text: Facebook Twitter Tweet Follow @twitter Google+ ... E-mail Print Bookmark Reddit StumbleUpon By Ryan Teague Beckwith and Angi Carter Posted on December 21, 2012 | Updated: December 21, 2012 2:06 pm MDT 0 comments Recommend0 Tweet0 Comments0 Email Print [View the story "Mass shootings: Where did the guns come from?" on Storify] Mass shootings: Where did the guns come from? Storified by Digital First Media· Fri, Dec 21 2012 12:30:23 The shootings at a Connecticut elementary school have renewed debate over gun control. It's unclear if the government will act to make rules more stringent, but if it does what points of sale would need to be addressed? Below is a look at where the weapons used in recent mass shootings came from. Columbine: An older friend, a private sale Guns Intratec TEC-DC9 (World Guns) In 1999, two students, Eric Harris and Dylan Klebold, killed 13 and injured 24 in a shooting spree at Columbine High School in Colorado. The guns: Intratec TEC-DC9 semi-automatic handgun, a HiPoint 9mm semi-automatic carbine and two sawed-off shotguns. Where they came from: Harris and Klebold, both 17, were too young to buy guns on their own. A friend of Klebold's, Robyn Anderson, bought three of the guns shortly after her 18th birthday at the Tanner Gun Show outside Denver. They bought the TEC-DC9 from a 22-year-old computer technician, Mark Manes, at the house where he lived with his parents, after being introduced to him at the gun show on a different occasion. Virginia Tech: A gun store, online Washingtonpost Glock 19 9mm (Washington Post) In April of 2007, Seung-Hui Cho killed 32 people and wounded 17 in two attacks on the Virginia Tech campus. The guns: Glock 19 9mm semi-automatic compact pistol, Walther P22 .22 caliber handgun Where they came from: In February of 2007, Cho bought a Walther P22 from TGSCOM Inc., an online gun dealer based in Green Bay, Wis., which later closed. He bought the Glock at Roanoke Firearms, about 30 miles from Virginia Tech, in early March. According to the store owner, he was easily cleared through the federal background check system. Fort Hood: A gun store Wikimedia FN Five-seveN (Wikipedia) In November of 2009, Army Maj. Nidal Malik Hasan allegedly shot and killed 13 and wounded 29 at the Fort Hood military base outside Killeen, Texas. The guns: FN Five-seveN semi-automatic pistol Where it came from: According to testimony at a military hearing, Hasan bought the gun, a targeting laser and magazine extenders that increased the capacity from 20 to 30 rounds on Aug. 1, 2009, at Guns Galore in Killeen. He returned to the gun store several times, buying up to eight boxes of ammunition each time. ABC News reported that Hasan passed a federal background check when he bought the gun. Binghamton: Gun stores Asset-cache 9mm Beretta (Getty Images) April 3, 2009: A 41-year-old Vietnamese immigrant named Jiverly Antares Wong (a.k.a. Jiverly Voong) opened fire at an American Civic Association immigrant community center in Binghamton, N.Y. He fatally shot 13 people before killing himself. The guns: 9 mm and .45 caliber Beretta handguns with high-capacity magazinesWhere they came from: The guns were legally purchased and Wong held permits for them. Tucson, Arizona: Retail store Washingtonpost Glock 9mm. (Washington Post) On Jan. 8, 2011, Jard Lee Loughner, 22, killed six people and wounded 13 more, including then-U.S. Rep. Gabrielle Giffords. The shooting spree erupted outside a grocery store in Tucson, Ariz. The gun: Glock semi-automatic 9mm with extended magazineWhere they came from: purchased legally at Sportsman's Warehouse in Tucson after passing background check Aurora theater: Local stores, gun shops Asset-cache Glock .40-caliber semi-automatic pistols (Getty Images) Twelve people are killed on July 20, 2012 when gunman James Holmes, 24, released a can of tear gas and then went on a rampage at an Aurora, Colo., movie theater during opening night of the Batman movie "The Dark Knight Rises." The guns: a semi-automatic variation of the military's M-16 rifle, a pump-action 12-gauge shotgun and at least one .40-caliber semi-automatic pistol Where they came from: Two months before the shooting, Holmes bought a Glock 40 pistol from outdoors shop Gander Mountain. Then he purchased four more weapons, including a shotgun and an assault rifle, from various gun shops around Aurora and Denver, and 6,000 rounds of ammunition from Internet stores. Sikh Temple: Gun shop Gunandgame Springfield 9MM X-D. (Gun and Game) Army veteran Wade Michael Page killed 6 people and wounded a police officer before taking his own life at the Sikh Temple of Wisconsin outside Milwaukee on Aug. 5, 2012. The gun: 9mm semi-automatic handgun with multiple ammunition magazines Where it came from: About a week before the shooting, Wade bought the handgun at The Shooter's Shop in West Allis, Wis. Two days later, he picked it up from the store. Sandy Hook Elementary School: Taken from mother Asset-cache Bushmaster XM-15 rifle (Getty Images) Adam Lanza, 20, of Newtown, Conn., shot and killed his mother on Dec. 14, 2012 at her home before driving her car to the elementary school where he killed 20 students, six adults and himself, police say. The guns: Bushmaster XM-15 rifle, 10mm Glock 20 SF handgun, 9mm Sig Sauer handgun, shotgunWhere they came from: They were reportedly taken from his mother, who was a gun enthusiast and frequent gun range visitor. According to one account, she bought the guns at Riverview Gun Sales in East Windsor, Conn. Recommend0 Tweet0 Comments0 Email Print


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Step 3 asks us to make a decision, this is something thats been easy for us alcoholics.
When drinking i was always making bold decision but they were always followed by timid actions. Now in AA we have to make sure our actions as bold as our decisions. If we don't we stay stuck.
God Bless

subset: commoncrawl


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2008 Scherrer - Chardonnay Scherrer Vineyard Chardonnay - USA - California - Sonoma - Alexander Valley - White
USA - California - Sonoma - Alexander Valley
Producer NotesQuiet, deliberate brilliance is a good way to describe Fred Scherrer and his wines. While winemaker for ten years at Dehlinger, he learned that the success in winemaking revolves around the vineyard. He began making wine from grapes grown on his father's property in Alexander Valley in 1991 and opened Scherrer in 1997. He produces Chardonnay, Pinot Noir, Cabernet Sauvignon, Syrah, Zinfandel and... More » |


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Caroline Spelman announces review of Government waste policy
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General Information About Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer
This PDQ summary covers the staging and treatment of ovarian epithelial, fallopian tube, and primary peritoneal cancer.
Epithelial carcinoma of the ovary is one of the most common gynecologic malignancies and the fifth most frequent cause of cancer death in women, with 50% of all cases occurring in women older than 65 years.[1] Findings from risk-reducing surgeries in healthy women with BRCA1 or BRCA2 mutations have reinforced the hypothesis that many high-grade serous cancers—the most common histologic subtype of ovarian cancer—may arise from precursor lesions that originate in the fimbriae of the fallopian tubes.[2] In addition, histologically similar cancers diagnosed as primary peritoneal carcinomas share molecular findings, such as loss or inactivation of the tumor-suppressors p53 and BRCA1 or BRCA2 proteins.[3] Therefore, high-grade serous adenocarcinomas arising from the fallopian tube and elsewhere in the peritoneal cavity, together with most ovarian epithelial cancers, represent "extrauterine adenocarcinomas of Müllerian epithelial origin" and are staged and treated similarly to ovarian cancer; since 2000, they usually have been included in ovarian cancer clinical trials.[4] On the other hand, clear cell and endometrioid ovarian cancers that are linked to endometriosis have different gene-expression signatures, as do mucinous subtypes.[3]
Stromal and germ cell tumors are relatively uncommon and comprise fewer than 10% of cases. (Refer to the PDQ summaries on Ovarian Germ Cell Tumors Treatment and Ovarian Low Malignant Potential Tumors Treatment for more information.)
Incidence and Mortality
Estimated new cases and deaths from ovarian cancer in the United States in 2015:[5]
- New cases: 21,290.
- Deaths: 14,180.
Risk Factors
The most important risk factor for ovarian cancer is a family history of a first-degree relative (e.g., mother, daughter, or sister) with the disease. Approximately 20% of ovarian cancers are familial, and although most of these are linked to mutations in the BRCA1 or BRCA2 genes, several other genes have been implicated in familial ovarian cancers.[6,7] The highest risk appears in women who have two or more first-degree relatives with ovarian cancer.[8] The risk is somewhat less for women who have one first-degree and one second-degree relative (grandmother or aunt) with ovarian cancer.
In most families affected with the breast and ovarian cancer syndrome or site-specific ovarian cancer, genetic linkage has been found to the BRCA1 locus on chromosome 17q21.[9-11] BRCA2, also responsible for some instances of inherited ovarian and breast cancer, has been mapped by genetic linkage to chromosome 13q12.[12] The lifetime risk for developing ovarian cancer in patients harboring germline mutations in BRCA1 is substantially increased over that of the general population.[13,14] Two retrospective studies of patients with germline mutations in BRCA1 suggest that these women have improved survival compared with BRCA1 mutation-negative women.[15,16][Level of evidence: 3iiiA] Most women with a BRCA1 mutation probably have family members with a history of ovarian and/or breast cancer; therefore, these women may have been more vigilant and inclined to participate in cancer screening programs that may have led to earlier detection.
For women at increased risk, prophylactic oophorectomy may be considered after age 35 years if childbearing is complete. In a family-based study among women with BRCA1 or BRCA2 mutations, of the 259 women who had undergone bilateral prophylactic oophorectomy, 2 of them (0.8%) developed subsequent papillary serous peritoneal carcinoma, and 6 of them (2.8%) had stage I ovarian cancer at the time of surgery. Of the 292 matched controls, 20% who did not have prophylactic surgery developed ovarian cancer. Prophylactic surgery was associated with a higher-than-90% reduction in the risk of ovarian cancer (relative risk [RR], 0.04; 95% confidence interval [CI], 0.01–0.16), with an average follow-up of 9 years;[17] however, family-based studies may be associated with biases resulting from case selection and other factors that may influence the estimate of benefit.[18] (Refer to the Description of the Evidence section in the PDQ summary on Ovarian, Fallopian Tube, and Primary Peritoneal Cancer Prevention for more information.)
After a prophylactic oophorectomy, a small percentage of women may develop a primary peritoneal carcinoma, similar in appearance to ovarian cancer.[19]
Ovarian cancer usually spreads via local shedding into the peritoneal cavity followed by implantation on the peritoneum and via local invasion of bowel and bladder. The incidence of positive nodes at primary surgery has been reported to be as high as 24% in patients with stage I disease, 50% in patients with stage II disease, 74% in patients with stage III disease, and 73% in patients with stage IV disease.[20] In this study, the pelvic nodes were involved as often as the para-aortic nodes. Tumor cells may also block diaphragmatic lymphatics. The resulting impairment of lymphatic drainage of the peritoneum is thought to play a role in development of ascites in ovarian cancer. Also, transdiaphragmatic spread to the pleura is common.
For patients with stage I disease, the most important prognostic factor is grade, followed by dense adherence, and large-volume ascites.[21] The use of DNA flow cytometric analysis of stage I and stage IIA patients may identify a group of high-risk patients.[22] Patients with clear cell histology appear to have a worse prognosis.[23] Patients with a significant component of transitional cell carcinoma appear to have a better prognosis.[24] Stage I tumors have a high proportion of low-grade serous cancers and have a distinctly different derivation than high-grade serous cancers, which usually present in stages III and IV. Many high-grade serous cancers originate in the fallopian tube and other areas of extrauterine mullerian epithelial origin.
Prognosis for patients with ovarian cancer is influenced by several factors, but multivariate analyses suggest that the most important favorable factors include the following:[25-29]
- Younger age.
- Good performance status.
- Cell type other than mucinous and clear cell.
- Lower stage.
- Well-differentiated tumor.
- Smaller disease volume prior to any surgical debulking.
- Absence of ascites.
- Smaller residual tumor following primary cytoreductive surgery.
Although the ovarian cancer-associated antigen, CA-125, has no prognostic significance when measured at the time of diagnosis, it has a high correlation with survival when measured 1 month after the third course of chemotherapy for patients with stage III or stage IV disease.[30] For patients whose elevated CA-125 normalizes with chemotherapy, more than one subsequent elevated CA-125 measurement is highly predictive of active disease, but this does not mandate immediate therapy.[31,32]
Case-control studies suggest that BRCA1 and BRCA2 mutation carriers have improved responses to chemotherapy when compared with patients with sporadic epithelial ovarian cancer. This may be the result of a deficient homologous DNA repair mechanism in these tumors, which leads to increased sensitivity to chemotherapy agents.[33,34]
Survival and Follow-up
Most patients with ovarian cancer have widespread disease at presentation. This may be partly explained by relatively early spread (and implantation) of high-grade papillary serous cancers to the rest of the peritoneal cavity.[35] Conversely, symptoms such as abdominal pain and swelling, gastrointestinal symptoms, and pelvic pain often go unrecognized, leading to delays in diagnosis. Screening procedures such as gynecologic assessment, vaginal ultrasound, and CA-125 assay have had low predictive value in detecting ovarian cancer in women without special risk factors.[36,37] Efforts have been made to enhance physician and patient awareness of the occurrence of these nonspecific symptoms.[38-42] (Refer to the PDQ summaries on Pain and Gastrointestinal Complications for more information.) As a result of these confounding factors, yearly mortality in ovarian cancer is approximately 65% of the incidence rate.
Long-term follow-up of suboptimally debulked stage III and stage IV patients showed a 5-year survival rate lower than 10% with platinum-based combination therapy prior to the current generation of trials, including taxanes.[25] By contrast, optimally debulked stage III patients treated with a combination of intravenous taxane and intraperitoneal platinum plus taxane achieved a median survival of 66 months in a Gynecologic Oncology Group trial.[43]
Numerous clinical trials are in progress to refine existing therapy and test the value of different approaches to postoperative drug and radiation therapy. Patients with any stage of ovarian cancer are appropriate candidates for clinical trials.[44,45] Information about ongoing clinical trials is available from the NCI Web site.
Related Summaries
Other PDQ summaries containing information related to ovarian epithelial, fallopian tube, and primary peritoneal cancer include the following:
- Yancik R: Ovarian cancer. Age contrasts in incidence, histology, disease stage at diagnosis, and mortality. Cancer 71 (2 Suppl): 517-23, 1993. [PUBMED Abstract]
- Levanon K, Crum C, Drapkin R: New insights into the pathogenesis of serous ovarian cancer and its clinical impact. J Clin Oncol 26 (32): 5284-93, 2008. [PUBMED Abstract]
- Birrer MJ: The origin of ovarian cancer—is it getting clearer? N Engl J Med 363 (16): 1574-5, 2010. [PUBMED Abstract]
- Dubeau L, Drapkin R: Coming into focus: the nonovarian origins of ovarian cancer. Ann Oncol 24 (Suppl 8): viii28-viii35, 2013. [PUBMED Abstract]
- American Cancer Society: Cancer Facts and Figures 2015. Atlanta, Ga: American Cancer Society, 2015. Available online. Last accessed April 1, 2015.
- Lynch HT, Watson P, Lynch JF, et al.: Hereditary ovarian cancer. Heterogeneity in age at onset. Cancer 71 (2 Suppl): 573-81, 1993. [PUBMED Abstract]
- Pennington KP, Swisher EM: Hereditary ovarian cancer: beyond the usual suspects. Gynecol Oncol 124 (2): 347-53, 2012. [PUBMED Abstract]
- Piver MS, Goldberg JM, Tsukada Y, et al.: Characteristics of familial ovarian cancer: a report of the first 1,000 families in the Gilda Radner Familial Ovarian Cancer Registry. Eur J Gynaecol Oncol 17 (3): 169-76, 1996. [PUBMED Abstract]
- Miki Y, Swensen J, Shattuck-Eidens D, et al.: A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 266 (5182): 66-71, 1994. [PUBMED Abstract]
- Easton DF, Bishop DT, Ford D, et al.: Genetic linkage analysis in familial breast and ovarian cancer: results from 214 families. The Breast Cancer Linkage Consortium. Am J Hum Genet 52 (4): 678-701, 1993. [PUBMED Abstract]
- Steichen-Gersdorf E, Gallion HH, Ford D, et al.: Familial site-specific ovarian cancer is linked to BRCA1 on 17q12-21. Am J Hum Genet 55 (5): 870-5, 1994. [PUBMED Abstract]
- Wooster R, Neuhausen SL, Mangion J, et al.: Localization of a breast cancer susceptibility gene, BRCA2, to chromosome 13q12-13. Science 265 (5181): 2088-90, 1994. [PUBMED Abstract]
- Easton DF, Ford D, Bishop DT: Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Am J Hum Genet 56 (1): 265-71, 1995. [PUBMED Abstract]
- Struewing JP, Hartge P, Wacholder S, et al.: The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. N Engl J Med 336 (20): 1401-8, 1997. [PUBMED Abstract]
- Rubin SC, Benjamin I, Behbakht K, et al.: Clinical and pathological features of ovarian cancer in women with germ-line mutations of BRCA1. N Engl J Med 335 (19): 1413-6, 1996. [PUBMED Abstract]
- Aida H, Takakuwa K, Nagata H, et al.: Clinical features of ovarian cancer in Japanese women with germ-line mutations of BRCA1. Clin Cancer Res 4 (1): 235-40, 1998. [PUBMED Abstract]
- Rebbeck TR, Lynch HT, Neuhausen SL, et al.: Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 346 (21): 1616-22, 2002. [PUBMED Abstract]
- Klaren HM, van't Veer LJ, van Leeuwen FE, et al.: Potential for bias in studies on efficacy of prophylactic surgery for BRCA1 and BRCA2 mutation. J Natl Cancer Inst 95 (13): 941-7, 2003. [PUBMED Abstract]
- Piver MS, Jishi MF, Tsukada Y, et al.: Primary peritoneal carcinoma after prophylactic oophorectomy in women with a family history of ovarian cancer. A report of the Gilda Radner Familial Ovarian Cancer Registry. Cancer 71 (9): 2751-5, 1993. [PUBMED Abstract]
- Burghardt E, Girardi F, Lahousen M, et al.: Patterns of pelvic and paraaortic lymph node involvement in ovarian cancer. Gynecol Oncol 40 (2): 103-6, 1991. [PUBMED Abstract]
- Dembo AJ, Davy M, Stenwig AE, et al.: Prognostic factors in patients with stage I epithelial ovarian cancer. Obstet Gynecol 75 (2): 263-73, 1990. [PUBMED Abstract]
- Schueler JA, Cornelisse CJ, Hermans J, et al.: Prognostic factors in well-differentiated early-stage epithelial ovarian cancer. Cancer 71 (3): 787-95, 1993. [PUBMED Abstract]
- Young RC, Walton LA, Ellenberg SS, et al.: Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials. N Engl J Med 322 (15): 1021-7, 1990. [PUBMED Abstract]
- Gershenson DM, Silva EG, Mitchell MF, et al.: Transitional cell carcinoma of the ovary: a matched control study of advanced-stage patients treated with cisplatin-based chemotherapy. Am J Obstet Gynecol 168 (4): 1178-85; discussion 1185-7, 1993. [PUBMED Abstract]
- Omura GA, Brady MF, Homesley HD, et al.: Long-term follow-up and prognostic factor analysis in advanced ovarian carcinoma: the Gynecologic Oncology Group experience. J Clin Oncol 9 (7): 1138-50, 1991. [PUBMED Abstract]
- van Houwelingen JC, ten Bokkel Huinink WW, van der Burg ME, et al.: Predictability of the survival of patients with advanced ovarian cancer. J Clin Oncol 7 (6): 769-73, 1989. [PUBMED Abstract]
- Neijt JP, ten Bokkel Huinink WW, van der Burg ME, et al.: Long-term survival in ovarian cancer. Mature data from The Netherlands Joint Study Group for Ovarian Cancer. Eur J Cancer 27 (11): 1367-72, 1991. [PUBMED Abstract]
- Hoskins WJ, Bundy BN, Thigpen JT, et al.: The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: a Gynecologic Oncology Group study. Gynecol Oncol 47 (2): 159-66, 1992. [PUBMED Abstract]
- Thigpen T, Brady MF, Omura GA, et al.: Age as a prognostic factor in ovarian carcinoma. The Gynecologic Oncology Group experience. Cancer 71 (2 Suppl): 606-14, 1993. [PUBMED Abstract]
- Mogensen O: Prognostic value of CA 125 in advanced ovarian cancer. Gynecol Oncol 44 (3): 207-12, 1992. [PUBMED Abstract]
- Högberg T, Kågedal B: Long-term follow-up of ovarian cancer with monthly determinations of serum CA 125. Gynecol Oncol 46 (2): 191-8, 1992. [PUBMED Abstract]
- Rustin GJ, Nelstrop AE, Tuxen MK, et al.: Defining progression of ovarian carcinoma during follow-up according to CA 125: a North Thames Ovary Group Study. Ann Oncol 7 (4): 361-4, 1996. [PUBMED Abstract]
- Vencken PM, Kriege M, Hoogwerf D, et al.: Chemosensitivity and outcome of BRCA1- and BRCA2-associated ovarian cancer patients after first-line chemotherapy compared with sporadic ovarian cancer patients. Ann Oncol 22 (6): 1346-52, 2011. [PUBMED Abstract]
- Safra T, Borgato L, Nicoletto MO, et al.: BRCA mutation status and determinant of outcome in women with recurrent epithelial ovarian cancer treated with pegylated liposomal doxorubicin. Mol Cancer Ther 10 (10): 2000-7, 2011. [PUBMED Abstract]
- Hogg R, Friedlander M: Biology of epithelial ovarian cancer: implications for screening women at high genetic risk. J Clin Oncol 22 (7): 1315-27, 2004. [PUBMED Abstract]
- Partridge E, Kreimer AR, Greenlee RT, et al.: Results from four rounds of ovarian cancer screening in a randomized trial. Obstet Gynecol 113 (4): 775-82, 2009. [PUBMED Abstract]
- van Nagell JR Jr, Miller RW, DeSimone CP, et al.: Long-term survival of women with epithelial ovarian cancer detected by ultrasonographic screening. Obstet Gynecol 118 (6): 1212-21, 2011. [PUBMED Abstract]
- Goff BA, Mandel L, Muntz HG, et al.: Ovarian carcinoma diagnosis. Cancer 89 (10): 2068-75, 2000. [PUBMED Abstract]
- Friedman GD, Skilling JS, Udaltsova NV, et al.: Early symptoms of ovarian cancer: a case-control study without recall bias. Fam Pract 22 (5): 548-53, 2005. [PUBMED Abstract]
- Smith LH, Morris CR, Yasmeen S, et al.: Ovarian cancer: can we make the clinical diagnosis earlier? Cancer 104 (7): 1398-407, 2005. [PUBMED Abstract]
- Goff BA, Mandel LS, Melancon CH, et al.: Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA 291 (22): 2705-12, 2004. [PUBMED Abstract]
- Goff BA, Mandel LS, Drescher CW, et al.: Development of an ovarian cancer symptom index: possibilities for earlier detection. Cancer 109 (2): 221-7, 2007. [PUBMED Abstract]
- Armstrong DK, Bundy B, Wenzel L, et al.: Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354 (1): 34-43, 2006. [PUBMED Abstract]
- Ozols RF, Young RC: Ovarian cancer. Curr Probl Cancer 11 (2): 57-122, 1987 Mar-Apr. [PUBMED Abstract]
- Cannistra SA: Cancer of the ovary. N Engl J Med 329 (21): 1550-9, 1993. [PUBMED Abstract]


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Teenage millionaire Yoshikata lives on his own in a magnificent mansion, and, having fired the original maids, needs help keeping up the place. Enter Izumi and Mitsuki, two girls of Yoshikata's age, who accept his offer of to fill in as live-in maids. Along with Anna, another maid, the three girls live with the eccentric Yoshitaka in a goofball comedy that brings laughs with every episode.
Spoken Languages: Japanese, English subtitles.
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Who would not like to curl up by the computer screen and see some lovely holiday gift offerings from the mid-30s?
Christmas catalog Sunday!
Tagged As: catalog, Christmas, holiday, NVL
• Meet the Author • NewVintageLady
I'm a left handed vegan animator always looking for long term work. I love cookies, fairy tales, cartoons, Shakespeare, and cocktails, but not in that order.
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Drugs A - Z
Vitamin E Oral drops, solution
It is added to a healthy diet to prevent or to treat low vitamin E levels
Generic Name: vitamin e | Brand Name: Amino-Opti-E
Brand Names:
Vitamin E 400 Dl-Alpha, Vitamin E Mixed Natural, Vitamin E 400 Mixed, Nutr-E-Sol, Centrum Singles-Vitamin E, Vitamin E Complex, E Pherol, Vitamin E Dl-Alpha, Aquavite-E, Vitamin E D-Alpha, See more brands »
What is this medicine?
Vitamin E (VAHY tuh min E) is a vitamin found in nature. It is added to a healthy diet to prevent or to treat low vitamin E levels.This vitamin may be used for other purposes; ask your health care provider or pharmacist if you have questions.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of the following conditions:- anemia
- bleeding problems
- history of stoke
- low vitamin K levels in the body
- recent surgery
- an unusual or allergic reaction to vitamin E, other medicines, foods, dyes, or preservatives
- pregnant or trying to get pregnant
- breast-feeding
How should I use this medicine?
Take this vitamin by mouth. Follow the directions on the package label. This vitamin may be added to cereal, fruit juice, or other food. Use a specially marked spoon or container to measure each dose. Ask your pharmacist if you do not have one. Household spoons are not accurate. You may use this vitamin on your skin to soften or moisturize if desired. Take your vitamin at regular intervals. Do not take your vitamin more often than directed.Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.What may interact with this medicine?
- cholestyramine
- mineral oil
- orlistat
- warfarin
What should I watch for while using this medicine?
Follow a good diet. Taking a vitamin supplement does not replace the need for a balanced diet. Some foods that have this vitamin naturally are cereal grains, fruits, green leafy vegetables, vegetable oils, and wheat germ oil.Too much of this vitamin can be unsafe. Talk to your doctor or health care provider about how much is right for you.
If you are scheduled for any medical or dental procedure, tell your healthcare provider that you are taking this vitamin. You may need to stop taking it before the procedure.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- changes in vision
- diarrhea
- dizzy with headache
- nausea, vomiting
- stomach cramps
- unusual bleeding or bruising
- unusually weak or tired
Where should I keep my medicine?
Keep out of the reach of children.Store at room temperature between 15 and 30 degrees C (59 and 85 degrees F). Protect from heat and light. Throw away any unused medicine after the expiration date.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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It's a perfect match. Best-seller Mary Kay® Oil-Free Eye Makeup Remover plus a Mary Kay® Mineral Eye Color Bundle, which features three mineral eye colors specially selected by expert makeup artists to intensify her blue eye color. Just look into her eyes, and you're done!
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ut3 used techniques of openGL3+ in a time the only openGL version for linux driver was 2.1
and ut3 used nvidia physX and 3 years ago physX do not run on linux.
today you can play ut3 on linux with wine if you have openGL3.3+
and this makes an port very easy today!!!!!! but 3 years ago wine also can not run ut3.
Did anyone in this thread consider they might be waiting for the OS ATI drivers to catch up?
The thing here that gets me skeptical is the fact that there is no actual meat in this code. No X11 or GLX calls, nada. Companies like blizzard have had wine 'sandbox detection' present for a while now in games like WoW and StarCraft II (they can detect they're running under wine).
This code may be a similar sandbox detection routine, so that developers using tech similar to Blizzard's Warren (eg. : punkbuster) wont banhammer Linux users trying to play legitimately.
Theres one good thing that noone can deny about this code though: They acknowledge that we (Linux gamers) exist, and in number enough to warrant not completely ignoring us (if only in the wine 'sandbox').


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Phoenix Audio Quattro3
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Rugby Herald: Who can fill Kahui's shoes?
Top Herald rugby scribes Wynne Gray and Gregor Paul discuss Richard Kahui's departure to Japan, and whether they should be included in the super 15 competition.
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a ho ejaculating five penis at the same time: one on each hand, one in the mouth, one up her pussy and one up her azz
yo that ho pulled off a pentagon in bathroom!
Beküldő: Fat Choke
2003. május 22.
3 more definitions
Top Definition
a group of five people who believe themselves to be much better than the rest of their friends
a group of five residents of Porter Hall at Miami University call themselves the pentagon
Beküldő: Abraham bin Laden
2008. december 4.
A Sexual position involving one women and five men. While being double-penetrated in both the anus and the vag, the young lad must use both her left and right hands to jerk-off two males. The fifth male stands in front for the blowjob. The move originated in Green Bay, Wisconsin when a teenage boy named Devin thought up the brilliant idea for one of his friend's mom.
Desperate for some action, a group of men paid a local HONEY to do the pentagon with them for a few minutes.
Beküldő: Melvin Dickerson
2008. április 11.
The act of having sex with a member of the opposite sex from each branch of the military: Air Force, Marines, Army, Navy, Coast Guard. This can be done all at once or one at a time.
DW: Dude I completed The Pentagon last night!
BM: No way! I'm still need a Coast Guard woman to complete mine.
BM: No way! I'm still need a Coast Guard woman to complete mine.
Beküldő: aj garza
2008. április 20.


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Monkey Surfing Backpackers Hostel Reviews
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The place is clean and comfortable in general. A few things could have been improved though: 1) too many mosquitoes at night - would be nice if they have some sorts of proper mosquito repellant 2) other folks in the room chatted late into the night and early in the morning - hmm... what are the quiet hours? 3) somehow the living room atmosphere was not super conducive for socializing. A lot of people kept to their own groups and felt a little anti-social. I did meet some new friends though.
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Staff weren't very friendly or helpful, they didn't really talk to us or greet us warmly. The other guests were quite cold towards us too (we were two western guys and the other guests were predominantly Taiwanese and Chinese). The hostel was extremely humid even when the weather was comfortable outside. The main living area had a lot of mosquitoes. Top floor dorm is too bright. The bathrooms were wet everywhere and weren't cleaned properly. No slippers were provided for the bathrooms.
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- Australia
- Male, 18-24
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Cards tackle another lefty against Dodgers
Lilly returns from DL as Gast seeks third victory to start career
In nearly a month before Friday, the Cardinals had faced just four left-handed starters. But this weekend, the Dodgers throw three lefties their way, something the Cardinals had previously not fared well against this season.
In those previous four games against left-handers, the Cardinals were held to three earned runs over 28 innings. They entered the Dodgers series hitting .223 against left-handers, compared to .281 against right-handers, despite having several right-handed hitters in the middle of their lineup, including Matt Holliday, Allen Craig and Yadier Molina.
But if the Cardinals were struggling against lefties, they showed no signs of it on Friday night against Dodgers lefty Chris Capuano, hitting him for five earned runs, including homers by Craig and David Freese in a 7-0 victory.
Saturday's lefty is Ted Lilly, who will start after being activated from the disabled list this week. Lilly strained his rib cage in April, exiting a game versus the Rockies having allowed four earned runs in three innings.
The Cardinals will counter with rookie John Gast, who makes the first road start of his career, after winning his first two decisions at Busch Stadium.
"I believe that is one that will come out in a wash in the long haul of the season," Cardinals manager Mike Matheny said of his team's numbers against lefties. "There's no reason why our guys would struggle, necessarily, just against left-handed pitchers. They've been going about their work the right way, and with as strong of a right-handed middle of the lineup that we have, I would imagine those numbers would even out."
Matheny added that it isn't fair to lump all left-handed pitchers into one category, considering they all have different styles and strengths.
"They're all so different," he said. "You could throw two righties out there that are completely different style pitchers and they have success against one and not the other. It's the same with lefties. We have to see if they can adjust to whatever their game plan is. None of them are the same."
Lilly is one of four straight left-handed starters for the Dodgers, marking the first time they sent four in a row to the mound since Eric Stults, Eric Milton, Clayton Kershaw and Randy Wolf did it in May 2009.
The Dodgers, who have struggled this season despite the club's high payroll, are last in the NL West. Manager Don Mattingly criticized his team's mental toughness at the end of a six-day road trip on Wednesday.
Dodgers president Stan Kasten backed his manager on Friday, adding that the blame for the Dodgers' poor start extends beyond the manager's office.
"I think all of us, from me on down, can do more," Kasten said. "We're evaluating every day. We haven't broken through yet."
Cardinals: Injured pitchers making progress
Cardinals pitchers Chris Carpenter and Jake Westbrook have made progress in their respective rehabilitation programs.
Carpenter responded well enough to an extended bullpen session that he may face live hitters as early as Tuesday. He's been throwing off the mound for several weeks and is getting closer to a Minor League rehab assignment.
Westbrook played catch to test his injured right elbow Friday and said it "felt not bad." He plans to throw on flat ground again Saturday before making a decision on his longer-term rehab plan.
And Jaime Garcia, the furthest from returning to the field, underwent surgery on his left shoulder on Friday. Cardinals general manager John Mozeliak said the Cardinals are optimistic that Garcia will be ready by the start of next season.
Dodgers: Ramirez closing in on rehab assignment
Shortstop Hanley Ramirez is closer to a Minor League rehab assignment as the Dodgers take a cautious approach to his return from a strained left hamstring.
After running curves, taking batting practice and fielding ground balls on Friday, Ramirez said he will appear in rehab games with Class A Rancho Cucamonga soon.
"It's almost June and I've only played four games," Ramirez said. "That's never happened in my career. They support me and I'm trying everything I can to stay healthy. It just happens. I've got to stay mentally strong, keep working and come back and help this team in some ballgames."
Worth noting
• The Dodgers moved pitching prospect Aaron Miller to the outfield, where he played at Baylor University until his sophomore season. He was selected 36th overall as a left-handed pitcher by the Dodgers in the 2009 First-Year Player Draft.
• Cardinals top prospect Oscar Taveras is closer to returning to action after being sidelined since May 12 with an ankle injury. Farm director John Vuch said Friday that Sunday is the target date for his return with their Triple-A club.
• In his second appearance since being recalled to the Majors, right-hander Mitchell Boggs pitched a scoreless ninth inning for the Cardinals, striking out one batter.
Chad Thornburg is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.


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It's All Politics
6:47 am
Sun August 12, 2012
Romney, Ryan Surrogates Trade Shots On Sunday Talk Shows
Originally published on Sun August 12, 2012 8:41 am
We're keeping our ear on the Sunday talk shows this morning. Obviously the topic of the day is Rep. Paul Ryan, whom the Republican presidential candidate Mitt Romney has chosen as his running mate.
Both parties have already traded hard shots, but it appears there is agreement that the addition of Ryan, who has led the GOP on matters of budget, focuses this presidential election. It is now focused on a broader narrative about the size and role of government.
We'll update this post with the highlights as the morning progresses:
-- On Meet The Press, Wisconsin Gov. Scott Walker says that adding Ryan to the ticket gives the American people what they want: A politician who speaks hard truths and is willing to make tough decisions despite political consequence.
Walker adds that with Ryan, Wisconsin all of a sudden becomes competitive for Republicans.
-- David Axelrod, one of Obama's senior strategists, was also on Meet The Press. He did not hold back. His message was that with Ryan, the Republicans are choosing a set of policy that gives the rich massive tax cuts, while slashing programs that benefit the poor and middle class.
The Romney/Ryan economic plan, said Axelrod, "is a prescription for economic catastrophe."
-- Bill Bennett, the conservative radio show host and former education secretary, makes a salient point on Meet The Press: The one thing that people aren't talking about is Ryan's ability to "argue and persuade." He thinks that will play a big role during this election.
-- On This Week, Former Vermont Gov. Howard Dean said the problem with the Ryan pick is that he is "well outside the mainstream" of American politics.
Specifically, he said, Ryan's budget ideas would mean "radical change" and has all of a sudden shifted the narrative in the election from a "referendum on Barack Obama to a referendum on Republican economic policy."
-- Political analyst and Morning Edition contributor Cokie Roberts added that this choice was made to shore up the base.
"People have their mind made up their minds" in this election. This choice is to make sure that the conservative base comes out to vote.
-- Newt Gingrich, who famously called the Ryan budget "right-wing social engineering" was on Face the Nation. He walked away from those comments saying Ryan was an "extraordinarily exciting choice."
He fought back against the Congressional Budget Office, which has said that the Ryan budget doesn't cut the deficit for decades. He called the independent agency's conclusions "factually false."


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Explore the help topics, and if you can't find your answer or just want to say 'hi', please email us -- we'd love to help!
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Pearl Couch, age 98, of Philip, SD, died Saturday, March 13, 2010, at the Philip Nursing Home. Services were held Wednesday, March 17, at the United Church in Philip, with Pastor Kathy Chesney officiating. Music was provided by Marianne Frein, pianist, and Maureen Palecek, vocalist. Usher was Jim Moriarty. Pallbearers were Bill Anderson, Ian Moriarty, Jacob Frein, David Jahner, Lloyd Frein and Keith Jahner. Interment was in the Masonic Cemetery of Philip.
Wayne Whidby, age 57 of Kadoka, SD, died February 1, 2010, in Mazatlan, Mexico. A memorial service will be held at 10:00 a.m. Friday, March 19, at the Kadoka City Auditorium in Kadoka, with Pastor Gary McCubbin officiating. Interment with military honors will be held at 2:30 p.m. Friday, March 19, at the Black Hills National Cemetery. A memorial is established. Today I was asked to do the hardest thing I have ever had to do, sum up the story of my father's life. Wayne Alex Whidby was born on March 24, 1952, in Fort Knox, KY, to Evelyn and Julian Whidby.
Rena Nemec, age 91, Midland, died Sunday, March 7, 2010, at the Philip Nursing Home. Visitation will be held from 6:00 to 7:00 p.m. on Wednesday, March 10, with a vigil service at 7:00 p.m., all at St. William Catholic Church in Midland. Mass of Christian burial will be held at 10:00 a.m. Thursday, March 11, at St. Willam Catholic Church in Midland, with Father Ron Garry as celebrant. Music will be provided by Barb Jones, organist, and Barb Petoske, vocalist. Ushers are Jim Petoske and John Nemec.
Bessie Anna (Petr) Krogman, age 81, White River, SD, was born October 11, 1928, in White River, the daughter of Adolf and Bessie (Fott) Petr. She went home to be with her Lord and Savior, March 3, 2010, at Rochester Methodist Hospital in Rochester, MN, with her daughter, Kristi, at her side. Bessie's father immigrated to America from Czechoslovakia and Bessie grew up on the family homestead southwest of White River. She attended the Ringthunder Elementary Country School and went to White River High School graduating in 1946.
Hazel Schwalm, age 76 of Midland, SD, died March 2, 2010, at St. Mary's Healthcare Center in Pierre. Services were held Monday, March 8, at the Open Bible Standard Church in Midland with Pastor Randy Ellendorf officiating. Music was provided by Marlis Doud. Ushers were Red Willoughby and Jerry Nemec. Pallberers were Ed Heeb, Gary Snook, Wylie Schwalm, Dick Nemec, David Flom and Mickey Daly. Interment was in the Midland Cemetery. Hazel E. Hanson was born December 23, 1933, in Midland, SD, the daughter of Joseph and Marie (Dhaenen) Hanson.
Local residents have the opportunity to celebrate life by joining in the community blood drive from 10:00 a.m. to 6:00 p.m. on Tuesday, March 9, at the Bad River Senior Citizen's Center, Philip. And now, volunteer donors will also be able to check their total cholesterol level. United Blood Services now offers free cholesterol testing to blood donors. United Blood Services does a total cholesterol test that allows donors to eat before the test; no fasting is required.
The city council's March 1 meeting began with the council approving the first reading of an ordinance establishing snow removal parking regulations. The ordinance applies to Pine Street from SD Highway 14 west of Philip to Wray Avenue, and Wray Ave. from Pine Street to Hwy. 14 east of Philip. A snow removal emergency exists whenever there is a snow accumulation on public property of four inches or more of falling or drifting snow.
by Del Bartels The ownership of Kennedy Implement has officially changed hands. Denny Kennedy has sold his share of the business to long-time partner Mark Buchholz. "Same name, same faces, everything will go on the same," said Buchholz. "For 27 years Mark and I have been in business together," said Kennedy. "We have tried to take care of the customers as well as possible. Mark and I have had a business relationship of good communication." Buchholz added, "... a very open line of communication." and Kennedy continued, "...
Conrad "Connie" Seidler, age 86, Kadoka, SD, died Monday, March 1, 2010, at the Rapid City Regional Hospital. Funeral services will be held at 10:00 a.m. Thursday, March 4, at the Kadoka City Auditorium, with Rev. Gus Craven officiating. Interment will be held at 2:30 p.m. Thursday, at Black Hills National Cemetery near Sturgis. Conrad Seidler, better known to his family and friends as "Connie," was born on his granddad's ranch at Nowlin, SD, on October 30, 1923, the son of Edward and Ella (Koehler) Seidler.
Frank Parsons, age 82, Philip, SD, died Sunday, February 28, 2010, at the Rapid City Regional Hospital. Funeral services were held at 2:00 p.m. Friday, March 5, at the American Legion Hall in Philip, with Pastor Kathy Chesney and Pastor Al Brucklacher officiating. Music was provided by Skye Brucklacher, flute, Carla Brucklacher, piano, Glenn Parsons, guitar, and a vocal duet by Glenn Parsons and Roger Porch. Ushers were Doug West, Brant Sundall and Bryan Olivier.
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Media: We are easy targets
Somewhere along the line, it's lost that I am a member of the media. Either that or the e-mail lists I wind up on are meant to send a message.
In actuality, I suspect, neither is the case. But I get a chuckle out of the stuff that gets sent around with particular venom and general mean spirit about the media.
We in the media, according to most of the e-mails, are anti-America, anti-military, anti-business, anti-family … basically, just "anti."
One I got not so long ago referenced the death of a Medal of Honor winner, who lived in Boise, Idaho.
The e-mail goes into great detail about his experience in Ia Drang Valley during the Vietnam War.
Ed Freeman, against orders, flew his helicopter into a firefight to save pinned-down infantrymen. Actually, he went back and forth 13 times for men that would have perished otherwise.
Then, the kicker … "I bet you didn't hear about this hero's passing in the media."
But the e-mailer was sure we had all seen lots of reports of celebrity antics and brushes with the law.
The final line read, "Shame on the American Media!"
Lazy and presumptive
Well, this kind of stuff drives me crazy. So, I immediately began to look up Mr. Freeman with this new, fancy technological tool, called "Google."
After exhaustive research of the woeful American media archives, and with my (media-hat-wearing) head hung low, I responded to the e-mail:
Just a quick search shows that the media did a fine job in covering this story, below are three stories that I found. I am sure there are more, including local television and radio, which I did not look for.
Even a Mississippi post office may be named after this war hero, I read in a newspaper account.
I believe people are too quick to jump on the media. If folks will take about three seconds to look for it, generally you will find that the media has done its job.
And yes, this is a great story about a great American that served his country well, and I am glad the media did a good job in reporting it. Best, Ross.
I included several links to the stories. Three seconds. That's all it took.
I know the media is an easy target and sometimes rightfully so as Howard Kurtz pointed out in his book "Media Circus: The Trouble with America's Newspapers."
Kurtz, the long-time Washington Post media critic, who last week jumped to the web's "Daily Beast," points out a bias toward bad news, and an emphasis on scandal.
But, by and large, the media — the middle-of-the-road media — does it right most of the time.
While we might not like everything we read or see, the media serves a great purpose in our society, which we would miss dearly were it not available in an objective form. I only hope we at the MBJ can live up to the other great journalism being practiced in every form of the profession.
Contact Mississippi Business Journal editor Ross Reily at email@example.com or (601) 364-1018.


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Linen Print Mirror Jewelry Box
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For further assistance please call our customer service department at 1.888.922.4119 or send an email to email@example.com


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Description:Proliant DL140 Single 2.4GHz Xeon 512MB 80GB ATAHewlett-Packard Part# 350534-B21
Overview:The affordable 1U dual processor HP ProLiant DL140 server is the first of the ProLiant 100 server series. Offering floating point performance and cluster scalability the DL140 server is ideal for grid computing and for cost-conscious customers who want to deploy clustered solutions for high-performance technical computing applications. The HP ProLiant DL140 offers expandable performance through the latest industry standard technologies and is designed to maximize processing throughput and dependability at a low cost. It provides exceptional value and is easy to set-up and maintain with industry standard management tools and components. Specifications: CategoryProliant Server Sub-CategoryDL140 GenerationG1 Part Number350534-B21 Products ID142981 Form FactorRack-Mountable ProcessorXeon 2.4 GHz Processors Qty1 Controller TypeDMA/ATA-100 (Ultra) x 2 Installed Memory512 MB (DDR SDRAM) ChipsetServerworks Grand Champion SL PlatformPC Hard Drive Capacity80 GB Maximum Storage Capacity320 GB Networking TypeNetwork Adapter Data Link ProtocolEthernet, Fast Ethernet Security FeaturesSetup Password, Power-On Password Installed L2 Cache Memory512 KB Installed Video Memory8 MB Expansion Bays2x3.5" Third-Height (Internal Access) Power Supply Output325 Watt Bios FeaturesPCI 2.2, ACPI 1.0 Power ConfigurationsACPI/APM Power Management, Wake on LAN Expansion SlotsPCI-X 64 Bit (133/100/66 MHz) x 1 Other FeaturesHyper Thread Technology Ready


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Individual Membership $50
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All Member Level Benefits Include:
• Free admission to MOCA galleries
• Free admission to selected screenings, performances and workshops
• Members-only exhibition previews and receptions
• Members-only discounts to programs at the MOCA Art Institute
• Subscription to MOCA's annual newsletter
• 10% Discount in the MOCA Shop
• Invitation to MOCA's annual Art Basel Miami Beach Kick-off Party


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Nov 16 2014 9:00AM - Nov 18 2014 6:30PM | Tokyo Big Sight 3-11-1 Ariake Koto-ku Tokyo 135-0063 Japan
View PDF
Online Registration has been closed. Onsite Registration will be available at Tokyo Big Sight.
Recent DIA initiatives have improved cooperation between government, industry, and academia for the purpose of promoting the commercialization of innovative medical technologies and products in Japan, Europe, and the US. These entities, with the participation of patients, have also worked toward dramatically improving the development of new medical technologies, drugs, and medical devices. These movements share the goal of overcoming common boundaries in order to achieve meaningful medical innovations.
In Japan, two acts were enacted on November 20th, 2013 in order to bring world-class medical technology to the public. One new act, the "Act Concerning Safety Assurance of Regenerative Medicine, etc.," centered on Regenerative Medicine. In addition, the revision of the Pharmaceutical Affairs Act introduced an Accelerated Drug Approval Program with conditions and time limits based on the characteristics of regenerative and other medicines.
Coupled with this framework of new regulations, breakthrough discoveries and inventions that originated in Japan, such as human induced pluripotent stem (iPS) cells and the medical robot suit, are expected to expand the horizons for health care of the future.
There are a wide variety of boundaries that we must transcend. These include the boundaries between industry, academia, government, and patients. There are also boundaries between specialized fields within science and technology; between pharmaceutical drugs, medical devices, and regenerative medicine; and between separate countries and regions. If the development of pharmaceutical drugs and medical devices only follows traditional methodologies and the assumptions of our current development environment, then it will become increasingly difficult to bring about revolutionary breakthroughs. It is essential that open innovation is encouraged in order to break down these existing barriers.
This year, our conference title calls on us to transcend these boundaries, and even surpass what we have taken as common sense or expected practice up until now with a strong will to make changes that can create a revolution in medical care.
Last year, the theme of the Japan Annual Meeting was "Revolutionary Drug Development." This year, we would like to help you work across disciplines and areas of expertise to create medical innovation for the realization of a revolution in medical care that truly meets the needs of patients.
Attendees should make airline and hotel reservations as early as possible. To reserve your room at the Sun Route Hotel Ariake or the Washington Hotel Tokyo Bay Ariake being located close to the venue, please contact below:
Hotel Sun Route AriakeAddress: 3-6-6 Ariake, Koto-ku, Tokyo 135-0063Telephone: +81-3-5530-3610URL: http://www.sunroute.jp/ariake/
Washington Hotel Tokyo Bay AriakeAddress: 3-7-11 Ariake, Koto-ku, Tokyo 135-0063Telephone: +81-3-5564-0111URL: http://tokyobay.washington-hotels.jp/
The most convenient airport is Haneda Airport and airport limousine bus services are available between the airport and the Tokyo Big Sight. For further information on the airport transportation, please visit the following link: http://www.limousinebus.co.jp/en/bus_services/haneda/odaiba_ariake.html
Please contact the DIA Japan office in Tokyo for further information.
Tel: +81-3-5575-2130Fax: +email@example.com www.diajapan.org
Professor, Dept of Clinical Pharmacology & TherapeuticsHamamatsu University School of Medicine, Japan
General Manager, CDM and Biostatistics, Pharmaceutical Development DivisionNippon Kayaku Co., Ltd., Japan
Associate Director, Drug Fostering & Evolution Coordination Dept, CMA HQsEisai Co., Ltd., Japan
Director of Clinical Research CenterChiba University Hospital, Japan
Senior Manager, Policy Intelligence Dept.Janssen Pharmaceutical K.K., Japan
Sr Scientist, CMC Regulatory Affairs, Regulatory Affairs Area, Japan DevelopmentMSD K.K., Japan
Japan Development Leader, CV/MET, Clinical ResearchPfizer Japan Inc., Japan
ChairmanGENEX Partners, Japan
Labelling Department, Development and Medical Affairs DivisionGlaxoSmithKline K.K., Japan
Senior Director, Regulatory Affairs Group, Asia Development DeptDaiichi Sankyo Co., Ltd., Japan
Director, Asia Pacific Data Sciences & Solutions, Medicines & Development UnitEli Lilly Japan K.K., Japan
Head, Regulatory Operation & Prescribing Information Group, Drug RA Dept.Novartis Pharma K.K., Japan
Clinical Pharmacologist, Clinical Pharmacology, Clinical ResearchPfizer Japan Inc., Japan
Senior Manager, Global Development JapanAstellas Pharma Inc., Japan
Department Manager, Quality & Regulatory Compliance Dept.Chugai Pharmaceutical Co., Ltd., Japan
Biostatistics Group, Data Science, Drug Development Div.Dainippon Sumitomo Pharma Co., Ltd., Japan
Office of Standards and Guidelines DevelopmentPharmaceuticals and Medical Devices Agency (PMDA), Japan
Professor, Department of BiostatisticsYokohama City University School of Medicine, Japan
Executive Director, Head of Regulatory Affairs, Japan DevelopmentMSD K.K., Japan
International Coordination OfficerPharmaceuticals and Medical Devices Agency (PMDA), Japan
"Drug-drug interaction? It seems to be complicated, so let's leave it to the specialists." That may be current thinking, but will this attitude serve us in the future? New Japanese drug-drug interaction guidelines include drastic changes, such as the application of physiological-based pharmacokinetic (PBPK) models and concrete directions in the descriptions on package inserts. These changes will impact not only pharmacokinetic departments, but other segments of the industry as well, such as regulatory affairs, clinical development and postmarketing, and clinicians and pharmacists who use this information.
This program will provide a basic understanding of drug-drug interaction and the background of new Japanese drug-drug interaction guidelines. The program will also explain the impact of these changes on package inserts. This information can help change "I don't know" to "I understand!"
Language: Japanese language only
It's very important to use appropriate tools when applying the Six Sigma process. In this program, we explain the methodology behind Six Sigma, DMAIC (Define-Measure-Analysis-Improve-Control). We will also introduce two analytic tools, Process mapping and Fish-bone diagrams, which are applicable in not only the Six Sigma project, but also in our day-to-day work activities.
This session will be an interactive discussion using real case studies. Participants will learn how to apply these tools for process improvement.
In the last DIA Japan annual meeting (2013), we shared the idea of using coaching tools as an effective communication process for driving projects.
This session is designed as a workshop to learn theoretical concepts (coaching psychology and neuro-linguistic programming) as well as basic skills of coaching through roleplaying involving participants. Also, we would like to explore by means of dialog how we can make the most of these skills and tools in different situations of a project.
1. Theoretical concepts of coaching 2. Basic skills for active listening 3. Basic skills for GROW model 4. Dialog
"Investigator Initiated Trial (IIT)" has an indispensable role of advancement of medicine, because IITs assume the role of awareness of treatment effectiveness, building evidences for standards therapies and developing new treatments for patients.
IIT has gained name recognition since last year due to repeated media exposure. Unfortunately, the most media coverage was disturbing, and the public is rigorously questioning how an IIT should to be in Japan.
Persons who engage in IIT are required to fully understand the international ethical guidelines and the related regulations in addition to high ethical standards when conducting a research. Currently, IIT is in revolutionary times: guidelines for ethical standards are under amendment. This tutorial session will provide an opportunity to learn the latest regulation, guidelines, and trends of IIT. Targeted audience includes physicians, nurses,pharmacists, and persons in pharmaceutical industry.
This session will present the prediction of human pharmacokinetics and safety from in vitro data using the systems pharmacology approach.
In addition, we will discuss IVIVE (in vitro to in vivo extrapolation) and physiologically-based pharmacokinetics (PBPK), and PBPK approach-based prediction for inter-individual variability regarding pharmacokinetic prediction. Furthermore, we will show the prediction for pediatric PK/PD using PBPK approach in order to optimize the pediatric dose.
Conversely, we will focus on the safety issues regarding the prediction for QT interval prolongation. While hERG assay and clinical QT interval evaluation should be performed under the current guidelines, computer simulation and the PK/PD modeling approach for cardiac safety evaluation should become the main stream in the near future. In this program, we will present computer simulation to predict action potentials and human ECGs.
This tutorial will cover an introduction to adaptive designs. The choice of design, adaptive or fixed, depends on many factors (such as uncertainty of compound attributes) and needs to be considered within the context of the entire clinical plan. Expected audiences are both statisticians and non-statisticians who are involved in study planning and execution.
Bayesian and Frequentist methodologies which can be used to perform adaptations in a trial will be described and how they can be used in adaptive designs will be illustrated. Trial simulations are useful and often necessary to understand the operating characteristics of a design. Real examples of simulations will be provided.
Case studies of several types of adaptive designs will be provided including sample size re-estimation, adaptive treatment allocation, group sequential designs, and seamless designs. Regulatory as well as implementation challenges of adaptive designs will bediscussed. Brief summaries in Japanese will be provided between parts.
Language: English language only
In this program, we will introduce the PM basic framework using an Investigator Initiated Trial (IIT) case study. During the group work session, we will discuss schedule planning and explain other PM tools.
We hope this training will provide information on how to resolve issues, as well as some of the day-to-day challenges involved with PM. The training will also help improve your IIT process effectively and efficiently by utilizing PM tools, plus provide an opportunity to build and strengthen the network among participants who have similar interests and challenges.
The debate on HTA continues in Japan, with a focus on trying to understand the methodology and how it could apply to the healthcare system in this country. At the same time in Europe, the field of HTA is in rapid evolution — due to refinements to the methodology of HTA itself, but also because of the request for convergence between requirements from regulatory and HTA agencies for additional data. The session will briefly cover the basics of HTA, and its implications for Japan.
Session Chair(s):
Keynote speech 1 of 2014 DIA Japan Annual Meeting will be presented by Dr. Hiroo Imura, President of Foundation for Biomedical Research and Innovation (FBRI). Dr. Imura successively held number of important positions such as President of University of Kyoto, Member of Council for Science, Technology and Innovation and since 2014 as President of FBRI has been leading the largest medical cluster in Japan promoting practical application of advanced medical science such as regenerative medicine. Further as Chairman of General Assembly of The Japan Association of Medical Science 2015 Kansai, Dr. Imura is challenging to new initiatives which will enhance innovation in medical science and medical treatment to be participated by all stakeholders including various professional fields, generations and patients and families. It is a great opportunity that we can listen to Dr. Imura's future vision who is really leading various significant initiatives in medical society now which transcend boundaries.
Listen to What the Patient Has to Say-A Message from Patients to Those Engaged in Drug Development -
This program will cover the current state and challenges of using biosimilar products from development to approval, as well as their usage in hospitals. Topics will be covered from the viewpoints of industry, government, and academia. Now that the first biosimilar antibody has been approved in Japan, the challenges for biological products that have complicated structure and interchangeability will also be discussed. In addition, the switch from innovator drugs to biosimilar drugs at medical institutions will be discussed, as well.
It is important to manage communication in cross-functional projects to produce innovation with stakeholders. One important communication management tools are meetings. Meetings are not only for progress reports, but for process management from project initiation to closing. The capability to manage meetings helps achieve project goals. In this session, members will learn the basics of meeting managements and the process design of project meetings, and discuss their applications in real-life settings.
In Japan, there are 15 core clinical research centers receiving strong support from the government. Their academic expertise is integral to the field of seed development. Overcoming obstacles to transfer the results of basic research into clinical research is not easy for academia, and collaboration with pharmaceutical companies and regulatory agencies is indispensable. Furthermore, there are expectations for the development of a Japanese NIH and national strategy districts. In this session, we will focus on several examples of successful seed development in medical institutions. In addition, we will examine the issues, direction, and solutions of the possibilities and outputs of drug development from the strategic viewpoint on pharmaceutical affairs of regulatory agencies.
In this session, we will focus on the process of submission to approvals in the review period, as well as global simultaneous submission and its challenges. The main topics include the issue of submission timing of answer as the analysis of trends in questionnaires in each authority (PMDA/FDA/EMA). (NOTE– I don't know what this means.) During the panel discussion, we will discuss the issues between PMDA and companies regarding the challenges of simultaneous review, and the differences of each authority.
In Europe, pharmaceutical companies are obligated to prepare Patient Leaflets. Patient Leaflets are written in a simple language to help patients understand the content. Patients can thus obtain information, designed specifically for patients, about any medications prescribed. In Japan, the Patient Medication Guide or Drug Information Sheet is prepared for some drugs; however, patients and their families still have difficulty in obtaining or understanding appropriate information about diseases or drugs. Pharmaceutical companies have not well understood the current situation in Japan. In this session, the regulatory agencies, pharmaceutical companies, and medical professionals will present their view on the current state, and what future actions are needed, including their request regarding the provision of information for patients. In addition, they will share and discuss with attendees topics related to information for patients.
Big data have recently brought global attention to various industries in many different ways. One could say; that Japan has fallen far behind in the practical usage of big data compared to the rest of the world. Japan is now starting to revise the policies that regulate personal data usage. Given the significant attrition rates in research and development (R&D), to plan and conduct appropriate clinical trials based on scientific grounds is becoming more and more crucial. In addition, optimization of post marketing safety measures using drug usage data of the real world clinical setting is desirable. This session introduces a few examples of big data usage overseas and discusses Japan's current situation and challenges.
In pharmaceutical R&D projects, there are conflicts caused by different positions of responsibilities, which happen frequently. Unnecessary conflict should be avoided. However conflict itself can be a trigger of breakthrough and the opportunity to build team's functionality stronger. In this session, we would like to introduce methodology and tools of project management, Six Sigma and facilitation to prevent and resolve the conflicts, through a case study of an R&D project. We hope that those clues are useful for your business from now.
The Faculty of Pharmacy, Musashino University, and the Office of Pharmaceutical Industry Research (OPIR) have performed investigations and gap-analysis surveys between bio-ventures and pharmaceutical companies. First, three speakers will present their own experiences and thoughts from the point of view of investor, advisor, and portfolio manager of a pharmaceutical company. In addition, a researcher from Musashino University will briefly present the outcome of the survey. All members, including session chairs, will take part in a panel discussion to discuss topics such as "What is the bottleneck to be a partner", "How to find a clue to a solution", "What is the best approach for the future collaboration".
Since the "Basic Principles on Global Clinical Trials" was implemented in 2007, the Japanese tactic to participate in early global development has been actively discussed and the simultaneous approvals utilizing this concept have become reality. In this session, as a next step of participation in multi regional clinical trials, presenters will provide ideas of how can Japan actively contribute to global clinical development. In the panel discussion, the values that Japan can provide to global clinical development will be discussed based on the ideas in the presentations.
Recently in Japan, the secondary use of some Electronic Health Records (EHR) databases has been made available for postmarketing drug safety. In this session, speakers from a regulatory agency, academia, and a pharmaceutical industry organization will discuss postmarketing drug safety using EHR. At the end of the session, we will have a panel discussion focusing on current issues and the future direction of postmarketing drug safety by using EHR in Japan.
The designation scheme for orphan drugs was established in 1993 in Japan, and since them, various incepted have been provided for the development of orphan drugs. Recently, because of recent medical and scientific advancement, advanced technologies have significantly evolved and medical views on unmet medical needs are becoming diversified. Expectations for drug discovery research will be much higher in the future. This session consists of two parts. Members will hear regulatory viewpoints from the authorities about scheme of "Orphan designate system" and any activities by academia to discuss how to improve the status in orphan drug development in Japan. Moreover, various business models in orphan development will be shared, for example NPO's activity to introduce a new drug in Japan.
Drug development is a collaborative work between investigators and pharmaceutical industries. Since the existence of COI is inevitable, managing COI in the conduct of clinical trials is needed to ensure the integrity of the research and to protect the welfare of human subjects. Based on the identification of COI, the nature and source of funding and financial incentives offered to the investigators must be disclosed to a participant in a clinical trial and ethics committee. Unfortunately, there are serious misconducts of clinical trials lacking the quality and reliability of data collected and concealing COI in Japan. This session will discuss the strategies for overcoming the drawbacks in clinical trials in Japan, especially the rational management of COI.
It is critical for both applicant and regulator to have a proper understanding of the objectives of a consultation, including the background or fundamental problems faced in order to make a productive discussion in the scientific consultation or NDA review process possible. In reality, however, the usefulness or comprehension varies depending on how the issues are addressed or how the opinions are written in the briefing or response materials. This session will focus on PMDA scientific consultation. In this session, the panelists will replicate typical consultation by using virtual new product. This will provide some ideas on how to avoid miscommunication and how to maximize the value of consultation. The panelists acting as applicants will replicate the process how they decide their response policy to the inquiry from PMDA and how they find a compromise. Conversely, panelists acting as PMDA will disclose the heated internal discussion that isn't open to the public. Just as in last year's session, the session will use a voting system. Other topics of discussion include CMC, nonclinical study, and phase III study including multiregional clinical trial, among others.
These sessions have covered benefit-risk balance assessment in previous annual meetings held in Japan. However, there were few opportunities to convey the Japanese approach for benefit-risk balance assessment to the world. In this session, we will reaffirm the relationship between BRMP and PBRER, which are fundamental to benefit-risk balance assessment and its periodic report. Subsequently we will get a better understanding of the current status of the leading countries. Furthermore, we will discuss Japanese future vision, and share opinions about the contribution to patients from the global viewpoint.
How to facilitate the Medical Affairs department (MA) is currently a topic of ongoing debate in Japanese Pharmaceuticals. In contrast to Europe and the US, where the role and contribution of MA is established, opportunities for collaboration with MA in Japan to let R&D department know the role of MA has been somewhat limited. The purpose of this session is to provide a basic understanding of the function of MA, focusing mainly on its relevance to the R&D department, as well as the process of product life cycle management as a whole.
In the second part of this session, various business models in orphan development will be shared, such as a new business model by CRO, and approaches to development of ultra orphan drugs by respective companies. Conventional development strategies and methods may not be efficient in this field, and approaches with new innovative ideas would be necessary. We could hear how to think development strategy of orphan drugs from regulator's point of view, and discuss how to more improve the status including thinking of new business model in orphan drug development.
In Japan, the development of regenerative medical products is expected to grow. This session consists of two parts. In the first part, the current situation and the challenges from development to commercialization for regenerative medical products will be explained from the viewpoint of industry, government, and university. Then, in the panel discussion, we will discuss the challenges at the early developmental stage (donor, autologous/allogenic cells), clinical stage (outsourcing for cell growth and storage under new law) and application stage (GMP and the Standards for Bioderived Raw Materials).
In Japan, the risk-based approach to monitoring (RBM) has been presented mainly as an outline. However, the pilot studies have been conducted mainly by industries whose headquarters are located outside of Japan. And an aggressive discussion for RBM implementation has been done, even though the pilot studies have not been conducted. At this session, we will update the current status of RBM implementation through questionnaires to the pharmaceutical industry. In addition, we will discuss the outlook of RBM implementation, including both sponsor and investigational site view.
The RMP was introduced last April in Japan. Although the framework of postmarketing safety measures appears to be consolidated, there were not many discussions on RMP contents; it is often said that Japan's postmarketing system remains basically unchanged. Now, RMPs of over 20 products were published on the PMDA website. Both companies and regulatory authorities have accumulated experience on RMPs, and it is highly beneficial to set up a forum for exchanging issues about RMPs and share them among relevant parties, including health care professionals. In this session, we will discuss the problems of RMPs and pharmacovigilance plans, which are clinically meaningful, and to explore the possibility of cooperation of better postmarketing safety measure for well-considered benefit-risk balance.
Required ideal talent is changing with the change of the times, and human resource development plan should be mapped out or revised in anticipation of the trend of drug development strategy, regulation and/or environmental change with information technology. The current trends require persons who can demonstrate their ability at the international stage of simultaneous global development, but what will the trends be after 10 years? In this session, the responsible persons for training/ human development in academy, industry, and government (PMDA) will talk about their successful experiences, issues to overcome, and ideal settings. In the panel discussion, we would like to discuss benefits, difficulties, and importance of exchanging human resources among academy, industry, and PMDA. We hope this session will inspire young associates who have uncertainty about the future career path and managers who are distressed about their subordinate's human/career development.
In Japan, the development of regenerative medical products is expected to grow. This session consists of two parts. In this second part, we will focus on the new regulation of regenerative medical products. The revision of the Pharmaceutical Affairs Law will be effective at the end of November, 2014. Under this revised law, a new approach is expected to develop innovate regenerative medical products and accelerate the derivation of them for the patient. In the panel discussion, we will consider what we are able to change in Japan using this new system.
The RMP was introduced in last April in Japan. Although the framework of postmarketing safety measures appears to be consolidated, there were not many discussions on RMP contents; and it is often said that Japan's postmarketing system remains basically unchanged. Now, RMPs of over 20 products were published on the PMDA website. Both companies and regulatory authorities have accumulated experience on RMPs, and it is highly beneficial to set up a forum for exchanging issues about RMPs and share them among relevant parties, including health care professionals. In this session, we will discuss the problems of RMPs and pharmacovigilance plans, which are clinically meaningful, and explore the possibility of cooperation of better postmarketing safety measure for wellconsidered benefit-risk balance.
Although various pharmaceutical companies have now accumulated experience in Asian multinational studies and global studies, such exposure is still only limited to certain members (e.g., members from the Asian Development Department, or members working on global studies). During this multinational session, the pros and cons of Japan local study, Asian study and global study will be discussed by three experts from clinical development, regulatory, and CRO. A panel discussion will also take place subsequently to highlight recent issues and to discuss how to solve them with the most current knowledge. Participants who previously focused only on Japan local development are also welcome. The goal of this session is to provide useful hints and tips for you to consider in your clinical development strategy in the near future.
The CRO industry in Japan has been growing for more than 20 years and is now firmly established in the pharmaceutical arena. The next step is to create a partnership for both pharmaceutical companies and CRO to prosper. Both parties need to consider past experience, including its successes and failures, during the course of actual operation. While placing high importance on the efficiency of clinical trials with maintaining the quality and integrity of the data, such as Risk-based Monitoring, it is obvious that we cannot discuss future prosperity for both parties without further mutual understanding. In this session, we will discuss the future relationship between pharmaceutical companies and CRO by exchanging and sharing ideas with industry panelists.
In 2012, TransCelerate BioPharma Inc., a company composed mainly of western companies, was established for the purpose of promoting the efficiency of clinical development activities. Some documents and tools, including a position paper for RBM, have been issued by TransCelerate, and they have been referred to as standard concepts and approaches for RBM implementation. In this session, representatives from member companies in TransCelerate will provide case studies of RBM in Japan.
Even in the therapeutic area where medical treatment by drugs has been traditionally common the treatment by medical devices has started for the patients who are resistant to treatment by drugs. Further such medical devices like PDT Laser and Vascular Embolization Beads which increase effectiveness of medical treatment when used together with drugs have been used for treatment of certain cancer which has been traditionally difficult to treat. As above, beyond combination products such as drug eluting stent the innovative combined usage of drug and medical devices has opened new phase of opportunities for new medical treatment As combined usage of drugs and medical devices is getting more complex how to evaluate the clinical benefit of such combined products is also getting complex. Since the criteria of clinical evaluation is different between drugs and medical devices because of their product characteristics it is important to start discussion for clinical evaluation criteria and methodology for new medical treatment by combined usage of drugs and medical devices.
Robot Suit HAL is the world's first cyborg-type robot developed by full use of Cybernics which is a new academic field (fused and interdisciplinary technology related to human, machine and information) consisting of neuroscience, motor physiology, robotics, information technology, behavior science, system integration technology, law, ethics and business management. HAL enhances and strengthens the limb motion of its wearer by detecting the weak bioelectrical signals through the body from the brain which generates the nerve signal to control the musculoskeletal system and promotes treatment for functional improvement, regeneration and acquisition for disabled people by spinal cord injury or stroke and also supports self-independent motion like activity of daily life and nursing-care motion when care-giver lifts patients. HAL has obtained CE marking, the certificate for all EU countries, as the first robotic therapeutic device and in Germany, application of public workers' compensation insurance to cover the costs of using HAL for medical treatment has been implemented. Now, medical contributions with a new perspective that transcends boundaries are accelerating by research and development in the field of new combined therapies such as HAL therapy with regenerative medicine and/or pharmaceuticals.
Adoptive Licensing (AL) is getting much attention as a system for improving access to new medicines or medical technologies with high medical needs. The EMA has already considered Medicine's Adaptive Pathways (MAPs) or Medicine's Adaptive Pathways to Patients (MAPPs) and launched a pilot project. In Japan, the Act on the Safety of Regenerative Medicine was enacted, permitting early approval of tissue-engineered medical products, which is thought to be a kind of AL. When institutionalizing AL, how far efficacy and safety should be ensured in order to permit access to medicines based on limited data, as well as how to assess the risks and benefits, are all important issues. In this session, we'll grasp the benefits and the problems of AL and discuss the expected system.
The 11th Annual Meeting DIA Japan 2014 offers interested companies following exhibit and support opportunities.
All prices include 8% Consumption Tax
Useful Links:
To apply discounts for tutorial(s) with full program, please send the application forms (both program and tutorials) to the DIA Japan Office via fax or e-mail.
There are no group discounts for this event.


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A place to put your everyday items like keys, wallet, lighter, but not limited to these items. It is so your nagging girlfriend will shut up about you losing shit.
Miles, put your shit in the man bowl or I will put up the man bowl sign up again.
od uživatele manbowlhater
08. Červen 2013


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For more information regarding certification in school administration, please contact the program director: Dr. Darlene McDonough Plassmann Hall B42 St. Bonaventure University St. Bonaventure, NY 14778 (716) 375-4026
If you wish to apply to this program, please contact the Graduate Admissions office at (716) 375-2021 or by email at email@example.com for graduate admission materials.
The SDL Advanced Certificate program is designed for candidates seeking to become administrators at the district level (superintendents). This 12-hour program includes coursework in negotiations, superintendency, and central office leadership. NY SDL certification requires these 12 hours and 60 total graduate credits.
The SDL certificate program is also offered in a hybrid format, with some class sessions and some online work. SDL classes meet three times each semester on Saturdays, alternating by semester between the SBU Buffalo Center and the main campus in Olean.
With the permission of the program director, up to three (3) credit hours may be transferred into this program.
Admission to the program requires:
My basic philosophy of teaching is based on two firmly held beliefs.