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By Don MacVittie | Article Rating: |
February 5, 2013 09:00 AM EST | Reads: |
4,719 |
February 5, 2013
BareMetalBlog talking about quality testing of hardware, in all its forms. F5 does a great job in this space.
For those of you new to the Bare Metal Blog series, find them all right here.
In all critical systems – from home heating units to military firearms – the failure of even one piece can have catastrophic results for the user. While it is unlikely that the failure of an ADC is going to be quite so catastrophic, it can certainly make IT staff's day(s) terrible and cost the organization a fortune in lost revenue. That's not to mention the problems that downtime's impact on an organizations' brand can have over the longer term. It is actually pretty scary to ponder the loss of any core system, but one that acts as a gateway and scaling factor for remote employee workload and/or customer access is even higher on the list of Things To Be Avoided ™.
In general, if you think about it the number of hardware failures out there is relatively minimal. There are a ton of pieces of network gear doing their thing every day, and yes, there is the occasional outage, but if you consider the number of devices NOT going down on a given day, the failure rate is very tiny.
Still, no one wants to be in that tiny percentage any more than they absolutely must. Hardware breaks, and will always do so, it is the nature of electronic and mechanical things. But we should ask more questions of our vendors to make certain they're doing all that they can to keep the chances of their device breaking during their otherwise useful lifetime to a minimum.
For an example of doing it right, we'll talk a bit about the lengths that F5 goes to in an attempt to make devices as reliable as possible from an electro-mechanical perspective. While I am an F5 employee, I will note that there is no doubt that F5 gear is highly reliable. It was known for quality before I came to F5, and I have not heard anything since joining that would change that impression. So I use F5 because (a) I am aware of the steps we take as an organization and (b) because our hardware testing is an example of doing it right.
And of course, there are things I can't tell you, and things that we just will not have room to delve into very deeply in this overview blog. I am considering extending the Bare Metal Blog series to include (among other things) more detail about those parts that I would want to know more about if I were a reader, but for this blog, we're going to skim so there is space to cover everything without making the blog so long you don't read to the end.
I admit it, I've talked to a lot of companies about testing over the years, and can't recall a vendor that did a more thorough job – though I can think of a few whose record in the field says they probably have a similar program. So let's look at some of the quality testing done on hardware.
Parts are not just parts.
An ADC, like any computerized system, is a complex beast. There is a lot going on and the quality of the weakest link is the piece that sets the life expectancy and out-of-the-box quality standards for the overall product. As such there are some detailed parts and subassembly tests that gear must go through.
For F5, these tests include:
- Signal Integrity Tests to test for signal degradation between parts/subsystems.
- BIOS Test Suites to validate that BIOS performs as expected and handles exception cases reliably.
- Software Design Verification Testing to detect and eliminate software quality issues early in the development process.
- Sub- Assembly Tests to verify correct subsystem performance and quality.
- FPGA System Validation Tests determines that the FPGA design and hardware perform as expected.
- Automated Optical Inspection used on the PCB production line to prevent and detect defects.
- Automated X-Ray Inspection takes 3D slices of an assembled circuit board to prevent and detect defects.
- In-Circuit Test using a series of probes to test the populated circuit board with power applied to detect defects.
- Flying Probe uses a "golden board" (perfect sample) to compare against a newly produced board to verify there are no defects.
Now that's a lot of testing, though I have to admit I'm still learning about the testing process, there may well be more. But you'll note that some things aren't immediately called out here – like items picked from suppliers, which could be caught in some of these tests but might not either. That is because supplier quality standards are separate from actual testing, and require that suppliers whose parts make it into F5 gear are up to standard.
Supply demands
So what do we, as an organization, require from a quality perspective of those who wish to be our suppliers? Here's a list. This list I KNOW isn't complete, because I pared it down for the purposes of this blog. I think you'll get the idea from what's here though.
- All assembly suppliers are ISO9000 and 140001 certified.
- Suppliers assemble and test their products to F5 specifications.
- Suppliers are monitored with closed loop performance metrics including delivery and quality.
- Formal Supplier Corrective Action Response program – when a fault is determined in supplier quality, a formal system to quickly address the issue.
- Quarterly reviews with senior management utilizing a formal supplier scorecard to evaluate supplier quality, stability, and more.
The biggest one in the list, IMO, is that suppliers assemble and test product to F5 specifications. Their part is going in our box, but our name is going on it. F5 has a vested interest in protecting that name, so setting the standards by which the suppliers put together and test the product they are supplying is huge. After all, many suppliers are building tiny little subsystems for inside an F5 device, so holding them to F5 standards makes the whole stronger.
By way of example, we require the more reliable but more expensive version of capacitors from our suppliers. For a bit of background on the problem, there is an excellent article on hardwaresecrets.com (and a pretty good overview on wikipedia.com) about capacitors. By demanding that our suppliers use better quality components, the overall life expectancy of our hardware is higher, meaning you get less calls in the middle of the night.
The whole is different than the sum of the parts
While an organization can test parts until the sun rises in the west, that will not guarantee the quality of the overall product. And in the end, it is the overall product that a vendor sells. As such, manufacturers generally (and F5 specifically) keep an entire suite of whole-product tests on-hand for product quality assessment. Here are some of them used at F5.
- Mechanical Testing Test the construction of the system by applying shock, drop, vibe, repetitive insertion/extractions, and more.
- Highly Accelerated Life Testing - Heat and vibration are used to determine the quality and operational limits of the device. The goal is to simulate years of use in a manageable timeframe.
- Environmental Stress Screening – Expose the device to extremes of environment, from temperature to voltage.
- MFG Test Suite System Stress testing - turn everything on, Reboot, Power Cycle, et cetera. By way of example, we cycle power up to 10,000 times during this testing.
- On-Going Reliability Testing - The products currently in the manufacturing line are randomly picked and then put in a burn-in chamber which then test the device at elevated temperature.
- Post Pack out Audit – Pull random samples from our finished good inventory to verify quality.
That's a lot of testing, and it is not anywhere near all that F5 does to validate a box. For example, while software testing got a hat-tip at the component level, our Traffic Management Operating System (TMOS) has a completely separate set of testing, validation, and QA processes that are not listed here because this is the Bare Metal Blog. Maybe at some point in the future I'll do a series like Bare Metal Blog on our software. That would be interesting for me, hopefully for you also.
It's not over when it's over
The entire time that Lori and I were application developers, there was a party to celebrate every time we finished a major piece of software. From an evening out with the team when our tax prep software shipped to a bottle of champagne on the roof of an AutoDesk office building when AutoCAD Map shipped, we always got to relax and enjoy it a bit.
While our hardware dev teams get something similar, our hardware test teams don't pack up the gear and call it a product. For the entire lifecycle of an F5 box – from first prototype to End of Life – our test team does continuous testing to monitor and improve the quality of the product. Unlike most of what you will find in this blog, that is pretty unique to F5. Other companies do it, but unlike ISO certification or HALT testing, continuous testing is not accepted as a mandatory part of product engineering in the computing space. F5 does this because it makes the most sense. From variations in quality of chips to suppliers changing their suppliers, things change over the production of a product, and F5 feels it is important to overall quality to stay on top of that fact. This system also allows for continuous improvement of the product over its lifecycle.
One of the many reasons I think F5 is a great company. I have twice run into scenarios that involved a vendor who did not do this type of testing, and it cost me. Once was as a reviewer, which means it was worse for the vendor than for me, and once as an IT manager, which means it was worse for me than the vendor. I would suggest you start asking your vendors about lifetime testing, because a manufacturing or supplier change can impact the reliability of the gear. And if it does, either they catch it, or you could be walking into a nightmare. The perfect example (because so many of us had to deal with it) was a huge multinational selling systems with "DeskStar" disks that we all now lovingly call "Death Star" disks.
You can rely on it
This process is a proactive investment by F5 in your satisfaction. While you might think "doesn't all that testing – particularly when continuous testing occurs over the breadth of devices you sell – cost a lot of money?", the answer is "nowhere near as much as having to visit every device of model X and repair it, nowhere near as much as the loss of business persistent quality issues generates". And it is true. We truly care about your satisfaction and the reliability of your network, but when it comes down to it, that caring is based upon enlightened self interest. The net result though is devices you can trust to just keep going.
I know, we have one in our basement from before we came to F5, It's old and looks funny next to our shiny newer one. But it still works. It's EOL'd, so it isn't getting any better, and when it breaks it's done, but the device is nearly a decade old, and still operates as originally advertised.
If only our laptops could do that.
Published February 5, 2013 Reads 4,719
Copyright © 2013 SYS-CON Media, Inc. — All Rights Reserved.
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More Stories By Don MacVittie
Don MacVittie is Founder of Ingrained Technology, LLC, specializing in Development, Devops, and Cloud Strategy. Previously, he was a Technical Marketing Manager at F5 Networks. As an industry veteran, MacVittie has extensive programming experience along with project management, IT management, and systems/network administration expertise.
Prior to joining F5, MacVittie was a Senior Technology Editor at Network Computing, where he conducted product research and evaluated storage and server systems, as well as development and outsourcing solutions. He has authored numerous articles on a variety of topics aimed at IT professionals. MacVittie holds a B.S. in Computer Science from Northern Michigan University, and an M.S. in Computer Science from Nova Southeastern University.
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subset: commoncrawl


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Lemigo is a modern clean and functional business hotel 20 minutes from the Airport, but clearly lacks the African charm you may have come to expect from your stays at some of the breathtaking lodges in Rwanda or Uganda. Its restaurant could improve in food selection and service. Overall, a no-frills place for the business traveller who will even find... More
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i have a customer today that would like a breacher barrel for his 590 now my problem is i cant seem to locate one. I found one mossberg makes for remington thats just what he wants but it has to fit the 590 . Does anyone know of where i might find it ( outside of the obvious )or has one they'd sell ?
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The Mossy breacher rocks. it is much better than the Remmy breacher. You will probably have to get it from Mossberg.
Dead Bears, the only good kind.
thx email sent


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U.S. and S. Korean drills canceled
Did the cancellation of joint military exercises between the U.S. and S. Korea in the Yellow Sea have anything to do with China. Not according to the Pentagon. A spokesman said the two navies couldn't agree on a timetable. He also said the exercises in international water should pose no problems for neither China nor North Korea The South Korean media reported the drills had been cancelled because of complaints from China.


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I discovered later that Senise appropriates these "interiors" from old and modern masters, something not apparent in the works themselves. This conceptual delight is part of Senise's game, as he refers to the painters' names in some of the titles. But there's something else, besides space and intellectual discourse, in Senise's art. Look at how much the artist invests in his mauve, gray, and sepia surfaces, following an almost heroic no-brush thesis. On the floor of his studio, Senise carefully cuts and glues long strips of canvas, adds monochromatic acrylic pigments, and then proceeds to attach them longitudinally onto wooden panels. The effect is of a lattice of bands arranged perpendicularly to the painting, with a robust, worn-out feel to it. Then as you stare at, and through, this traumatized mesh, you'll get lost in the man-made emptiness.
Through Oct. 25 at the Centro Cultural Espa�ol, 800 Douglas Rd, Coral Gables; 305-448-9677.
Misty Wanderings and Hidden Ways
With photos by Joseph Tamargo, Stuart Coppin, and Jos� Rodriguez, through Nov. 3 at Art Center/South Florida, 800 Lincoln Rd, Miami Beach; 305-674-8278.
"Proyecta," a show curated by Marcelo Leslabay, is the most recent exhibit at the increasingly active Centro Cultural Español. The display brings together a number of contemporary Spanish graphic, industrial, and fashion designers for an initiative very similar to that of other European efforts to unify national enterprises into a more global image. In a sense "Proyecta" signals Spain's arrival at the upper echelon in the design world.With close to $1.5 billion in services expenditures, Spain has become the fourth-largest design power in Europe, after England, Germany, and France. The Spanish emergence on the design stage is similar to the Italian boom during the 1950s, thanks to the amazing mobilization of all things design in Barcelona since 1992 -- still an example for any city in Europe today and the model for the more recent rise of Madrid.
Artists such as Isidro Ferrer, Ipsum Planet, Niall O'Flynn, Andreu Balius, and Miriam Ocariz, among others, are the new generation with a vocabulary fully formed in Spanish. Ferrer works with a cool Miró-like iconography to produce direct and catchy images, which also incorporate Mediterranean traditions, an indication of the social and political repositioning of Catalonia.
I was more impressed with the graphic and fashion design than with the industrial design, though these days that happens to be the case in most places. And in particular I favored Niall O'Flynn's Tensa Lamp to his Rascal chair, which seems a little uncomfortable for something as flatly ergonomic as an office chair. On the other hand, O'Flynn's Balanza, a birch slablike rocking chair with sensual curving, is a witty piece.
Neo 2 is a hip publication by Ipsum Planet, a collective of graphic and advertising designers from Madrid. Though it's a bit on the sensationalist side, I have to concur with Neo 2's editorial policy favoring artificiality and the ultracontemporary as a way of expressing Madrid's ever-changing times. Neo 2's layout, photos, design, and typeface are as good as any of the top English or Italian magazines.
Miriam Ocariz, from Bilbao, makes graphic-design clothing. Her series "Perlas" (Pearls) on black fabrics such as wool, rayon, and polyester creates object-illusions on attire similar to Nicola Constantino's skin costumes. Ocariz's products are conceptual and chic.
Alberto Martínez and Álvaro Rey build interactive designs, some of which have been sponsored by prestigious entities such as the Royal College of Arts in Britain and Phillips. For this pair of young creators, society is still behind technology. So their interface bridges the gap between scientists and consumers. Don't miss Arrow Project, where the mouse's cursor is literally taken out of the monitor to interact with objects on your desk, thanks to a mix of tools that involve PC, camera, and laser technology.
Reflecting on design, special mention must go to Mónica Tárrega, a young Spanish architect in charge of the interior renovation, who has given the center's space itself a face-lift. In addition to conveying a more cohesive image for the center's continuous and diverse use, Tárrega worked with the site to display an up-to-date touch, one that exposes "unfinished" textures on columns and ceiling to achieve a bolder, more socially involved atmosphere for Spain's proxy in Latin American Miami. The place looks open, transparent, and sympathetic. Wait for those glass bookcases facing the inner patio to be put in and, designwise, the Spanish Cultural Center may become one of the coolest places to visit in Miami.


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ADP said that manufacturers added 3,000 net new workers in February, its slowest pace since January 2014. This suggests that the weaker demand and production data seen in other economic indicators has begun to negatively impact the pace of hiring. Still, employment has expanded for 13 straight months, averaging 14,275 per month over that time frame, according to ADP. Moreover, over the past six months, employment growth has been even stronger, averaging just over 17,580 each month. Hopefully, the weaker rate of hiring observed in February is just a respite to stronger gains in the months ahead. (continue reading…)
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ISM: Manufacturing Activity Weakened in February on West Coast Ports, Reduced Energy Prices
The Institute for Supply Management (ISM) said that growth in manufacturing activity has continued to slow over the past few months, starting 2015 off on a weaker note. The headline purchasing managers' index (PMI) has fallen from 57.9 in October to 52.9 in February, it slowest pace since January 2014, when severe winter storms dampened activity across-the-board. The sample comments suggest that the West Coast ports slowdown and falling energy prices were top-of-mind for many of the respondents, helping to explain much of this easing. At the same time, the stronger U.S. dollar and sluggish growth abroad were also likely factors, with export orders (down from 49.5 to 48.5) declining for the second straight month. (continue reading…)
Personal Spending Fell in January for the Second Straight Month
The Bureau of Economic Analysis said that personal spending decreased by 0.2 percent in January, falling for the second straight month. Durable and nondurable goods spending were also lower in both December and January, and these data suggest that Americans remain cautious in their spending. Of course, there could also be other factors at play, such as lower gasoline prices and heavy snow storms in some regions of the country. Still, on a year-over-year basis, personal spending has increased 3.6 percent, a fairly decent growth rate. (continue reading…)
Monday Economic Report – March 2, 2015
Here is the summary for this week's Monday Economic Report:
While manufacturers remain mostly optimistic in their outlook, we have seen softness in a number of recent economic indicators. Slower economic growth internationally, a stronger U.S. dollar, reduced crude oil prices and the West Coast ports slowdown have been cited as reasons for this weaker-than-desired performance. Along those lines, real GDP growth in the fourth quarter was revised lower, down from 2.6 percent to 2.2 percent. In addition, surveys from the Dallas, Kansas City and Richmond Federal Reserve Banks all reflected decelerated levels of new orders and exports. Most notably, Texas manufacturers have been adversely impacted by the sharp drop in petroleum prices, dampening demand throughout the energy supply chain and for the larger regional economy. Yet, even in the Dallas report, respondents continued to be more positive than negative in their expectations for sales, production, employment and capital spending over the next six months. (continue reading…)
Real GDP Growth Revised Down to 2.2 Percent in the Fourth Quarter
Real GDP grew 2.2 percent in the fourth quarter, according to the Bureau of Economic Analysis. This was down from the previous estimate of 2.6 percent growth. Slower growth in inventory replenishment and stronger import growth accounted for the bulk of the revision. For the year as a whole, real GDP rose 2.4 percent in 2014, only slightly better than the 2.3 percent and 2.2 percent rates seen in 2012 and 2013, respectively. Still, this was largely the result of a decline in activity in the first quarter due to weather and other factors, with real GDP growth averaging a quite-healthy 4.8 percent pace in the second and third quarters. As of right now, growth in the first quarter of 2015 (or the current one) should be roughly 2.8 percent, and I am still forecasting growth of around 3 percent for all of 2015. (continue reading…)
Kansas City Fed: Manufacturing Activity Slowed to a Near Crawl in February
The Kansas City Federal Reserve Bank said that manufacturing activity slowed to a near crawl in February, mirroring the easing we have seen in other regions. The composite index of general business conditions dropped has declined from 8 in December to 3 in January to 1 in February. The silver lining, of course, is that activity in the sector continues to expand, albeit barely, as it has now for 14 straight months. Still, the weaker headline figure was pulled lower by contracting levels of new orders (down from -8 to -10), exports (down from -7 to -13) and employment (down from zero to -4). There were several reasons cited in the sample comments for the softness, including sluggish global growth, reduced crude oil prices and the West Coast ports slowdown. (continue reading…)
Consumer Prices Fell Once Again on Lower Gasoline Costs
The Bureau of Labor Statistics said that the consumer price index (CPI) fell 0.7 percent in January. This mirrored producer price index (PPI) data released the week before. More importantly, consumer prices have decreased 0.2 percent over the past 12 months, the first negative year-over-year pace since October 2009. Of course, this downward shift in inflation has been spurred by lower gasoline prices, which fell 18.7 percent in January alone. Indeed, the average price of regular gasoline declined from $3.639 a gallon during the week of June 23 to $1.982 a gallon the week of January 26, according to the Energy Information Administration. (It has begun to rise a bit since then, with an average of $2.256 per gallon this week.) (continue reading…)
New Durable Goods Orders Rebounded in January on Strong Aircraft Orders
The Census Bureau said that new durable goods orders rose 2.8 percent in January, rebounding from the 3.7 percent decline observed in December. It was the strongest increase in durable goods orders in six months, with demand off in four of the past five months. As such, manufacturing activity since July 2014 has been less-than-desired, providing a bit of a contrast with better demand and sentiment data elsewhere. The sluggish global economic environment has likely played a role in this softness. On a year-over-year basis, durable goods orders have risen 5.4 percent, but this strength is somewhat misleading, as it builds off of the significant weather-related slowdowns seen 12 months ago. (continue reading…)
Chinese Manufacturing Shifted to a Marginal Expansion in February
The HSBC Flash China Manufacturing PMI shifted to a marginal expansion in February, improving slightly after contracting for two straight months. The headline index increased from 49.7 in January to 50.1 in February. The underlying data were mixed. New orders (down from 50.8 to 50.4) and output (up from 50.1 to 50.8) grew slowly for the month, even as the pace of sales slipped a bit. At the same time, new export orders (down from 51.1 to 47.1) and employment (up from 49.1 to 49.3) declined on net. Export sales, in particularly, deteriorated to their lowest level since August 2013, which was disappointing. The index for hiring, which has contracted now for 24 consecutive months, increased to a 7-month high, with the pace of the decline decreasing. Final PMI data will be come out on Monday, March 2. (continue reading…)
Conference Board: Consumer Confidence Pulled Back in February
The Conference Board said that consumer sentiment fell sharply in February. The Consumer Confidence Index declined from a revised 103.8 in January to 96.4 in February. The January figure had been originally reported to be 102.9, and it was the highest point for this measure since August 2007. The decrease in attitudes in this report in February mirrored similar drops in perceptions in the most recent University of Michigan and National Federation of Independent Business surveys. Still, the depth of the pullback in February was larger than expected, and it suggests that the American public remains more anxious than desired. (continue reading…)


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The U.S. received two points apiece by Seth Ambroz, Max Gaede, Cason Hohmann and Sam Warning, who each scored once, and goalie Zane Gothberg turned aside 32 shots as the Americans secured a spot in the semifinal round by wrapping up first place in Group A with a 5-1 victory over Sweden.
Gaede, Hohmann and Ambroz all scored in a span of 7:25 in the second period to give the United States a 4-1 advantage. Jimmy Mullin also connected for the U.S., notching his tournament-leading fourth goal. Ambroz, a likely top 15 draft pick in June, was named the Player of the Game for the Americans. Ambroz is blogging for NHL.com this season.
In the other preliminary contest held Wednesday, Grayson Downing and Dylan Walchuk scored third-period goals to snap a 2-2 tie and give Canada West a 4-2 triumph over Russia before 3,497 in attendance.
Russia, which yielded 52 shots to Switzerland one night earlier, allowed 53 shots to Canada West. Russian goalie Oleg Dyatlov made 49 saves and was named Player of the Game for his team. Downing received similar honors for Canada West, which will next face Sweden. Russia will battle Canada East.


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Deaf-mute man writes notes to help catch burglary suspect
FARGO, N.D. - A deaf-mute man scribbled notes to help police here identify and arrest a suspect who allegedly robbed the man and broke into a downtown liquor store early today, authorities said.
The victim was riding a bicycle when he flagged down a Fargo bike officer in the 100 block of Broadway at 1:51 a.m., Sgt. Jason Nelson said.
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Easter devotions are here! Sign up for our Lent and Easter email devotions.
5:17 When the Philistines heard. While David's reign over Judah had not been contested by the Philistines, the extension of his domain to the northern tribes posed a threat to Philistine interests that they could not ignore.
stronghold. See 1 Sam. 23:14 note.


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VIEWS: 2 PAGES: 11 CATEGORY: Lease Agreement POSTED ON: 12/23/2009
Exhibit 10.13 FOURTH AMENDMENT TO LEASE THIS FOURTH AMENDMENT TO LEASE (the "Amendment") dated as of the 27th day of November 2001, by and between FV OFFICE PARTNERS, L.P., successor in interest to Dean Witter Realty Income Partnership III, L.P., a limited partnership organized and existing under the laws of Delaware (hereinafter referred to as "Landlord"), and COVALENT GROUP INC., successor in interest to Covalent Research Alliance Corp., a corporation organized and existing under the laws of Nevada whose present address is 1275 Drummers Lane, Wayne, PA 19087 (hereinafter referred to as "Tenant"). WITNESSETHTHAT: WHEREAS, Landlord leased certain premises at Glenhardie Corporate Center in the building located at 1275 Drummers Lane, Wayne, Pennsylvania 19087 (the "Building"), to Tenant pursuant to that certain Lease dated September 9, 1994, amended by that certain First Amendment to Lease dated March 25, 1996 and that certain Second Amendment to Lease dated November 14, 1996 (collectively, the "Original Lease"); WHEREAS, Landlord and Interactive Health Computing Inc. ("IHC") entered into that certain Agreement of Lease dated January 15, 1996 as amended by a First Amendment to Lease dated March 25, 1996 (the "IHC Lease") regarding certain space located on the first floor of the Building. Landlord consented to the assignment of the IHC Lease to Tenant pursuant to that certain Assignment and Assumption of Lease dated September 30, 1999 between Tenant and IHC in which Tenant assumed the rights and obligations of the IHC Lease (the "Assignment and Assumption") and that certain Consent to Assignment and Assumption between Landlord, IHC and Tenant dated September 1999 (the "Consent"). The IHC Lease, the Assignment and Assumption and the Consent are hereinafter collectively referred to as the "IHC Lease Documents." The Original Lease and the IHC Lease Documents as the same has been modified by that certain Third Amendment to Lease dated July 31, 2001 (the "Third Amendment") are hereinafter collectively referred to as the "Lease". The term "Premises" as used herein shall have the same meaning as specified in the Third Amendment; and WHEREAS, Landlord and Tenant have agreed to further amend the Lease in accordance with the terms and conditions set forth herein; NOW THEREFORE, Landlord and Tenant for good and valuable consideration, intending to be legally bound, hereby agree as follows: 1. Effective January 30, 2002 the Premises shall be expanded to encompass Suite 200 consisting of approximately 4,576 rentable square feet or an acceptable similar suite of similar size in the Glenhardie Corporate Center (the "Additional Premises"). Landlord shall provide the Additional Premises to Tenant in its "as-is, whereis" condition. 2. Effective January 30, 2002 the term "Premises" as used herein shall include the Additional Premises and the Premises shall consist of approximately 18,782 rentable square feet. 3. During the period between January 30, 2002 and the Long-Term Premises Commencement Date (as hereinafter defined) the minimum fixed annual rent for the Premises (as defined in Paragraph 2 above) shall be $24.00 per rentable square foot payable in equal monthly installments. During such period "Tenant's proportionate share" shall be 29.774%. 1 4. Landlord agrees that prior to entering into a lease for the Expansion Space (as hereinafter defined), Landlord shall provide Tenant with a written notice offering Tenant the option to expand (the "Expansion Offer") into 1,238 rentable square feet on the second floor of the Building in the space known as Suite 207 (the "Expansion Space") on the following terms and conditions: (a) Tenant shall have ten (10) business days after receipt of the Expansion Offer to accept the Expansion Offer by delivery of written notice to Landlord. (b) The Expansion Space shall be provided at $22.00 per rentable square foot and the term shall be coterminous with and subject to the same terms and conditions as are applicable to the Premises in the Lease. (c) Landlord shall not be obligated to offer the Expansion Space to Tenant more than one time prior to the Maturity Date (as defined in Paragraph 11 below). (d) Tenant shall not be in default of the Lease at the time of its exercise of the Expansion Offer nor at the commencement of the lease term for the Expansion Space. (e) Effective upon the commencement of the term for the Expansion Space, the Expansion Space shall become a portion of the Premises. 5. On the date on which Landlord gives written notice to Tenant that the Long-Term Premises (as hereinafter defined) is substantially complete (the "Long-Term Premises Commencement Date") the portions of the Premises known as Suites 101, 104 and 200 consisting of approximately 1,245, 1,222 and 4,576 rentable square feet respectively (collectively, the "Give Back Space") shall be surrendered by Tenant to Landlord within thirty (30) days of the Long-Term Premises Commencement Date ("Give Back Space Surrender Date"). Upon the occurrence of the Give Back Space Surrender Date the Give Back Space shall cease to be a portion of the Premises and Tenant shall not have access to or use of the Give Back Space. Tenant shall surrender the Give Back Space to Landlord as of the Give Back Space Surrender Date in the condition and manner specified in the Lease. Tenant shall not be required to pay Landlord Fixed Rent for the Give Back Space for the period between the Long-Term Premises Commencement Date and the Give Back Space Surrender Date; however, Tenant shall be required to pay all other sums payable by Tenant to Landlord pursuant to the provisions of the Lease. The term "substantial completion" as used in this Amendment shall have the same meaning as set forth in Article 3 (b) of the Lease. 6. As used in this Amendment the term "Long-Term Premises" shall mean and refer to in the aggregate: (i) approximately 11,739 rentable square feet on the first floor of the Building known as Suite 100; and (ii) approximately 22,287 rentable square feet on the third floor of the Building known as Suite 300. 7. From and after the Long-Term Premises Commencement Date: (i) the term Premises shall mean and refer to the Long-Term Premises; (ii) Tenant's proportionate share shall be 53.940%; and (iii) the minimum fixed annual rent for the Long-Term Premises shall be $25.50 per rentable square foot payable in equal monthly installments. Such minimum fixed annual rent shall increase at a per annum cumulative rate of $.50 per rentable square foot. 8. Landlord shall provide the Long-Term Premises to Tenant in its "as-is" condition subject to the construction specifications attached hereto as Exhibit "A" and made a part hereof (the "Tenant Improvement Work"). Landlord shall provide Tenant with a tenant improvement allowance of $15.00 per 2 rentable square foot in the Long-Term Premises (the "Tenant Improvement Allowance") which may be used by Tenant, at Tenant's option, to pay for the cost of the Tenant Improvement Work or for Tenant's relocation costs incurred in connection with its occupancy of the Long-Term Premises. All Tenant Improvement Work shall be performed in accordance with the terms and conditions of Exhibit "A". All costs related to the Tenant Improvement Work in excess of the Tenant Improvement Allowance shall be paid by Tenant. 9. The Landlord shall perform all Tenant Improvement Work in a good and workmanlike manner. Landlord shall complete all Tenant Improvement Work on or before January 1, 2003 (the "Completion Date") unless Landlord's completion of the Tenant Improvement Work is delayed by Tenant's failure, without limitation, to fulfill its obligations under Exhibit "A". In the event such Tenant delay results in the Completion Date occuring after January 1, 2003, then the Long-Term Premises Commencement Date shall be deemed to have occurred on January 1, 2003, notwithstanding the fact that all Tenant Improvement Work was not substantially complete on that date, and Landlord's obligation to complete the Tenant Improvement Work by the Completion Date shall be extended for a period of time equal to the aggregate amount of such Tenant delay. If due to a delay caused by Landlord, Landlord is unable to complete the Tenant Improvement Work by the Completion Date in such manner as the Long-Term Premises may be deemed substantially complete in accordance with the terms of Paragraph 5 of this Amendment, Tenant's minimum fixed annual rent shall be abated in an amount equal to one (1) day of the minimum fixed annual rent for the Long-Term Premises for each day substantial completion is delayed beyond the Completion Date. 10. Landlord agrees that the provisions of Section 8 (i) regarding Tenant's access to premises under construction shall be applicable to the Long-Term Premises before the Completion Date. 11. The term of the Lease is hereby extended for a period of five (5) years from the Long-Term Premises Commencement Date (such date, the "Maturity Date"). 12. Tenant shall have the option to extend the term of the Lease for one five (5) year period (the "Option Period") provided Tenant delivers written notice to Landlord not less than nine (9) months prior to the Maturity Date. Tenant may exercise the option provided in this Paragraph 12 provided Tenant is in compliance with the following terms and conditions: (a) Tenant shall not be in default under the Lease either at the time of Tenant's proposed exercise of the option or as of the commencement date of the Option Period; (b) At the time Tenant elects to exercise the option Tenant shall, in Landlord's reasonable judgment, be creditworthy; (c) Prior to Tenant's proposed exercise of the option Tenant shall not have previously assigned the Lease or sublet all or any portion of the Premises unless such assignment or sublet was to an affiliate and permitted under the terms of the Lease; (d) All of the terms of the Lease during the Option Period shall remain the same except that the minimum fixed annual rent payable during the Option Period shall be at the then current market rate for similar space in Glenhardie Corporate Center. Such rent shall be negotiated in good faith between the parties provided, however, notwithstanding anything contained in this Paragraph 12 to the contrary, in no event shall the minimum fixed annual rent during the Option Period be less than the minimum fixed annual rent in effect during the year immediately preceding the Option Period; and 3 (e) The five year renewal option specified in this Paragraph 12 shall be Tenant's sole right to extend or renew the Lease and any renewal or option provision currently contained in the Lease, if any, shall be null and void and of no further force or effect. 13. Articles 20(d)(iii)(A) and 20(d)(iii)(B), which comprise the Confession of Judgment portion of the Lease are hereby restated and reconfirmed as follows: If Tenant shall default in the payment of the rent or any other sums due hereunder by Tenant, Tenant hereby irrevocably authorizes and empowers any prothonotary or attorney of any court of record to appear for Tenant in any and all suits or actions which may be brought for said rent and/or said other sums; and in said suits or actions to confess judgment against Tenant for all or any part of said rental and/or said other sums, including but not limited to the amounts due from Tenant to Landlord under clauses (i), (ii), or (iii) of this Article 20, and for interest and costs, together with an attorneys' commission for collection of five percent but not less than Ten Thousand Dollars ($10,000). Such authority shall not be exhausted by one exercise thereof, but judgment may be confessed as aforesaid from time to time as often as any of said rental and/or other sums shall fall due or be in arrears, and such powers may be exercised as well after the termination or expiration of the term of this lease. When this lease or Tenant's right of possession shall be terminated by covenant or condition broken, or for any other reason, either during the term of this Lease, and also when and as soon as such term shall have expired or been terminated, Tenant hereby irrevocably authorizes and empowers any attorney or any court of record as attorney for Tenant and any persons claiming through or under Tenant to confess judgment in ejectment against Tenant and all persons claiming through or under Tenant for the recovery by Landlord of possession of the Premises, for which this Lease shall be sufficient warrant, whereupon, if Landlord so desires, a writ of execution or of possession may issue forthwith, without any prior writ or proceedings whatsoever, and provided that if for any reason after such action shall have been commenced the same shall be determined, canceled or suspended and possession of the Premises hereby demised remain in or be restored to Tenant or any person claiming through or under Tenant, Landlord shall have the right, upon any subsequent default or defaults, or upon any subsequent termination or expiration of this Lease or any renewal or extension hereof, or of Tenant's right of possession, as hereinbefore set forth, to confess judgment in ejectment as hereinbefore set forth one or more additional times to recover possession of the said Premises. In any action of or for ejectment or for rent or other sums, if Landlord shall first cause to be filed in such action an affidavit made by it or someone acting for it setting forth the facts necessary to authorize the entry of judgment, such affidavit shall be conclusive evidence of such facts; and if a true copy of this Lease (and of the truth of the copy such affidavit shall be sufficient evidence) be filed in such action, it shall not be necessary to file the original as a warrant of attorney, any rule of court, custom or practice to the contrary notwithstanding. Tenant releases to Landlord, and to any and all attorneys who may appear for Tenant, all procedural errors in any proceedings taken by Landlord, whether by virtue of the warrants of attorney contained in this Lease or not, and all liability therefor. Tenant Please Initial Here /s/ KMB ------- 14. The parties represent and warrant to each other that they have not employed, dealt with or negotiated with any broker or agent other than Fox Realty Co. and Smith Mack & Company. Landlord agrees to pay all commissions owed to the named brokers in this Paragraph 14. Each party agrees to indemnify, defend and hold the other party harmless from and against any and all demands, actions, loss, damage or liability, including, without limitation, reasonable attorneys' fees, to which the other party may now or hereafter become subject by reason of any claim for commission, fee or other compensation to any broker or agent not listed in this Paragraph 14 due as a result of the acts of the indemnifying party. 4 15. Landlord and Tenant agree they shall each utilize their best efforts so that a new lease incorporating all of the terms and conditions of the Lease will be executed by January 1, 2003, provided, however, that in the event a new lease is not signed, the terms and conditions of the Lease shall remain in full force and effect. Landlord and Tenant agree that the execution of a new lease is for convenience of maintaining adequate documentation of the Lease and shall not constitute a renegotiation or modification of the Lease. 16. The submission by Landlord to Tenant of this Amendment shall have no binding force or effect, shall not constitute an option for the leasing of the Premises nor confer any rights or impose any obligations upon either party until execution thereof by Landlord and the delivery of an executed original copy thereof to Tenant. 17. All capitalized terms in this Amendment not otherwise defined herein shall have the meaning set forth in the Lease. This Amendment may be signed in counterparts. 18. All of the terms, conditions and provisions of the Lease are incorporated herein by reference as fully as though set forth in this Amendment. 19. The Lease remains in full force and effect, unamended, except as expressly modified by this Amendment. All of the recitals set forth above are hereby ratified and confirmed by Landlord and Tenant and incorporated herein by reference. 20. The individual signing below on behalf of the Tenant represents that s/he has the authority and power to bind the Tenant. IN WITNESS WHEREOF, the parties hereto have executed this Fourth Amendment to Lease the date set forth above. LANDLORD: FV OFFICE PARTNERS, L.P. a Delaware limited partnership By: FVGP, L.L.C., a Pennsylvania limited liability company, General Partner By: /s/ Robert G. Lee --------------------------Robert G. Lee a Member TENANT: COVALENT GROUP INC. a Nevada corporation By: Kenneth M. Borow, M.D. ------------------------------Name: /s/ Kenneth M. Borow, M.D. ----------------------------Title: CEO/President 5 EXHIBIT "A" COVALENT GROUP INC. LONG-TERM PREMISES CONSTRUCTION SPECIFICATIONS ' ---------------------------------------------- A. TENANT IMPROVEMENT ALLOWANCE ---------------------------Landlord shall provide to Tenant an allowance in the sum of Five Hundred Ten Thousand Three Hundred Ninety Dollars ($510,390.00), which Tenant may use to pay the cost of improvements and modifications to the Long-Term Premises, moving expenses, data and telephone wiring, the cost of state and local permits, space planning, Landlord's construction management fee pursuant to Paragraph H below, furniture, fixtures and equipment for the Long-Term Premises (the "Tenant Improvement Allowance"). Tenant may apply up to Seventy Two Thousand Dollars ($72,000.00) of the Tenant Improvement Allowance toward the Long-Term Premises first month's Fixed Rent. B. LONG-TERM PREMISES Landlord shall provide the Long-Term Premises in its "as is" condition, free of debris and broom swept, subject to the Landlord's completion of the Tenant Improvement Work as hereinafter described in this Exhibit "A". C. TELEPHONE/DATA COMMUNICATIONS Tenant shall make arrangements with and pay for installation to the Telephone or Data Company for its required installation within the Long-Term Premises and will cause all such work to be performed at a time compatible with Landlord's construction of the Tenant Improvement Work. At the expiration or earlier termination of this Lease, Tenant shall remove all telephone and data cabling and equipment and shall repair all damage to the LongTerm Premises caused by the installation or removal of these items. Costs for this work may be taken from the Tenant Improvement Allowance. D. MONUMENT SIGNAGE Provided Tenant commits to lease fifty percent (50%) or greater of the space in the Building, Landlord agrees that it shall provide, at Tenant's sole cost and expense, identification of Tenant at the entrance drive, which Tenant identification shall be located adjacent to or below the identification sign of the Building. The size, type and location of the identification shall conform to the existing signage as determined by Landlord. The costs for the signage may taken from the Tenant Improvement Allowance. E. HEATING, VENTILATION AND AIR-CONDITIONING Landlord, at Landlord's sole cost and expense shall retrofit the year-round heating, ventilating, and air conditioning system in the Long-Term Premises. Landlord shall provide wall-mounted thermostats with individual controls for each zone within the Long-Term Premises. Landlord will remove all abandoned heating, venting and air-conditioning equipment from the Long-Term Premises. 1 F. SCHEDULE OF DELIVERY OF TENANT'S DRAWINGS 1. Tenant shall furnish Landlord, for its approval, the following complete descriptive information with drawings, including both basic construction and finish work for the Tenant Improvement Work on or before the dates listed below: a. On or before May 1, 2002: 1. The location and extent of floor loading and floor opening in excess of building standard. 2. The special air-conditioning needs by location and general description of need. 3. Location and description of special plumbing requirements. 4. Estimated total electrical load including lighting for entire space. 5. Partition locations, and type. 6. Door locations, size and type. 7. Location of electrical outlets and telephone outlets. 8. Any structural installations. 9. Air-conditioning loads. 10. Specific plumbing requirements, including plans and specifications. 11. Cabinet work and any other information affecting other trades. 12. Decorative plans including paint schedule, floor coverings, draperies, wall coverings. 13. Architectural detailing. 2. Filing of Plans: Landlord shall without delay file all necessary plans and obtain all necessary approvals and permits in connection with the Tenant Improvement Work. 3. Substitutions: All Tenant Improvement Work shall require the installation of new materials at least comparable to the quality installed in the building. Tenant may substitute material, equipment, and fixtures for those specified for basic construction with written consent of Landlord not to be unreasonably withheld, conditioned or delayed. Tenant shall pay Landlord the cost to Landlord for such substitute items which is in excess of such items included in basic construction of the Tenant Improvement Work. The cost to Tenant for such substitution shall be Landlord's cost for the substitute item plus 5% of Landlord's cost for Landlord's expenses and profit in the handling of the substitution. Tenant may also request Landlord to omit the installations of 2 any item not therefore installed and, provided such omission shall not delay Landlord's completion of Tenant Improvement Work. Tenant shall be entitled to any credit for any such item omitted against any additional item or any item of a different kind of character. G. TENANT'S FINISH WORK 1. Landlord further agrees to approve or perform, at Tenant's request, upon submission by Tenant of acceptable plans and specifications any additional or non-standard work over and above that specified in Paragraphs B, C, D and E of this Exhibit "A" (Tenant Additional Work). Tenant Additional Work shall be performed by Landlord, at Tenant's sole expense, as an extra to Tenant Improvement Work. Tenant may also have Tenant's contractors perform the Tenant Additional Work as herein below provided. Prior to commencing any Tenant Additional Work, Landlord will submit to Tenant written estimates of the cost of the Tenant Additional Work. If Tenant shall fail to approve in writing any such estimate within five (5) working days the same shall be deemed disapproved in all respects by Tenant and Landlord shall not be authorized or obligated to proceed thereon. Tenant agrees that to the extent the cost of Tenant Additional Work shall exceed Twenty Five Thousand Dollars ($25,000.00) the same shall be collectible as additional rent pursuant to the Lease and in default of payment thereof, Landlord shall (in addition to all other remedies) have the same rights as in the event of default of payment of rent. 2. Tenant may, at its option after occupancy of Long-Term Premises, employ its own subcontractors to finish trade work; such as, carpentry, millwork, cabinet work, carpeting and draperies as may be initially furnished and installed by Tenant in the Long-Term Premises, provided such subcontractors work in harmony with, and do not interfere with the labor employed by the Landlord, its contractors or any other tenant or their contractors, and otherwise comply with the provisions of the Lease, and provided Tenant's subcontractors accept the administrative supervision of Landlord's representative. Workmen's Compensation, public liability insurance and property damage insurance, with a hold harmless provision, all in amounts and with companies reasonably satisfactory to Landlord, shall be maintained by such finish trades subcontractors; certificates of such insurance and waivers of liens shall be furnished to Landlord prior to commencement of work. H. WORK PERFORMED BY TENANT PRIOR TO COMMENCEMENT OF LEASE Landlord shall permit Tenant and its agents to enter the Long-Term Premises prior to the Long-Term Premises Commencement Date to perform, through its own contractors, work other than Tenant Improvement Work and any Tenant Additional Work to be performed by Landlord, such other work, including but not limited to, decorations and cosmetic improvements as Tenant may desire at the same time that Landlord's contractors are working in the space. The foregoing approval to enter prior to the Long-Term Commencement Date, however, is conditioned upon Tenant's workmen and mechanics working in harmony and not interfering with the labor employed by Landlord, Landlord's mechanics or contractors or by any other tenant or their contractors and compliance with the terms of the Lease; and further provided that Workmen's Compensation and public liability insurance and property damage insurance, with hold harmless provisions, all in amounts and with companies reasonably satisfactory to Landlord, shall be provided and at all times maintained by Tenant's contractors engaged in the performance of the work, and before proceeding with work, certificates of such insurance shall be furnished to Landlord. If at any time, entry by Tenant's contractors shall cause material disharmony or interference with Landlord's contractors performing Tenant Improvement Work or Tenant Additional Work, this license may be revoked by Landlord upon twenty-four (24) hours written notice to Tenant. 3 Entry by Tenant, its contractors, employees or agents shall be deemed to be under all of the terms, covenants, provisions and conditions of the said Lease except as to the covenant to pay rent. Landlord shall not be liable in any way for any injury, loss or damage which may occur to any of Tenant's decorations or installations made prior to the Long-Term Commencement Date, the same being installed solely at Tenant's risk. The provisions of these construction specifications are specifically subject to the provisions of the Lease. I. LANDLORD'S CONSTRUCTION MANAGEMENT FEE During the period between January 1, 2002 and Tenant's occupancy of the Long-Term Premises, Landlord shall have the right to provide construction management for and on behalf of Tenant, at Tenant's sole expense, at an amount equal to five percent (5%) of the alteration's total cost. From and after Tenant's occupancy of the LongTerm Premises, Landlord shall have the right to provide construction management for and on behalf of Tenant, at Tenant's sole expense, as provided for in Article 9 of the Lease. J. TERMS IN LEASE All capitalized terms used in this Exhibit "A" shall have the meaning proscribed to them in the Fourth Amendment to Lease to which this Exhibit "A" is expressly made a part thereof. 4 EXHIBIT 21 - SUBSIDIARIES Subsidiaries: Organized under the Laws of: Covalent Group, Limited United Kingdom Covalent 2000 United Kingdom Covalent 2001 United Kingdom EXHIBIT 23.1 INDEPENDENT AUDITOR'S CONSENT We consent to the incorporation by reference to Registration Statements Numbers 33-95602, 333-37756 and 333-44096 on Form S-8, Form S-8 and Form S- 3, respectively, of our report dated March 8, 2002 (which report expresses an unqualified opinion and includes an explanatory paragraph related to the Company's change of method of revenue recognition), appearing in the Annual Report on Form 10-KSB of Covalent Group, Inc. for the year ended December 31, 2001. /s/ Deloitte & Touche LLP Philadelphia, Pennsylvania March 29, 2002


text: Bolinas is a small town with incredible charm. Although most residents would rather not see tourisim you will be treeted well there. Smileys is an old building (1850's). It is a step back in time with great bartenders and patrons. The hotel is a lot of fun if you don't mind the lack of phone or TV. Smileys is a... More


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Did any one around the globe actually use this shock pump?
I can't find a single review or any mention of it on any MTB forum no matter how I look.
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Serve this lively soup, a fine showcase for Dungeness crab, to brighten up a winter day.
Sunset JANUARY 2008
1. In a 5-qt. pot over medium-high heat, melt butter. Add onion, carrots, bay leaf, white rice, salt, and black pepper. Cook, stirring, until onions are light golden, about 6 minutes. Add 5 cups water and bring mixture to a boil, then reduce heat and simmer 25 minutes. Remove bay leaf.
2. Working in batches, purée soup in a blender until smooth. Return soup to pot, stir in lemon zest, and keep warm. In a small bowl, toss crab with lemon juice and minced chives. Put an equal mound of crab mixture in the center of each of 4 soup bowls, then ladle soup around crab. Garnish with chopped chives.
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Tom Sawyer and Ty Russell invite Daryl Brock over for an afternoon of poolside fun where they can all suck, rim, butt-play and fuck. And the lucky guest eats it all up, eagerly taking advantage of their endless hospitality.
Tom Sawyer, Daryl Brock, Ty Russell
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Mars Red / Ash 2003 Mercedes-Benz SL500. 36,389 miles from new, optional SL2 Package, Wood Package, AMG Sport Package and Comfort Package, optional panoramic... More
1951 Chevrolet 2 Door Deluxe Hardtop Northwest Classic Auto Mall advertises this vehicle for the owner. If you are interested in this vehicle or have any... More
1969 Chevrolet Impala ConvertibleClassic cars have heritage and history and a completely unique style thatSets them apart from all the other cars on the... More
1957 Chevrolet Bel Air1957 Chevrolet Bel Air 2-Door model in mint conditionYellow metallic with a white top plus a Black vinyl interiorEquipped with a... More
1955 Ford Fairlane Sunliner Convertible1955 Ford Convertible292 EngineOriginal conditionOlder restorationTires excellent 92000 milesV8Manual transmissionUnit is located in Milton Freewater OR.Qualified buyers may be eligible... More
1929 Ford A1929 Ford Model A Roadster in mint conditionPPG Dark Carmine-Red metallic exterior with a Tan interiorCustom built back in September of 2012... More
1967 Chevrolet Nova Northwest Classic Auto Mall advertises this vehicle for the owner. If you are interested in this vehicle or have any questions, please contact... More
GR Auto Gallery is pleased to present this 2011 BMW 550i for purchase. For the gentleman (or lady) who doesn't have time to drive... More
While ponycar prices continue to skyrocket, many classic car buffs are turning to a great affordable alternative for their classic needs: The Ford Falcon.... More
Well, you can forget about keeping a low profile in this 1973 Ford Bronco 4x4, but I bet you won't mind one bit. With... More
There aren't many better ways to have fun in a car than with a first-generation Camaro. This 1967 Chevrolet Camaro hardtop definitely has the... More
1984 Porsche 911 Carrera Targa '84 Porsche 911 Carrera Targa, matching numbers, chassis# WPOEBO918ES160618, engine# 64E0145. Comes in white with blue interior, manual transmission, AC,... More
This car has been fully restored from the frame up. New paint, new interior, engine painted. The interior has been restored using the same type material... More
Restored 1971 Ford Mustang Mach 1. Rebuilt 351c 4V with Compcam, Edelbrock carb and intake, Pertronix ignition, portplates, windage tray, ram air, aluminum drive... More
Recent Body-Up Restoration, clean Alabama car, beautiful torch red paint, white vinyl interior, 350 ci GM crate engine, 4 bbl, aluminum intake, "Rams Horn"... More


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Our experience with Color Me Empowered has been wonderful! They work hard to reinforce self-esteem and optimism. And the public art projects are always very, very exciting!
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WEDNESDAY, Jan. 26 (HealthDay News) -- Replacing the commonly used blood-thinner heparin with a clot-dissolving stroke drug in dialysis catheters once a week may reduce the incidence of catheter malfunctions and infections, according to new research.
Recombinant tissue plasminogen activator (rt-PA) is a medication normally used to break up stroke-causing clots in the brain. However, when researchers used this drug in dialysis catheters instead of heparin after one of three dialysis sessions a week, the rate of catheter malfunction dropped from 35 percent to 20 percent. In addition, the infection rate was 4.5 percent in the group that received rt-PA compared to 13 percent for the group treated only with heparin.
"With rt-PA we could reduce the rates of catheter malfunction by about 50 percent and infections by almost two-thirds," said the study's lead author, Dr. Brenda Hemmelgarn, an associate professor of medicine at the University of Calgary in Alberta, Canada.
Results of the study are published in the Jan. 27 issue of the New England Journal of Medicine, and funding for the study was provided by Hoffmann-La Roche, a manufacturer of rt-PA.
Central venous catheters are used in dialysis to draw the blood out, and then to return it to the body after it has been cleansed by the dialysis machine. Catheters are the fastest method for allowing vascular access, but they have a higher risk of complications (such as infection and hospitalization) than other access methods, according to an accompanying editorial in the journal.
Because of time constraints, most people undergoing hemodialysis have catheters, according to background information in the article. And, about half of those catheters stop working within a year, often because of blood clots, said Hemmelgarn. Or an infection may occur, and serious catheter-related infections are one of the most common
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Great Hotels of the World offers an unrivalled collection of the best 4 and 5 star luxury hotels and resorts. Each hotel is selected for its dedication to the highest standards of luxury, unique sophistication, surroundings and innovative facilities.
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Tuesdays 10:00 PM on MTVFollow Awkward
Awkward Season 3 Episode 20: "Who I Want to Be" Photos
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Awkward Season 3 Episode 20 Quotes
Without the bad days we can never appreciate the good ones, and, there are so many good days coming your way. Just do me a favor, forgive yourself like you forgave me.
Ally: Suck it up, big girls don't cry.
Sadie: Whore.
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Pronunciation: inexorability
Added on: 2012-03-08
Listened: 22 times
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Pronunciation: tiết kiệm
Added on: 2013-01-18
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Photo Gallery: SHOT 2013 Day Two products Best new items discovered on second day of SHOT Show 2013. Share This Photo Gallery Prev Next Comments Galleries View More Photo Galleries Prev Next Photo 14 of 14 Best New Gear on the Floor TRUE TIMBER HEATED CLOTHING: True Timber Camo offers a new, expansive brand of heated clothing. Each is heated by a lithium ion battery for long use and comes in any pattern carried by True Timber. http://www.truetimber.com
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Chuy's Holdings, Inc. Announces Preliminary Fourth Quarter 2012 Sales Results
-Chuy's Provides 2013 Outlook-
-Chuy's Management to Present at the 15 th Annual ICR XChange Investor Conference-
AUSTIN, Texas, Jan. 10, 2013 (GLOBE NEWSWIRE) -- In advance of its presentation next week at the ICR XChange Investor Conference, Chuy's Holdings, Inc. (the "Company") (Nasdaq:CHUY) today announced preliminary, unaudited revenues and comparable restaurant sales results for its fourth quarter ended December 30, 2012. The Company also provided updated guidance for fiscal year 2012, as well as an initial outlook for fiscal year 2013.
For the fourth quarter of 2012, total revenues were approximately $46.7 million, an increase of 40.3% compared to revenues of $33.3 million in the fourth quarter of 2011. The Company's fourth quarter of 2012 included 14 weeks compared to 13 weeks in the fourth quarter of 2011. Revenues in the fourth quarter of 2012 attributed to the extra week totaled approximately $3.3 million. The Company's comparable restaurant sales increased 5.2% during the quarter for the 13-week period ended December 23, 2012 compared to the 13-week period ended December 25, 2011. Comparable restaurant sales were positively impacted by an extra 1.5 operating days in 2012 as a result of the Company's restaurant closing schedule on Christmas Eve and Christmas Day during the 13-week period in 2011. Excluding the impact of the extra 1.5 days, comparable restaurant sales increased 3.0%. Based upon these preliminary sales results, the Company has updated its guidance and currently anticipates that its fiscal year 2012 pro forma diluted net income per share will range between $0.59 to $0.61. The Company's 2012 guidance includes an estimated $0.04 to $0.05 per share positive impact due to the extra week in the fourth quarter of 2012, an increase from the Company's previous expectation of $0.02 to $0.03, due to better than expected sales in the 53 rd week. Steve Hislop, President and Chief Executive Officer of Chuy's Holdings, Inc., stated, "We're pleased to cap off fiscal 2012 with solid sales growth driven by strong comparable restaurant sales and continued contribution from our new unit openings. With a strong pipeline of new units planned for 2013, we are confident that we are in great shape to build upon our 2012 results as we enter the new year."Check Out Our Best Services for Investors
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The staff were very welcoming and helpful in assisting us with our touring. There is a peaceful atmosphere, as well as a meditation room. The hotel is a short walk from the Roman Hot Springs. Breakfast was lovely.
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