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Use of Common Genetic Variants (Single Nucleotide Polymorphisms) to Predict Risk of Non-familial Breast Cancer
Revision Date(s) 06/09/14; 07/08/13, 07/10/12
Testing for one or more single nucleotide polymorphisms (SNPs) to predict an individual's risk of breast cancer is considered investigational.
The OncoVue® and BREVAGen™ breast cancer risk tests are considered investigational for all indications, including but not limited to use as a method of estimating individual patient risk for developing breast cancer.
Genetic Cancer Susceptibility Panels Using Next Generation Sequencing
SNP Panel Tests
There is no specific CPT code for this test. Effective in 2013, the unlisted multianalyte assay with algorithmic analysis (MAAA) code 81599 would be the most appropriate code to report for this testing when results are reported as a risk score or probability.
Clinical Genetic Tests
Neither OncoVue® nor BREVAGen™ is offered over the Internet or directly to consumers. Patients may self-refer by finding the location of a participating member of the Breast Cancer Risk Testing Network, available on the InterGenetics website (for OncoVue®) or by using the BREVAGen Doctor Locator, available on the Phenogen Sciences website (for BREVAGen™), and making an appointment.
BRCA genetic testing should be used in those from high-risk families; see Related Policies for details.
NOTE: There is no specific code for the OncoVue or BREVAGen™ test. The unlisted multianalyte assay with algorithmic analysis code 81599, which became effective in 2013, would probably be reported for these tests.
Several singlenucleotide polymorphisms (SNPs), which are single base-pair variations in the DNA sequence of the genome, have been found to be associated with breast cancer and are common in the population but confer only small increases in risk. Commercially available assays test for several SNPs to predict an individual's risk of breast cancer relative to the general population. Some of these incorporate clinical information into risk prediction algorithms. The intent of both types of test is to identify subjects at increased risk who may benefit from more intensive surveillance.
Rare, single gene variants conferring a high risk of breast cancer have been linked to hereditary breast cancer syndromes. Examples are mutations in BRCA1 and BRCA2. These, and a few others, account for less than 25% of inherited breast cancer. Moderate risk alleles, such as variants in the CHEK2 gene, are also relatively rare and apparently explain very little of the genetic risk.
In contrast, several common SNPs associated with breast cancer have been identified primarily through genome-wide association studies (GWAS) of very large case-control populations. These alleles occur with high frequency in the general population, although the increased breast cancer risk associated with each is very small relative to the general population risk. Some have suggested that these common-risk SNPs could be combined for individualized risk prediction either alone or in combination with traditional predictors; personalized screening programs could then vary by starting age and intensity according to risk. Along these lines, the American Cancer Society recommends that women at high risk (>20% lifetime risk) should undergo breast magnetic resonance imaging (MRI) and a mammogram every year, and those at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram.(1)
SNP Panel Tests
Several companies, such as those listed in Table 1, offer testing for breast cancer risk profiles using SNPs. Most companies offer testing direct-to-consumers (DTCs). algorithms or risk models for these tests are proprietary. When reported on company websites, panels range in number from 6 to 15 SNPs.
Table 1. Tests for Breast Cancer Susceptibility Using SNP-Based Risk Panelsa
ND, not described .
a This is not an exhaustive list.
b The easyDNA website includes a "note for U.S. residents" that states, "easyDNA would like to inform all its clients that as per the U.S. Food and Drug Administration's [FDA] directive, it can only provide genetic health testing to U.S. residents if their physician has agreed to the test."(2)
Clinical Genetic Tests
Two companies currently offer risk assessment based on SNP panel testing and clinical information. Neither is provided as a DTC test. Both are listed in the Genetic Testing Registry of the National Center for Biotechnology Information.
The OncoVue® Breast Cancer Risk Test (InterGenetics™ Inc., Oklahoma City, OK) is a proprietary test that evaluates multiple, low-risk SNPs associated with breast cancer. Results are combined with personal history measures to determine breast cancer risk at different times during adulthood. The test does not detect known high-risk genetic factors such as BRCA mutations (associated with hereditary breast and ovarian cancer, see Related Policies). OncoVue® synthesizes various genetic and medical history risk measures into a personalized single-risk estimate for premenopause, perimenopause, and postmenopause for each patient, with comparison to the average population risk at each of these life stages. The test is stated to be "an aid in the qualitative assessment of breast cancer risk…not intended as a stand-alone test for the determination of breast cancer risk in women."(3)
For women without a strong family history of breast cancer and at average risk before testing, OncoVue® purports to estimate a woman's individual risk and place her in standard-, moderate-, or high-risk groups. The results are intended to help a woman and her physician decide if more frequent exams and/or more sophisticated surveillance techniques are indicated. For women already known to be at high risk based on a family history consistent with hereditary breast cancer, the test is represented as having added value by indicating greater or lesser risk at different life stages.
OncoVue® is available only through the Breast Cancer Risk Testing Network (BCRTN), described as a network of Breast Care Centers engaged in frontline genetic identification of breast cancer risk levels in their patients. (4) BCRTN member centers will provide genetic breast cancer risk testing for their patients using OncoVue® as part of a comprehensive education program to help OncoVue® "at-risk" women understand their risk level and intervention strategies. BCRTN members will be selected for the network based on a number of criteria, including quality standards of care, level of breast cancer surveillance technology, and the capacity to provide patient education on genetic testing and future risk management protocols. As of March 2014, 32 participating centers (36 locations), located in 20 states, were listed on the company website.
BREVAGen™ (Phenogen Sciences, Charlotte, NC) evaluates 7 breast cancer-associated SNPs identified in GWAS. Risk is calculated by multiplying the product of the individual SNP risks by the Gail model risk. BREVAGen has been evaluated for use in Caucasian women of European descent age 35 years and older. Like OncoVue®, BREVAGen™ does not detect known high-risk mutations, e.g., in BRCA. According to the BREVAGen™ website, "suitable candidates" for testing include women with a Gail lifetime risk of 15% or greater; with high lifetime estrogen exposure (e.g., early menarche and late menopause); or with relatives diagnosed with breast cancer.(5) BREVAGen™ is not suitable for women with previous diagnoses of lobular carcinoma in situ, ductal carcinoma in situ, or breast cancer, because the Gail model cannot calculate breast cancer risk accurately for such women, or for women with an extensive family history of breast and ovarian cancer.
Phenogen Sciences maintains on its website a list of physicians who have been trained to use BREVAGen™. As of March 2014, more than 100 participating centers in 19 states were listed on the company website.
FDA Status
No SNP-based test to predict breast cancer risk has been approved or cleared by FDA. These tests are offered as laboratory-developed tests under the Clinical Laboratory Improvement Amendments (CLIA) licensed laboratories. Clinical laboratories may develop and validate tests in-house and market them as a laboratory service; laboratories offering such tests as a clinical service must meet general regulatory standards of CLIA and must be licensed by CLIA for high-complexity testing.
FDA has not yet developed specific rules for DTC genetic testing. On November 22, 2013, FDA issued a warning letter to 23andMe ordering the site to "immediately discontinue marketing the Saliva Collection Kit and Personal Genome Service until such time as it receives FDA marketing authorization for the device." (6) Currently, the test is available on the company website with the alert, "At this time we do not offer health-related genetic reports."(7) Current and new customers receive "ancestry-related information and raw genetic data without 23andMe's interpretation."
Under current regulations, CLIA requires that laboratories demonstrate the analytical validity of the tests they offer. However, there is no requirement for a test to demonstrate either clinical validity or clinical utility. Some states (e.g., New York) have chosen to regulate DTC laboratories. Because these reviews are not public, the scientific standards applied are unknown.
Medical policies are systematically developed guidelines that serve as a resource for Company staff when determining coverage for specific medical procedures, drugs or devices. Coverage for medical services is subject to the limits and conditions of the member benefit plan. Members and their providers should consult the member benefit booklet or contact a customer service representative to determine whether there are any benefit limitations applicable to this service or supply. This medical policy does not apply to Medicare Advantage.
This policy was created in April 2010 and updated periodically with literature review. The most recent update covers the period through March 18, 2014.
Genome-wide association studies (GWAS) examine the entire genome of thousands of subjects for single nucleotide polymorphisms (SNPs), single base-pair variations in the DNA sequence at semi-regular intervals, and attempt to associate variant SNP alleles with particular diseases. Several case-control GWAS, primarily in white women, have investigated common risk markers of breast cancer. In recent years, several SNPs associated with breast cancer have been reported at a high level of statistical significance and have been validated in 2 or more large, independent studies.(9-17) Recently, SNPs associated with breast cancer risk in Asian and African women have been the subject of more than a dozen articles, although these appear exploratory.(18-31) GWAS also have identified SNPs in specific genes associated with the onset or severity of chemotherapy-induced toxicity.(32,33)
SNP Panel Tests
As noted in the Background section, estimates of breast cancer risk, based on SNPs derived from large GWAS and/or from SNPs in other genes known to be associated with breast cancer, are available as laboratory-developed test services from different companies. The literature on these associations is growing, although information about the risk models is proprietary. Independent determination of clinical validity in an intended -use population to demonstrate clinical validity has not been performed. There are also no studies to suggest that use of SNP-based risk assessment has any impact on health care outcomes. No peer-reviewed reports have been published in which commercially available breast cancer risk estimators have been compared with each other to determine if they report similar results on the same individuals, specifically for breast cancer.
Several meta-analyses have investigated the association between breast cancer and various SNPs. Meta-analyses of case control studies have indicated that specific SNPs are associated with increased or decreased breast cancer risk (see Table 2). Other meta-analyses have revealed the interaction between environment (e.g., obesity, age at menarche) (34,35) or ethnicity(36-40) and breast cancer risk conferred by certain SNPs. Zhou et al. (2013) found that a specific polymorphism in the vitamin D receptor gene increased breast cancer risk in African but not Caucasian women. (41) Breast cancer risk associated with SNPs in microRNAs is commonly modified by ethnicity. (42-45) Meta-analyses of GWAS have identified SNPs at new breast cancer susceptibility loci. (46-48) All of these markers are considered to be in an investigational phase of development.
In 2014, the Breast Cancer Association Consortium published a mega-analysis of 46,450 case patients and 42,461 controls from 38 international meta-analytic studies. (49) The authors assessed 2-way interactions among 3277 breast cancer-associated SNPs. Of 2.5 billion possible 2-SNP combinations, none were statistically significantly associated with breast cancer risk. The study suggests that risk models may be simplified by eliminating interaction terms. Nonetheless, the authors cautioned that despite the large sample size, the study may have been underpowered to detect very small interaction effects, which tend to be smaller than main effects.
Table 2. Results of Meta-Analyses of SNPs and Associations with Breast Cancer
a 40 ATR and 50 CHEK1 SNPs genotyped.
b 34 SNPs and groups of SNPs genotyped in 8 chemokine candidate genes: CCL3, CCL4, CCL5, CCL20, CCR5, CCR6, CXCL12, and CXCR4.
c 384 SNPs genotyped in FGFR1, FGFR3, FGFR4, and FGFRL1.
Primary Studies
Because there are no published studies of commercial SNP-based breast cancer risk predictors, published studies of the clinical usefulness of other similar SNP combinations as risk predictors will be considered here.
Aston et al. (2005) evaluated more than 14,000 oligogenotypes, defined by two or more SNPs in 10 breast cancer-associated genes. (71) The association with breast cancer was considered statistically significant for 37 oligogenotypes. The authors observed that oligogenic combinations of 2 to 10 SNPs were strongly associated with wide variation in breast cancer risk; that for many combinations, genes affected breast cancer risk in a manner not predictable from single gene effects; and that compared with individual SNPs, these combinations stratified risk over a broader range.
In 2008, Pharoah et al. considered a combination of seven well-validated SNPs associated with breast cancer, five of which are included in the deCODE BreastCancer™ test. (72) A model that simply multiplies the individual risks of the seven common SNPs was assumed, and would explain approximately 5% of the total genetic risk of non-familial breast cancer. Applying the model to the population of women in the U.K., the risk profile provided by the 7 SNPs did not provide sufficient discrimination between those who would and would not experience future breast cancer to enable individualized preventive treatment such as tamoxifen. However, the authors suggested that a population screening program could be personalized with results of SNP panel testing. They concluded that no women would be included in the high-risk category (defined as 20% risk within the next 10 years at age 40 to 49 years, according to the National Institute for Health and Care Excellence), and therefore none would warrant the addition of magnetic resonance imaging (MRI) screening or consideration of more aggressive intervention.
Reeves et al. (2010) evaluated the performance of a panel of seven SNPs associated with breast cancer in 10,306 women with breast cancer and 10,383 without cancer in the U.K. (73) The risk panel also contained 5 SNPs included in the deCODE BreastCancer™ test and used a similar multiplicative approach. Sensitivity studies were performed using only four SNPs and using 10 SNPs, both demonstrating no significant change in performance. Although the risk score showed marked differences in risk between the upper quintile of patients (8.8% cumulative risk to age 70 years) and the lower quintile of patients (4.4%), these changes were not viewed as clinically useful when compared with patients with an estimated overall background risk of 6.3%. Of note, simple information on patient histories; for example, presence of one or two first-degree relatives with breast cancer, provided equivalent or superior risk discrimination (9.1% and 15.4%, respectively).
It is assumed that many more genetic risk markers remain to be discovered because substantial unexplained heritability remains. (74) Researchers from the Collaborative Oncological Gene-Environment Study group, a mega-consortium established to follow-up previous GWAS and candidate gene association studies, estimate that "more than 1000 additional loci are involved in breast cancer susceptibility." (46) One reason more genetic associations have not been found is that even large GWAS are underpowered to detect uncommon genetic variants.(75)
Two approaches have recently been described to help address this problem. Braun and Buetow (2011) described a technique for multi-SNP analysis of GWAS data based on the study of patient cases selected using their association with known pathways related to disease risk. (76) The authors coined the term Pathways of Distinction Analysis to describe this methodology and demonstrated that using this approach facilitated the identification of disease-related SNPs by creating clusters of similar variants within disease groups that stood out when compared with control groups.
In 2012, Silva et al. reported on the use of DNA pooling methods to aid in detection of genetic polymorphisms.(77) They combined DNA from many individuals (up to 200 patients or controls) into a single sample in an effort to pre-select SNPs of interest in different populations. They concluded that test accuracy was sufficiently robust to allow use of pooling to estimate allelic distributions in populations of interest.
Although there are no guidelines regarding the clinical use of SNP panels for estimating breast cancer risk, the published literature is in general agreement that their use in clinical or screening settings is premature due to a lack of a more complete set of explanatory gene variants and to insufficient discriminatory power at this time.(72,73,75,78-81) Whether or not additional SNP studies are likely to be informative is under debate, as the study size to detect more and more rare variants becomes prohibitively large. As the cost of whole genome sequencing continues to decrease, some predict that this will become the preferred avenue for researching risk variants. Challenges to sorting through the growing literature on this diagnostic approach include nonstandardization and nontransparency of studies. (82) Janssens et al. (2011) published a methods paper providing a road map for optimal reporting and an accompanying detailed article describing good reporting practices.(83)
In 2011, Bloss et al. reported on the psychological, behavioral, and clinical effects of risk scanning in 3639 patients followed for a short time (mean [SD], 5.6 [2.4] months).(84) These investigators evaluated anxiety, intake of dietary fat, and exercise based on information from genomic testing. There were no significant changes before and after testing and no increase in the number of screening tests obtained in enrolled patients. Although more than half of patients participating in the study indicated an intent to undergo screening in the future, during the course of the study itself, no actual increase was observed.
Section Summary
Common SNPs have been shown in primary studies and meta-analyses to be significantly associated with breast cancer risk; some SNPs convey slightly elevated risk of compared with the general population risk. Panels of SNPs are commercially available, with results synthesized into breast cancer risk estimates. These have not been clinically validated and clinical utility has not been demonstrated. Most of these tests are commercially available as direct-to-consumer (DTC) tests. Use of such risk panels for individual patient care or for population screening programs is premature because (1) performance of these panels in the intended -use populations is uncertain, and (2) most genetic breast cancer risk has yet to be explained by undiscovered gene variants and SNPs. Long-term prospective studies with large sample sizes are needed to determine the clinical validity and utility of SNP-based models for use in predicting breast cancer risk. The discrimination offered by the limited genetic factors currently known is insufficient to inform clinical practice.
Clinical Genetic Tests
The OncoVue® test was developed by evaluating samples from a large case-control study for 117 common, functional polymorphisms, mostly SNPs, in candidate genes likely to influence breast carcinogenesis. A model using weighted combinations of 22 SNPs in 19 genes together with several Gail model (personal and family history characteristics) risk factors was subsequently identified by multiple linear regression analysis. OncoVue® improved individual sample risk estimation, compared with the Gail model alone (p<0.001), by correctly placing more cases and fewer controls at elevated risk. (85) In the same study, the model was validated on an independent sample set with similarly significant results. To date, this study has only been published in a meeting abstract; no details of the study or its results are available. Note that the Gail model has been shown to accurately estimate the proportion of women (without a strong family history) who will develop cancer in large groups but is a poor discriminator of risk among individuals.(86)
Using the same case control validation data, OncoVue® was also compared with risk estimation determined by 7 SNPs reported in other GWAS (87); the GWAS risk scores were unable to stratify subjects by risk for breast cancer, whereas OncoVue® significantly stratified patients by risk. This study has not been published. Independently, SNPs derived from GWAS are known to result in only low-level estimates of risk at best; in 1 example, a 14-SNP polygenic risk score yielded an odds ratio of only 1.3 for estrogen receptor (ER)-positive breast cancer and 1.05 for ER-negative breast cancer.(73)
An additional analysis of the same case-control data was reported at the 2010 San Antonio Breast Cancer Symposium. (88) The OncoVue® risk score was calculated in the same discovery set (4768 Caucasian women, 1592 cases, 3176 controls) and 2 independent validation sets (1137 Caucasian women, 376 cases, 761 controls; 494 African American women, 149 cases, 345 controls). For both OncoVue® and Gail model risk scores, positive likelihood ratios (proportion of patients with breast cancer with an elevated risk estimate [≥20%] divided by the proportion of disease-free subjects with an elevated risk estimate) were calculated. OncoVue® exhibited a 1.6- to 1.8-fold improvement compared with the Gail model in more accurately assigning elevated risk estimates to breast cancer cases rather than controls. At higher risk thresholds, the fold improvement increased and exceeded 2.5 in some sample sets.
Does OncoVue testing improve the accuracy of breast cancer risk prediction beyond standard risk prediction measures?
The performance of OncoVue® was studied in women from the Marin County, CA, Breast Cancer Adolescent Risk Factor study. A retrospective case control study was developed within the cohort, and samples were evaluated with OncoVue® testing. OncoVue® assigned high-risk status (defined as ≥12% lifetime risk of developing breast cancer) to 19 more women who had had breast cancer (of 169 cases) than did the Gail model, which represented an approximately 50% improvement. (89) OncoVue® was also more effective at stratifying risk in the high-risk Marin County population than 7 SNPs reported in other GWAS. (90) These studies have not yet been published in a peer-reviewed journal.
Several supportive studies are listed on the InterGenetics, Inc. website; most are meeting abstracts. These address conceptual aspects of the OncoVue® test but do not appear to report data using the final OncoVue® test configuration. One fully published study characterizes SNPs that exhibit breast cancer risk associations that vary with age. (91) This study stratified breast cancer cases and normal controls into three age groups, then determined breast cancer risk for SNP homozygotes and heterozygotes for each of 18 candidate SNPs within each age group. Of these, 5 SNP variants had statistically significant odds ratios for at least 1 age group. In a separate validation sample, only 1 had a statistically significant odds ratio but not in a pattern similar to that of the discovery set. The other 4 SNPs, although not significant, were judged to have patterns of results similar to that of the discovery set and were investigated further by a sliding 10-year window strategy, the results of which the authors suggest clarify age-specific breast cancer risk associations. The authors note the need for additional validation in other populations and nonwhite ethnicities.
Do results of OncoVue® testing lead to changes in management that result in health outcome improvements?
The medical management implications of this test are unclear. The Gail model was originally designed for use in clinical trials, not for individual patient care and management. (92) Thus using the Gail model as a baseline for comparison may not be sufficiently informative. In addition, no evidence of improved outcomes as a result of management changes in OncoVue®-identified high-risk patients has been presented or published. The OncoVue® sample report makes no recommendations regarding patient management. The InterGenetics Inc. website makes this statement regarding test results: "A Moderate to High Risk result gives a woman several options: More comprehensive surveillance for breast cancer with mammograms, ultrasound and now Magnetic Resonance Imaging-MRI. Earlier detection means better long-term survival. Breast cancer prevention drugs like Tamoxifen can actually reduce breast cancer in high risk women."
A pilot study using buccal samples from women in the Marin County, CA retrospective case control study previously described aimed to examine the genotypes of subjects determined to be high risk (≥12%) by OncoVue®.(93) Of 22 SNPs assessed by the OncoVue® assay, one (rs7975232 in the vitamin D receptor gene) occurred significantly more often in high-risk cases than in the overall (all cases plus controls) sample (64% vs. 34%; p<0.001); however, the incidence among all cases (29%) was less than that among controls (39%). The authors postulate a potential prevention strategy using vitamin D supplementation in women with this genotype. Although recent retrospective studies support an association between sunlight exposure, elevated serum levels of vitamin D (25[OH]D)/vitamin D supplementation, and reduced risk of breast cancer, prospective uncontrolled studies gave mixed results (positive or no association).(94,95) Clinical trials demonstrating improved health outcomes in patients identified as high risk due to OncoVue detection of the rs7975232 SNP who were subsequently treated with vitamin D supplementation have not been reported.
In 2010, Mealiffe et al. published a clinical validation study of the BREVAGen™ test. (81) The authors evaluated a 7-SNP panel in a nested case control cohort of 1664 case patients and 1636 controls. A model that multiplied the individual risks of the 7 SNPs was assumed, and the resulting genetic risk score was assessed as a potential replacement for or add-on test to the Gail clinical risk model. The net reclassification improvement was used to evaluate performance. Combining 7 validated SNPs with the Gail model resulted in a modest improvement in classification of breast cancer risks, but area under the curve (AUC) only increased from 0.557 to 0.594 (0.50 represents no discrimination, 1.0 perfect discrimination). The impact of reclassification on net health outcome was not evaluated. The authors suggested that best use of the test might be in patients who would benefit from enhanced or improved risk assessment, e.g. those classified as intermediate risk by the Gail model.
Information about analytic validity of the BREVAGen™ test is provided in the published study, but is indeterminate. Genomic DNA samples were analyzed on custom oligonucleotide arrays (Affymetrix Inc., Santa Clara, CA). Mean concordance across duplicate samples included for quality control was 99.8%; breast cancer loci had call rates (a measure of SNP detection) above 99%. For approximately 70% of samples with sufficient DNA available, whole genome amplification also was carried out using the Sequenom (San Diego, CA) MassARRAY platform. Across samples that had not been excluded for lack of DNA or poor quality data (proportion not reported), concordance between the 2 assays was 97%, and the resulting call rate was 96.8%. Genotype data for 121 samples that had 1 or more inconsistencies between the Sequenom analysis, and the corresponding custom array genotype were excluded. Conflicting calls were not differentially distributed across case patients and controls. The authors acknowledged that the 2 assays performed "relatively poorly," but asserted that consensus calls were nonetheless accurate.
In 2013, Dite et al. published a similar case control study of the same 7 SNPs assuming the same multiplicative model (based on independent risks of each SNP). (96) Predictive ability of the Gail model with and without the 7 SNP panel was compared in 962 case patients and 463 controls, all 35 years of age or older (mean age, »45 years). AUC of the Gail model was 0.58 (95% confidence interval [CI], 0.54 to 0.61); in combination with the 7-SNP panel, AUC increased to 0.61 (95% CI, 0.58 to 0.64; bootstrap resampling, p<0.001). In reclassification analysis, 12% of cases and controls were correctly reclassified and 9% of cases and controls were incorrectly reclassified when the 7-SNP panel was added to the Gail model. Risk classes were defined by 5-year risk of developing breast cancer (<1.5%, ≥1.5% to <2.0%, and ≥2.0%). Although addition of the 7-SNP panel to the Gail model improved predictive accuracy, the magnitude of improvement is small, the overall accuracy is moderate, and the impact on health outcomes is uncertain.
Other Clinical Genetic Tests
Other large studies have evaluated 8 to 18 common, candidate SNPs breast cancer cases and normal controls to determine whether breast cancer assessments based on clinical factors plus various SNP combinations were more accurate than risk assessments based on clinical factors alone.
Although results of these studies support the concept of clinical genetic tests, they do not represent direct evidence of their clinical validity or utility.
Section Summary
There is a lack of published detail regarding OncoVue® and BREVAGen™ test validation, supportive data, and management implications. Available data suggest that OncoVue® and BREVAGen™ may add predictive accuracy to the Gail model. However, the degree of improved risk prediction may be modest, and clinical implications are unclear. There is insufficient evidence to determine whether using breast cancer risk estimates from OncoVue® or BREVAGen™ in asymptomatic individuals changes management decisions and improves patient outcomes.
Ongoing Clinical Trials
An online search of ClinicalTrials.gov identified the following active studies:
Clinical utility of single nucleotide polymorphisms (SNP) panel tests and clinical genetic tests (OncoVue®, BREVAGen™, and others) is unknown. Information about analytic performance (reproducibility) of marketed tests is lacking. Most tests are in an investigational phase of development, having demonstrated associations between the SNPs tested and breast cancer risk. Clinical genetic tests may improve predictive accuracy of currently used clinical risk predictors. However, the magnitude of improvement is small and clinical significance is uncertain. Whether potential harms of these tests due to false negative and false positive results are outweighed by potential benefit associated with improved risk assessment is unknown. Use of these tests is therefore considered investigational.
Practice Guidelines and Position Statements
National Comprehensive Cancer Network
Current guidelines from the National Comprehensive Cancer Network identify the following limitations of multigene cancer panels: unknown significance of some variants, uncertain level of risk associated with most variants, and unclear guidance on risk management for carriers of some variants.(101) For breast cancer risk assessment, the Gail model(102) or risk models for women with elevated risk based on family history (e.g., Claus et al(103) or Tyrer-Cuzick et al. (104)) are recommended.(101,105)
Medicare National Coverage
There is no national coverage determination (NCD). In the absence of an NCD, coverage decisions are left to the discretion of local Medicare carriers.
Unlisted multianalyte assay with algorithmic analysis
Unlisted chemistry procedure
Type of Service
Place of Service
Add to Pathology/Laboratory Section - New medical policy with literature search through March 2011; considered investigational. ICD-10 codes included.
Policy renumbered to 12.04.63 (previously 2.04.63) and reassigned to new Genetic Testing category.
Replace policy. Policy updated with literature search, references 12, 13, 19-22, 27-30 added. No change to policy statement.
Update Coding Section – ICD-10 codes are now effective 10/01/2014.
Effective 1/1/13, CPT codes 81200 – 81479 will be used for lab testing; these replace codes 83891 – 83912 which are deleted effective 12/31/12.
Update Related Policies. Add 12.04.91.
Replace policy. Policy updated with literature search through April 9, 2013; references 23-33 added. No change to policy statement.
Update Related Policies. Change title to 12.04.57.
Update Related Policies. Add 12.04.93.
Update Related Policies. Change title to 12.04.504.
Annual Review. Policy updated with literature review through March 18, 2014. Policy combined with Policy No. 12.04.57 (Non-BRCA Breast Cancer Risk Assessment [e.g., OncoVue]) and title changed to "Use of Common Genetic Variants (SNPs) to Predict Risk of Nonfamilial Breast Cancer;"; references 1-2, 6-8, 34-45, 48-50, 52-53, 56-64, 66-67, 69-70, 74, and 96 added. Investigational policy statement for OncoVue® and BREVAGen™ modified to indicate investigational for all indications.
Update Related Policies. Remove 12.04.91.
Disclaimer: This medical policy is a guide in evaluating the medical necessity of a particular service or treatment. The Company adopts policies after careful review of published peer-reviewed scientific literature, national guidelines and local standards of practice. Since medical technology is constantly changing, the Company reserves the right to review and update policies as appropriate. Member contracts differ in their benefits. Always consult the member benefit booklet or contact a member service representative to determine coverage for a specific medical service or supply. CPT codes, descriptions and materials are copyrighted by the American Medical Association (AMA).


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Club competitions
National team competitions
Sabine Niedola collected 18 points and 16 rebounds and Karlene Nimane hit a driving lay-up with less than a second remaining to give Latvia a thrilling 77-75 victory over Turkey on the opening day of the U20 European Championship for Women.The 17-year-old Niedola came off the bench and carried the Latvians to the win with eight points and seven offensive rebounds in the fourth quarter alone.
One of the brightest stars from last summer's U16 European Championship for Women, Niedola gathered 10 offensive rebounds in the Group B encounter. Nimane tallied 15 points and Anete Steinberga also collected a double-double with 14 points and 12 rebounds for the winners.Turkey fought back from an 11-point first quarter deficit to pull ahead by as many as 10 points. But in the end, it was not enough despite 28 points, 10 rebounds and three blocked shots by Turkey star Bahar Caglar. Yasemin Dalgalar added 16 points and Gizem Yavuz scored 14 in a losing effort.Latvia pulled ahead early 21-10 and still led 25-15 after one period. But Caglar scored nine points in a 17-2 run to go up 32-27 and Turkey led 38-34 at the break. The lead bulged to 10 points at 48-38 and it was 56-46 before Nimane drained a triple to close the third period.Turkey were still ahead 72-67 with less than two minutes left. Niedola's three-point play was answered by one from Calgar. After a Steinberga lay-up, Nimane evened the game at 75-75 on a three-pointer with 29 seconds to play. Nimane then stole a pass by Calgar and drove the length of the court and made a lay-up with 0.33 seconds to play for the victory.
Ukraine ease past BulgariaUkraine also opened up their championship with a victory, beating Bulgaria 88-61 in Group C thanks to 25 points from Taisiia Bovykina.The Ukrainians jumped ahead 21-13 after one period and led by 17 after scoring the first nine points of the second period. Bulgaria used two 10-0 runs to pull within 36-33 just before the break.But Bovykina sparked a 13-3 run early in the third period to open a 53-40 cushion. And it was still 13 points 64-51 going into the fourth. A 13-0 surge in the opening stages of the final period ended all doubts as the lead grew to 77-53. Oleksandra Prystupa also had an outstanding game for the winners with 16 points and 10 rebounds while 17-year-old Olesya Malashenko chipped in 18 points and seven rebounds. Bulgaria were paced by Jaklin Zlatanova with 16 points while Veselka Todorova had 14 points and Marta Tzankova scored 11.

subset: commoncrawl


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Over the weekend, the Los Angels County Sheriff's Department hosted a Gifts for Guns Program, which allowed people to turn in firearms to deputies with no questions asked. Furthermore, in exchange for the guns, the Sheriff's department was giving out gift cards.
The purpose of the event is to take unused or unwanted guns out of the picture. Aside from taking guns directly off the streets, it helps allow law abiding residents to safely surrender their firearm if it is not wanted anymore.
KHTS covered the event Saturday, where the Sheriff's department collected 150 guns. After Sunday's event the grand total was pushed to 255. See more pictures of the guns collected by reading Saturday's story.
The Sheriff's Department is planning on continuing this successful program throughout the county. Future Gifts For Guns collection events will be held on the following dates at the following locations:
April 25, 10 a.m. to 5 p.m.
* Altadena Sheriff Station
* San Dimas Sheriff Station
May 2, 10 a.m. to 5 p.m.
*Crescenta Valley Sheriff Station
* Marina del Rey Sheriff Station
May 8-9, 10 a.m. to 5 p.m.
* East Los Angeles Sheriff Station
* Lennox Sheriff Station
* Industry Sheriff Station
May 22-23, 10 a.m. to 5 p.m.
* Lost Hills Sheriff Station (May 23 only)
* Avalon Sheriff Station (May 22 only)
May 30-31, 10 a.m. to 5 p.m.
* Temple Sheriff Station
* Compton Sheriff Station
* Pico Rivera Sheriff Station
The drop off sites are not generally at the Sheriff's Station itself. Contact any of the above referenced stations or Sheriff's Headquarters Bureau (323) 526-5541 for more details and safe surrender locations or visit the LASD.org Web site.
Of course, the Santa Clarita Sheriff's Station will always allow for the safe surrender of guns. If you would like to get rid of your firearm, simply put it in your trunk, unloaded. Then drive to the Sheriff's department, leave the gun in the trunk and alert the front desk personnel that you have a firearm you would like to surrender. A deputy will then take the gun out of your trunk.
All guns surrendered to Los Angeles County Sheriff's deputies are logged and destroyed.
Next week, deputies will combat another sort of danger; identity theft. A free community shred event will be taking place in the College of the Canyon's parking lot on Saturday from 9:00 a.m. to 3:00 p.m.
All residents are allowed to bring their personal documents that need to be destroyed to the event, where deputies will oversee the safe destruction, thus preventing criminals from going through your trash and pulling out sensitive information.
Also, the day will provide people the chance to drop off all electronic waste and unused medicine for safe disposal.
For more information on this event, click here.


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I know the more high-end cards really need to stay cool, especially for those who like overclocking their cards. I'm wondering if any of you know about a card that is new and powerful but still doesn't produce as much relative fan noise even at higher stress levels. This is supposed to be a gift and I have zero knowledge on this specific aspect as I usually just accept fans as a part of the package when buying cards, but I know the one I'm getting it for prefers to keep the system relatively silent, using a water cooling system and so on instead of fans.
I've been thinking about getting a GTX680 or a Radeon7970, but then there's plenty of versions of every card as well, such as Gainward, Sapphire, XFX and ASUS.
I welcome any recommendations on this to help me pick something up.
Thanks a bunch!


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St. Jude Up 'til Dawn is a student-led, student-run philanthropic program, where college students across the country raise funds for St. Jude Children's Research Hospital. Students fundraise throughout the year and celebrate their success with an all-night event.
Once you're registered (Find Your School page), you will get your own personal fundraising website, where you can share your story through email and social media.
St. Jude provides all the materials you need to promote and execute your event successfully. This includes a personal St. Jude representative who will walk you through the process and answer your questions


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Ad Astra Radio: Our Interview with Goran Ghafour
This week for Ad Astra Radio, we interviewed novelist, journalist and KU Ph.D. student Goran Ghafour
Dancing Bear Variety Hour, Ep. 8
On the May episode of DBVH, we provide passive-aggressive life advice, the latest Khaled Sheikh Mohammed sports analysis, and misleadingly suggestive audio. Plus, the next episode of the USS Carpathia!!
Summer Changes – 5/8
Our final Ad Astra Radio of the school year presents stories of the changes a college community faces as it prepares for summertime. From graduation, to summer sports, to the buildings we inhabit.
Sunflower Reading Series – 5/1
Featuring readings from Crystal Boson and Louise Krug, with live audio from Megan Kaminksi and Joshua Clover.
Dancing Bear Variety Hour, Ep. 7
Kid friendly raps, psychic frenemies, and an inaptly-placed Westboro Baptist Church promo make up this episode, alongside a special noir mystery installment of the USS Carpathia.
Civic Engagement – 4/10
From student government to local volunteerism, to activism on a global scale, we bring you stories of people who care!
Sunflower Reading Series – 4/3
Readings by English Professor Joe Harrington and MFA student Sara Leavens. Also, a special preview of this year's Student Senate candidates.
Dancing Bear Variety Hour, Ep. 6
The crew of the USS Carpathia visits an alien planet for Alternative Spring Break, and to determine whether a supercomputer is a sentient being. Also, tour guide Claude, RobodeskCop, and stories from The Vault!
The Relationships Episode – 3/13
Valentine's Day may be over, but that doesn't stop Ad Astra from taking a look at relationships of all kinds – from parents to superheroes.
KJHK wins 24 KAB awards
KJHK 90.7 FM, the student-run radio station at the University of Kansas, recently received 24 broadcasting awards – more than any other college or university media outlet in the state – from the Kansas Association of Broadcasters. The 2014 KAB award count is a record for KJHK, exceeding the previous station record of 20 KAB awards received in 2013. KJHK students brought in awards for undergraduate radio news and sports coverage, graduate radio programming, and the station's website, www.kjhk.org. In the graduate radio division, KJHK students won 10 of the 11 honors awarded. A full list of KJHK's 2014 KAB Student Broadcasting Awards is included at the end of this release. The 2014 Student Broadcasting…


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The Railway Board has finally given approval to the rolling stock of Maharashtra's first metro rail – Mumbai Metro (Versova-Andheri-Ghatkopar corridor). Now, a decision on the fare hike is awaited.
According to sources, with the Railway Board approval has been given for the mechanical systems of the metro rail.
Another source involved in the construction of the metro rail shared that the Railway Board on Tuesday made notings on the file of Mumbai Metro and the sanction letter for the rolling stock of the metro rail is likely to be received by the state authorities by Friday.
Earlier in May, the Commissioner of Metro Railway Safety had issued a provisional safety certificate to the 11.04 km long metro route. Thereafter, permission from the Railway Board was eagerly awaited.
Construction on the project had begun in 2008 with a deadline set for March 2012. Reliance Infrastructure-led Mumbai Metro One Private Limited (MMOPL) had announced that their revised deadline was March 2014, but that too was missed.
There is a possibility that the corridor will be inaugurated by a state dignitary within a fortnight. However, just before the commissioning of the project a final call will be taken on whether to increase the metro rail fares as demanded by RInfra or to retain the fare hike approved in September last year.
In September 2013, the chief minister had increased the ticket rates as per the clauses of the concession agreement signed between RInfra and state authorities.
The initial fares were (up to 3km) Rs 8 (3-8 km) and Rs 10 (over 10 kms). The CM had increased it to Rs9 (up to 3 km), Rs 11 (3-8 km) and Rs 13 (over 8 km), as against Rinfra's demand of Rs22 (up to 3 km), Rs28 (3-8 km) and Rs 33 (over 8 km).
Once the route is opened for public, it is expected to ease commuting woes for Mumbai and is also likely to reduce ridership of the suburban locals of Mumbai due to its East-West connectivity.
Submission of DPR (Detailed Project Report) to MoR (Ministry of Railways)
Approval of DPR by MoR
MoR sends comments on DPR to MoUD (Ministry of Urban Development)
Submission of SOD (Schedule of Dimensions) and DBR (Design Basis Report) to RDSO (Research, Design and Safety Organisation) through MoR
Scrutiny of SOD and DBR in RDSO and communication to MoR
Approval of SOD and DBR through MoR
Submission of documents to RDSO/MoR as per annexures A to E2
MoR sends comments on SOD and DBR to Metro Operators
RDSO sends comments and suggestions on docs. to Metro
Issue of speed certificate by RDSO for conducting speed Trial
Communication of Approval to MoUD
Scrutiny and examination of test certificates as per clause 6 of the manual
Metro applies to CRS (Commissioner for Railway Safety) /CMRS (Commissioner for Metro Railway Safety) for sanction for conducting oscillation trial
Sanction of CRS /CMRS for conducting oscillation trial
RDSO conducts oscillation & EBD (Emergency Braking Distance) trials
RDSO conducts coupler force, controllability and/or any other special test, if required
Metro applies for authorisation of CRS / CMRS
CRS /CMRS conducts inspection
CRS/CMRS Authorises the Metro for opening of Corridor
Metro apply for sanction of MoR based on CRS/CMRS authorisation
Sanction of MoR to Metro for commercial running of metro at the specified speed.
Opening of corridor by Metro.
There will be food and beverage shops, convenience stories, mobile and accessories stores as well as ATM machines at the 12 metro stations.


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Micromet Presents Preclinical Data Showing Activity of Erbitux and Vectibix Based BiTE Antibodies against KRAS- and BRAF-mutated Human Colorectal Cancer Cells
Study Presented at 2009 AACR Meeting Highlights Potential Therapeutic Approach to Treat Patients Unresponsive to Erbitux and Vectibix
Micromet's researchers converted cetuximab and panitumumab into novel bispecific antibodies based on Micromet's proprietary BiTE technology. Both of Micromet's EGFR BiTE antibodies were able to direct T cells against cetuximab/panitumumab-resistant human colorectal cancer cells harboring KRAS and BRAF mutations, resulting in the destruction of these cancer cells. In mice, daily EGFR BiTE antibody doses as low as 0.1 microgram/kilogram were sufficient to prevent tumor growth from mutated human colorectal cancer cells. Studies in a relevant non-human primate species suggest that active serum levels of the cetuximab-based BiTE antibody are tolerated.
"The data show that our BiTE technology can overcome significant limitations of conventional monoclonal antibodies," commented
(1)Lutterbuese, R. et al. Highly efficient lysis of KRAS- and BRAF-mutated human colon cancer cells by T cell-engaging BiTE antibodies derived from anti-EGFR antibodies cetuximab and panitumumab AACR Annual Meeting 2009, abstract no. 3251
(2)Tol, J. et al., N. Engl. J. Med. 360 : 563-572 (2009)
(4)Amado, R.G. et al., J. Clin. Oncol. 26: 1626-1634 (2008)
(5)Bargou, R. et al., Science 321: 974-977 (2008)
About Micromet
Micromet, Inc. (www.micromet-inc.com) is a biopharmaceutical company with offices in
Forward-Looking Statements
This release contains certain forward-looking statements that involve risks and uncertainties that could cause actual results to be materially different from historical results or from any future results expressed or implied by such forward-looking statements. These forward-looking statements include statements regarding the efficacy, safety and intended utilization of its EGFR BiTE antibody. You are urged to consider statements that include the words "ongoing," "may," "will," "believes," "potential," "expects," "plans," "anticipates," "intends," or the negative of those words or other similar words to be uncertain and forward-looking. Factors that may cause actual results to differ materially from any future results expressed or implied by any forward-looking statements include the risk that product candidates that appeared promising in early research, preclinical studies or clinical trials do not demonstrate safety and/or efficacy in subsequent clinical trials, the risk that encouraging results from early research, preclinical studies or clinical trials may not be confirmed upon further analysis of the detailed results of such research, preclinical study or clinical trial, the risk that additional information relating to the safety, efficacy or tolerability of our product candidates may be discovered upon further analysis of preclinical or clinical trial data, the risk that we or our collaborators will not obtain approval to market our product candidates, the risks associated with reliance on outside financing to meet capital requirements, and the risks associated with reliance on collaborators, including MedImmune, Merck Serono, TRACON and Nycomed, for the funding or conduct of further development and commercialization activities relating to our product candidates. These factors and others are more fully discussed in Micromet's Annual Report on Form 10-K for the fiscal year ended
Any forward-looking statements are made pursuant to Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and, as such, speak only as of the date made. Micromet, Inc. undertakes no obligation to publicly update any forward-looking statements, whether as a result of new information, future events or otherwise.
SOURCE Micromet, Inc.


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With the Lok Sabha polls already into fifth phase, the focus in Delhi has now shifted to the assembly here. The three main political parties are now hunting for their would be chief ministers. While Aam Aadmi Party is comfortable with Arvind Kejriwal, the Congress and the BJP are juggling with names. For the Congress party, Ajay Maken seems to be the best option available while the BJP has gone beyond its existing party leaders and may try to pitch in former IPS officer Kiran Bedi as its chief ministerial face for Delhi.
With Delhi's former CM Sheila Dikshit, governor of Kerala, now out of active politics, Congress party general secretary and senior party leader from Delhi Ajay Maken is preparing his pitch.
Sources in the Delhi Congress said that Maken is keen for the top job. "Surveys suggest that Maken might not make it to Lok Sabha from the New Delhi seat he is contesting. He has served as a minister in Dikshit's cabinet in the past. He has a clean image making him the appropriate choice for Delhi," said a senior Congress leader.
Maken is known to be close to the first family of the Congress. He has replaced Dikshit on many fronts. Like Dikshit who had accompanied Sonia Gandhi to the polling station in the 2009 election, this time it
was Maken walking behind her.
After Congress came down to eight from 43 seats in Delhi assembly, JP Agarwal resigned from the post of the party president. Maken's name was doing rounds in the corridors to replace Agarwal. Maken had then refused to take up the job and proposed the name of Arvinder Singh Lovely for the post.
Lovely was known to be close to Dikshit while Maken never shared a good rapport with her. By recommending Lovely's name for Delhi Congress chief, Maken has managed to win over him and his supporters. "Lovely's loyalists have now shifted. He is working on the instructions of Maken and will extend him all the support, if Maken contests the Delhi election," added the Congress leader.
The former office-bearers of the party are also of the view that it was on the instructions of Maken that Lovely got the PCC dissolved just before the Delhi election. "Now, Maken will want his own set of people in the PCC. This will further hit the morale of the party workers," said a former PCC member.
The rift within the Congress party has already started to widen as the office-bearers feel let down after the sudden dissolution of PCC.
Amidst all the infighting, the Congress and the BJP will be submitting their affidavits in the Supreme Court on AAP's petition in the Supreme court. AAP had moved the court challenging President's rule in Delhi. The parties are to file their affidavits on Thursday.
Meanwhile, rumours are rife that BJP is considering Kiran Bedi for the top Delhi post. The party hopes that their CM candidate in Delhi, Dr Harsh Vardhan, will win the Chandni Chowk Lok Sabha seat. For them Bedi will fill the vacuum. Bedi was approached by the party even before the Delhi elections, but she had then refused the offer. "Bedi is the best option available with the BJP to pacify AAP's strength in the capital," said a source.
For AAP, Kejriwal is their face to to go polls. In case, Kejriwal is able to win the Varanasi Lok Sabha seat, the party will pitch his close aide, Manish Sisodia, for the top post in the national capital.


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When My girls were toddlers I used to make sun bonnets to match their summer dressers. It had a flap at the back and a brim at front tied under the chin. I am sure it was all one piece....it was very simple to make. Does anyone have anything like this ?
Ottobre has a few bonnet patterns, the one I have is several peices though, but they have other ones I haven't really looked at. They are all cute though!
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Pronounced: JAR-Quez
Bio: 2014-15 Complete Bio
(as of March 12, 2015)
Features: Smith Is A Shot Blocking Wonder
ON SMITH: One of the rising stars in the ACC who displayed his exceptional talents during his freshman season and who is sure to be an all-star candidate during the remainder of his career at Florida State…one of the promising sophomores in the ACC who is sure to be one of the top shot blockers in school history before his career as a Seminole is over…his burgeoning talent will continue to emerge as his playing time continues to grow beginning with his sophomore season and for the remainder of his career at Florida State…showed flashes of a strong ability to score the basketball as he totaled eight points in his first career ACC road game at Clemson (Jan. 9, 2014) and added seven on the road at NC State (Jan. 29, 2014)…helped lead Florida State to 22 wins, a third place finish in the Puerto Rico Tip-Off and a semifinal appearance in the NIT at Madison Square Garden during the 2014 season…with Smith in the line-up during his freshman season, Florida State played in its school record ninth consecutive postseason tournament and cemented itself as the third winningest program in the ACC since the start of the 2005-06 season…has an incredible ability to rebound and block shots…his athleticism will continue to make him a dominant rebounder and shot blocker for the Seminoles during the remainder of his collegiate career…utilizes his athleticism to play effectively at the rim on both the offensive and defensive ends of the court…is still growing and will become more explosive in both his speed and his aerial ability as he continues with the strength and conditioning program at Florida State…considered to be a fearless competitor…excellent mobility and range…has great hands and the ability to catch and release quickly…was Florida State's first commitment for the class of 2013…ranked No. 63 on the CBSSports.com list of the top 100 high school players in the Class of 2013…a four-star recruit and the No. 18 ranked power forward by Rivals.com…ranked as the No. 57 player in the Class of 2013 by Rivals.com…ESPN.com ranked him as the 60th best overall player and the 15th best power forward at the end of his senior season…the 23rd best power forward in the class by 247sports.com…
AS A FRESHMAN (2014): Averaged 2.4 points (ninth on the team), 1.5 rebounds (ninth on the team) and 0.7 blocked shots (third) while playing in 34 of 36 games and averaging 10.1 minutes played per game…one of five Seminoles who blocked at least 20 shots with 14 of his 24 blocked shots coming in ACC play…ranked third on the team with a 0.8 blocked shots per game average in ACC play…blocked at least one shot in 16 of the Seminoles' 34 games with his career high of three blocked shots coming against NCAA Tournament teams Virginia (Jan. 4) in his first ACC game and against North Carolina (Feb. 17)…multiple blocked shots came in six different games including two in the first game of his career against Jacksonville (Nov. 8)…totaled three blocked shots in his first career ACC game against Virginia…two blocked shots came in victories over Notre Dame (Jan. 21) and Virginia Tech (Feb. 5) and in the ACC Tournament against Virginia (March 14)…totaled seven blocked shots (2.3 bpg) in three games against ACC Champion Virginia…his 24 blocked shots during his freshman season rank as the 10th highest blocked shots total by a freshman in school history…scored his career-high eight points in his first ACC road game in Florida State's 56-41 win over Clemson…totaled his career of four field goals made and five field goals attempted in the Seminoles' victory at Littlejohn Coliseum…scored points in each of the first five games of his career and averaged 2.2 points in five games (all victories) against Jacksonville (Nov. 8, three points), at UCF (Nov. 13, four points), against UT-Martin (Nov. 17, four points), No. 10 VCU (Nov. 21, two points) and against Northeastern (Nov. 24, two points)…seven points in a victory over Jacksonville State (Dec. 8) ranked as tied for his highest single game point total of his freshman season… also totaled seven points on the road at NC State (Jan. 29)…averaged 10.1 minutes played per game with double figure minutes coming in 19 of the 34 games he played in…his career-high of 19 minutes played came in the Seminoles' 106-62 victory over Charlotte in Tallahassee (Dec. 17)…totaled three points, three rebounds and one blocked shots in the Seminoles' win over the 49ers…his ACC career high of 18 minutes came as Florida State played host to Clemson in Tallahassee (Feb. 5)…averaged more minutes played per game in 18 games (10.4 mpg) than he did in the 16 non-conference games he played in (9.8 mpg)…at least 10 minutes played in 12 of 18 ACC games…made four 3-point shots on the season with made shots from the bonusphere coming against Jacksonville, Jacksonville State, at Miami (Jan, 18) and at NC State…Florida State was 3-1 in the four games in which he made a 3-point shot…was a perfect four of four from the free throw line (both career high for free throws made and free throws attempted in a single game) in the Seminoles 77-53 win over Jacksonville State…also a perfect two of two from the free throw line in Florida State's ACC victory over Virginia Tech…
AT JONES COUNTY: Graduated from Jones County High School in 2013…averaged a near triple-double of 16.3 points, 12.4 rebounds, and 7.5 blocks per game during his senior season…scored 20 points or more in eight games which included a 40 point game in the season opener against Putnam County…played in 29 games, nine of which he had triple doubles and 11 double-doubles his senior year…helped lead Jones County to the state playoffs for the first time in 12 years…Smith was named Georgia Basketball boys' co-player of the year in Region 2-AAAAA and was named to the first team all-state by Atlanta Journal Constitution…averaged 6.8 points, 7.0 rebounds and 4.2 blocked shots as a junior…was also named to the Georgia Athletic Coaches Association all-star roster and named the Middle Georgia Player of the Year…Played for the Georgia Stars.
PERSONAL: Born September 16, 1994…son of Sherlena and Willie Frank Smith…grew three inches between his freshman and senior seasons at Jones County… selected Florida State over Georgia, Georgia Tech, Alabama, Auburn, Tennessee, Georgetown, Florida, Kansas, NC State and South Carolina.
Basketball Training Center


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Explore the Entrepreneurship.org Resource Center to find resources. Designed with entrepreneurs in mind, our resource center allows you to find materials to grow great ideas.
Making a little girl's life better may rival extensive work with his alma mater as Stephen Cooper's most rewarding giving back.
Founding a business was so much fun for three Harvard juniors that they did it several times--until they found something that worked. They begged, bartered and borrowed resources, with a little help from their folks. And, because they knew their industry and added value as managers, they grew their temp agency for Web professionals into a permanent, international leader.
Stan Christensen is a partner at Arbor Advisors, an investment banking firm where he negotiates on behalf of mid-market technology companies. He has nearly twenty years of experience in both transactional and operations
roles and has worked on hundreds of transactions. Before starting Arbor, he was the General Manager of Eazel, a Linux-based software startup. He started his career in corporate finance on Wall Street, and then worked for ten years with
CMG, a negotiation advisory firm affiliated with The Harvard Negotiation Project. In this capacity he worked with corporations and governments-advising, negotiating, and mediating transactions and conflicts. In 1996 he was selected as a
Kellogg Fellow for his work in the non-profit and public sectors. He is a member of The Council On Foreign Relations and currently teaches a course on Negotiation at Stanford University in The School of Engineering. He holds an M.B.A. from
Harvard Business School and a B.A. from Brigham Young University.
Prominent industry leaders team up with Stanford Faculty to discuss entrepreneurial solutions to problems in the areas of international affairs, human health and the environment. They tackle world issues from a global and technical perspective beyond the usual bureaucratic approach with a special focus on developing nations.
Does Six Sigma methodology have benefits small- to medium-sized entrepreneurial manufacturing firm? "Yes!" proclaims this author, a Six Sigma Master Black Belt. He provides an overview of, outlines four actions needed for a company to succeed with, and defines steps to deploying Six Sigma.
Steve Burrill, CEO of Burrill & Co., provides an overview of the life sciences industry, reflecting on insights he has gained throughout his career. Along the way, he shares his laws of survival and anecdotes that relate the keys to his success in the areas of biotechnology, venture capital and merchant banking.
Dr. Larry Brilliant is the Executive Director of Google.org, where he leads major initiatives aimed at reducing global poverty, improving the health of the least advantaged in the world, and working to halt the effects
of the climate crisis. Larry is an M.D. and M.P.H., board-certified in preventive medicine and public health. He is a founder and director of The Seva Foundation, which works in dozens of countries around the world, primarily to eliminate
preventable and curable blindness. He serves as a member of the strategic advisory committee for Kleiner Perkins (KPCB) Venture Capital and also sits on the boards of The Skoll Foundation, Health Metrics Network, Omidyar Networks Humanity
United, and InSTEDD, an organization bringing technological tools to improve disaster response. In addition to his medical career, Larry co-founded The Well, a pioneering virtual community, with Stewart Brand in 1985. He also holds a
telecommunications technology patent and has served as CEO of two public companies and other venture-backed start-ups. The author of two books and dozens of articles on infectious diseases, blindness, and international health policy, Larry
has worked at every level of government. He was recently a "first responder" for CDC's smallpox bio-terrorism response effort, volunteered in Sri Lanka for tsunami relief, and established an interdisciplinary consultancy to prepare for
possible pandemic influenza. Larry lived in India working as a United Nations medical officer for more than a decade where he played a key role in the successful World Health Organization (WHO) smallpox eradication program and has recently
worked for the WHO polio eradication effort as well. He was Associate Professor of epidemiology, global health planning and economic development at the University of Michigan. Larry earned a Masters in Public Health in health planning and
economic development from the Univ
Teresa Briggs currently serves as a Managing Partner at Deloitte's Silicon Valley office. Over the past two years, Briggs has worked to double the firm's staff to at least 1,300. She joined the firm when only seven
percent of the partners were women. She arrived at Deloitte & Touche as one of the youngest partners in the company. Rising quickly, she moved to Deloitte's New York office working to redesign the company's corporate strategy at a
national level, which then led to her current position. On top of all her accomplishments at Deloitte, Briggs has served on the Management Board of Advisors at her alma mater, the University of Arizona, and she spent eight years serving on
the board of the Boys and Girls Club of San Francisco. Teresa also recently participated in the Leadership Group's Annual CEO/Elected Official Cycle‐To‐Work Day Challenge to help curb climate change, riding from Redwood
Shores to downtown San Jose and back. She was also recently named a "Woman of Distinction" in the San Jose / Silicon Valley Business Journal, and she has been added to the Business Journal's "Who's Who in Silicon Valley" list. Briggs holds
a Bachelor of Science from the University of Arizona.
Steve Blank is a retired serial entrepreneur with over 30 years of experience in high technology companies and management. He is a Consulting Professor at Stanford in the Graduate School of Engineering STVP Program.
Steve has been a founder or participant in eight Silicon Valley startups since 1978. His last company, E.piphany, started in his living room. His other startups include two semiconductor companies (Zilog and MIPS Computers), a workstation
company (Convergent Technologies), a supercomputer firm (Ardent), a computer peripheral supplier (SuperMac), a military intelligence systems supplier (ESL) and a video game company (Rocket Science Games). Steve is on the board of
CafePress.com, an on-line marketplace, and IMVU, a 3D IM social network. Steve was appointed by Governor Arnold Schwarzenegger to the California Coastal Commission and is the Chairman of Audubon California and on the board of the Peninsula
Open Space Trust (POST.) His Google Tech talk, "The Secret History of Silicon Valley" (available on YouTube) is one of the definitive views on the early history of innovation in Silicon Valley. Steve teaches entrepreneurship and a
methodology of managing marketing, sales and business development in high technology startups. His course text "Four Steps to the Epiphany" is the definitive work on Customer Development and is one of the foundations of Lean
Investment in military veteran entrepreneurship, a public good
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M83: Hubble's Deepest View of the Universe
December 8, 2009
How far is far? And how do you know when you get there? NASA's Hubble Space Telescope has taken the deepest photograph of the universe ever made in near-infrared light. The picture reveals several thousands of far-flung galaxies. The farthest, merely dim points of light in this view offer a peek at the universe as it looked just 600 million years after the Big Bang. No galaxies have ever been seen before at such early times. This image reveals the emergence of stars and galaxies in the infant universe's formative years. This new Hubble view clearly demonstrates that the James Webb Space Telescope will have a lot to go hunting for at the horizon of the universe. Credit: NASA, ESA, and G. Bacon and M. Estacion (STScI)
Topics: Technology Internet, European Space Agency, Hubble Space Telescope, Space exploration, National Aeronautics and Space Administration, Hubble Ultra Deep Field, Hubble Deep Field, Big Bang, Galaxy, Physical cosmology, James Webb Space Telescope, Space Telescope Science Institute


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Hey everyone, first time poster but longtime Arkham player!
So a group of us got together and decided to play using Stormson99's campaign rules with an extra modification I found elsewhere that you play the next chapter with half the terror level rounded down of the previous chapter, as well as the Epic Battle cards should we ever fight an Ancient One. However, we don't typically randomize the Ancient Ones with the expansions we're playing. We either pick or randomize the Ancient One, then sculpt the expansions to play with around that.
We've done 5 Ancient Ones so far:
1. Glaaki (with Dunwich)
2. Cthugha (with Innsmouth)
3. Shub-Niggurath (with Black Goat herald and a One of the Thousand cult variant to spread more corruption)
4. Nyarlathotep (with Dark Pharaoh herald)
5. Atlach Nacha (with Kingsport).
None of our characters (Marie Lambeau, Mandy Thompson, Jenny Barnes, and Leo Anderson) have been devoured or retired. So far, they've all been a breeze; our only close call was with Nyarlathotep, when the Doom Track was one away from unleashing him.
Currently, we're very super-powered:
Marie Lambeau is using Zebulon Whateley, Seven Books of Hsan, Red Sign of Shudde Mell, Shriveling, Wither, and a Spirit Vessel to make her monsters worth even more.
Mandy Thompson is using True Magick with Healing Stone, so she's gaining a Clue Token every round for free.
Leo Anderson is carrying a Shotgun and an Enchanted Blade/Enchanted Knife combo, and has Eric Colt.
Jenny Barnes is carrying a Lamp of Alhazred and a Tommy Gun, accompanied by her beefcake bodyguard/bedtime buddy Tom "Mountain" Murphy, as well as a Vision Quest to suck up clues faster.
We're also hoarding two Find Gate spells. In this last campaign in Kingsport, Mandy Thompson acquired Captain of the White Ship, and since it's a status card, it technically carries over. Our bank is depleted: everyone (except Marie, although she was recently deputized) has excessive amounts of money from Retainers, Deputy salaries, the Business Associates relationship between Leo and Mandy, and Jenny Barnes' trust fund.
Our only detriments are that Marie Lambeau has Schizophrenia and Jenny Barnes has Claustrophobia. At this point, it's almost really unfair to the game.
So, we turn to you, the community, to tell us what we should do next to make us at least break a sweat! We have all of the expansions and are willing to play with fan-made material, so you can go nuts. We'll take (almost) all suggestions and incorporate them into our next chapter.
I'll be posting session progress each time we play. We're getting together about two to three times a week, and our goal is to go through all 24 ancient ones, ending with Azathoth using all of the expansions.
One idea we're incorporating for this upcoming campaign is we're doubling the $ cost of everything, and increasing the cost of location encounters like South Church and Police Station by 1 gate/5 toughness of monster trophies. This way it scales up to match our progress.
We're also considering drawing two mythos cards a turn, and resolving the gate opening of the first card only. The concern in the group is the doom track climbing too quickly, although I think it should be fine.
So, we pose this question for you:
Who should our next Ancient One be, and with what buffs/detriments? What expansions/part of expansions should we be using with that?
Looking forward to hearing your suggestions!


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AMSTERDAM, April 15, 2013 /PRNewswire/ --
CPhI Worldwide - a division of UBM Live - and its sister brand, PharmaEvolution (http://www.pharmaevolution.com) will introduce annual and monthly reports covering key trends in the global pharmaceutical industry.
CPhI, which hosts a number of successful and well-respected pharmaceutical conferences and exhibitions around the world, will leverage its longstanding independent position within the industry to analyze trends identified by its attendees and a group of expert advisors. Together with content partner, PharmaEvolution, a new peer-to-peer community website, CPhI will examine key topics and issues, and promote online discussion.
The first monthly report covering Formulation & Ingredients will be released in May and subsequent reports will examine such topics as outsourcing, biopharmaceutical development and manufacturing and generic drug development.
The first annual report, which will review the current state of the global pharma industry, will be released in September, one month before the CPhI Worldwide conference in Frankfurt in mid-October. It will feature insights from thought leaders in key sectors of the industry, evaluating current practices and projecting near and long-term trends - as well surveying all CPhI attendees - providing an aggregated view of the industry from its most senior people for the first time.
The monthly reports will be developed and data collected by PharmaEvolution, a joint venture with UBM DeusM, launched on February 25, which aims to promote direct online sharing between professionals in pharmaceutical research and development, manufacturing, supply chain management, and quality. On PharmaEvolution, industry insiders share best-practices, self-assessment tools, technical articles, webcasts, chat, and non-traditional formats designed to help profess
|SOURCE UBM Live
Copyright©2012 PR Newswire.
All rights reserved


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15th Annual Honda of Houston/FMF AMA Texas Winter Series
Only a couple classes were updated for 2015. The new year will bring an Air-Cooled ONLY class for 50cc bikes. The remaining PeeWee classes will see the return of the 51cc 4-5 and 51cc 6-7 along with the standard 51cc 4-6, 7-8 and 4-8 Open. The Mini Beginner classes have been revamped as well for the Texas Winter Series to give our newest riders plenty of competition to race against.
For Sunday big bike day the addition of the Two-Stroke 16+ class will offer a new smell in the air. Returning in 2015 is the very popular 250 C age group classes. The Vet's were not forgotten as the series will offer Vet Expert riders with the return of the Vet 25+ A class. Everyone will line the fences to see who the BIG DOG is for 2015 when the 250 and 450 pro classes hit the track. Each round of the series is an AMA Pro Am event and will only add to the buzz. The Pro-Am purse will increase from $15,000 in 2014 to $20,000 in 2015 over the five rounds (see Purse Payout below).
Awards and contingency product will be handed out at the final round to the TOP 10 finishers in each amateur class that competed in 4 of 5 rounds.
Rd 1 January 3-4, 2015 – Freestone Raceway (Rd 1 – Results) Rd 2 January 17-18, 2015 (Make-Up Date) – Swan Raceway Park (Rd 2 – Results) Rd 3 January 24-25, 2015 – Oakhill Raceway (Rd 3 – Results) Rd 4 February 7-8, 2015 – Village Creek MX (Rd 4 – Results) Rd 5 February 28-March 1, 2015 – Freestone Raceway (Rd 5 – Results)
Class Structure (Revised 12/01/14)
Purse Payout (Released 08/15/14)
Points Scale (Released 06/15/14)
Specialty Points (Golden Helmet Award, Bronze Bar Award, Vet Horizon Award)
- Cobra ($3,000)
- Honda ($35,250)
- Kawasaki ($25,500)
- Suzuki ($47,000)
- Yamaha ($17,500)
Note: Factory contingency may not be posted when the series begins however the OEM's will retro-payout contingency for all rounds in the Texas Winter Series. You cannot be paid factory contingency unless you register as required by the OEM's. Cobra pays overall for the series.


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Legal Resources
Use the filters to find legal resources like cases, reports, staff opinions, and events. You can sort by topic, type or industry.
Displaying 1801 - 1823 of 1823
The regulations require financial institutions to provide particular notices and to comply with certain limitations on disclosure of nonpublic personal information. A financial institution must provide a notice of its privacy policies and practices with respect to both affiliated and nonaffiliated...
Rule Summary: Unavailability Rule
Rule Summary: Energy Labeling Rule
Rule Summary: CAN-SPAM Rule
The CAN-SPAM Act requires the Commission to issue regulations "defining the relevant criteria to facilitate the determination of the primary purpose of an electronic mail message." The CAN-SPAM Act applies almost exclusively to "commercial electronic mail messages".
Rule Summary: Telemarketing Sales Rule
Rule Summary: Interpretations of Magnuson-Moss Warranty Act
Rule Summary: Contact Lens Rule
The Contact Lens Rule contains two key requirements. The first requirement is that contact lens prescribers (i.e., optometrists and ophthalmologists) must provide patients with a copy of their contact lens prescriptions at the completion of a contact lens fitting. The second requirement is that a...
Case: PerfectData Corporation
Federal Trade Commission Decisions, Volume 116, Page 769
Rule Summary: Holder in Due Course Rule
The Preservation of Consumers' Claims and Defenses [Holder in Due Course Rule], formally known as the "Trade Regulation Rule Concerning Preservation of Consumers' Claims and Defenses," protects consumers when merchants sell a consumer's credit contracts to other lenders. Specifically, it preserves...
Rule Summary: Business Opportunity Rule
Rule Summary: Mail, Internet, or Telephone Order Merchandise Rule
The Rule, issued in 1975, requires sellers who solicit buyers to order merchandise through the mail, via the Internet, or by phone to have a reasonable basis to expect that the sellers can ship within the advertised time frame, or, if no time frame is specified, within 30 days. The Rule also...
Federal Trade Commission Decisions, Volume 115 , Page 339


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Army of Two
- Platforms: PS3, X360
- Developer: EA Games
- Publisher: Electronic Arts
- Genre: Action, Third Person
- VN:F [1.9.22_1171]User Score: 0 votes
- Add to MyGames
Today, the United States is awarding an unprecedented number of contracts to Private Military Corporations (PMC) in an effort to maintain its presence worldwide. Since the Vietnam War, this number has increase ten fold and is only rising. As the clear cut flow of the chain of command blurs and the military responsibilities of a nation slipping out of its own control, it is getting hard to tell who really holds the power.
As ex-Army Rangers now turned contractors for a PMC, ARMY OF TWO challenges you to fight along side your team-mate on missions developing and using the combined skills necessary to become the deadliest TWO man military outfit. Whether with a live player or ARMY OF TWO's unique partner AI, ARMY OF TWO delivers a revolutionary new way to play an action shooter.
From TWO man sniping to parachuting, players will experience action-packed scenarios where they will have to use their wit, strength and an arsenal of shared customizable weapons to successfully defeat their enemies and complete the mission at hand.
On or offline, players can seamlessly transition from AI to a live partner as they fight their way through war, turmoil and a conspiracy so vast it threatens the entire world. When one man is not enough, it's going to take an army of two to save us
No News has been linked to this game.
Army of Two
Have you been searching for a true co-op experience, then this is just the game for you!
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Sun-soaked Scandinavian shelter
Before the climate talks in Copenhagen kick off, check out this gorgeous Danish apartment building that makes use of solar power and passive daylighting.
Thu, Dec 03, 2009 at 06:15 PM
As all eyes begin to turn (if they weren't turned already) towards the beautiful city of Copenhagen for the commencement of next week's UN Climate Change Conference, I thought I'd share with you a bit of green architectural eye candy from Denmark. But before you read on and check out the below renderings, be sure to vote and help make MNN student correspondent Divina Baratta a Hopenhagen Ambassador. Check back here for continued updates from Copenhagen, including dispatches from my co-blogger Karl Burkart. And if you yourself are heading to the city, a personal recommendation: visit the Louisiana Museum of Modern Art, located a 40-minute train trip north of the city.
Okay, back to the regularly scheduled eco-architectural ogling. It was recently announced that Team +, a collective of several Danish architectural firms, has won a green residential design competition in Denmark called Housing +. The mission of the competition was to design a zero-energy residential structure that is both high quality and super sustainable. Team +'s sun-drenched, solar-powered design, Bolig +, will begin construction next year in the city of Aalborg.
The jury of the Housing+ competition explains what gave Bolag+ the winning edge:
Good daylight, flexible dwellings in a compact, well insulated and tight building, designed to gain maximum benefit from the sun without overheating. A building complex fitted with the best technical solutions linking user behaviour, passive solar gain and the local fossil energy supply.
Looks and sounds like a real green beauty. For more info on Bolig+, head on over to World Architecture News.
Via [World Architecture News] via [Ecofriend]
The opinions expressed by MNN Bloggers and those providing comments are theirs alone, and do not reflect the opinions of MNN.com. While we have reviewed their content to make sure it complies with our Terms and Conditions, MNN is not responsible for the accuracy of any of their information.


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Potassium radioisotopes
potassium radioisotopes
Unstable isotopes of potassium that decay or disintegrate emitting radiation. K atoms with atomic weights 37, 38, 40, and 42-45 are radioactive potassium isotopes.
Please contribute to this project, if you have more information about this term feel free to edit this page
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Beautician Shahnaz Husain offers tips and answers queries. Send your queries to email@example.com
What are the benefits of sandalwood paste? How should it be used? — Vaishnavi
Sandwood paste has a cooling effect and ia widely used to relieve prickly heat and skin conditions such as rashes, pimples, acne and boils. Sandalwood has powerful healing and protective properties and is one of the best known natural antiseptics. It can be mixed with a little rose water and applied on the face. The paste can be added to face packs. Mix multani mitti with rose water and sandalwood paste into a paste and apply it on the face. Wash it off after it dries. It helps oily and pimple prone skin.
Suggest how I can prevent acne on my face. — Bubbly
Check whether you have dandruff or oily hair/scalp, as these can lead to pimples on the face. After a shampoo wash, add the juice of a lemon to a mug of water and use it as a last rinse. Mix a little rose water with sandalwood paste and apply it daily. Wash it off after 15 minutes. Mix multani mitti with rose water into a paste and apply it on the face two or three times a week. Wash it off after it dries.
I have dandruff, lice and nits, as a result of which I am losing a lot of hair. — Manasa
Apply vinegar on your hair and scalp. After an hour, comb your hair with a fine-toothed lice comb and have the nits removed manually. Vinegar loosens the nits making them easier to remove. Then wash your hair with a mild herbal shampoo. Add two tablespoons of vinegar to a mug of water and use it as a last rinse. Then comb your hair again with the lice comb. Do this daily for a week. Have weekly henna treatments. Add 4 teaspoons each of lemon juice and coffee, 2 raw eggs, one teaspoon of methi seed powder and enough tea water to the henna powder, mixing it into a thick paste. Tea water can be made by boiling used tea leaves again in enough water, and cooling and straining the liquid. If your hair is dry, add two teaspoons of oil. Apply the henna on your hair and wash it off after an hour. These treatments will also help your dandruff problem.
My skin is always dry. Suggest a solution. — Sidha
Avoid soap and use a cleansing gel or cream. Apply it on your face and wipe it off with moist cotton wool. Apply a sunscreen before going out in the sun, or a moisturiser if you are at home. Once daily, at any time, mix honey with a little egg yolk or pure almond oil and apply it on your face. Wash it off with water after 15 minutes. At night, after cleansing your face, massage your face with a nourishing cream to which a few drops of water have been added. Remove excess cream with moist cotton wool before bedtime.
Keywords: beauty tips, sandalwood paste, acne prevention, hair loss, skin care


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As part of his amazing show at Siren Studios Hollywood a few weeks back, artist Gregory Siff also celebrated our incredible collab project, and so he did it in the best way he knows how.
He pumped up the tunes on the 'Music To Paint To' playlist he compiled exclusively for the twelve Bar site, got out his spray cans, fetched a ladder, and created a huge mural of his trademark etched faces, with an additional nod to the face of our brand, the Twelve bar Heart.
Of course we were on hand to provide a soundtrack of our own – James Brown's incredible rare groove 'People Get Up And Drive Your Funky Soul' from the 'Motherlode' LP. What's more you can experience the creation of a Gregory Siff artwork yourself via the brilliant time-lapse video of the mural's painting courtesy of videographer Todd Stefani.
To get your hands on one of the last available collab tees Gregory Siff x Twelve Bar: There & Back, go to our online store now.
Buy our exclusive Gregory. X Twelve Bar tee here


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American playwrights really aren't known as good farceurs. That designation usually is reserved for British writers such as Ray Cooney or perhaps a French playwright or two. But Michael Parker has been trying for several years to write the quintessential American farce and comes close with "There's A Burglar in my Bed" which has just opened at Hopewell's Off-Broadstreet Theatre.
It is certainly the best of his many attempts, which have titles such as "No Sex Please, We're Sixty;" "Sin, Sex and the CIA:" "Hotbed Hotel;" and "The Amorous Ambassador," All of which Parker has written for the American marketplace with only small success. "Burglar" has all of the necessary ingredients including a set with eight doors. In this show, they are not slammed so much as opened and shut with exquisite timing so that the clever cast can convey the intricate comings and goings at the Massachusetts beach house of William W. Worthington III and his somewhat bored wife, Ashley. He is filthy rich, she wouldn't mind some of that money, and since both are currently cheating on each other and there is an expensive necklace resting in the beach house safe, an exchange of some cash might be expected.
Now add the customary hangers on -- a professional photographer, a specialist in marital dalliances; a friend perfectly willing to strip and pose for "nasty" pictures plus the inevitable mistaken identity scenes (lots of them) -- and there are laughs aplenty. And what the script doesn't provide, director Bob Thick and a particularly adept company of mostly veteran actors works very hard to make up for. Barry Abramowitz and Vicky Czarnik have a wonderful time as the Worthingtons, ready to hug whoever walks into view. Her main squeeze is Edward P, Brookstone (Teddy) played by Brady Dunbar Niederere. His is "Buffy" DuVal (proper name Lorraine, played by Tess Ammerman). Meanwhile John Bergeron, as the photographer spends much of the evening (just two hours, including intermission) getting conked on the head and peeling herself off the floor. Alexis Newbauer spends the same time climbing into and out of her clothes. And Katie Munley tries to figure out why she is dressed more or less like a nun.
It's not supposed to make much sense, so don't worry if you have trouble following the plot. Have fun, laugh a lot and thank your lucky stars there is not a Christmas tree, a nutcracker nor an angel in sight. Incidentally, playwright Parker, who has spent so much time and energy writing "the American farce," was born in the UK, acted on the London stage when he was 12, toured with the National Shakespeare Company and graduated near the top of his class at Britain's famous Royal Military Academy at Sandhurst.
Go figure.
"There's A Burglar In My Bed" will continue at Off-Broadstreet Theatre, 5 so. Greenwood Ave., Hopewell through Dec. 22. Performances run Friday and Saturday eves at 8 p.m. and Sunday matinees at 2:30 p.m. The theater is always open one hour earlier for desserts and beverages. (609) 466-2766.


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I love that my co-workers think of cows when they think of Wisconsin (thanks, Jess and Briar, for the awesome flyer!).
Also, please come to Room of One's Own Feminist Bookstore, 307 W. Johnson, on Wednesday (May 14) from 6:00-8:00PM for a participatory discussion about Feminism In/Action: What is your feminism for and why does it matter?
Isn't a rack of independent magazines a lovely sight?
Long for the days of camp but without the whole overnight, sleeping bag part?
Well, look no futher, for ZINE CAMP is here!
Thank you, TrumbullPlex folx, for letting us use your space for Sunday's discussion. Thank you, Adele, Clara, and Jess for making the event happen here, and for getting the word out (and special thanks to Clara for the tour and history of the TrumbullPlex, a radical housing collective in the Woodbridge neighborhood of Detroit). And a huge thank you to everyone who attended. I didn't count, but I think between 20 and 25 people came. I felt honored to be in the presence of so many people committed to honesty, sincerity, openness, and creating a safe space to share what are sometimes difficult and differing perspectives.
Our Midwest fundraising/outreach tour is off to a fabulous start...
This post is gonna be in the form of a conversation with the amazing
Jess Hauser, who organized one incredible dance party/fundraiser last night at the Temple Bar here in Detroit.
Please join these participatory discussions about how—and whether—feminism can become a transformative, justice-centered movement for social change.
Everything's coming together. Here's what's happening in Chicago. Please spread the word...
Another update on my upcoming trip...
Ok, folks – here's my heart on the line: I organized my entire trip around Mother's Day so that I could combine the organization I love plus my mom and grandma, who – as much as they support and love me – really don't "get" what my work is all about.
So please, Twin Cities friends, come – and bring anyone special you want to appreciate – and let's celebrate Mother's Day with gratitude for the amazing people that allowed us to live the lives we have today.
If nothing else, do it for my grandma! She's 91 and she's incredible.
I'm posting updates to my Midwestern trip as they're finalized. Here's what's happening in Milwaukee. More on other cities to come soon!
If you live in Milwaukee, please come out for these events – and spread the word!
Bitchcraft, a weekend of music, arts, crafts, and words will take place Saturday, May 17–Sunday, May 18. All events are free—donations are very much encouraged (and appreciated!) and benefit the nonprofit project you know and love as B-Word/Bitch.
Bitchcraft kicks off Saturday, May 17, 5–8 p.m., at Woodland Pattern Book Center, 720 E. Locust St., with performances by singer-songwriters Heidi Spencer and Stephanie Rearick; a sneak preview of "Devotion to Thread," an exhibit curated by Faythe Levine; and some brief comments from me about what we're up to at Bitch!
Part two of Bitchcraft takes place Sunday, May 18, 4–5:30 pm. I'll facilitate a special session of the Femiknits discussion group—open to non-knitters!—at Broad Vocabulary Bookstore, 2241 S. Kinnickinnic Ave. Our discussion will focus on the ways in which feminism can be re-imagined in our communities. Even if you don't knit, please come and share your ideas, stories, and struggles.
Adult Sex Toys
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Get your first look at NeNe Leakes in NBC's upcoming sitcom "The New Normal!"
Production for the series is rolling right along and now there's a preview!
Although NeNe doesn't appear until far into the clip, the trailer does set up the premise for the sitcom. NeNe will play the assistant of the gay couple's lawyer.
The show will center on a gay couple and a surrogate name Goldie, who is carrying their baby. Goldie is a single mom with dreams of being a lawyer. She and her daughter head for California after a sudden, crushing breakup with her boyfriend (she caught him in bed with another woman).
"The New Normal" also features Goldie's uber-conservative (if slightly racist) grandmother.
Judging from the clip, it looks like NeNe's character Rocky might play another very important role on the show, which will air Tuesdays at 9:30 p.m. (EST) starting this fall.
See what you can expect from the series in the hilarious clip below!
—Sonya Eskridge
Here's more:
NeNe Leakes lands 'Normal' gig
NeNe Leakes is officially divorced


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Mast mounted Roller Furling Main Sail
2 Attachment(s)
would someone tell me the pros/cons of a roller furling main sail
Re: Mast mounted Roller Furling Main Sail
I am very interested in this as well, looks like there are no takers with this question so far. Its not everyday you see these types of mainsail configurations.
There is a Union Polaris 36 for sale by my place and that has a roller furling main mast setup like the pictures you showed.
Re: Mast mounted Roller Furling Main Sail
In-mast furlers are a better setup than the external 'add-on' style shown. Luff sag, and the 'slot' between the sail and the mast minimize the effectiveness and the lack of roach on the sail makes things worse.
In mast furlers do away with the slot/gap but do share some of these other downsides. However unless racing many will embrace the convenience, and sadly furling mains are becoming almost standard on many new boats today. And if not racing, the performance hit is probably not a big issue for most.
Like many things sailing, there are fans, detractors, and converts. Furling mains are not for me....... yet.. :rolleyes:;)
This has been discussed before at length.. do a search on the topic and you'll get pages of reading to do...
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