. The figure missed analyst e
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The Commerce Department reported on Tuesday that it increased its estimate of third quarter US gross domestic product, the value of all goods and services produced, to a 3.9 percent annualized rate from the 3.5 percent rate reported in October. The figure beat analyst expectations of 3.3 percent by
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- Daily Technical Strategist on EURJPY
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Writer's Block
So for the past two days I've been sitting staring at blank word document trying to figure out what to write about for this week's blog. It is not that there isn't anything to write about…as a matter of fact there a lot is as we are in the peak of feting season leading up to Antigua's Carnival. But being that we're a hotel we are trying to share with you all things sun, sea and sand…all that touristy stuff. …
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"Knock! Knock!" "Who's there?" "Summer!" "Summer who?" "SUMMER! SUMMER IS HERE!" <— Does this list look familiar? Yep that was our New Year's resolution list for you. And we are very proud of how well you've been sticking to your diet and working on your bikini body…we can't wait to see you poolside or on the beach in that fabulous bikini. We are even more excited and honoured that you and your family have chosen Trade Winds Hotel as your summer …
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The number one…to many it may be the loneliest number especially when it comes to travelling. But of late the number of persons travelling solo has been increasing. For many, travelling solo is the ultimate liberating experience affording you flexibility where your time is truly your OWN. Despite being tagged as one of the Caribbean's most romantic destination, Antigua is also perfect for the solo traveller. Whether you are looking for an exotic and intimate setting to hide yourself away …
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Busy As Bees We've Been…
It seems like just yesterday we were decking the halls and getting all glitzy and glamourous for Christmas and making New Year's resolutions…and what a wonderful time we had here at Trade Winds Hotel and Bay House Restaurant & Bar…thank you for spending and sharing that time with us. Now Spring is here and we are very excited and we've been up to quite a lot. In January we began converting our upper deck into a state of the art …
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Mexico Multimedia
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Increases in energy production in Canada and the U.S., combined with promising reforms in Mexico, are creating what some describe as a "North American energy renaissance." The world's energy equation is changing, with more developments on the way. What are the implications of traditional energy producers becoming consumers and consumers becoming producers? That's the focus of this edition of REWIND.
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Mexico's Missing Students: Growing Demands for Answers and Justice
It's been two months since the arrest and disappearance of a group of Mexican students, and anger and demands for answers and justice continues to grow. What does this tragic situation tell us about security in Mexico? And has government and law enforcement, at all levels, responded effectively? These are just some of the questions addressed by Mexico Institute Director Duncan Wood during this episode of NOW.
Eric Olson on the Influx of Unaccompanied Immigrant Children
Eric Olson is interviewed on C-Span's Washington Journal about the influx of unaccompanied immigrant children to the U.S. southern border from Honduras, Guatemala and El Salvador, based on his time in those countries.
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Andre 3000′s Transformation Into Jimi Hendrix Is The Highlight Of Jimi: All Is By My Side
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Trans rectal ultra sound guided prostate biopsies: a single centre experience in Sri Lanka.
ABSTRACT Trans rectal ultrasound guided prostate biopsy (TRUS) was introduced to Sri Lanka in 2002.
1. To study clinicopathological features of males subjected to TRUS biopsy 2. To compare estimation of tumour burden by two methods in carcinoma prostate (CaP).
749 symptomatic males subjected to TRUS biopsy over 64 months at a single centre. Information was retrieved from case records. Tumour burden in CaP was calculated as: 1. Calculated tumour burden (CTB)--total percentage tumour in each core/total number of cores 2. Percentage positive biopsy cores (PPBC)--number of positive cores/total number of cores X 100. SPSS 15.0, student's t test and Spearman's rank correlation coefficients were used for statistical analysis.
35.2% had CaP, microacinar in type. 34.88% were poorly differentiated. CaP was frequent among older patients (P<0.00001). The prostate volume in CaP was significantly lower than in the benign group (P<0.05). Prostate specific antigen (PSA) level was significantly higher in CaP (P<0.00001). A 99.6% sensitivity and 4.7% specificity was observed at PSA of 4 ng/ml for detecting CaP. Specificity was 98% at 25.5 ng/ml, with a sensitivity of 44.4%. CTB and PPBC had similar correlations with biochemical/histological parameters of CaP and were strongly correlated (0.786).
Males with CaP were older, had higher PSA levels and smaller prostates. A cut off level of PSA >4 ng/ml could be used for directing symptomatic patients for TRUS biopsy to detect CaP, keeping in mind that specificity is 98% only at 25.5 ng/ml. Both CTB and PPBC could be used to calculate tumour burden in TRUS with CaP.
- Citations (10)
- Cited In (0)
- SourceAvailable from: gva.es[Show abstract] [Hide abstract]
ABSTRACT: Each year the American Cancer Society publishes a summary of existing recommendations for early cancer detection, including updates, and/or emerging issues that are relevant to screening for cancer. In last year's article, the guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers were updated, as was the narrative pertaining to testing for early lung cancer detection. Although none of the ACS's guidelines were updated in 2001, work is proceeding on an update of screening recommendations for breast and cervical cancer and an update of these guidelines will be announced in the January/February 2003 issue of CA. As in previous issues, we review recommendations for the "cancer-related check-up," in which clinical encounters provide case-finding and health counseling opportunities. Finally, we provide an update of the most recent data pertaining to participation rates in cancer screening by age, gender, and ethnicity from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) and National Health Interview Survey (NHIS).CA A Cancer Journal for Clinicians 01/2002; 52(1):8-22. · 153.46 Impact Factor
Article: Systematic transrectal ultrasound guided prostate biopsy after negative digitally directed prostate biopsy.[Show abstract] [Hide abstract]
ABSTRACT: The diagnostic accuracy of digitally directed prostate biopsies was evaluated by performing systematic ultrasound guided biopsies on 44 patients who had previously had a negative prostate biopsy by systematic digitally directed technique. All 44 patients still had palpable abnormalities. Core biopsies (2 to 4) were obtained from each lateral lobe of the prostate with 2 additional cores directed at hypoechoic lesions. Only 4 of the 44 ultrasound directed biopsies (9.1%) were positive for cancer. These results confirm the postulate that random systematic digitally directed biopsy is highly accurate in making the diagnosis of prostate cancer. They also suggest that performing biopsies in a systematic pattern is more important than the method used to guide the biopsy needle.The Journal of Urology 04/1992; 147(3 Pt 2):827-9. · 3.75 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: A free screening clinic for cancer of the prostate was held in Madison County, New York, in September 1990, in conjunction with Prostate Cancer Awareness Week, a program of the Prostate Cancer Educational Council. Serum prostate specific antigen and digital rectal examination were used to screen 565 men. The two tests were equally effective in identifying patients with carcinoma. Of 118 patients with one or both tests positive, 54 were biopsied. Carcinoma was found in 20 of these. Four carcinomas were found in patients with prostate specific antigen (PSA) greater than four ng per ml with negative rectal examination. The costs for adding PSA to the protocol appeared reasonable in terms of the number of carcinomas identified.Annals of clinical and laboratory science 21(6):371-80. · 0.88 Impact Factor
Page 1
Ceylon Medical Journal
Trans rectal ultra sound guided prostate biopsies: a single centre
experience in Sri Lanka
M D S Lokuhetty1, H D Wijesinghe2, D T Abeysuriya3, U C Samarasinghe4 and N D Perera5
(Index words: carcinoma prostate, prostate biopsy, Sri Lanka, serum PSA)
Background Trans rectal ultrasound guided prostate
biopsy (TRUS) was introduced to Sri Lanka in 2002.
Objectives 1. To study clinicopathological features of
males subjected to TRUS biopsy 2. To compare
estimation of tumour burden by two methods in
carcinoma prostate (CaP).
Methods 749 symptomatic males subjected to TRUS
biopsy over 64 months at a single centre. Information
was retrieved from case records. Tumour burden in CaP
was calculated as: 1. Calculated tumour burden (CTB) –
total percentage tumour in each core/total number of
cores 2. Percentage positive biopsy cores (PPBC) –
number of positive cores / total number of cores X 100.
SPSS 15.0, student's t test and Spearman's rank
correlation coefficients were used for statistical analysis.
Results 35.2% had CaP, microacinar in type. 34.88% were
poorly differentiated. CaP was frequent among older
patients (P<0.00001). The prostate volume in CaP was
significantly lower than in the benign group (P<0.05).
Prostate specific antigen (PSA) level was significantly
higher in CaP (P<0.00001). A 99.6% sensitivity and 4.7%
specificity was observed at PSA of 4ng/ml for detecting
CaP. Specificity was 98% at 25.5ng/ml, with a sensitivity
of 44.4%. CTB and PPBC had similar correlations with
biochemical/histological parameters of CaP and were
strongly correlated (0.786).
Interpretation Males with CaP were older, had higher
PSA levels and smaller prostates. A cut off level of PSA
>4ng/ml could be used for directing symptomatic patients
for TRUS biopsy to detect CaP, keeping in mind that
specificity is 98% only at 25.5ng/ml. Both CTB and PPBC
could be used to calculate tumour burden in TRUS with
Carcinoma prostate (CaP) accounted for 4.9% (301
cases) of all cancers affecting Sri Lankan men in 2005 [1].
Trans rectal ultrasound guided core biopsy of the prostate
(TRUS biopsy), is considered a safe and accurate
diagnostic test for CaP [2]. This study aims to document
our experience with 749 TRUS biopsies in symptomatic
men, since introduction of the technique to Sri Lanka in
September 2002.
1,2,3Department of Pathology, Faculty of Medicine, University of Colombo, 4Nawaloka Hospital, Colombo and 5National
Hospital of Sri Lanka.
Correspondence: HDW, e-mail: <firstname.lastname@example.com>. Received 25 July and revised version accepted 11
December 2008. Competing interests: none declared.
Page 2
Vol. 54, No. 1, March 2009
1. To study clinicopathological features of
symptomatic men subjected to TRUS biopsy of
prostate, with a view to formulate future diagnostic
strategies for CaP.
2. To compare estimation of tumour burden by
calculated tumor burden (CTB) and percentage
positive biopsy core (PPBC) methods in diagnosed
Materials and methods
749 TRUS biopsies performed over a period of 64
months at a single tertiary care hospital in the private sector
were included in the study. All these men presented with
lower urinary tract symptoms with or without abnormal
digital rectal examination (DRE) findings. DRE and
ultrasound examination of the prostate followed by
biopsies, were performed by a single radiologist using an
18 G needle. A minimum of 6 tissue cores were obtained
from right and left sides of the base, middle and the apical
regions of the prostate. Additional cores were obtained
from nodules, if present.
The age and serum PSA (obtained prior to DRE and
ultrasonography) were retrieved from case records. The
prostate volume was obtained from documented
ultrasonography findings. Prostate specific antigen
density (PSAD) was calculated by dividing the serum PSA
in ng/ml by the volume of prostate in milliliters. Hematoxylin
and eosin stained slides were examined by a single
pathologist and categorised as follows 1. Benign with/
without inflammation 2. CaP (acinar/ductal) and atypical
glands suspicious, but not diagnostic of carcinoma. CaP
were graded and scored based on the Gleason scoring
system [3].
The tumour burden was calculated as:
Calculated tumor
burden (CTB)
= Total of percentage tumor in
each core
Total number of tissue cores
Percentage positive
biopsy cores (PPBC)
= Number of positive tissue
cores × 100
Total number of tissue cores
Presence of high-grade prostatic intra epithelial
neoplasia (PIN) and perineural invasion were documented.
SPSS 15.0 software was used for analysis. Student's t test
was used to compare means and Spearman's rank
correlation coefficients were used to assess correlations.
264 (35.2%) were diagnosed to have CaP on TRUS
biopsy. 454 (60.6%) were diagnosed as benign. Small acini
that were suspicious but not diagnostic of carcinoma were
seen in 31 cases (4.2%). The age of the study population
ranged from 33-90 years with a mean age of 69.3 years
(SD=8.2 years). The mean age of men with CaP was 71.3
years (SD=7.8 years). The mean age of those diagnosed
as benign was 68.1 years (SD=8.2 years). Older men
had malignant disease more often than younger men
(P<0.00001) (Figure 1).
Figure 1. Distribution of patients with benign and
malignant diagnosis according to age
Serum PSA was measured in 716 men (Table 1). The
mean serum PSA was 51.2 ng/ml (SD=80.0 ng/ml) in men
with diagnosed CaP. It was 20.1 ng/ml (SD=31.1 ng/ml) in
the benign group (Table 2). This difference was
statistically significant (P< 0.00001). When the receiver
operating curve (ROC curve) was applied, a sensitivity of
99.6% and a specificity of 4.7% were seen at a serum PSA
level of 4 ng/ml in detecting CaP. A specificity of 98% was
observed only at serum PSA of 25.5 ng/ml, however with
a low sensitivity (44.4%). Application of recommended
age specific PSA cut off values [4] showed no change in
sensitivity and no significant increase in specificity as
compared to a cut off serum PSA of 4 ng/ml. The mean
Serum PSA Density (PSAD) for the CaP and the benign
groups were 1.3 ng/ml2 (SD=1.8 ng/ml2) and 0.56 ng/ml2
(SD=2.1 ng/ml2) respectively. This difference was not
statistically significant (p>0.05). The mean prostate volume
was 41.6ml (SD=26.8 ml) in the CaP group. The non-cancer
group had a mean prostate volume of 52.3 ml (SD=32.8
ml). This difference was statistically significant (P<0.001).
CaP was small acinar in type in 99.2% (262/264). An
additional large duct component was present in two. The
combined Gleason score of CaP group is shown in table 3.
Majority (60/172-34.88%) had poorly differentiated
carcinomas with a Gleason score of 8 to 10. There was a
trend for increasing levels of serum PSA and PSAD with
higher Gleason scores (Table 3). High grade prostatic
intraepithelial neoplasia (PIN) was seen in a man,
associated with a moderately to poorly differentiated
adenocarcinoma of small acinar type. Perineural invasion
was present in 19 (7.1% - 19/264) men with CaP. There was
<50 50-59 60-69 70-7980-89>=90
Age groups
Age of benign patientsAge of cancer patients
Page 3
Ceylon Medical Journal
no association between perineural invasion and the
Gleason's score (P>0.05).
Spearman's rank correlation coefficients for
associations of PPBC and CTB with the biochemical and
Table 1. Serum PSA levels in relation to histological diagnosis
<4 ng/ml 4.1-10 ng/ml>10.1 ng/ml Total number
Benign 21137275433
Malignant1 55 196252
Benign with suspicious foci1 1218 31
Total 23204489 716
histological parameters are shown in Table 4. None of the
differences of correlations between CTB and PPBC
were statistically significant (Table 4). However, a strong
correlation of 0.780 was noted between PPBC and CTB.
Table 2. Means of PSA, PSAD and prostate volume in relation to histological diagnosis
Mean serum
PSA (ng/ml)
PSAD prostate volume
Benign 20.17 (SD = 31.15) 0.56 (SD = 2.12)52.36 (SD = 32.87)
Malignant 51.22 (SD = 80.01) 1.31 (SD = 1.87) 44.54 (SD = 55.97)
Benign with suspicious foci27.75 (SD = 64.28)0.5 (SD = 1.02)56.04 (SD = 29.98)
Table 3. Distribution of the combined Gleason's score in patients with CaP and its
association with serum PSA and PSAD
Gleason's Score
DifferentiationNumber of
2-5 Well 2 1.1624.171.06
6 Moderately 58 33.72 24.580.76
7 Moderately to poorly52 30.2355.99 1.29
8-10 Poorly 60 34.8888.992.14
Total172 100.00
Table 4. Spearman's rank correlation coefficients for association of PPBC and
CTB with biochemical and histological parameters of CaP
PPBC Calculated tumor
burden (CTB)
Difference between the
two correlations
PSA level0.398 (p<0.01) 0.245 (p<0.01) Not significant
PSA density 0.435 (p<0.01)0.329 (p<0.01) Not significant
Combined Gleason's score 0.400 (p<0.01) 0.295 (p<0.01)Not significant
Perineural invasion-0.176 (p<0.01)-0.175 (p<0.05)Not significant
Page 4
Vol. 54, No. 1, March 2009
The prevalence of CaP in this TRUS guided biopsy
series is 35.2%. Brawer et al reported a prevalence of 30.5%
for CaP in 187 TRUS biopsies of men who had PSA levels
greater than 4.0 ng/ml [5]. The prevalence observed in this
study is slightly higher.
Mean PSA level of men with CaP was significantly
higher than those with benign disease. The mean prostate
volume in patients with CaP was significantly lower than
in the benign group; however the difference between the
mean PSAD values of the two groups was not statistically
significant. These observations can be explained by
current knowledge that malignant prostate epithelial cells
are capable of producing more PSA per gram of tissue
than normal or hyperplastic cells [6]. It also confirms that
PSAD is not reliable for exclusion of a man with high PSA
from biopsy.
A sensitivity of 99.6% for CaP detection was obtained
at a cut off serum PSA level of 4 ng/ml. Therefore it is
desirable that all symptomatic men with serum PSA levels
above 4 ng/ml are directed towards further investigations
including TRUS biopsy. However, it should be borne in
mind that the specificity for CaP is only 4.7% at this level
of serum PSA. As the specificity for CaP increases with
rising serum PSA (36.8% at PSA 10.05 ng/ml and 98% at
PSA of 25.5 ng/ml) a raised level of PSA especially above
25.5 ng/ml makes a symptomatic man more likely to have
CaP. It is documented that most men with slightly elevated
PSA levels (4-10 ng/ml) do not have carcinoma [7]. Our
observations were similar.
The pathology of CaP in Sri Lanka is hitherto not
documented. 99.2% of the CaP in this series was of small
acinar type. The majority were poorly differentiated with a
combined Gleason score of 8-10. High grade PIN was
detected in one case in association with CaP. None had
high grade PIN in the absence of carcinoma. Documented
incidence for high grade PIN in TRUS is 4.6% [8]. However,
in these countries serum PSA is used as a screening tool
for CaP in asymptomatic men [9]. Therefore it is likely that
men with pre-invasive stage of disease (high grade PIN)
are detected more often than in our setting.
Recent studies show that both the number of cores
positive for cancer and the total percentage of core length
involved by cancer independently predict extra capsular
extension and positive surgical margins [10]. This
information obtained by TRUS biopsies play a critical role
in patient management. Having calculated the burden of
tumour in the study sample by two different methods,
PPBC showed a higher correlation with the PSA level, PSA
density and combined Gleason's score when compared
with CTB. The difference in correlations by the two
methods however were not significant. In view of the strong
correlation observed between them, it is possible to use
both PPBC and CTB to calculate tumour burden in TRUS
biopsies. However, calculation of CTB is time consuming
and laborious, where as PPBC is more user-friendly. PPBC
was shown to be related to the preoperative serum PSA
level, Gleason score, clinical stage, extra-prostatic disease,
seminal vesicle involvement and to have a relationship
with biological outcome after radical prostatectomy [11].
Similarly PPBC was related to the serum PSA level and the
Gleason score in this study. Although radical prosta-
tectomy is still not widely performed in Sri Lanka, it is
offered more often in therapeutic protocols of localized
CaP. Therefore, the results of this study on tumour burden
on TRUS biopsies will be useful when CaP diagnosed on
TRUS biopsy are directed to curative surgery.
We gratefully acknowledge the contributions made
by Prof Rajitha Wickremasinghe of the University of
Kelaniya, who guided us in the statistical analysis of data
and all surgical colleagues who referred symptomatic men
for TRUS biopsy.
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text:
Posted by Luke Edwards, 27 November 2009
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