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Originally published Saturday, April 7, 2012 at 8:05 PM
Corrected version
Ryan Leaf's life of lies a tragic part of fallen football hero
Times reporter Danny O'Neil travels to Great Falls, Mont., to get the inside story on infamous ex-football player Ryan Leaf, who went from college stardom at Washington State to NFL bust to — now — having a string of criminal charges.
Seattle Times staff reporter
Reporting the storyThe details of Ryan Leaf's two arrests in Great Falls, Mont., were reconstructed using the charging papers from the Cascade County District Attorney, the incident reports filed with the district court and interviews with individuals associated with the case, including Chris Hickman, the Great Falls Police sergeant who runs the Central Montana Drug Task Force.
Leaf's lawyer, Kenneth Olson, declined to comment on the case. Leaf's family did not respond to multiple requests for an interview. Leaf was not available to comment. His lawyer said he didn't want Leaf interviewed, and the Cascade County Detention Center guidelines state inmates can visit only with immediate family and attorneys.
GREAT FALLS, Mont. — In the end, Ryan Leaf wasn't recognized as the quarterback who led Washington State to its first Rose Bowl in 67 years.
He wasn't identified by his NFL infamy, either.
Leaf was picked out of police photos by a victim who had returned home to find a tall guy coming out of her trailer home wearing shiny black loafers. He said something about being at the wrong address.
A little while after the man drove off last Sunday afternoon, the victim discovered three bottles of prescription medicine were gone. The missing medication became part of a police investigation that resulted in Leaf's second drug-related arrest in 3 ½ days.
When the area's drug task force arrived at Leaf's house, police officers were already there. He wore a sweatshirt similar to the one described by the victim, and those shiny, black loafers were at the front of his closet. Officers also found 89 pills identified as hydrocodone in the pocket of his robe hanging in his bathroom, according to an incident report filed.
Leaf stayed silent after being informed of his arrest, said Great Falls Police sergeant Chris Hickman. No shock, no protests. When Leaf was taken to the county jail, it demonstrated both the fragility of sobriety and strength of addiction.
After all Leaf had been through — from the unmitigated failure of his professional playing career to the drug problem that cost him a college coaching job to the brain tumor that was removed last year — he seemed to have found a bit of happiness in his hometown. He was living on his own in a one-bedroom mother-in-law of a house. The first of three books he agreed to write was published last year. He was driving the unofficial state car of Montana: a big, black pickup truck.
Great Falls is a town with more than 50,000 residents, big enough to have two public high schools yet small enough for many people to leave their doors unlocked. That last fact is significant because police allege that twice in a week Leaf walked into a home without permission and walked out with drugs that are illegal without a prescription.
The guy who became famous in college, then infamous in the NFL, spent the past week in the Cascade County jail. He is being held without bond facing seven criminal charges in Montana — five of them felonies — plus a parole violation in Texas. The happiness Leaf professed to have found had become yet another lie, and if Leaf hasn't hit rock bottom, well, you certainly can see it from here.
"It's just a sad deal," said Jack Johnson, his high-school coach. "I hope he gets through it."
"I was good at two things, athletics and lying. I was always worried about what others were thinking about me or how I was being perceived ... soon lying, to make the story more about who I wanted people to think I was, ultimately won out."
— Ryan D. Leaf, "596 Switch"
That poignant reflection has become a cringingly prophetic passage early in Leaf's book.
Leaf was scheduled to sign that book at the Barnes & Noble in Billings on Saturday, March 31. It would be his first trip to the town since high school, and he was planning to go with his father, John.
Leaf was excited. At least that's what he told Troy Shockley, a reporter for The Billings Gazette. They arranged to meet for dinner Friday, the night before Leaf's signing.
Leaf never made it out of Great Falls that day, his lies piling up until a monthlong police investigation brought them crashing down into a heap of criminal charges.
Shockley got a call just after 3 p.m. Ryan's father called to say they wouldn't be coming, and while he didn't say what happened, that became clear soon enough.
Leaf was arrested for possession of the same kind of painkillers that led to his guilty plea to eight felonies in Texas and cost him a promising college coaching career at West Texas A&M.
In Texas, he was accused of taking a painkiller prescribed for one of his players, prompting an investigation that found Leaf had acquired more than 1,000 pills in less than a year from various local pharmacies.
He resigned from coaching in November 2008, then spent 42 days in a Canadian rehabilitation facility. That's where he was when he was indicted in Texas in May 2009. He pleaded guilty to eight drug charges, and was sentenced to 10 years of probation.
Painkillers like hydrocodone, oxycodone and morphine are legal only with a prescription, but their illicit, unprescribed use is nothing short of a public-health crisis in this country. More fatalities are caused by prescription drugs annually than by heroin and cocaine combined.
Leaf might have been struggling with his sobriety for months, perhaps even longer. According to Hickman, who's in charge of the Central Montana Drug Task Force, the Great Falls post office has records of multiple cash-on-delivery packages Leaf began receiving in January. A year and a half ago, there were reports of a black truck like Leaf's or a man matching Leaf's description seen at seemingly random houses, explaining he must be at the wrong address.
Publicly, Leaf gave no hint he was struggling with his recovery.
Last October, Leaf said he had been sober since Nov. 16, 2008, during a chat on The Seattle Times' website. Last month, he was interviewed by Neil Scott for the national radio program "Coast to Coast Recovery." The conversation was recorded on March 16, a date that corresponded with both Leaf's sobriety date and his college number.
The task force's investigation of Leaf had been triggered by a tip from a postal inspector. Leaf had been receiving packages from Florida for several months and paying for them with cash. Those packages began arriving in January, cost between $500 and $700, and were coming twice a week by the end of March. Police believe he received a delivery as recently as March 27.
Officers had Leaf's probation officer summon him on the morning of March 30. Leaf initially denied receiving the packages, but when confronted with evidence, admitted he had received up to 10 packages containing prescription medicines, but asserted they were not narcotics.
Leaf denied having any narcotics in his possession and denied taking any. But when police searched his truck, as allowed by the terms of Leaf's probation, officers found 28 oxycodone pills in a golf bag with his name embroidered on it. Those pills were in an unmarked bottle. There was another bottle in the bag, bearing the name of another Great Falls resident.
Police discovered the bottle had been taken after Leaf entered a home through an unlocked side door without permission, only to be seen by a housekeeper. Leaf said he was dropping off a book, but left with a bottle of pills from the back bathroom.
A urinalysis ordered by Leaf's probation officer detected opiates in his system, and during interrogation, Leaf admitted to officers that he had taken the pills and also had pills from an old prescription.
Hickman has worked in the drug task force for more than seven years, running it for the past two and a half. Leaf's arrest was straightforward. It was also sad.
"I was sick in my stomach," said Hickman, one of the arresting officers. "I hated to see that."
Leaf was released from jail that Friday after posting bail, which was set at $76,000. Just after 6 p.m., he sent a text message to the reporter he was supposed to meet in Billings: "This tumor stuff just keeps getting in the way."
It was a reference to the benign tumor found on his brainstem May 19, a golf-ball sized mass removed six days later.
"I've made sum mistakes, & have no excuses. i'm using the tools I've learned 2 move forward rather than backwards, & will B open 2 talking abt the details in the days 2 come. i'm confident that thr will B further understanding when the facts R revealed, & feel vry blessed 4 all of the support, esp from my friends & family." #beblessed
— Ryan Leaf via Twitter, March 31
Football is a footnote in this story.
The question of what kind of player Leaf could have been is history. Leaf turns 36 next month, 10 years removed from his last NFL game. He had accepted what happened in a career in which he had 36 interceptions and 14 touchdowns. He won just four games as a starting quarterback, but insisted he would not be defined by his lack of NFL success.
The issue is what kind of person he could become as he fought the demons of addiction in his hometown, where he said he'd found the happiness that had eluded him since entering the NFL in 1998.
He wrote his book and began making public appearances without any of the cockiness or combativeness that had become a trademark of his athletic career. Of all America's faults, a reluctance to forgive is not one of them, and pretty soon the criticism that had been constant for Leaf the past 10 years turned to compassion.
T.J. Simers, The Los Angeles Times columnist who branded Leaf "the punk" before he played his first NFL game, described a newfound maturity. Cougars fans gave him a standing ovation when he appeared at a Seattle hotel to celebrate the school's recruiting class in February 2010. He hosted a radio show in San Diego, a city where the crowd had once booed when he appeared on the scoreboard as part of a Make-A-Wish commercial in the middle of a game.
Even in his hometown of Great Falls — where he has been a polarizing figure since high school — people he had once aggravated pulled for his personal comeback.
"It was really good and refreshing to see him with a fresh attitude," said Jon Kasper, his high-school teammate. "Having people rooting for him to overcome his past demons."
Kasper was a year ahead of Leaf at C.M. Russell High School, and he caught Leaf's first varsity touchdown pass. Like everyone else in this town, Leaf rubbed him the wrong way at some point, and most likely more than once.
There was never any question of Leaf's athletic prowess. Here was a monster of a kid who could dunk a basketball with his elbows in high school and throw a football more than halfway down the field without warming up.
"It was really kind of awesome what he could do," said George Geise, sports editor at The Great Falls Tribune for 33 years until he retired in 2011.
But Leaf was also the kind of kid who was once ejected from a Little League game, and told another kid he walked like a girl.
The local feeling about him?
"Ambivalent," Geise said.
The second player picked in the 1998 NFL draft was never the most celebrated quarterback from his hometown. That is Dave Dickenson, the overachieving honor student who wasn't even 6 feet tall but led C.M. Russell to 24 consecutive wins, two state titles and set passing records at the University of Montana in the 1990s.
Leaf's team won the Class AA state title in 1992, his junior year. He became the starting quarterback the fourth game of that season, but as a senior he suffered a thumb injury that kept him in a cast for two weeks, and the team lost in the first round of the playoffs.
Leaf, who wouldn't agree to a jailhouse interview for this story, grew up in a middle-class home. His father worked in insurance and his mother was a nurse. The metal frame on the doorbell outside their home reads, "Home Sweet Home."
His family paid for a notice in his senior yearbook. It showed Leaf as a kid wearing a San Diego Chargers helmet and No. 14 jersey juxtaposed against his senior football photo. The dedication: "From a little boy with a dream to a young man who gets to realize his dream."
That dream might have faded, but that didn't change the fact that he led Washington State to its first Rose Bowl since 1931. Millions of kids grow up dreaming of playing for the Dallas Cowboys. Leaf started for them on Thanksgiving Day, 2001.
He came home to live in a tiny house that was built back from the street and next to an alley with a porch light powered by an orange extension cord. But he said he was happy, and after all the turbulence of the past 10 years, that counted for something.
It's too much to say there was some groundswell of support to really get behind Leaf this time, but at the same time, there wasn't anyone who didn't hope he had gotten things together.
"You really want to root for him," Kasper said.
"You're always addicted to painkillers when you're an addict ... It's like brushing your teeth. You've got to do something every day."
— Ryan Leaf on www.seattletimes.com, Oct. 20, 2011
Ryan Leaf faced a choice the last afternoon he spent out of jail.
His parents' house sits halfway between Leaf's home and the single-wide trailer police officers allege he burglarized last Sunday.
That afternoon, he must have come to the intersection that leads out of the development where his parents live and found himself at a literal crossroads.
Turn right and he could go south back toward town, return home and restart his recovery. Turn left and he would be on Bootlegger Trail, a two-lane highway with a 70 mph speed limit shooting straight out into the country.
Try to imagine the sheer weight of that moment for Leaf.
He has been called a punch line and a bust. He was dealing with a chemical addiction, and an emotional crisis after the sobriety had become a mirage. He was facing new criminal charges in Montana from his arrest just a few days earlier and the very real prospect that Texas would come after him, with the threat of a sentence that could run as high as 20 years.
Last Sunday afternoon, with all those consequences piling up, Leaf turned left and made a bad situation worse. He headed down Bootlegger Trail until he came to the dirt road that led to that trailer, which had three lawn mowers, several loose car tires and a boat in the front yard.
He was inside when the resident came home. She didn't see a former football star, or even a professional failure. He was just a tall guy with shiny, black loafers who had taken a wrong turn.
Danny O'Neil: 206-464-2364 or firstname.lastname@example.com. On Twitter @dannyoneil.
Information in this article, originally published April 7, 2012, was corrected April 9, 2012. A previous version of this story said Great Falls, Mont., has two high schools, but it has two public high schools plus Central Catholic.
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Olaf Suess1*, Sven Mularski1, Marcus A Czabanka2, Mario Cabraja3, Stefanie Hammersen4 and Theodoros Kombos5
* Corresponding author: Olaf Suess firstname.lastname@example.com
Author Affiliations
1 Zentrum für Wirbelsäulenchirurgie und Neurotraumatologie, DRK Kliniken Berlin Westend, Spandauer Damm 130, Berlin, 14050, Germany
2 Neurochirurgische Klinik, Charité-Universitätsmedizin Berlin, Berlin, Germany
3 Interdisziplinäres Wirbelsäulenzentrum, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
4 Neurochirurgie, Vivantes Klinikum im Friedrichshain, Berlin, Germany
5 Abteilung für Neurochirurgie, Schlosspark-Klinik, Berlin, Germany
Patient Safety in Surgery 2014, 8:35 doi:10.1186/s13037-014-0035-4
Lipomas in the lower spinal canal can lead to progressive neurological deficits, so they may have to be surgically removed. Intraoperative neurophysiological monitoring serves to minimize the morbidity of the surgical procedure. However, so far there are no evidence-based recommendations which type of monitoring procedure or combination of procedures to choose.
The aim of this study was to evaluate the feasibility and value of various intraoperative monitoring techniques: motor and sensory evoked potentials (MEP, SEP), free-running and triggered electromyography (EMG). Thirty cases of spinal lipomas of the Conus medullaris (dorsal Type A: 20.0%; caudal Type B: 33.3%; transitional Type C: 46.7%) were retrospectively evaluated over a 12-year period.
The patients were mostly pediatric and suffered from persistent pain (73.3%), pareses (56.7%), sensory deficits (43.4%), and/or urogenital dysfunctions (60.0%). SEPs were successfully evoked in 66.7% of cases, MEPs in 86.7% of cases, and EMGs in 100%. MEP alterations correlated with direct mechanical maneuvers in the operating site. SEP changes correlated mostly with physiological events, such as rinsing/cooling of the operating site. Spike-, burst- or tonic train-activity was found in the free-running EMG that occurred only with certain manipulation patterns. Irreversible MEP changes and signal loss in the triggered EMG correlated with post-operative deficits.
The results of this study showed, that intraoperative monitoring could be considered a helpful tool during lipoma tumor surgery near the Conus medullaris. Most reliable results were obtained from transcranial MEPs, free-running EMGs, and triggered EMGs. That's why the authors favor a routine set-up consisting of at least these three techniques, as this enables mapping at the beginning of the operation, continuous functional testing during surgery, and prognosis of the post-operative symptomology.
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© 2014 Suess et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Charlottesville, VA (April 1, 2014). Researchers from Syracuse, New York, report a new, highly accurate, neuromonitoring method that can be used during thoracic spine surgery to prevent malpositioning of pedicle screws such that they enter the spinal canal and possibly cause postoperative neurological impairment. Findings of this prospective, blinded, and randomized study are reported and discussed in two companion papers published today online, ahead of print, in the Journal of Neurosurgery: Spine, specifically "Neuromonitoring with pulse-train stimulation for implantation of thoracic pedicle screws: a blinded and randomized clinical study. Part 1: Methods and alarm criteria. Clinical article" and "Neuromonitoring with pulse-train stimulation for implantation of thoracic pedicle screws: a blinded and randomized clinical study. Part 2: The role of feedback. Clinical article" by Blair Calancie, Ph.D., and colleagues.
Disorders of the back and spine are extremely common, particularly in older adults. Nerve roots or the spinal cord itself can become compressed, leading to neurological symptoms of pain, numbness, and weakness. Sometimes, spine surgery is required to treat these types of problems.
The thoracic spine has 12 vertebrae, stacked on top of one another like building blocks. Each vertebra has a pair of "pedicles"undefinedshort, thick pieces of bone that connect the back part of a vertebra (the vertebral arch) with the front part (the vertebral body). Collectively, these structures enclose the spinal canal, through which the spinal cord passes from the base of the brain down to the upper lumbar vertebrae.
Certain types of spine surgery require that neighboring vertebrae be fused together to prevent movement. This is frequently accomplished by placing bone fragments on selected vertebrae and mechanically stabilizing the vertebrae by implanting multiple bone screws, which are used to anchor a pair of rods placed along either side of the spine. The bone fragments grow into the patient's vertebrae and form a strong bone fusion.
Modern spine fusion surgery is generally considered safe, but occasionally things can go wrong. When performed in the thoracic spine, bone screws are inserted into the pedicles with the screw tips ending in the vertebral body. If a screw is angled too far medially (inwardly into the spinal canal), it can compress and damage the spinal cord. This in turn can cause new neurological symptoms in the lower body and, in the worst case, permanent paralysis.
To avoid this possibility, researchers from Syracuse developed and tested a new intraoperative neuromonitoring method that they hoped could decrease the risk that a malpositioned pedicle screw might breach the spinal canal. The researchers separate their detailed findings into two companion articles in the Journal of Neurosurgery: Spine, the first describing the method itself and the second demonstrating how information gained from the neuromonitoring procedure can affect the surgical protocol.
New Intraoperative Neuromonitoring Method
Intraoperative neuromonitoring is fairly new. Although it has been in use at major university/academic centers for roughly the past 20 years, it is only now starting to be used in smaller community hospitals. The general idea is to perform intraoperative neuromonitoring testing intermittently during surgeries that directly place the brain and/or spinal cord at risk and watch for any changes in test results that might reflect a loss or worsening of nerve function due to technical issues such as placing a bone graft against the spinal cord or overstraightening the spine in a patient with scoliosis. Early detection of such a change can give the surgeon time to "undo" whatever action led to the change in test results, thereby avoiding new problems or symptoms.
There are currently two intraoperative neuromonitoring tests of brain and spinal cord function that are used widely in thoracic spine surgery: somatosensory evoked potential testing, which focuses on function of the spinal cord's sensory pathways, and motor evoked potential testing, which focuses on function of the spinal cord's motor pathways. Although both tests provide valuable information to the surgeon, neither one can detect bone screws that are placed too close to the spinal cord, except for the rare instance in which a screw actually penetrates the cordundefinedat which point permanent damage may already have been done.
The new intraoperative neuromonitoring procedure described in the companion papers involves two steps: 1) initiation of electrical stimulation (4-pulse trains) passing within the trajectory track planned for the pedicle screw; and 2) measurement of electromyographic (EMG) responses to the stimulation from the patient's leg muscles.
The neuromonitoring results are based on tests conducted during thoracic spine surgeries performed in 71 patients at Upstate University Hospital and Crouse Hospital in Syracuse, NY. During these operations, 802 screws were placed in vertebrae to anchor spinal rods. The authors describe how during this type of operation, the surgeon creates a pathway, or track, in the center of the pedicle by using a pedicle finder (similar to an awl). The surgeon then inserts a probe into the pedicle track to "feel" for any defect that might indicate a present or potential breach in the side of the pedicle nearest the spinal canal (the medial wall). These steps are integral parts of the operation: if no defect is found, the surgeon normally inserts the screw, whereas if a defect is found, the surgeon can revise the track if it seems necessary. For the purposes of the present study, before placing the pedicle screw in the track, the surgeon inserted a second ball-tip probe capable of delivering electrical stimulation to navigate the pedicle track, paying attention specifically to the medial wall of the track.
Brief, low-intensity pulses of electricity (repetitive stimulus trains at intensities up to 20 mA) were delivered through the ball-tip while the surgeon moved the probe along the pedicle's walls. If the dense bone of the pedicle wall was intact, it provided insulation from the electrical current, rendering the stimulation inert. Conversely, if there was a defect in the wall facing the spinal cord, motor nerve fibers in the spinal cord were activated. This activation was confirmed by measuring electromyographic (EMG) activity from leg muscles whose nerves were acted upon by these spinal cord motor nerve fibers.
The researchers sought a particular stimulation thresholdundefinedthe minimum stimulus intensity needed to cause an EMG response from the leg during electrical stimulation of the pedicle track. In theory, the lower the stimulus intensity, the higher the probability that a pedicle wall breach has occurred near the spinal cord; identification of a low stimulus threshold thus serves as a caution against placing a screw along that pedicle track.
Testing the New Method
To provide a comparison, the researchers stimulated the pedicle screw itself, once inserted, and assessed EMG responses to this stimulation from leg muscles as well as from intercostal and abdominal muscles. Postoperative computed tomography (CT) scans were later examined and compared with intraoperative EMG recordings by multiple reviewers who were blinded to (kept unaware of) patient identities and intraoperative test results. This was done to determine how well intraoperative neuromonitoring of pedicle track thresholds could predict which screws once inserted would veer too far medially and thereby encroach upon the spinal cord.
The researchers report that postoperatively 32 pedicle screws were found to have breached the spinal canal to an extent (2 or more millimeters) that is clinically relevant and should be avoided. This medial malpositioning of all 32 pedicle screws had been predicted intraoperatively, prior to screw insertion, by EMG responses of leg muscles to the 4-pulse train stimulation delivered within the pedicle tracks.
In contrast, electrical stimulation of the screw after placement did not always elicit a response from the targeted muscles, even when the spinal canal had been breached. As expected, neither somatosensory nor motor evoked potential testing was effective in detecting signs of screw malpositioning, confirming that these "standard-of-care" tests were ineffective for detecting and/or preventing this type of surgical risk.
By applying a receiver operating characteristic analysis, the researchers found that their new method of pedicle-track 4-pulse stimulation and leg muscle responses proved most effective when a combination of 10-mA (lower threshold cutoff) and 15-mA (upper threshold cutoff) stimulation intensities was used. In this study, a 10-mA threshold had an 88% chance of detecting a clinically relevant medial breach (2 or more millimeters) by an implanted screw and a 15-mA threshold increased that chance to 100% accuracy.
Providing Feedback to the Surgeon
The second paper on the new neuromonitoring method covers the role of feedback during surgery. Although the study was prospective, blinded, and randomized, under specific conditions some blinding was discarded.
During Phase 1, which covered the first 65 cases, as a rule no neuromonitoring feedback was given to the surgeon during the operation. Exceptions to this rule, however, were made in cases in which muscle responses to pedicle-track stimulation indicated a breach of the medial pedicle wall that would result in direct physical contact between screw and spinal cord. This was indicated by leg muscle responses to a stimulation intensity of 4 mA or less. When this occurred, "break-the-blind" feedback was relayed to the surgeon. During Phase 2, "planned feedback" was provided to the surgeon in 50% of the remaining pedicle tracks. Here too, break-the-blind feedback was relayed to the surgeon in cases randomized to no planned feedback if the leg muscle response was highly predictive of a breach that could lead to endangerment of the spinal cord.
The researchers broke the blind for 29 pedicle tracks. Based on this information, the surgeon revised the pedicle track before the screw was ever placed. The researchers say it's conceivable that any one of these 29 screws could have caused permanent neural injury had its malpositioning not been prevented by this new form of intraoperative testing.
Feedback to the surgeon and consequent revision of pedicle tracks "led to a significant reduction in the numbers of screws with clinically relevant medial malpositioning." Among the pedicle tracks for which feedback to the surgeon was provided and surgical revision of the track was performed, there was no instance of clinically relevant medial encroachment on the spinal canal.
Summary Findings
For the researchers, the success of the new neuromonitoring method was verified by the high chances of detecting a clinically relevant medial breach (2 mm or more) before screw placement: 88% using a 10-mA stimulation threshold and 100% using a 15-mA threshold. The rates of false positives associated with this neuromonitoring method were 10% when the alarm threshold selected was 10 mA and 26% when it was 15 mA. These values demonstrate that this new neuromonitoring method represents a considerable improvement over other methods of detecting medial screw malpositioning used today, such as screw stimulation and monitoring of somatosensory and motor evoked potentials.
With this NIH-funded prospective, randomized, and blinded clinical studyundefineda first in the field of neuromonitoringundefinedthese researchers have proved that use of their novel real-time intraoperative test can significantly reduce the incidence of pedicle screws placed too close to the spinal cord during thoracic spine surgery, thereby making the surgical procedure safer for patients undergoing this surgery.
Calancie B, Donohue ML, Harris CB, Canute GW, Singla A, Wilcoxen KG, Moquin RR: Neuromonitoring with pulse-train stimulation for implantation of thoracic pedicle screws: a blinded and randomized clinical study. Part 1: Methods and alarm criteria. Clinical article. J Neurosurg Spine, published ahead of print April 1, 2014. DOI: 10.3171/2014.2.SPINE13648
Calancie B, Donohue ML, Moquin RR: Neuromonitoring with pulse-train stimulation for implantation of thoracic pedicle screws: a blinded and randomized clinical study. Part 2: The role of feedback. Clinical article. J Neurosurg Spine, published ahead of print April 1, 2014. DOI: 10.3171/2014.2.SPINE13649
Disclosure: This study was supported by a grant from the National Institutes of Health to B. Calancie (R01 NS063055). Digitimer Ltd. (Welwyn Garden City, UK) designed and provided the researchers with a current:voltage adapter for recording voltage pulses calibrated to the intensity of current pulses being delivered. Dr. Moquin reports a consultant relationship with K2M.
The authors hail from the following institutions: SUNY Upstate Medical University (Drs. Calancie, Donohue, and Singla, and Ms. Wilcoxen), Syracuse Orthopedic Specialists (Dr. Harris), and Crouse Neurosciences (Drs. Canute and Moquin), all of which are located in Syracuse, New York.
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The Journal of Neurosurgery: Spine is a monthly peer-reviewed journal focused on neurosurgical approaches to treatment of diseases and disorders of the spine. It contains a variety of articles, including descriptions of preclinical and clinical research as well as case reports and technical notes. The Journal of Neurosurgery: Spine is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons. Other peer-reviewed journals published by the JNS Publishing Group each month include the Journal of Neurosurgery, Neurosurgical Focus, and the Journal of Neurosurgery: Pediatrics. All four journals can be accessed at http://www.thejns.org.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 8,300 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, and peripheral nerves. For more information, visit http://www.AANS.org.
IONM - Medico-Legal Research:
Intraoperative neural monitoring (IONM), utilizing somatosensory evoked potentials (SEP) and electromyography (EMG), was introduced to cervical spine surgery in the late 1980's. However, as SEP only provided physiological data regarding the posterior cord, new motor deficits were observed utilizing SEP alone. This prompted the development of motor evoked potential monitoring (MEP) which facilitated real-time assessment of the anterior/anterolateral spinal cord. Although all three modalities, SEP, EMG, and MEP, are routinely available for IONM of cervical spine procedures, MEP are not yet routinely employed. The purpose of this review is to emphasize that MEP should now routinely accompany SEP and EMG when performing IONM of cervical spine surgery. Interestingly, one of the most common reasons for malpractice suits involving the cervical spine, is quadriparesis/quadriplegia following a single level anterior cervical diskectomy and fusion (ACDF). Previously, typical allegations in these suits included; negligent surgery, lack of informed consent, failure to diagnose/treat, and failure to brace. Added to this list, perhaps, as the 5 th most reason for a suit will be failure to monitor with MEP. This review documents the value of MEP monitoring in addition to SEP and EMG monitoring in cervical spine surgery. The addition of MEP0 should minimize major motor injuries, and more accurately and reliably detect impending anterior cord deterioration that may be missed with SEP monitoring alone.
Keywords: Cervical surgery, electromyography, intraoperative monitoring, motor evoked potentials, neurological, somatosensory evoked potentials, spine surgery
Read the full article:
The need to add motor evoked potential monitoring to somatosensory and electromyographic monitoring in cervical spine surgery *
* Epstein NE SURGICAL NEUROLOGY INTERNATIONAL SPINE: The need to add motor evoked potential monitoring to somatosensory and electromyographic monitoring in cervical spine surgery Surgical Neurology International, Year 2013, Volume 4, Issue 6 [p. 383-391] DOI: 10.4103/2152-7806.120782
© 2013 Epstein; This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Intraoperative nerve monitoring (IONM) has many applications in different surgical fields. In head and neck surgery, IONM has been used to perform surgery of the parotid, thyroid and parathyroid glands, preserving the facial and recurrent nerves. However, hypoglossal nerve neuromonitoring has not been addressed with such relevance.
A retrospective review of surgeries performed on patients with special tongue and floor of mouth conditions was undertaken to examine the indications that prompted its use. Particular attention was given to the pathology, intraoperative findings and the final outcome of each patient.
Four patients, aged between 6 years and 68 years, with complex oral tongue and floor of mouth lesions were reviewed. Three patients were male, aged 22 years and younger, and two of these patients had oral tongue cancers with previous surgery. Oral tongue and neck conditions are challenging since the functions of the hypoglossal nerve are put at risk. The use of IONM technology allowed us to preserve nerve functions, speech and swallowing.
Although IONM of the hypoglossal nerve is not a common indication in tongue and floor of mouth lesions, under special conditions its application can be extrapolated to challenging surgical cases, like the ones described.
Carlos S Duque, Andres F Londoño, Adriana M Penagos, Diana P Urquijo and Juan P Dueñas
World Journal of Surgical Oncology 2013, 11:225 doi:10.1186/1477-7819-11-225
Editor: Suzette M. LaRoche, MD, Emory University School of Medicine
Paperback ISBN: 9781936287390
e-book ISBN: 9781617050787
Demos Medical Publishing 2013
Pages: 352
Awarded FIVE STARS
by the United Neurodiagnostic Professionals of America
One of a kind: written by expert physicians for all practitioners involved in continuous EEG monitoring in the ICU. Technologists, nurses, neurologists, researchers, educators, managers and entrepreneurs benefit from this practical, clear and concise handbook. True to its title, this compact text easily fits into lab coat pockets for instant reference.
Brand new, yet already highly-praised by the intensive care community, the Handbook of ICU EEG Monitoring accurately informs readers on all aspects of current cEEG technology. Each chapter introduces Key Points for focus and organization, facilitating quick absorption of complex material. Readers will be able to find all the answers to their questions faster than ever before! Here, eminent physicians and select accomplished specialists address the most important questions the industry faces today as cEEG case loads in ICU settings increase exponentially.
Book Features:
Throughout, the Handbook of ICU EEG Monitoring contains neurological scales used in the ICU scoring system, graphs of EEG tracings, artifact patterns, references and recommendations for additional reading. Contained are many priceless pearls to help you unravel the mysteries of a most exciting and lucrative trend in health care. Reading this book guarantees you will impress anyone working in the ICU. Available in paperback or e-book format, the Handbook of ICU EEG Monitoring contains all the facts to help you overcome the tough challenges of this highly-profitable and emerging neurodiagnostic specialty. A good thing to have handy in your pocket. Be prepared for the challenges and opportunities ahead in ICU EEG monitoring.
Read the Fully Detailed Book Review @ IONM.pro http://ionm.pro/2013/06/13/handbook-of-icu-eeg-monitoring-a-book-review/
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Justin Silverstein, MS, CNIM, Spine Medical Services, Clinical Neurophysiology, Commack, NY
Justin Silverstein, MS, CNIM, Spine Medical Services, Clinical Neurophysiology, Commack, NY
The xtreme lateral/ transpsoas approach is a new minimally invasive surgical access technique to achieve a discectomy and interbody fusion. This technique has been promoted as being made safe by the application of a specific intra-operative neurophysiological protocol involving direct stimulus and recording of lower extremity EMG responses. Despite this technique, we continued to see post-op nerve injuries, especially when working on the L4-5 level.
When reviewing the salient anatomy of the lumbar plexus at this level of the psoas muscle, we see the variable proximity of the fully formed femoral nerve and contributing branches. It is this nerve that is most at risk and injury may result in the most devastating postoperative complications.
Read the entire article on our Surgical Neurophysiology & Neuromonitoring Group ℠ blog
@ http://ionm.pro/2013/03/12/saphenous-nerve-somatosensory-evoked-potentials-technique-and-application-for-the-reduction-of-femoral-nerve-injury-during-lateral-access-surgery/
EMG and Evoked Potentials During Spine Surgery – Intraoperative Neuromonitoring Made Easy – A Guide
EMG is an important clinical electrodiagnostic tool to assess function of neuromuscular tissue. It assesses spinal motor nerve roots and determines correct placement of hardware in surgical procedures, including cervical, thoracic, and lumbosacral spinal decompression, instrumentation, and fixation of spinal deformity. Evoked potentials provide information on vascular compromise of the spinal cord and nerves. Hence, concurrent recordings of EMG and evoked potentials can assess function integrity of the spinal cord and nerve more accurately. In this chapter, we will discuss application of EMG and evoked potentials in spinal surgery.*
Many articles have been written on the subject yet none has captured the essence in such a concise and easy to understand format. This article will serve as a useful guide for the beginning and advanced clinical practitioner in intraoperative neurophysiological monitoring. In addition, an exhaustive list of reference articles provides easy access to the most important sources to reference for use in daily practice.
Access the full length free article at the United Neurodiagnostic Professionals of America (UNPA) website
Click here:
EMG and Evoked Potentials During Spine Surgery – Intraoperative Neuromonitoring Made Easy – A Guide
The information contained is for entertainment purposes only. All contents and link-outs are generated and embedded from publicly available sources. The United Neurodiagnostic Professionals of America, its owners, and managers are not responsible for the embedded contents obtained through Getbookee.org. The following presentations are not to be considered a replacement for the Current Procedural Terminology (CPT) book or the International Classification of Diseases 9th Revision-Clinical Modification (ICD-9-CM) book. It is designed simply as a resource to help you obtain a better understanding of IONM coding. Always refer back to the full Current Procedural Terminology (CPT) book when coding. Current Procedural Terminology (CPT) is copyright 2012 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listing are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT is a trademark of the American Medical Association. International Classification of Diseases 9th Revision-Clinical Modification (ICD-9-CM) is copyright 2012 Ingenix. All Rights Reserved. Education Disclaimer: The information provided is general coding/billing information only – it is not legal advice; nor is it advice about how to code, complete or submit any particular claim for payment. It is always the provider's responsibility to determine and submit appropriate codes, charges, modifiers and bills for services rendered. This coding and reimbursement information is subject to change without notice. Before filing any claims, providers should verify current requirements and policies with the payer.


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Go Green Baby is owned by myself Natalie and my husband Jamin. Our family moved to Kingston in July 2007 from Edmonton, Alberta. Originally from Ottawa, I felt at home in Kingston. Jamin was born and raised in the British Columbia and has spent much time in Kingston during his career. October 10, 2007 we welcomed our son Kohen into our lives. He was the "baby" behind Go Green Baby. September 17, 2009 we welcomed our daughter Ryann into the family. Scarlett joined our family in March of 2012 and has been a perfect addition to our growing family. Our most recent member is beautiful Sadie who joined us August 2014. She has been a blessing and a completion to our family.
You are probably wondering why we decided to open Go Green Baby. The idea originated from our personal interest in the environment and in organic and natural baby products. We began cloth diapering Kohen when he was one month old. As we began our search for the perfect cloth diaper, we found ourselves confused, lost and uninformed. We were unable to touch, feel or even see many of the cloth diapers. Almost all were available through online stores, but very little was available locally. Cloth diapers are an investment and we did not want to invest in a set ofdiapers that may not fit our son or that we may not like. There were so many styles and types of diapers and we had no idea where to start.
We want to give families in Kingston and surrounding areas an opportunity to see, touch and learn about various styles and types of cloth diapers, as well as a place where they can learn about and purchase natural and organic products for their loved ones. Most recently, my husband has begun a woodworking business called Re-wood Toys. Our dedication to natural and organic products is evident in our line of natural wood teethers, rattles and toys. Each product is made using locally sourced hard woods that are no longer usable. He recently completed a redesign of our shop, making all the fixtures, displays and shelving himself.
We are very excited to meet you and for you to become a part of our growing community and family. Most important to our business is the relationship that we develop with families and individuals in our community. We pride ourselves on offering excellent customer service, but also going above and beyond to make you and your family feel welcome in not only Kingston but in our small community. We want to hear your stories, share you experiences and become a part of your family.


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Hi all- here is a Throwback Thursday post. Oh to be young(er) and so naïve! My daughter is now in college! Yikes! How cute are these! I haven't done anything crafty in a few years. But, after jumping into the blogosphere I was lured back to my glue and staple guns and craft stores! I started [Read more…]
Sports Themed Coat Rack..
The great thing about this project is it can be tweaked for lots of sport theme interests. The never-ending, on-going decorating of my boys bedrooms. So both of my boys are competitive tennis players so needless to say much of their free time, is spent on a court. So, they wanted their love of the [Read more…]


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If Charlie Parker Was a Gunslinger,
There'd Be a Whole Lot of Dead Copycats
Containing Multitudes Since 2004
Poets are both clean and warm
And most are far above the norm
Whether here or on the roam
Have a poet in every home! #28
H.D. (aka Hilda Doolittle)
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Este curso cubre cuestiones de seguridad de alimentos, y técnicas para mantener un entorno seguro en términos de alimentos. Le ayudará a entender mejor cómo el manejo adecuado de los alimentos no solo es obligatorio, sino que mejora la seguridad además de reducir costos.
* Indicates course duration. This course is not for credit hours.
Package Description: The Learn2Serve Food Safety Manager Principles Course provides necessary training…
Package Description: The Learn2Serve Food Safety Manager Principles Course provides necessary training leading up to the Food Protection Manager Certification Exam. This course covers food safety issues, regulations, and techniques to maintain a food-safe environment. The Learn2Serve Food Protection Manager Certification Exam is designed to test and assess foodservice employees on competencies relevant to the prevention of foodborne illness. To become a Certified Food Protection Manager, a candidate must pass a food safety examination from an accredited certification provider as recognized by ANSI-CFP. The certificate will be valid for a maximum period of 5 years. We do recommend checking with your local health department as certificates may expire sooner. 360training's Learn2Serve Food Protection Manager Certification is approved by the American National Standards Institute and the Conference for Food Protection (ANSI-CFP). This accredited exam is accepted in all states that have mandatory certification requirements for Food Management Professionals.
Learn2Serve Food Protection Manager Certification Exam – Proctored by 3rd Party Test Center
Become a Learn2Serve Food Manager today! Approved by ANSI-CFP! Includes PSI Test Center and proctor fee*! The Learn2Serve Food Protection Manager Certification is approved by the American National Standards Institute and the Conference for Food Protection (ANSI-CFP). The exam will be proctored by an employee at the test center location. After purchasing the exam, please https://candidate.psiexams.com/ to schedule your exam. A candidate must pass a food safety examination from an accredited certification provider as recognized by ANSI-CFP. The certificate will be valid for a maximum period of 5 years. We do recommend checking with your local health department as certificates may expire sooner *Retakes not included. Additional exam retake fee will apply.
*Retakes not included. Additional exam retake fee will apply.
All food service managers who are responsible for the storage, preparation, display and serving of foods to the public must successfully pass a Food Manager Certification examination. Each licensed establishment shall have at least one certified food manager.
Certification Renewal — Every 5 years
Who has to be certified? Certification applies to Managers Only.
Do managers require training? Manager training is NOT required.
Do all mangers require certification? Under Florida Statute 509 "All" managers are to obtain certification through examination within 90 days of employment.
Who qualifies as a manager? Managers are anyone who supervises employees when receiving, preparing, storing or serving food.
Must the certified manager be present? Under Florida Administrative Code 61C-3, at least one manager with the certification must be present at all times in operations with (4) or more employees.
How does someone become certified? Certification is through a proctored approved examination.
What examinations are approved? Examination must be through an ANSI accredited program of instruction. 360training.com's Learn2Serve is an ANSI-CFP Accredited Examination Provider.
How long is the certification in effect? Certification must be renewed every 5 years through examination.
Do all employees require training? All employees must receive Training: All employees must be trained in an approved program if they handle food or equipment in contact with food, prepare, or serve food. They must be trained within 60 days of employment.
Do employees need to be certified? No Certification is required of employees: Certification applies only to managers. Employees must be trained in an approved program.
Do employees take a test? Testing of employees is prohibited by law
What are approved employee-training programs? The state maintains a list of approved employee training programs. To be approved, the training must have been in use and submitted for review prior to Nov 1 2000.
What will inspectors look for? Inspectors will review a roster of attendees to training programs and/or certificates of completion. If there are employees on staff for more than 60 days and they are not on the roster, or such employee cannot produce proof of training the facility is out of compliance. Inspectors will review the training course and check against the approved vendor list. They will check the letter sent by the approved vendor confirming the approved course.
How long is the approved training in effect? The approved training must be repeated every 3 years.
Who has to report training to the state? Only third parties report training. The in house-certified manger does not need to report the attendees to the course he conducts. The third party instructor must provide the list of attendees they train to the state. The onsite course automatically updates the states training database
Who is approved to conduct training? Certified professional Food Managers.
Course Details
The Learn2Serve Food Manager Training course successfully prepares food safety managers to pass any ANSI-CFP* nationally accredited certification examination. 360training.com's Learn2Serve is an ANSI-CFP Accredited Examination Provider. More importantly, the materials are presented in ways that ensure both managers and handlers will remember the food safety principles long after training has taken place. After the course, please visit www.learn2serve.com/certified to purchase the Learn2Serve Certified Food Protection Manager Certification Exam. Please remember, the examination must be proctored.
Learn2Serve makes obtaining your DBPR food handler training certification simple and hassle free. Click to enroll, complete the course and print your certificate. We will report your training information to the DBPR. We know you have a tough schedule and that's why we're the only provider offering live 24-hour help to make sure you don't waste time if your in of need technical assistance.
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Costa de Sol Estepona-HEATED Pool 2 bed holiday vacation flat rent let condo apartments in wonderful Villa close Sea & Estepona Port. Gdns Pkg Wi-Fi(See also id 350 & id 20528 ). Below you will see some photos, prices, a calendar and a description of the property.
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Seneca Foods Corporation Retains ICR For Investor Relations Services
MARION, N.Y., Dec. 23 /PRNewswire-FirstCall/ -- Seneca Foods Corporation (Nasdaq: SENEA, SENEB), a leading nationwide producer of canned fruits and vegetables, today announced that it has retained ICR, a leading investor relations and strategic advisory firm, to assist in the Company's shareholder communications program.
ICR, founded in 1998 by a group of former institutional capital markets professionals, is headquartered in Westport, Connecticut, with additional offices in New York City, Los Angeles, Boston, Chicago, Minneapolis, Beijing, and Shanghai. ICR provides comprehensive communication services ranging from ongoing investor relations and public relations to crisis and transaction support, corporate governance and digital media projects. Employing more than 100 professionals and representing more than 225 companies, ICR is one of the fastest growing IR firms in the United States.
Roland E. Breunig, Chief Financial Officer, stated, "We are excited to announce our partnership with ICR as we seek to increase our visibility within the investment community and more effectively target our communications to interested stakeholders. As one of the leading national producers of canned produce, Seneca Foods is positioned well to benefit from several favorable industry and consumer trends, including the ongoing shift in food and beverage consumption towards better-for-you products and the increasing acceptance and demand for private label canned produce. Therefore, we feel it is appropriate to expand our investor relations outreach to ensure all potential stakeholders are aware of Seneca Foods' growth and development opportunities. We are confident that ICR's extensive knowledge of the capital markets, as well as considerable background in the food and beverage industry, will be instrumental in driving this effort."
Seneca Foods is scheduled to present at the upcoming 12th Annual ICR XChange Conference to be held at the St. Regis Monarch Beach Resort & Spa in Dana Point, CA. The presentation will begin at 11:35am PT on January 14th.Investors and interested parties may listen to the live webcast of this presentation. To access the webcast, please visit www.senecafoods.com and click on "Company Profile" and then "Investor Information" at the appropriate time. A replay of the presentation will be available for one week.
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AccuBond represents the most advanced bonded core bullet technology to date. Through a proprietary bonding process that eliminates voids in the bullet core, AccuBond marries Nosler's traditional copper-alloy jacket with its special lead-alloy core. The result is a bullet that flies true, penetrates deep, retains its weight and won't cause extensive barrel fouling, plus it retains 60-70% of it's weight. The white polymer tip helps protect against deformation while initiating expansion upon impact. This is not loaded ammunition.
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Rate Dr. Oren Steinmetz
Dr. Oren Steinmetz's Ratings
Unfortunately due to one staff member I was not able to give a better score for Staff. His other staff members seem okay though none intervened when one member was particularly rude. The doctor himself is very professional and human, excellent patient skills. He did take the time to listen to my complaint about one of his staff doctors', was very reassuring and very compassionate. I did not denote one ounce of arrogence or rudeness in him. He did tell me to call him if I had any concerns of symptoms but his secretary did not return my call till 2 days later. The problems disappeared so I can not complain though if it was an emergency it might be worrisome. In my experience he is a fine physician and would highly recommend him.
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My appointment was at 9:00 A.M and he saw me at 8:40, he also shook my hand. Doctors never do that, what a miracle. He was very helpful, listen to my questions and answered them, unlike most doctors who don't listen or change the subject.He told me how to fix my problem and then informed my GP. He is a nice guy, good doctor, punctual and his admin or secretary is terrific.I'd play golf with him any day
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Dr. Steinmetz the angel 0f death wosrt doctor ever who doestn care for our dear mother and his team of staff dont ever go too him for anything!!!! firth floor ross pavillion at the royal vic hodptail in montreal que canada.
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Very caring and responsive - took excellent care of my father who needed surgery for an aneurysm. Appointments were always on time and he always took the time answer all of our questions.
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Probably one of he most gifted physicians in vascular medicine and vascular surgery. Truly an honourto be treated by such a caring, compassionate and skilled clinician.
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After providing a clear and precise assessment of my condition, Dr. Steinmetz spelled out the risks associated with doing nothing vs. doing the related surgery. He subsequently performed the surgery. The operation was successful; my convalescence, uneventful. In my opinion he is skilled and thoroughly professional.
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Teen Shot In Leg In St. Paul
December 28, 2011 6:34 PM
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ST. PAUL (WCCO) — Police are looking for shooting suspects after a teen was shot in the leg in St. Paul.
St. Paul Police say the shooting occurred early Wednesday afternoon at the cross streets of Arcade and Phalen.
Police received reports of shots fired just before 3 p.m.
One teenage boy showed up at Regions Hospital with a gun shot wound to the leg.
Police say the incident is under investigation and there are no suspects at this time.


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October 31, 2009
Photo by Tori Boone
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Family honors ancestors with Day of the Dead
Sisters Laura and Sanjuana Macias spent Saturday morning preparing an altar in remembrance of their dead ancestors. The three-tiered display consists of rolls, sweet potatoes, a pumpkin, oranges, bananas, corn, apples and salt; water, tequila and beer; and cigarettes. At the top of the altar is a portrait of Jesus flanked by two angel statues.
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Tag Archives: Tracey Edmonds
Nene Leakes Makes More Than $1.5 Million Per 'Atlanta Housewives' Season
Rumor almost dispelled as reality TV hints about her salary
Nene Leakes, the outspoken 'OG' of 'Real Housewives of Atlanta,' is rumored to make more…
By Kevin L. Clark
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-cheap -good quality -cool design -nice materials -good size for many devices -handy -good size, ideal for iphone and alike None really. :) Maybe the stamps / prints won't last too much time, but are well done for its price. Much better than other similar items at my local store x10 times expensive. ... Read more
Great material and perfectly finished. I've a Samsung Wave 2 and it fits great, with extra space to save earphones for example. The pictures are so cool, all my firends love it and some of them ordered one for themselves. Very secure for your phone because you can close it and it's also very soft in ... Read more
Looks like expensive designer made stuff! I guess it could selled as a brand for 10-20 $ Textile is very thick and rubber cats look like they will last very long without wearing off. When your phone falls down it surely will protect it from being destroyed. Actually I was very surprised how good it looks ... Read more
I really like this bag, it's big and long enough for any phone even a small hand held pda device. The quality is sturdy enough for a long time use or normal wear and tear. Like other users mentioned, the only drawback is probably the pictures printed on the pouch, but that's inevitable. It's cheap and ... Read more
-Reasonable price -Nice size -good colour -Soft -Picture is imprinted with ink, and has not been rubbed off yet. -comes with other colours -String feels cheap -After a white, the inner lining seems to be falling apart. I get flakes of white on my electronic. :\ -I love using pouches for electronics I ... Read more
The price is really decent for the item you get. It comes in a really bright color just as pictured. It fits most phones, even those squatty wide ones like mine. Like other users mentioned, the print probably won't last too long after many uses. It's not a picture stitched into the cloth, but rather ... Read more
* Nice modern print * Easy to use * Phone fits in easily * Camera fits in * Soft white fabric inside * Thick fabric * Does not look or feel cheap * Does not scratch my screen * Easy to carry by the rope * Fabric loses color on yellow cord so it turns orange after a few days. * After a while print starts ... Read more
-a very cute pouch -cheap -easy to use -protects very well -it's actually very good quality -good colour -came exactly as pictured -bigger than expected -english words make sense -printing is paint like substance, and in large areas it was cracking. Specifically near the bottom. -the string is very cheap.... Read more
- Cute orange cat design on the outside - Seems like good quality (so far...!) - Perfect for carrying around and protecting your digital camera, since it has the perfect size for it. - Has a string, to keep your items secure! - The inside is not cushioned, it could be a little "fluffier". The ... Read more
-Larger than pictured. -cute -fairly good priced. -soft pouch -has the draw sting, which helps keep it closed. -no risk of electronic falling out. -protects -sting seems cheap and easy to break. -might not have enough padding -doesn't close fully -sewn slightly badly, but for the cost, it's expected,... Read more


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"Previous preclinical data indicates that reovirus tends to localize in the lungs, and we have seen clinical responses in metastatic lung lesions with REOLYSIN(R) as a monotherapy or in combination with paclitaxel and carboplatin," said Dr. Brad Thompson, President and CEO of Oncolytics. "A significant clinical opportunity for REOLYSIN(R) is in the treatment of patients with metastatic cancers including NSCLC who have a mutated K-RAS gene and are unlikely to respond to treatment with EGF receptor inhibitors."
About Lung Cancer
Lung cancer is the second most common cancer in men and women and is the leading cause of cancer death. More people die of lung cancer than of colon, breast and prostate cancers combined. During 2008, there will be about 215,020 new cases of lung cancer in the U.S., of which 85% to 90% will be NSCLC. Only about 15% of people diagnosed with lung cancer are still alive after five years. There is no single, first-line therapy approved for NSCLC in the U.S., but first-line combination treatments include avastin/paclitaxel/carboplatin, vinorelbin/cisplatin, gemcitabine/cisplatin, paclitaxel/cisplatin and docetaxel/cisplatin. Other therapies approved for second and third-line treatments are used as well. For more information about lung cancer, please go to http://www.cancer.org.
About Oncolytics Biotech Inc.
Oncolytics is a Calgary-based biotechnology company focused on the development of oncolytic viruses as potential cancer therapeutics. Oncolytics' clinical program includes a variety of Phase 1/2 and Phase 2 human trials using REOLYSIN(R), its proprietary formulation of the human reovirus, alone and in combination with radiation or chemotherapy. For further information about Oncolytics, please visit http://www.oncolyticsbiotech.com
This press release contains forward-looking state
|SOURCE Oncolytics Biotech Inc.
Copyright©2008 PR Newswire.
All rights reserved


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LMAC118 has reviewed 1 products.
1 result returned for ""
Great winter flat!
This shoe is comfortable, warm, and has better foot support than most flats. They have this shoe in half sizes which is awesome, so make sure to order your exact size! The length of the shoe is exact to size. I wore them all over the city in 40 degree weather and my feet were warm with no pain!
Runs Narrow
Runs Wide
Runs Small
Runs Large


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HOME NFL Baltimore Ravens Gear Baltimore Ravens Ladies Baltimore Ravens Ladies Hats (22 items) Product ID: 1027614
Main Content
Order as many items as you like with our $4.99 flat rate shipping.
This item ships within one business day.
Order as many items as you like with our $4.99 flat rate shipping.
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During the cold months, it can be hard to look cute while wearing all that bulky but necessary winter gear. Stay cute, keep warm and show off your Ravens pride with this Nashoba knit hat from '47 brand. This adorable winter cap has a soft faux-fur lining to keep your noggin warm while its embroidered Baltimore logo on the left earflap will keep you outfitted in Ravens team spirit. With its charming woven snowflake design and spunky pom on top, this beanie will give you plenty of cuteness to last all winter long!
- 100% Acrylic
- Ear flaps with tie
- Imported
- Officially licensed NFL product
- Quality embroidery
- Team logo and colors
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Special event items are produced by manufacturers only after the outcome of a game or event. These are advanced sale items and will ship immediately after they are received in our warehouse.
Manufacturer direct items are shipped directly from the manufacturer. These items are not available for international or expedited shipping.
Customized items can be personalized with options such as your name, your favorite number, and/or designs. Some options may be limited by league rules.


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Hunger kills more people worldwide than HIV, tuberculosis, and malaria combined, and children are the most vulnerable. Malnutrition and hunger-related diseases account for 35 percent (3.1 million) of the 8.8 million deaths of children younger than five each year. Malnutrition is a complex problem that can be caused by a lack of adequate food, illness, and poor caring practices – but it is preventable and curable.
International Medical Corps runs nutrition and food security programmes in some of the world's most food-stressed areas, including Afghanistan, Ethiopia, Somalia, Chad, and Sudan. Our nutrition programmes have a 90 percent success rate, meaning that almost all the malnourished children who come through our programmes recover. Recognising that malnutrition is not just an issue about food, we address nutrition at every contact point we have with community members from water and sanitation projects, screening during primary health care visits, and provision of therapeutic nutrition care. We work with all levels of government, civil society, and parents to improve their ability to provide the range of activities needed to promote healthy growth and prevent malnutrition in children.
In addition, most of the decision-making regarding critical influential behaviours occurs in the home. Thus, International Medical Corps targets health facilities, community leaders, households and individuals to bring positive and lasting changes in attitudes, knowledge and behaviours


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Biographical Sketch of Eli Tadpole
Dorcas, daughter of William and. Amanda (Fish) Foreman was born in Tahlequah District, January 9, 1871, educated at Eureka in above named District. Married January 1885, Eli, son of John and Lucinda Tadpole, born in Tahlequah District, March 18, 1865 and educated in the Cherokee National Schools. They are the parents of Lelia, born Apr.


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Hirschy Annex
Hirschy Annex, the largest hall for men, houses 107 students. It was completed in 1966. Rooms on the second and third floor open into a corridor that encircles a floor lobby and computer lab. A main lobby and kitchen are adjacent to the first floor.
Hirschy Annex Staff 2014-15
|Hall Director:
Eli Weikart
|Apt. above Multicultural Center
|RA: Colten Kelso
|1st Floor, Room 118
|RA: Appiah Adubofour
|2nd Floor north, Room 228
|RA: Cameron Huss
|2nd Floor south, Room 238
|RA: Octavian Cohen
|3rd Floor north, Room 328
|RA: Alex Nibert
|3rd Floor south, Room 338
Average measurements for Hirschy Annex:
Wall Dimensions - 13' 2"x 14' 2"
Windows - 7' 6"x4'
Bed frame - 36.5"x80"
Mattress - 36"x80"


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Book your room at Travel Inn Motel
Please enter your travel dates.
Beaumont hotel with an outdoor pool
Situated in Beaumont, this hotel is close to Christus Hospital St. Elizabeth, McFaddin-Ward House Historic Museum, and Fire Museum of Texas. Local attractions also include Art Museum of Southeast Texas and Edison Museum.
Hotel Features
Travel Inn Motel provides complimentary wireless Internet access, free self parking, and a 24-hour front desk.
Room Amenities
In addition to premium cable television, guestrooms include beds with memory foam mattresses, complimentary wireless Internet access, and refrigerators.Information missing or incorrect? Tell us!
At your hotel
At your hotel
Travel Inn Motel features an outdoor pool. Public areas are equipped with complimentary high-speed wireless Internet access. Onsite self parking is complimentary.
- 24-hour front desk
- Number of floors - 2
- Free Wi-Fi
- Total number of rooms - 63
- Year Built 1963
- Free self parking
- Number of buildings/towers - 1
- Outdoor pool
Stay connected
Available in all rooms: Free Wi-Fi
Available in some public areas: Free Wi-Fi
Park your car
Free self parking
In your room
- Premium bedding
- Phone
- Free local calls
- Premium TV channels
- Microwave
- Refrigerator
- Private bathroom
- Hair dryer (on request)
- Shower/tub combination
- Television
- Cable TV service
- Free Wi-Fi
- Memory foam mattress
The fine print for Travel Inn Motel
When you arrive
Check-in time starts at 2 PM
Minimum check-in age is 21
When you leave
Check-out time is 11 AM
How you can pay
Your pets
Pets allowed, Only dogs and cats are allowed, Maximum number of pets per room 1
You need to know
Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
- Minimum Spring Break check-in age is 21 years old.
No cribs (infant beds) available
No elevators
- Pet fee: USD 10 per night (maximum USD 1 per stay)
We should mention
This property's policy is to refuse certain bookings for the purpose of group events or parties, including pre-wedding stag/bachelor and hen/bachelorette parties. Only registered guests are allowed in the guestrooms. This property allows pets in specific rooms only (surcharges apply and can be found in the Fees section). Guests can request one of these rooms by contacting the property directly, using the contact information on the booking confirmation.


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Home » News » Education
Mayor shows off classrooms of the future at West High
Myamilet Santiago, a West High School senior, takes part in a remote classroom with groups of students from Memorial and Central high schools on Thursday. (MARK HAYWARD/UNION LEADER)
Gatsas was accompanied by state Education Commissioner Viriginia Barry and School Superintendent Tom Brennan as he visited an economics class that uses a video screen to connect three West students to their counterparts at Memorial and Central high schools, forging together a single class.
Then he visited a computer lab where 10 students were taking online classes.
"This is another educational opportunity we offer the students of Manchester so we can broaden their horizons and get them the educational opportunities of the future," Gatsas said.
At the computer lab, he acknowledged donations from three area businesses that total $37,500. Officials used the funds to purchase computers and video equipment for the three high schools, as well as to provide faster Internet connections in the computer labs.
Brennan thanked the business representatives as well as Gatsas. "If it weren't for you," he told Gatsas, "none of this would have happened."
In making the announcement at West, Gatsas traveled to the home turf of Patrick Arnold, the West Side alderman who is challenging him for mayor.
"I'm glad to see the mayor is taking a look at finally moving the school district forward," Arnold said. He said Gatsas lacks vision for education, and the schools are hurt financially when the city spends too much money on projects such as the long-delayed Innoprise software overhaul.
Two separate high-tech learning styles were on display Thursday.
One involved online video links that gave the three West students entre into a Central economics course. However, the audio was scratchy, which Central Principal Ron Mailhot apologized for.
"There's some technical glitches," said Jasmine Bergeron, a Memorial student. "We're going to get used to it, and it's going to be like any other class."
A mammoth video monitor allowed the West students to see both the Central and Memorial classrooms and vice versa. The teacher doesn't use a white board, but can put videos and graphics on a screen for students.
West senior Zach Ziemba said he would have preferred to be in a traditional class.
"I don't know how you're going to do this in the future." Ziemba said. If students don't behave, the classes will not work, he said.
The instruction taking place at the computer lab involves coursework through the Virtual Learning Academy Charter School. Most work is done on a computer, and a teacher only becomes involved via phone or email when students have questions, or when they are ready for tests.
Ten students sat in front of new 4 GB RAM-memory computers. They replaced computers with a memory capacity of 256 megabites.
Students said they liked the flexibility of the coursework.
"I think it's easier (than a regular class)," said Kaitlyn Nadeau, a senior who used VLACS to recover credits and get up-to-date on her coursework. In a traditional class, if Nadeau doesn't understand something, she can't stop the class, she said.
With VLACS, if Nadeau doesn't understand something, she can take a break and research it, she said.
"If you're in class and you don't understand something, it's not like you can pull out a computer," she said.
Acting West Principal Keith Puglisi said self-pacing is a big selling card for VLACS. It's difficult for a teacher to give a lot of individual attention to large classes, he said.
"You have 30 kids and one teacher, that's a daily struggle for any educator," he said.
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Sullivan in the top running for state's Assistant Principal of the YearREADER COMMENTS: 0
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Schedule for today's Queen City Invitational Basketball, Bauer Christmas Hockey tournamentsREADER COMMENTS: 0
Merrimack teen allegedly held girl captive
'Interview' buzz spreads to NH
Pipeline push gets a second wind
Murder suspect fit for trial?


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This bighearted couple is dedicated to aiding children with disabilities. But while they're assisting these special needs kids, their own home is rapidly deteriorating around them.
As the EM:HE bus rolls on to Quincy Township, Pennsylania, Ty fills us in on Mathew and Blasia Drumm, a loving couple with two autistic sons. The Drumms help manage a special needs Little League. During the school year, Blasia also works as a teacher's aid at the Franklin Learning Center for Handicapped Children.
We discover that Mathew and Blasia have lent a helping hand to other blossoming leagues that have developed in the surrounding area, and in 2006 were awarded the Penn Marr Challenger League, Division Family Service Award.
Unfortunately, Matthew and Blasia were unaware at the time they purchased their home that both it and the lot it's on were previously used as a dump site for trash and waste. We feel this couple's pain upon discovering that because of their financial hardships, they've not been able to make any improvements to the house.
Our sadness turns to shock upon learning the Drumms' entire home is heated by a single wood-burning stove—definitely a hindrance to the Drumms' hope to one day work full time from home to help other special needs families.
Much to our joy, Ty and the design crew tirelessly carry out their vision of transforming this family's junkyard home into a fresh dwelling where the Drumms can offer in-home respite care to other special needs children.
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