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OBSERVATION Acne Vulgaris A Disease of Western Civilization Loren Cordain, PhD; Staffan Lindeberg, MD, PhD; Magdalena Hurtado, PhD; Kim Hill, PhD; S. Boyd Eaton, MD; Jennie Brand-Miller, PhD Background: In westernized societies, acne vulgaris is with multiple comedones or grades 2-4) was observed. a nearly universal skin disease afflicting 79% to 95% of ´ Of 115 Ache subjects examined (including 15 aged 15-25 the adolescent population. In men and women older than years) over 843 days, no case of active acne (grades 1-4) 25 years, 40% to 54% have some degree of facial acne, was observed. and clinical facial acne persists into middle age in 12% of women and 3% of men. Epidemiological evidence sug- Conclusions: The astonishing difference in acne inci- gests that acne incidence rates are considerably lower in dence rates between nonwesternized and fully modern- nonwesternized societies. Herein we report the preva- ized societies cannot be solely attributed to genetic dif- lence of acne in 2 nonwesternized populations: the Kita- ferences among populations but likely results from ´ van Islanders of Papua New Guinea and the Ache hunter- differing environmental factors. Identification of these fac- gatherers of Paraguay. Additionally, we analyze how tors may be useful in the treatment of acne in Western elements in nonwesternized environments may influ- populations. ence the development of acne. Observations: Of 1200 Kitavan subjects examined (in- cluding 300 aged 15-25 years), no case of acne (grade 1 Arch Dermatol. 2002;138:1584-1590 A CNE AFFECTS between 40 the incidence of acne is lower than in west- million and 50 million in- ernized populations. Schaefer,7 a general dividuals in the United practitioner who spent almost 30 years States. 1 Although acne treating Inuit (Eskimo) people as they mainly affects adoles- made the transition to modern life, re- cents, it is also present in children and ported that acne was absent in the Inuit adults. One study found some degree of population when they were living and eat- facial acne in 54% of women and 40% of ing in their traditional manner, but upon men older than 25 years.2 In this same acculturation, acne prevalence became group, clinical facial acne affected 12% of similar to that in Western societies. the women and 3% of the men and per- sisted into middle age. Cunliffe and Gould3 For editorial comment From the Department of Health reported similar results 20 years earlier. In see page 1591 pediatric populations, the prevalence of and Exercise Science, Colorado State University, Fort Collins acne increases with age. In 10- to 12-year- Prior to World War II, Okinawa was (Dr Cordain); Department of old children, 28% to 61% of the popula- an isolated island outpost in the South Community Medicine, tion has clinically diagnosed acne, whereas China Sea, and its native inhabitants lived University of Lund, Lund, 79% to 95% of 16- to 18-year-old adoles- a rural life with few or none of the trap- Sweden (Dr Lindeberg); cents are affected.4-6 Even a significant per- pings of industrialized societies. Exten- Department of Anthropology, centage of children (aged 4-7 years) are di- sive medical questionnaires by US physi- University of New Mexico, agnosed with acne.5 Thus in the Western cians administered to local physicians who Albuquerque (Drs Hurtado and world, acne is a ubiquitous skin disease af- had practiced from 8 to 41 years revealed Hill), Department of Radiology fecting primarily adolescents but also a sig- that, "These people had no acne vul- and Anthropology, Emory nificant portion of adults older than 25 garis."8 Dermatological examination of University, Atlanta, Ga (Dr Eaton); and Department of years. 9955 schoolchildren (aged 6-16 years) Biochemistry, Human Nutrition Few studies have evaluated the preva- conducted in a rural region in Brazil found Unit, University of Sydney, lence of acne in nonwesternized soci- that only 2.7% of this pediatric popula- Sydney, Australia eties. However, there is suggestive evi- tion had acne.9 Dermatological examina- (Dr Brand-Miller). dence in nonindustrialized societies that tion of 2214 Peruvian adolescents by pe- (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1584 ©2002 American Medical Association. All rights reserved. diatricians demonstrated that acne prevalence (grades 1-4) of dairy products, alcohol, coffee, and tea was close to was lower (28%) in Peruvian Indians than in mestizos nil, and that of oils, margarine, cereals, sugar, and salt (43%) or whites (45%).10 was negligible. Estimated carbohydrate intake was high, In South Africa, dermatologists found lower rates almost 70% of daily energy, while total fat intake was low of acne among the Bantu11 than among whites12 residing (20% of daily energy). Virtually all of the dietary carbo- in Pretoria. Bantu adolescents (aged 15-19 years; n=510) hydrate intake was in the form of low–glycemic load tu- maintained a 16% incidence rate of acne,11 whereas among bers, fruits, and vegetables. the white adolescents (n=1822), the incidence was 45%.12 For the entire sample of Bantus of all ages (n=3905), the Methodology overall occurrence of acne was 2%,11 whereas in the total white sample across all ages (n = 16 676), the incidence During 7 weeks in 1990, one of us (S.L.) visited all 494 of acne was 10%.12 Among the Zulu it was suggested that houses in Kitava and performed a general health exami- acne became a problem only when these people moved nation in 1200 subjects 10 years or older, including 300 from rural African villages to cities.13 All of these stud- subjects between 15 and 25 years. Dr Lindeberg is a gen- ies suggest that the prevalence of acne is lower among eral practitioner whose formal training included detec- rural, nonwesternized people than in fully modernized tion of acne comedonica, acne papulopustulosa, and acne Western societies. conglobata. As a practicing physician in Sweden, he regu- Herein we report the absence of acne in 2 nonwest- larly examines European patients with acne ranging from ernized populations: the Kitavan people living on the Tro- grade 1 through grade 4. briand Islands near Papua New Guinea and the Ache ´ All subjects were examined specifically for skin dis- hunter-gatherers of Paraguay. Additionally, we evaluate orders, including acne. However, the examinations were how elements in nonwesternized environments may in- also designed to detect a number of other common West- fluence the development of acne. ern diseases. Subjects were examined in daylight at a close enough distance to detect acne or scarring. In male sub- jects, the face, chest, and back were examined, whereas in RESULTS female subjects, only the face and neck were examined. For the classification of acne the following system was used: THE KITAVAN ISLANDERS grade 1, comedones present (open or closed), few papules present; grade 2, comedones and papules present, few pus- Population Parameters tules present; grade 3, comedones, papules, and pustules present, few nodules present; and grade 4, comedones, pap- Kitava is an island belonging to a group of coral atolls known ules, pustules, nodules, and cysts present. as the Trobriand Islands located in Milne Bay Province, Papua New Guinea. Kitava has a surface area of 25 km2 and Dermatological Results is home to 2250 native inhabitants who live as subsis- tence horticulturalists and fishermen. Electricity, tele- Not a single papule, pustule, or open comedone was ob- phones, and motor vehicles were absent in 1990. Most Kita- served in the entire population examined (N=1200). Al- vans live in villages of 20 to 400 people. Some Western goods though no closed comedones were reported, it is pos- are received from the New Guinea mainland, but the in- sible that they were present but undetected. Single bruises, fluence of the Western lifestyle has been minimal. scars, papules, or pustules of infectious origin were fairly common, including tropical ulcers, which rapidly healed General Health following treatment with penicillin V. A number of in- tramuscular abscesses were also encountered. Cardiac death and stroke are extremely rare among Kita- vans.14 Overweight, hypertension, and malnutrition are ´ THE ACHE HUNTER-GATHERERS also absent.14,15 Kitavans have low levels of serum insu- lin,16 plasma plasminogen activator inhibitor 1 activ- Population Parameters ity,17 and leptin,18 which suggests high insulin sensitiv- ity throughout life. A moderately high level of physical ´ The Ache of eastern Paraguay were full-time hunter- activity, roughly 1.7 multiples of basal metabolic rate in gatherers occupying a 20000-km2 area between the Para- male subjects, is another characteristic feature.16 Three ´ guay and Parana rivers until contact with Western civi- of 4 Kitavan men and women are daily smokers. Infec- lization in the mid-1970s. Following contact, the Ache ´ tions, accidents, complications of pregnancy, and senes- people settled in small communities near their tradi- cence are the most common causes of death. Life expec- tional foraging range and now follow a mixed hunting- tancy is estimated at 45 years for newborns and 75 years gathering and farming economy. Many aspects of Ache ´ or more at age 50. Mean age at menarche is 16 years.19 socioecology have been studied over the past 20 years.20-23 Diet General Health Tubers, fruit, fish, and coconut represent the dietary main- Since the late 1970s, multiple lines of evidence have dem- stays in Kitava. Dietary habits are virtually uninflu- onstrated that contact with Western civilization was not enced by Western foods in most households. The intake necessarily beneficial from an overall health perspec- (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1585 ©2002 American Medical Association. All rights reserved. tive.22 Over the contact period, the Ache population has ´ been present and gone undetected. As in the Kitava sample, decreased by 30% as a result of deaths, primarily of res- skin infections and intramuscular abscesses were com- piratory tract infections. However, chronic diseases preva- mon and responded well to treatment with antibiotics such lent in urban communities (eg, diabetes, asthma, hyper- as erythromycin and tetracycline. tension, and other cardiovascular disease) are still absent or rare.22,24 COMMENT Diet GENETIC AND ENVIRONMENTAL CONSIDERATIONS ´ The Ache diet contains wild, foraged foods, locally cul- tivated foods, and Western foods obtained from exter- Of the 300 Kitavans at greatest risk for acne (aged 15-25 nal sources. By energy, their diet consists of 69% culti- years), not a single case of acne was observed. In a simi- gens, 17% wild game, 8% Western foods, 3% domestic lar Western population, some degree of facial acne would meat, and 3% collected forest products.25,26 The culti- be found in at least 120 subjects.2,4-6 In Western popu- gens consist mainly of sweet manioc, followed by pea- lations the development of acne has hereditary and en- nuts, maize, and rice, whereas the Western goods are vironmental components. Familial studies have demon- mainly pasta, flour, sugar, yerba tea, and bread.23 strated that hereditary factors are important in determining susceptibility to acne,28 whereas twin studies have sug- Methodology gested that although sebum secretion is under genetic con- trol, the development of clinical lesions is modified by The population was examined repeatedly over an 843- environmental factors.29 day period (September 1997 to June 2001), specifically Clearly, genetic susceptibility to acne cannot be ruled for acne and for other skin and health disorders. I. out in the interpretation of our observations. However, it Hurtado, MD, a general practitioner from the Instituto is unlikely that the effective absence of acne in the Kita- Venezolano de Investigaciones Cientifics, Caracas, Ven- ´ van and Ache people resulted entirely from genetic resis- ezuela, initially examined all 115 subjects. Dr Hurtado's tance to acne, since other South American Indians10 and formal training included the detection and diagnosis of Pacific Islanders30 whose ethnic backgrounds are similar acne using the International Consensus Conference on ´ to the Ache and Kitavans but who live in more western- Acne Classification system27 with the following catego- ized settings maintain considerably higher acne inci- ries: mild, few to several comedones, papules, and pus- dence rates than those we report. Consequently, our ob- tules, no nodules; moderate, several to many comedo- servations are suggestive that elements common to the Ache ´ nes, papules, and pustules, few to several nodules; and and Kitavan environments but not present in Western severe, numerous comedones, papules, and pustules, many settings may operate together with genetic factors to nodules. The face, chest, neck, and back of all subjects prevent acne. were examined at a close distance under bright lighting. Every 6 months following the initial assessment, THE PROXIMATE ETIOLOGY identical follow-up examinations were conducted by 1 OF ACNE VULGARIS of 6 family practitioner physicians who were also for- mally trained in the detection and recognition of acne Acne is well understood to result from the interplay of 3 using either the International Consensus Conference on factors: (1) hyperkeratinization and obstruction of Acne Classification system27 or the 4-grade classifica- sebaceous follicles caused by abnormal desquamation tion scheme used in the Kitavan sample. All subjects were of the follicular epithelium; (2) androgen-stimulated in- regularly screened for any health problems by a health creases in sebum production; and (3) colonization of the care worker, and all ailments were recorded in a log, in- follicle by Propionibacterium acnes, which generates in- cluding rashes, skin infections, and other dermatologi- flammation.31,32 The ultimate mechanism responsible for cal disorders. One of us (M.H.) compiled all of the health factors 1 and 2 is not well understood.32,33 It is likely that care data during the observation period, including the any environmental element underlying the develop- dermatological data used in the present study. Over the ment of acne must operate via modulation of the known observation period, the sample included an average of proximate or ultimate (genetic) causes. 115 subjects (59 men and women 16 years or older and 58 boys and girls younger than 16 years), including 15 DIET AND HYPERINSULINEMIA subjects aged 15 to 25 years. Although diet is infrequently considered as an etiologic Dermatological Results agent in the development of acne,34 it represents a well- recognized factor in acute35and chronic36,37 hyperinsu- Not a single case of active acne vulgaris (mild, moderate, linemia. Recent evidence has demonstrated that the hor- or severe27 or grades 1 to 4) was observed in all 115 sub- monal cascade triggered by diet-induced hyperinsulinemia jects over the 843-day study period by any of the 7 exam- elicits an endocrine response that simultaneously pro- ining physicians. One 18-year-old man appeared to have motes unregulated tissue growth and enhanced andro- acne scars. Not a single papule, pustule, or open comedo gen synthesis. Hence, hyperinsulinemic diets may rep- was observed in the entire population. Although no closed resent a previously unrecognized environmental factor comedones were reported, it is possible that they could have in the development of acne via their influence on fol- (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1586 ©2002 American Medical Association. All rights reserved. licular epithelial growth and keratinization and on an- RXR homodimer–mediated signaling.54 Studies in knock- drogen-mediated sebum secretion. out rodents show that the RXRα gene is required for actions of the 2 endogenous retinoic acid ligands (trans HYPERINSULINEMIA AND FREE retinoic acid and 9-cis-retinoic acid),55,56 and RXR ago- IGF-1 AND IGFBP-3 nists and IGFBP-3 are growth inhibitory in many cell lines.57 Additionally, RXR is the major RXR receptor in Chronic and acute hyperinsulinemia initiate a hor- skin.58 Consequently, low plasma levels of IGFBP-3 in- monal cascade that favors unregulated tissue growth by duced by hyperinsulinemia may reduce the effective- simultaneously elevating levels of free insulinlike growth ness of the body's natural retinoids to activate genes that factor 1 (IGF-1) and reducing levels of insulinlike growth normally would limit follicular cell proliferation. factor binding protein 3 (IGFBP-3).38-41 Because free IGF-1 is a potent mitogen for virtually all body tissues,42 el- HYPERINSULINEMIA, IGF-1, ANDROGENESIS, evated concentrations of free IGF-1 have a high poten- AND SEBUM PRODUCTION tial for stimulating growth in all tissues, including the follicle. Sebum production, essential to the development of acne,32 In support of the notion that insulin-triggered el- is stimulated by androgens.31,32 Consequently, hyperinsu- evations in free IGF-1 levels may promote acne via hy- linemia may promote acne by its well-established andro- perkeratinization are data showing that IGF-1 is re- genic effect. Insulin and IGF-1 stimulate the synthesis of quired for keratinocyte proliferation in humans43 and that androgens in ovarian59,60 and testicular61,62 tissues. Fur- in transgenic mice, overexpression of IGF-1 results in hy- thermore, insulin and IGF-1 inhibit the hepatic synthesis perkeratosis and epidermal hyperplasia.44 Furthermore, of sex hormone binding globulin (SHBG),63,64 thereby in- women with postadolescent acne maintain elevated creasing the bioavailability of circulating androgens to tis- serum concentrations of IGF-145 and are mildly insulin sues. Cross-sectional studies demonstrate inverse relation- resistant.46 ships between serum SHBG and insulin65 and IGF-1.66-68 The reductions in IGFBP-3 levels stimulated by el- Additionally, sebum production is stimulated not only evated serum insulin levels38,39 or by acute ingestion of by androgens,31,32 but also by insulin69 and IGF-1.70 Di- high–glycemic load carbohydrates47 also may contrib- rect injections of recombinant IGF-1 in humans elicit an- ute to unregulated cell proliferation in the follicle. In mu- drogenesis and acne.71 Higher serum androgen,72 insu- rine knockout cells lacking the IGF receptor, IGFBP-3 lin,45 and IGF-146 concentrations are associated with the acts as a growth inhibitory factor.48 Accordingly, IGFBP-3 presence of acne in women. Taken together, these data sug- is inhibitory to growth by preventing IGF-1 from bind- gest that the endocrine cascade induced by hyperinsu- ing to its receptor. Hyperinsulinemia indirectly in- linemia enhances sebum synthesis and the development creases the number of epidermal growth factor recep- of acne. tors by elevating levels of plasma nonesterified fatty acids,49 and it also induces production of transforming growth POLYCYSTIC OVARY SYNDROME factor 1.50 Increased concentrations of these cytokines depress localized keratinocyte synthesis of IGFBP-3, Acne is a characteristic feature in patients with polycys- thereby increasing the availability of free IGF-1 to its ke- tic ovary syndrome, who are also frequently hyperinsu- ratinocyte receptors,51 which in turn promotes keratino- linemic, insulin resistant, and hyperandrogenic.73 These cyte proliferation. Consequently, hyperkeratinization of patients typically maintain elevated serum concentra- sebaceous follicles may result synergistically from eleva- tions of androgens and IGF-1 and lower concentrations tions in free IGF-1 levels and/or reductions in concen- of SHBG.73-75 Androgen levels can be lowered and dis- trations of IGFBP-3. ease symptoms alleviated by improving insulin sensitiv- ity through weight loss76 or by use of pharmaceuticals IGFBP-3 AND RETINOID RECEPTORS such as metformin77 that improve insulin metabolism. Nu- merous studies78-80 have reported that tolbutamide, an an- Insulin-mediated reductions in IGFBP-3 levels may fur- tihyperglycemic drug similar to metformin, is therapeu- ther promote unregulated follicular growth by affecting tically effective in treating acne. the nuclear retinoid signaling pathway. Retinoids are natural and synthetic analogues of vitamin A that DIETARY CHARACTERISTICS AND INSULIN inhibit cell proliferation and promote apoptosis.52 The RESISTANCE IN NONWESTERNIZED SOCIETIES body's natural retinoids (trans retinoic acid and 9-cis- retinoic acid) act by binding 2 families of nuclear recep- ´ Both the Ache and Kitavan diets are composed of mini- tors: retinoic acid receptors (RARs) and retinoid X mally processed plant and animal foods and are virtu- receptors (RXRs). Retinoid receptors, in turn, activate ally devoid of typical Western carbohydrates that yield gene transcription by binding as RAR-RXR het- high glycemic loads that may acutely 35 or chroni- erodimers or RXR-RXR homodimers to retinoic acid cally36,37 elevate insulin levels (Table). Recently accul- response elements located in the promoter regions of turated hunter-gatherer populations who have adopted target genes whose function is to limit growth in many Western diets frequently are hyperinsulinemic and in- cell types.53 sulin resistant and have high rates of type 2 diabetes,81,82 Insulinlike growth factor binding protein 3 is a li- whereas hunter-gatherer and less westernized popula- gand for the RXR nuclear receptor and enhances RXR- tions living in their native environments rarely exhibit (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1587 ©2002 American Medical Association. All rights reserved. Glycemic Loads of Western Refined and Unrefined Traditional Foods* Western Refined Foods Unrefined Traditional Foods Food Glycemic Index Glycemic Load Food Glycemic Index Glycemic Load Crisped rice cereal (Rice Krispies) 88 77.3 Parsnips 97 19.5 Jelly beans 80 74.5 Baked potato 85 18.4 Toasted corn cereal (Cornflakes) 84 72.7 Boiled millet 71 16.8 Hard candy (Life Savers) 70 67.9 Boiled broad beans 79 15.5 Rice cakes 82 66.9 Boiled couscous 65 15.1 Table sugar (sucrose) 65 64.9 Boiled sweet potato 54 13.1 Shredded wheat cereal 69 57.0 Boiled brown rice 55 12.6 Graham crackers 74 56.8 Banana 53 12.1 Wheat and barley cereal (Grape-Nuts) 67 54.3 Boiled yam 51 11.5 Toasted oat cereal (Cheerios) 74 54.2 Boiled garbanzo beans 33 9.0 Rye crispbread 65 53.4 Pineapple 66 8.2 Vanilla wafers 77 49.7 Grapes 43 7.7 Corn chips 73 46.3 Kiwi fruit 52 7.4 Candy bar (Mars) 68 42.2 Carrots 71 7.2 Stoned wheat thins 67 41.9 Boiled peas 48 6.8 Shortbread cookies 64 41.9 Boiled beets 64 6.3 Granola bar 61 39.3 Boiled kidney beans 27 6.2 Angel food cake 67 38.7 Apple 39 6.0 Bagel 72 38.4 Boiled lentils 29 5.8 Doughnuts 76 37.8 Pear 36 5.4 White bread 70 34.7 Watermelon 72 5.2 Waffles 76 34.2 Orange 43 5.1 Bran cereal (All-Bran) 42 32.5 Cherries 22 3.7 Whole wheat bread 69 31.8 Peach 28 3.1 Croissant 67 31.2 Peanuts 14 2.6 *Glycemic load = glycemic index carbohydrate content in 100-g portions. The glycemic reference is glucose with a glycemic index of 100. these symptoms,83-85 including other unacculturated South REFERENCES American Indian tribes.86 Neither the Kitavan islanders ´ nor the Ache hunter-gatherers manifest the classic symp- toms of insulin resistance. The Kitavans are not over- 1. White GM. Recent findings in the epidemiologic evidence, classification, and sub- types of acne vulgaris. J Am Acad Dermatol. 1998;39(2, pt 3):S34-S37. weight or hypertensive,14,15 and they maintain low se- 2. Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad rum concentrations of insulin,16 plasminogen activator Dermatol. 1999;41:577-580. inhibitor 1,17 and leptin,18 which are indicators of high 3. Cunliffe WJ, Gould DJ. Prevalence of facial acne vulgaris in late adolescence and insulin sensitivity. in adults. BMJ. 1979;1:1109-1110. Dietary interventions using low–glycemic load car- 4. Rademaker M, Garioch JJ, Simpson NB. 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"It's a wonderful life": signal- pression of insulin-like growth factor binding protein-3 (IGFBP-3) in human ing generosity among the Ache of Paraguay. Evol Hum Behav. 2000;21:263- ´ keratinocytes is regulated by EGF and TGF 1. J Cell Physiol. 1999;179: 282. 201-207. 24. Hurtado AM, Hill KR, Rosenblatt W, Bender J, Scharmen T. A longitudinal study 52. Evans TRJ, Kaye SB. Retinoids: present role and future potential. Br J Cancer. of tuberculosis outcomes among immunologically naıve Ache natives of Para- ¨ ´ 1999;80:1-8. guay. Am J Phys Anthropol. In press. 53. Yang Q, Mori I, Shan L, et al. Biallelic inactivation of retinoic acid receptor 25. McMillan G. Ache Residential Grouping and Social Foraging [dissertation]. B2 gene by epigenetic change in breast cancer. Am J Pathol. 2001;158:299- Albuquerque: University of New Mexico; 2001. 303. 26. Kaplan H, Hill K, Lancaster J, Hurtado AM. The evolution of intelligence and the 54. Liu B, Lee HY, Weinzimer SA, et al. Direct functional interaction between insu- human life history. Evol Anthropol. 2000;9:156-184. lin-like growth factor-binding protein-3 and retionoid X receptor-alpha regu- 27. Pochi PE, Shalita AR, Strauss JS, et al. Report of the Consensus Conference on late transcriptional signaling and apoptosis. J Biol Chem. 2000;275:33607- Acne Classification: Washington, DC, March 24 and 25, 1990. J Am Acad Der- 33613. matol. 1991;24:495-500. 55. Wendling O, Chambon P, Mark M. Retinoid X receptors are essential for early 28. Goulden V, McGeown CH, Cunliffe WJ. The familial risk of adult acne: a com- mouse development and placentogenesis. Proc Natl Acad Sci U S A. 1999;96: parison between first-degree relatives of affected and unaffected individuals. Br 547-551. J Dermatol. 1999;141:297-300. 56. Chiba H, Clifford J, Metzger D, Chambon P. Distinct retinoid X receptor-retinoic 29. Walton S, Wyat EH, Cunliffe WJ. Genetic control of sebum excretion and acne: a acid receptor heterodimers are differentially involved in the control of expres- twin study. Br J Dermatol. 1989;121:144-145. sion of retinoid target genes in F9 embryonal carcinoma cells. Mol Cell Biol. 1997; 30. Fleischer AB, Feldman SR, Bradham DD. Office-based physician services pro- 17:3013-3020. vided by dermatologists in the United States in 1990. J Invest Dermatol. 1994; 57. Grimberg A, Cohen P. Role of insulin-like growth factors and their binding 102:93-97. proteins in growth control and carcinogenesis. J Cell Physiol. 2000;18: 31. Eichenfield LF, Leyden JJ. Acne: current concepts of pathogenesis and ap- 1-9. proach to rational treatment. Pediatrician. 1991;18:218-223. 58. Thacher SM, Vasudevan J, Chandraratna RA. Therapeutic applications for li- 32. Thiboutot DM. Acne: an overview of clinical research findings. Adv Clin Res. 1997; gands of retinoid receptors. Curr Pharm Des. 2000;6:25-58. 15:97-109. 59. Barbieri RL, Smith S, Ryan KJ. The role of hyperinsulinemia in the pathogenesis 33. Webster GF. Acne vulgaris: state of the science. Arch Dermatol. 1999;135:1101- of ovarian hyperandrogenism. Fertil Steril. 1988;50:197-212. 1102. 60. Cara JF. Insulin-like growth factors, insulin-like growth factor binding proteins 34. Green J, Sinclair RD. Perceptions of acne vulgaris in final-year medical student and ovarian androgen production. Horm Res. 1994;42:49-54. written examination answers. Australas J Dermatol. 2001;42:98-101. 61. Bebakar WM, Honour JW, Foster D, Liu YL, Jacobs HS. Regulation of testicular 35. Holt SA, Brand Miller JC, Petocz P. An insulin index of foods: the insulin de- function by insulin and transforming growth factor-beta. Steroids. 1990;55:266- mand generated by 100-kJ portions of common foods. Am J Clin Nutr. 1997; 270. 66:1264-1276. 62. De Mellow JS, Handelsman DJ, Baxter RC. Short-term exposure to insulin-like 36. Daly ME, Vale C, Walker M, Alberti KG, Mathers JC. Dietary carbohydrates and growth factors stimulates testosterone production by testicular interstitial cells. insulin sensitivity: a review of the evidence and clinical implications. Am J Clin Acta Endocrinol. 1987;115:483-489. Nutr. 1997;66:1072-1085. 63. Crave JC, Lejeune H, Brebant C, Baret C, Pugeat M. Differential effects of insulin 37. Zammit VA, Waterman IJ, Topping D, McKay G. Insulin stimulation of hepatic and insulin-like growth factor I on the production of plasma steroid-binding globu- triacylglycerol secretion and the etiology of insulin resistance. J Nutr. 2001;131: lins by human hepatoblastoma-derived (Hep G2) cells. J Clin Endocrinol Metab. 2074-2077. 1995;80:1283-1289. 38. Nam SY, Lee EJ, Kim KR, et al. Effect of obesity on total and free insulin-like 64. Singh A, Hamilton-Fairley D, Koistinen R, et al. Effect of insulin-like growth factor- growth factor (IGF)-1, and their relationship to IGF-binding protein (BP)-1, IGFBP-2, type I (IGF-I) and insulin on the secretion of sex hormone binding globulin and IGFBP-3, insulin, and growth hormone. Int J Obes Relat Metab Disord. 1997; IGF-I binding protein (IBP-I) by human hepatoma cells. J Endocrinol. 1990;124: 21:355-359. R1-R3. 39. Attia N, Tamborlane WV, Heptulla R, et al. The metabolic syndrome and insulin- 65. Pugeat M, Crave JC, Elmidani M, et al. Pathophysiology of sex hormone binding like growth factor I regulation in adolescent obesity. J Clin Endocrinol Metab. globulin (SHBG): relation to insulin. J Steroid Biochem Mol Biol. 1991;40:841- 1998;83:1467-1471. 849. 40. Brismar K, Fernqvist-Forbes E, Wahren J, Hall K. Effect of insulin on the hepatic 66. Vermeulen A, Kaufman JM, Giagulli VA. Influence of some biological indexes on production of insulin-like growth factor-binding protein-1 (IGFBP-1), IGFBP-3, sex hormone-binding globulin and androgen levels in aging or obese males. and IGF-1 in insulin-dependent diabetes. J Clin Endocrinol Metab. 1994;79:872- J Clin Endocrinol Metab. 1996;81:1821-1826. 878. 67. Pfeilschifter J, Scheidt-Nave C, Leidig-Bruckner G, et al. Relationship between 41. Holly JMP. The physiological role of IGFBP-1. Acta Endocrinol. 1991;124:55- circulating insulin-like growth factor components and sex hormones in a popu- 62. lation-based sample of 50- to 80-year-old men and women. J Clin Endocrinol 42. Ferry RJ, Cerri RW, Cohen P. Insulin-like growth factor binding proteins: new Metab. 1996;81:2534-2540. proteins, new functions. Horm Res. 1999;51:53-67. 68. Erfurth EM, Hagmar LE, Saaf M, Hall K. Serum levels of insulin-like growth fac- 43. Rudman SM, Philpott MP, Thomas GA, Kealey T. The role of IGF-I in human skin tor I and insulin-like growth factor-binding protein 1 correlate with serum free and its appendages: morphogen as well as mitogen? J Invest Dermatol. 1997; testosterone and sex hormone binding globulin levels in healthy young and middle- 109:770-777. aged men. Clin Endocrinol. 1996;44:659-664. (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1589 ©2002 American Medical Association. All rights reserved. 69. Zouboulis CC, Xia L, Akamatsu H, et al. The human sebocyte culture model pro- 79. Bettley FR. The treatment of acne vulgaris with tolbutamide. Br J Dermatol. 1961; vides new insights into development and management of seborrhoea and acne. 73:149-151. Dermatology. 1998;196:21-31. 80. Singh I, Gaind ML, Jayram D. Tolbutamide in the treatment of skin diseases. Br 70. Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors J Dermatol. 1961;73:362-366. have different effects on sebaceous cell growth and differentiation. Endocrinol- 81. Daniel M, Rowley KG, McDermott R, Mylvaganam A, O'Dea K. Diabetes ogy. 1999;140:4089-4094. incidence in an Australian aboriginal population: an 8-year follow-up study. Dia- 71. Klinger B, Anin S, Silbergeld A, Eshet R, Laron Z. Development of hyper- betes Care. 1999;22:1993-1998. androgenism during treatment with insulin-like growth hormone factor-I 82. Ebbesson SO, Schraer CD, Risica PM, et al. Diabetes and impaired glucose (IGF-I) in female patients with Laron syndrome. Clin Endocrinol. 1998;48:81-87. tolerance in three Alaskan Eskimo populations: the Alaska-Siberia Project. Dia- 72. Thiboutot D, Gilliland K, Light J, Lookingbill D. Androgen metabolism in seba- betes Care. 1998;21:563-569. ceous glands from subjects with and without acne. Arch Dermatol. 1999;135: 83. Merimee TJ, Rimoin DL, Cavalli-Sforza LL. Metabolic studies in the African Pygmy. 1041-1045. J Clin Invest. 1972;51:395-401. 73. Falsetti L, Eleftheriou G. Hyperinsulinemia in the polycystic ovary syndrome: a 84. O'Dea K. Marked improvement in carbohydrate and lipid metabolism in diabetic clinical endocrine and echographic study in 240 patients. Gynecol Endocrinol. Australian Aborigines after temporary reversion to traditional lifestyle. Diabetes. 1996;10:319-326. 1984;33:596-603. 74. Nestler JE. Insulin regulation of human ovarian androgens. Hum Reprod. 1997; 85. Mouratoff GJ, Scott EM. Diabetes mellitus in Eskimos after a decade. JAMA. 1973; 12(suppl 1):53-62. 226:1345-1346. 75. Thierry van Dessel HJ, Lee PD, Faessen G, Fauser BC, Giudice LC. Elevated se- 86. Spielman RS, Fajans SS, Neel JV, Pek S, Floyd JC, Oliver WJ. Glucose tolerance rum levels of free insulin-like growth factor-I levels in polycystic ovary syn- in two unacculturated Indian tribes of Brazil. Diabetologia. 1982;23:90-93. drome. J Clin Endocrinol Metab. 1999;84:3030-3035. 87. Salmeron J, Ascherio A, Rimm EB, et al. Dietary fiber, glycemic load, and risk of 76. Pasquali R, Casimirri F, Vicennati V. Weight control and its beneficial effect on NIDDM in men. Diabetes Care. 1997;20:545-550. fertility in women with obesity and polycystic ovary syndrome. Hum Reprod. 1997; 88. Frost G, Leeds A, Trew G, Margara R, Dornhorst A. Insulin sensitivity in women 12(suppl 1):82-87. at risk of coronary heart disease and the effects of a low glycemic diet. Metabo- 77. Ehrmann DA. Insulin-lowering therapeutic modalities for polycystic ovary syn- lism. 1998;47:1245-1251. drome. Endocrinol Metab Clin North Am. 1999;28:423-438. 89. Berrino F, Bellati C, Secreto G, et al. Reducing bioavailable sex hormones through 78. Cohen JL, Cohen AD. Pustular acne, staphyloderma and its treatment with tol- a comprehensive change in diet: the Diet and Androgens (DIANA) Randomized butamide. CMAJ. 1959;80:629-632. Trial. Cancer Epidemiol Biomarkers Prev. 2001;10:25-33. CME Announcement CME Announcement In mid-2003, online CME will be available for JAMA/ Archives and will offer many enhancements: • Article-specific questions • Hypertext links from questions to the relevant con- tent • Online CME questionnaire • Printable CME certificates and ability to access total CME credits We apologize for the interruption in CME and hope that you will enjoy the improved online features that will be available in mid-2003. (REPRINTED) ARCH DERMATOL / VOL 138, DEC 2002 WWW.ARCHDERMATOL.COM 1590 ©2002 American Medical Association. All rights reserved.
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DiscardedYKTTW Free City YKTTW Discussion
|Free City
An urban, commercial city-state with republican institutions
Typically a thriving metropolis, at least by Medieval Stasis standards, the Free City may answer to a monarch in some sense, but if so its charter provides it with a lot of autonomy, or it may answer to no monarch at all, being a city-state, possibly joined in a loose confederation. In lieu of royal leadership, don't expect democracy, though. Perhaps it is ruled by an aristocratic senate, perhaps the city is run by a group of guilds (which is to say well-off masters within those guilds, not struggling apprentices or journeymen), perhaps it is run by a wealthy Big Screwed-Up Family, or perhaps it is ruled by a tyrant who assumes no royal titles while being no less an autocrat. (The tyrant could actually be more benevolent toward the ordinary people of the city than the oligarchic rule of a hereditary senate or elite guild council.) Democracy isn't impossible either, but it isn't to be expected. Expect the inhabitants of the city to be less obsessed with honor, religious piety, and tradition than the rural, monarchic societies around them, and more interested in getting rich and enjoying cultural creativity. Free Cities may be, loosely, a Fantasy Counterpart to The Republic, and might be the home of a Proud Merchant Race. A Free City also has a good chance of being a Merchant City. However, while The Republic is often the protagonist-state in more modern settings, the Free City is more morally ambiguous: rarely as evil as The Empire, but often showing a certain corrupt, venal, cowardly aspect compared to the heroic knights of The Kingdom.
- In Chronicles of the Kencyrath, Tai-tastigon
- In The City & the City, Beszel and Ul Qoma.
- In Discworld, Ankh-Morpork (which appears in most books) and Ephebe (which appears far more rarely). Ankh-Morpork is more renaissance, while Ephebe more classical.
- In The Edge Chronicles, Undertown is a city created specifically as a haven of freedom and civilization, although it's ruled by corrupt merchants.
- In the Elenium, the city of Chyrellos is a free city (the fantasy equivalent of Vatican City)
- The Fafhrd and the Gray Mouser series featured the powerful central city of Lankhmar, which not only had its own independent ruler, it even had its own gods.
- In Gor, the basic civilized governmental unit is the city-state a la Greece, with some cities becoming more state-like a la Rome.
- In The Hobbit, Lake-Town (a.k.a. Esgaroth), at least until the evil republican officials prove their greed and uselessness and the rightful hereditary king is restored to his throne.
- In Neverness, the City of Neverness.
- In Perdido Street Station, New Crobuzon.
- In A Song of Ice and Fire, The Free Cities across the Narrow Sea.
- In Swordspoint, there is a nameless city.
- In Dungeons & Dragons, Waterdeep and Ravens Bluff in the Forgotten Realms campaign setting and the Free City of Greyhawk in the Greyhawk setting.
- In GURPS, Tredroy.
- In 7th Sea, Freiburg. The feudal prince who nominally reigns is a figurehead.
- In "Warhammer", the Free City of Marienburg: a rich port city which bought its independence from the Empire during the reign of a weak Emperor who was deposed shortly afterwards.
- In Dragon Age II, the Free Marshes are a loose confederation of Free Cities.
- In Order Of The Stick, Cliffport seems to be one.
- In Avatar: The Last Airbender, Omashu. Yes its ruler is called the king, but said king is a benevolent tyrant who reigns over a fairly advanced city.
- It's implied that the entire Earth Kingdom is a loose collection of such cities.
- The city-states ("poleis") of Ancient Greece (mostly Delian League cities rather than Sparta)
- The imperial free cities of the Holy Roman Empire, especially those in the Hanseatic League
- The cantons of medieval Switzerland
- the city-states of Italy in The Renaissance. (as well as Venice, a republican city-state from the midst of the Dark Ages.)
- Novgorod prior to Russian annexation. (Although documentation on this instance is a little spotty.)
- The seafaring, mercantile Kalinga republic prior to its conquest by Ashoka and the Mauryan Empire. (Documentation on this is even spottier.)
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subset: commoncrawl


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Why CancellationException is runtime exception?
I get a Future instance via ExecutorService.submit(Callable task).
The task may be very time-consuming, so at some time, user may cancel the task by calling method Future.cancel() in another thread, e.g Swing EDT.
It's possible that no one knows the task is cancelled, so some codes still call method Future.get() to try to get the task result, then a CancellationException is thrown.
But unfortunately, the codes don't handle the exception, because it just be runtime exception, and Future.get() doesn't throw it.
Why CancellationException is not checked exception?
In fact, the other get method, Future.get(long timeout, TimeUnit unit), would throw TimeoutException, which is checked exception.
I think it's common case that a task is cancelled at runtime, so it's necessary to force application codes to handle the exception, or the application will doesn't work.


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Notice: The event scheduled for June 22-23 at OCN's Panther Lake has been postponed but we will return next month.
Next Event: Summer Series Event #2
Location: Orange County National (Crooked Cat)
Date: July 28-29, 2015 (Tuesday-Wednesday)
Entry Deadline: Monday, July 20th @ 5pm (ET)
Minimum Field size required: 30 Players
36-Holes (Stroke Play) No Cut
Entry Fees: Any / All Professionals....$320.00
Amateur: $280.00 (Must Have a USGA HDCP. of 5 or less).
Anyone interested in playing should contact the FPGTour office at 407-619-4778 for more information
Go to the "Tee-Times" page to view the Player List
The 2015 Winter Series Finale
Host site: Eagle Dunes Golf Club...Sorrento, FL
April 23-24 (Thursday-Friday)
Field size : 46 Players
Sorrento, FL
Ross Beal of Orlando fired a second consecutive round of -6 under 66 to capture the FPGTour's Winter Series Finale at Eagle Dunes.
Danny Ellis (the 2009 Ocala Open Champion) from Heathrow, FL finished three shots back at -9 to finish alone in second.
This concludes the FPGTour's Winter Tournament program but we will return in June for a new Limited Summer Tournament Schedule......Thanks to all our FPGTour members and guests for their continued support in making this past Winter a great success.
Full Field Final Results can be found on the "Results Page".
Congrats to the following FPGTour players who now have exempt status on PGA Tour Canada:
Ross Beal
Kyle Wilshire
Jared Wolfe
Zack Byrd
Wade Binfield
Chase Marinell
and the following Players who earned Conditional Status:
Jean-Philip Cornellier
Vaita Guillaume
Cody Martin
Brendan Kelly
Drew Preston
Owen Curry
Max Gilbert
Brett Cairns
Chris Kennedy
Don Leafstrand
Winter Springs Classic @ Tuscawilla
Date: April 6-7, 2015 (Monday-Tuesday)
Host Professional: David Huebsch
Course Info: 6,851 yds. (Par 72) (Private Facility)
Winter Springs, FL
Jason Millard of Murfreesboro, TN captured the Winter Springs Classic firing back to back rounds of 68 and finished at -8 under par. Jason's margin of victory was just one-shot over Connor Godsey, overnight leader Kevin Gillick, and Daniel Kim.
The rain fried the Tournament Director's computer, so Official results with Money distribution will be loaded to the web site on Wednesday. We apologize for the inconvenience.....Mother Nature got us today.
FYI......145 earned last place Money
Full Field Final Results are now available on the "Results Page".
Notice: OTM Results have been corrected and payout adjusted to include a player I mistakenly omitted from that field....
Notice: Please be sure to check the "Tour News
and Updates" page for important information....
2015 Daytona Beach Open
Site: Daytona Beach Golf Club (North Course)
March 20-22, 2015
Field size: 110
Daytona Beach, FL
Jeff Dennis of Jacksonville, FL captured the 2015 Daytona Beach Open with rounds of 67-63 for a two day total of 130 (-14 under par). Jeff fired a remarkable -9 under par final round to come from four shots back and win this Championship.....
His margin of victory was one shot over Eric Cole of Tequesta, FL and Tim Crouch of Mt. Vernon, OH
As a side note....While Jeff was working his magic in Daytona Beach, FPGTour member Matt Every was doing the same in Orlando at Arnold Palmer's Bay Hill Invitational....Matt successfully defended his title on Sunday at the famed Bay Hill Club.....
Congratulations to both Matt and Jeff on some great golf this weekend.
Go to the "Results Page" for full field Final Results
2015 Ocala Open Championship @ Candler Hills Golf Club
Ocala, FL
Dan McCarthy of Syracuse, NY fired a closing round of 7 under par 63 in todays final round to capture the 2015 Ocala Open. He finished just one shot ahead of overnight leader Tim O'Neal, along with Rd.2 leader Adam Schenk, and 2014 Ocala Champion Patrick Sheehan.
The victory was Dan's first on the Florida Professional Golf Tour and earned him the first place check of $12,000.00
The FPGTour heads North next weekend for the 2015 Daytona Beach Open.
Rd.1Rd.2Rd.3TotalWinningsDan McCarthy69 62 63 194 $12,000.00 Adam Schenk63 65 67 195 $5533.33 Patrick Sheehan65 6367 195$5533.33 Tim O'Neal666168 195 $5533.33Kevin Aylwin68 64 65 197 $3200.00 Nick Lindheim67 63 68 198 $2450.00 Chris Trunzer65 64 69 198 $2450.00Bo Hoag7064 65 199 $1500.00 Tommy Schaff66 65 68 199 $1500.00Derek Bohannon696763 199 $1500.00 Eric Cole65 66 69 200 $1260.00Connor Godsey70 63 67 200 $1260.00 Drew Stoltz66 66 68 200 $1260.00 Casey Pyne65 70 66 201 $1203.33 Bubba Dickerson65 68 68 201 $1203.33Daniel Mazziotta67 64 70 132 $1203.33
Full Field Final Results can be found on the "Results Page".
Please go to the "Results" page for Full Field Final Results
This week: Crane Lakes Invitational & Pro-Am
Location: Crane Lakes CC....Port Orange, FL
Friday: Pro-Am Day
Saturday-Sunday: Championship
Defending Champion: Jon Mansfield
Port Orange, FL
For the second straight week it took four extra holes to determine a champion in Sudden-Death.
Nick Lindheim, Kevin Aylwin, Nathan Kimsey, and Jeff Sorenson finished the 36-Hole event tied at -5 under par 127. On the fourth extra hole, Lindheim sank a 15 foot Eagle putt to claim the victory.
More to come later.....Thanks
Please go to the "Results" page for Temporary Final Results....
2015 Wildwood Open
Saturday-Sunday, February 21-22
Wildwood, FL
Tim O'Neal of Savannah, GA has won the 2015 Wildwood Open after beating Charlie Delsman and Eric Cole in a Sudden Death Play-Off that lasted 4 holes. O'Neal made Birdie on the final play-off hole to win the event in darkness.
A special "Thanks" to Steve Wresh, PGA Head Professional and the Members and Volunteers of Continental Country Club for their generosity.
As a side Note: This years Winner of the Annual drawing for a Free Entry into the Ocala Open:
Mr. Jackson Davison of Rockford, MI
Congrats Jackson, see you at the Ocala Open
The FPGTour heads north to Crane Lakes CC in Port Orange, FL next weekend for the 2nd Annual Crane Lakes Invitational and Pro-Am.... Jon Mansfield of Clearwater, FL is the Defending Champion.
Rd.1Rd.2TotalWinnings**Tim O'Neal68 65 133 $3100.00 Eric Cole64 69 133 $2000.00 Charlie Delsman64 69 133 $2000.00 Shawn Warren70 66 136 $1333.33 Jared Wolfe69 67 136 $1333.33 Joe Harney66 70 136 $1333.33 Kevin Gillick70 67 137 $950.00 Casey Pyne65 72 137 $950.00 Robert Taylor67 70 137 $950.00 Will McCurdy70 67 137 $950.00
Please go to the "Results Page" for Full Field Results....
2015 2-Man Team Championship
Thursday-Friday, February 12-13
Location: Stoneybrook East Golf Club....Orlando, FL
Field Size: 44 Teams
Format: Rd.1 (2 -person Scramble)
Rd.2....(Four-Ball) Stroke Play
The Team of Michael Kinkopf and Alex Redfield both from Columbus, OH won the 2015 2-Man Team Championship with rounds of 61-62 for a -21 under par total of 123 to win by a single stroke.
The pair found themselves sitting 3 strokes behind the leaders after Rd.1 but went out in the 4-Ball format on day two and fired a -10 under par 62
The FPGTour heads to Continental Country Club next weekend for the 2015 Wildwood Open and Pro-Am
Rd.1Rd.2TotalWinningsMichael KinkopfAlex Redfield61 62 123 $1500.00 ea.Mitch GrayZak Drescher 58 66 124 $1000.00 ea. John Balmer IIIBobby West58 66 124 $1000.00 ea.
Michael Kinkopf
Alex Redfield
Mitch Gray
Zak Drescher
John Balmer III
Bobby West
Please go to the "Results Page" for Full Field Final Results
The 2015 Indian River Open
Site: New Smyrna Beach Golf Club, New Smyrna, FL
Date: Saturday- Sunday, February 7-8, 2015
Field Size: 134
New Smyrna Beach, FL
Jacksonville resident Jared Wolfe opened the IRO Championship with -8 under par 64 then followed that with a final round 68 (that included back to back double-bogey's) on 15 and 16, and a three putt par on 18 to win by one over Nick Lindheim.
This was Jared's first win on the FPGTour.....
The Tour heads to Orlando next Thursday-Friday for the 2015 2-Man Team Championship at Stoneybrook East Golf Club.
Full Field Temporary Results are available on the Results
The 2015 Volusia County Open....New Smyrna Beach, FL
Hosted By Venetian Bay Golf Club
2014 POY and leading money winner Nick Lindheim of Sattelite Beach, FL came out firing on all cylinders in todays final round following up his opening round of -3 under 69 with a -9 under par 63 to capture the 2015 Volusia County Open. Lindheim came from six strokes back of first round leader Jason Millard who opened with 63 but could only muster a -1 under round of 71 in the finals to end up in 3-way tie for second place -10 with Don Leafstrand and Kevin Aylwin .
The FPGTour has next week off before heading back to New Smyrna Beach for the 2015 Indian River Open scheduled for February 7-8.
Rd.1Rd.2TotalWinningsNick Lindheim6963 132 $2600.00Don Leafstrand67 67 134 $1333.33 Kevin Aylwin68 66 134 $1333.33 Jason Millard63 71 134 $1333.33 Casey Pyne70 67 137 $900.00 Ross Beal70 67 137 $900.00 Jeff Dennis69 68 137 $900.00
Please go to the "Results Page" for Full Field Final Results
2015 Kissimmee Open
Saturday-Sunday, January 17-18
Kissimmee, FL
Logan Blondell of Lakeland, FL captured his first Title on the Florida Professional Golf Tour winning the 2015 Kissimmee Open with rounds of 69-66 for a -9 under par total of 135.
Scott Berliner, Jeff Sorenson, Aaron Murphy, Rob Oppenheim, and Jared Wolfe all finished the event 2-shots back at 137 for a 5-way tie for 2nd place.
124 Players returned scores in this event.
The FPGTour heads north to New Smyrna for the 2015 Volusia County Open scheduled for next Saturday-Sunday, January 24-25
Full Field Final Results are available on the "Results Page"..
Black Bear Golf Club.....Eustis, FL
Monday-Tuesday...January 12-13, 2015
Eustis, FL
Nick Lindheim of Sattelite Beach, FL successfully defended his title today at Black Bear firing rounds of 65+66 for a two day total of -13 under par. This is the 3rd straight year Nick has won this event.
After heavy rains forced officials to suspend play in round one leaving 40+ competitors on the back nine, play resumed at 7:45am on Tuesday morning with those stranded on the back side left to clean up their first round, and without a re-pair, allowed the rest of the field to start their 2nd rounds also at 7:45 off the first tee.
All went well and the event finished without a hitch.
Low round of the day came from Chris Brant who finished in 2nd place with rounds of 70-65.
The FPGTour heads to the Kissimmee Golf Club for the 2015 Kissimmee Open scheduled to begin on Saturday, January 17. There are 128 competitors entered in the event.
Go to the "Results Page" for Full Field Final Results
This week: New Years Open @ Disney World
The Palm Course
Par 72
Yardage: 6870
Course Architect... Joe Lee
Saturday-Sunday, January 3-4, 2015
Lake Buena Vista, FL
Charlie Delsman of Colgate, WI captured the 2015 New Years Open at Disney World's Palm Course firing rounds of 68-66 for a two day total of 10 under par. His margin of victory was three shots over Willie Mack III, Yohann Benson, and last years POY Nick Lindheim, who all finished the event at -7 under par.
The FPGTourheads to Black Bear in Eustis for Event #8 on January 12-13 (Monday-Tuesday)....Defending Champion is Nick Lindheim of Sattelite Beach, FL
Rd.1Rd.2TotalWinningsCharlie Delsman6866 134$2700.00Nick Lindheim6968 137 $1433.33 Willie Mack III67 70 137 $1433.33 Yohann Benson7067 137 $1433.33 Tim O'Neal68 70138 $1050.00Eric Cole67 71 138 $1050.00 Bubba Dickerson68 71 139 $850.00 Jacob Tilton6772 139 $850.00 Scott Berliner71 69 140 $700.00 Craig McCoy68 73 141$575.00 Chris Brant68 73 141 $575.00
Full Field Final Results are now available on the "Results Page"
Lake Buena Vista @ Disney
Thursday-Friday Dec. 11-12, 2014
Field Size: 92 Players
Lake Buena Vista
Wow...What a final round....Kinda cold but not for everyone.
Chris Cho of Kent, WA pulled off the come back of year at Disney's LBV course. After firing an opening round of +1 (73) and being two shots out of the money, Chris set his sites on just trying to play well enough to maybe eek out a check from the bottom of the almost $20,000 purse. With all players starting the final round off the 10th tee, Chris turned his front nine in 3 under par carding 33 and now putting him close to his goal of making that check at 2 under for the Championship. But he wasn't finished, in fact he was just getting warmed up.
Things got a little interesting after he made Eagle 3 at his 10th hole, he added 5 more birdies for 29 to fire a closing round of ten under 62. His -9 under par total was good enough for a two shot margin of victory.
He is now the first player ever to be eligible for the OTM 2nd Day event (which for those of you who don't already know) means after round one your not sitting all that pretty as far as making money for this event, anyway, he is now the first person in that position to come from so far behind and actually win the Championship. Quite an accomplishment.
Congrats to Chris on a fantastic final round of golf.
Also, congrats go out to Drew Preston who fired an impressive closing round of -8 under 64 to finish in a 6-way tie for 2nd place.
And as a side note: For those of you who recognize that last name, but can't remember exactly why ....Chris is the younger brother of my dear friend and FPGTour assistant for so many years....Christine
And I'm sure she's smiling in Seattle right now.
Rd.1Rd.2TotalWinningsChris Cho73 62 135 $2750.00David Lawrence67 70 137 $1216.67 Charlie Delsman67 70 137 $1216.67 Patrick Sheehan67 70 137 $1216.67 Drew Preston7364 137 $1216.67 Jared Wolfe7265 137 $1216.67 Yohann Benson7067 137 $1216.67 Josh Manske 71 67 138 $800.00 Chris Mory69 70 139 $587.50 Brian McDonough73 66 139 $587.50 Roger Rowland 67 72 139 $587.50 Dylan Newman69 70 139 $587.50
Please go to the "Results Page" for Full Field Final Results
Next Weeks Event at Grand Cypress has been Temporarily postponed. The FPGTour will make every effort possible to re-schedule the event at a later date. Sorry for the inconvenience.
The 54th Annual Riviera Open
Riviera Country Club
Ormond Beach, FL
Par 71
Ormond Beach,
Charlie Delsman has won the 54th Annual Riviera Open with rounds of 63-68 to finish at -11 under par and secure a two stroke victory over Ross Beal and Eric Cole.
A special thanks go out to the Meyer's family and their staff at Riviera Country Club for another fantastic Championship.
In the senior Division, John Elliott of Providence, RI fired rounds of 69-66 (-9 under par ) to win by 4 strokes over Mark Bucek. Elliott picked up an additional $1200.00 for the Sr Div. win while Bucek took home $900. Don Bell of Port Orange finished 3rd and earned $600.
Three players tied at +2 and rounded out the Sr. pay out taking home $233.33. They were Mike Beaver, John VanWart, and Gerry James.
The Regular Division skin game (Carried over from Round One paid out two skins today.
Hole # 10.....(2)......Theo Betz.......$920.00
Hole # 13.....(3).....J.C. Horne.......$920.00
The FPGTour heads to Disney World for next weeks event hosted by the Lake Buena Vista course.
Thanks for your support......
Rd.1Rd.2TotalWinningsCharlie Delsman63 68 131 $2700.00 Ross Beal67 66 133 $1450.00 Eric Cole65 68 133 $1450.00 Nick Lindheim67 67 134 $1100.00 Scott Berliner6768 135 $900.00 Jeff Dennis6471 135 $900.00 John Elliott6966 135 $900.00 Josh Manske68 68 136 $675.00 John Balmer III7066 136 $675.00 Jason Millard 69 67 136 $675.00 Chas Narramore67 69 136 $675.00
Please go to the "Results Page" for Full Field Final Results
The 2014 Thanksgiving ClassicHosted by Terry Govern, PGA at Green Valley CCClermont, FL Saturday-Sunday, November 29-30 Clermont, FL John Balmer III of Ocala, FL fired back to back 68's to capture the 2014 Thanksgiving Classic by one shot over Eric Cole of Tequesta, FLAll in all it was a great weekend that drew a field of 73 competitors. Thanks go out to everyone associated with Green Valley Country Club for their hospitality. We will return next year for another great weekend of golf. The FPGTour heads north to Ormond Beach next week for the 54th Annual Riviera Open. PlayerRd.1Rd.2TotalWinningsJohn Balmer III6868136 $2100.00Eric Cole6770 137 $1500.00 Patrick Sheehan7267 139$1200.00 Greg O'Mahony70 70140 $775.00 Chris Cho7268 140 $775.00 David Lawrence7268 140 $775.00 Nick Lindheim70 70 140 $775.00 Bobby West68 73 141 $500.00 Peter Campbell6972 141 $500.00 Aaron Sherry7269 141 $500.00 Please go to the "Results Page" for full field final results... Event #2 @ Sweetwater Country ClubNovember 18-19, 2014 (Tuesday-Wednesday)Sweetwater is located in Longwood, FL Longwood, FL Kyle Wilshire of Georgetown, KY fired a closing round of 69 to claim his first FPGTour victory at Sweetwater Country Club. Kyles 2-day total of 135 (-9 under par) was good for a 5 stroke margin of victory over Bobby West from Watertown, SD. The FPGTour heads to Green Valley Country Club in Clermont, FL for the Thanksgiving Weekend Classic on November 29-30. Rd.1Rd.2 TotalWinningsKyle Wilshire66 69 135 $2250.00 Bobby West70 70 140 $1600.00 Charlie Delsman 69 72 141 $908.33 Jeff Bors73 68 141 $908.33 Willie Mack III7071 141 $908.33 Patrick Sheehan7368 141 $908.33 Eric Cole75 66141 $908.33 Scott Berliner73 68 141 $908.33 Bobby Gage71 72 143 $575.00 Patrick Lamb73 70 143 $575.00 Please Go to the "Results Page" for full field final Results..... The Results Page is acting funny, Just scroll down, all scores and results are there.......Sorry for the less than fantastic Microsoft Operating system....This is why someone created the Mac The Florida Professional Golf Tour's2014-2015 Season Opener 54-Hole Stroke Play EventNovember 9-11, 2014Alaqua Country ClubPar 72 6400 yds.Longwood, FL The 36 Hole cut came at 143.... Jacob Tilton of Evans, GA is the 2014 "Season Opener Champion" firing rounds of 70-64-65 for a 11 under par total of 199 to win by two strokes. Tilton came from two back to grab victory by two shots from Eric Cole of Tequesta, FL. who finished at 201 (-9) Jeff Sorenson, PGA member from Blaine, MN finished alone in 3rd at 7 under par 203. The FPGTour heads to Sweetwater CC next week for the second event of the season. Patrick Sheehan is the defending champion. Rd. One Skins Report...Hole #13.....(3)....Josh Salah.......$700Congrats to Josh for the only Skin out in Rd.1 There were NO skins awarded in Rd.2....All those entered in the skins game will receive skins credit...... Round 3 Skins report....Hole # 15...(2)....Joe Juszczyk......$400 Rd.1Rd.2 Rd.3TotalWinningsJacob Tilton706465 199$9850.00Eric Cole66 6669 201 $1800.00Jeff Sorenson666770 203$1500.00Jackson Davison727163 206 $1250.00Jackson Koert6868 70 206 $1250.00Paul Wackerly716769 207 $962.50Jason Millard677169 207 $962.50Casey Pyne686772 207$962.50Anthony Degol 6670 71 207$962.50 Bobby West 69 68 71 208 $775.00 Jared Wolfe657370 208$775.00 Go to the "Results" Page for Full Field Final Results Please remember to check the "Tour News and Updates" page every time you visit for important updates. Players may use any of the following methods of payment to submit membership fees and entries: We accept the following forms of payment....MasterCard, Visa, American Express, Discover, Bank Drafts, Cashiers Checks, and Money Orders.Please Note: All Credit Card transactions carry a new 3.5% convenience fee.Credit card payments can be made by phone or on-site. Cash is also accepted for entries on-site at each event with the exception of the 2015 Ocala Open. Personal checks drawn on (U.S. Banks only) will also be accepted for Membership dues and entry payment by FPGTour members only. For more information on the FPGTour contact:Rick Hendershot at firstname.lastname@example.com Below is the NEW tour mailing address: The FPGTour,LLCc/o Rick Hendershot, PGA P.O. Box 916473 Longwood, FL 32791-6473 Players are encouraged to call the following telephone number to enter any event listed on our schedule...Rick Hendershot...407-619-4778We accept the following credit cards:
Here's some important information below....or you can use the contact us page located in the menu above, fill out the form and hit submit....We will contact you.Thanks for visiting the web site...The FPGTour, LLCDBA / Florida Professional Golf Tour c/o Rick Hendershot, PGA P.O. Box 916473 Longwood, FL 32791-6473 407-619-4778 Please remember to check the "Tour News and Updates" page every time you visit for important updates. Players may use any of the following methods of payment to submit membership fees and entries: We accept the following forms of payment....MasterCard, Visa, American Express, Discover, Bank Drafts, Cashiers Checks, and Money Orders.Please Note: All Credit Card transactions carry a new 3.5% convenience fee.Credit card payments can be made by phone or on-site. Cash is also accepted for entries on-site at each event with the exception of the 2015 Ocala Open. Personal checks drawn on (U.S. Banks only) will also be acceptedfor Membership dues and entry payment by FPGTour members only. For more information on the FPGTour contact:Rick Hendershot at email@example.com Below is the NEW tour mailing address: The FPGTour,LLCc/o Rick Hendershot, PGA P.O. Box 916473 Longwood, FL 32791-6473 Players are encouraged to call the following telephone number to enter any event listed on our schedule...Rick Hendershot...407-619-4778We accept the following credit cards:
Here's some important information below....or you can use the contact us page located in the menu above, fill out the form and hit submit....We will contact you.Thanks for visiting the web site...The FPGTour, LLCDBA / Florida Professional Golf Tour c/o Rick Hendershot, PGA P.O. Box 916473 Longwood, FL 32791-6473 407-619-4778 The Florida Professional Golf Tour uses ScoreCast Tournament Software exclusively for all their scoring solutions.All Tournament results are generated using:
Here's some important information below....or you can use the
contact us page located in the menu above, fill out the form
and hit submit....We will contact you.
Here's some important information below....or you can use the contact us page located in the menu above, fill out the form
Continental Country Club...Wildwood, FL
$5000 added money sponsor...
Wildwood Open and Pro-Am
February 20-22, 2015
2014 Champion...Drew Preston....Ada, MI
2015 Ocala Open Champion
Dan McCarthy....Syracuse, NY
2014 Champion................Patrick Sheehan
2013 Champion................Travis Hampshire
2012 Champion................Yohann Benson
2011 Champion................Ted Potter Jr.
2010 Champion................Ted Potter Jr.
2009 Champion................Danny Ellis
2008 Champion................Travis Hampshire
2007 Champion................Rod Perry


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F700GS cross country road trip preparation
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Pig. Can. Fly.
Joined: Mar 2009
Location: TBD...
Oddometer: 3,084
Originally Posted by
Zeke Markham
What is the 6K service for? Oil? Why not do it yourself, save money and time. If that's not an option though, while going from Bonneville to Death Valley, it might be worth it to stop in Vegas or Reno depending on your route for the service, Long Beach BMW is really expensive.
And are you planning on staying in San Francisco, or going back to NJ? If going back to NJ you might want to up your mileage estimate a bit. Going straight through on the freeway is about 3K one way, add in detours and fun roads and it'll be more.
Not trying to discourage or anything of the sort, just trying to help out.
Any idea how much the service in Vegas? $205 isnt too bad for CA, especially for a little piece of mind. Most BMW dealers seem to give a bit more attention to those traveling and passing through. Where would you dispose of oil and filter?
jmrobyou, if you need a contact in SoCal shoot me a PM.
"There's a force in the universe that makes things happen. All you have to do is get in touch with it, stop thinking, let things happen, and be the ball." - Ty Webb
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Jason drove in NASCAR for 13 years after winning 3 straight USAC Silver Crown ... Watch Video Date: 12/16/2012 Title: Revolutionary Motorsports Crashes Onboard Angles 3 Description: This is the Revolutionary Motorsports Crashes: Onboard Angles 3. This video contains crashes that were filmed using onboard and in-car video cameras placed ... Watch Video Date: 8/20/2012 Title: WTF Moments in NASCAR 11 Description: This is the 11th remake of the WTF Moments In NASCAR series. Clips are owned by nascarvideoarchive, battalianfan888, goduckcargo99, EJ4060, ... Watch Video Date: 7/14/2012 Title: Revolutionary Motorsports Crashes Amateur Angles 8 Description: This is the Revolutionary Motorsports Crashes: Amateur Angles 8. This video contains crashes that were filmed on home video cameras. I DO NOT claim and of ... Watch Video Date: 5/25/2012 Title: Lost Racing Legends (Indianapolis 500) Description: WARNING* This video contains images of fatal racing crashes. A Film From Nothingman. 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Watch Video Date: 4/8/2012 Title: Revolutionary Motorsports Crashes Amateur Angles 7 Description: This is the Revolutionary Motorsports Crashes: Amateur Angles 7. This video contains crashes that were filmed on home video cameras. I DO NOT claim and of ... Watch Video Date: 4/1/2012 Title: A Tribute to Jason Richards Description: This is bradk12fan's Tribute to Jason Richards. Jason Richards started racing when he was 8 in New Zealand. Jason Richards would win only 1 race in V8 ... Watch Video Date: 2/1/2012 Title: Revolutionary Motorsports Crashes Onboard Angles Special Description: This is the Revolutionary Motorsports Crashes: Onboard Angle Special. This video contains crashes that were filmed using onboard and in-car video cameras ... Watch Video Date: 1/1/2012 Title: A Tribute to Richie Evans Description: This is bradk12fan's tribute to The King of the Modifieds, Richie Evans. Richie Evans started racing in 1962 at Utica-Rome Speedway. Richie Evans won the ... Watch Video Date: 12/21/2011 Title: Revolutionary Motorsports Crashes Amateur Angles 6 Description: This is the Revolutionary Motorsports Crashes: Amatuer Angles 6. This video contains crashes that were filmed on home video cameras. I DO NOT claim and of ... Watch Video Date: 12/4/2011 Title: A Tribute to Rick Huseman Description: This is bradk12fan's tribute to Rick Huseman. Rick Huseman started racing in 1999. Rick Huseman was a 2-time Champion in what is now the Traxxas TORC ... Watch Video Date: 11/19/2011 Title: Revolutionary Motorsports Crashes Amatuer Angles 5 Description: This is the Revolutionary Motorsports Crashes: Amatuer Angles 5. This video contains crashes that were filmed on home video cameras. I DO NOT claim and of ... Watch Video Date: 11/4/2011 Title: A Tribute to Francois Cevert Description: Tribute from Nothingman. Albert Francois Cevert was born on February 25, 1944 in Paris France. At 16 he was racing scooters with his friends on the streets of ... Watch Video Date: 10/22/2011 Title: A Tribute to Dan Wheldon Description: Last Sunday, the motorsports world stood still. Everyone was glued to the Indycar race in Las Vegas on their tvs, the internet, and the radio, hoping and praying ... Watch Video Date: 10/13/2011 Title: A Tribute to Bobby Hamilton Sr. Description: This is bradk12fan's tribute to Bobby Hamilton Sr. Bobby Hamilton Sr. started out racing late models in Nashville. He got his chance in NASCAR when he ... Watch Video Date: 10/1/2011 Title: WTF Moments in NASCAR 10 Description: This is the 10th remake of the WTF Moments In NASCAR series. Clips are owned by daMOOSEisLOOSE, pacmancucumber1783, OldSchoolNascar, CO024, ... Watch Video Date: 9/17/2011 Title: Revolutionary Motorsports Crashes 38 Remake Description: This is the Remake of 38th crash compilation in the Revolutionary Motorsports Crashes Series. I DO NOT claim and of the footage, clips, or music in this video as ... Watch Video Date: 9/4/2011 Title: Revolutionary Motorsports Crashes Amatuer Angles 4 Description: This is the Revolutionary Motorsports Crashes: Amatuer Angles 4. This video contains crashes that were filmed on home video cameras. I DO NOT claim and of ... Watch Video Date: 8/27/2011 Title: Revolutionary Motorsports Crashes 34 Remake Description: This is the Remake of 34th crash compilation in the Revolutionary Motorsports Crashes Series. I DO NOT claim and of the footage, clips, or music in this video as ... Watch Video Date: 8/21/2011 Title: WTF Moments in NASCAR 9 Description: This is the 9th remake of the WTF Moments In NASCAR series. Clips are owned by yacinemomo, anonymousjoe9, heymistahdj, gibbysgarage, ... Watch Video Date: 8/18/2011 Title: Revolutionary Motorsports Crashes 3 2011 Remake Description: This is the 3rd crash compilation in the Revolutionary Motorsports Crashes Series. I DO NOT claim and of the footage, clips, or music in this video as my own. 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Articles tagged dailey and vincent
18 Dec 2008 // 9:00 PM
The year's best bluegrass music is chock full of harmonies that recall classic dueting brothers, tight-knit family pickin', and even bluegrass for people who don't like bluegrass.READ more
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Colette Carr "Static" (video) (Premiere) // Music
House of Blondes "First of July" (audio) (premiere) // Music
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A project that I am currently working on requires a USB stick plugged into the Raspberry Pi Model A USB port. All of the writes go to the USB stick and not the SD card with the operating system. In theory when the SD card is write protected the card will last longer. Since (most) USB drives come with some software installers, I wanted to have a clean drive to work with. The one I got was a 16GB PNY miniature USB from Best Buy for $8.
It came formatted as FAT32 and this one did not have any additional files on it, but just to be on the safe side I re-formatted the drive. Keeping it as FAT32, because this file system has read and write capabilities with Linux, Mac, and Windows. At this point, power on the Raspberry Pi but keep the USB drive unplugged. Since the Model A does not have a network port, I used the USB Console Cable available from Adafruit. This worked perfectly because it kept the single USB port open.
To start lets make a folder under the pi users home for where we can mount the USB drive later and can be written to and read from.
mkdir /home/pi/usb
After connecting the console cable and connecting via the serial interface, I was able to log in and run the commands to check what was mounted.
sudo blkid
The output should show the SD card mounted, then after plugging in the USB drive you should see another line added that looks similar to this
/dev/sda1: LABEL="Untitled" UUID="7E4F-6DA1" TYPE="vfat"
Next we need to edit the file systems table. To do this you can use your favorite terminal text editor, for me I like nano.
sudo nano /etc/fstab
Add this line to the end of the file. This tells the OS to mount the device sda1 to the folder /home/pi/usb. Giving permissions for reads and writes to the default pi user. (note that the line is broken into two, it should be all on one on Pi):
/dev/sda1 /home/pi/usb vfat uid=pi,gid=pi,umask=0022,sync,auto,nosuid,rw,nouser 0 0
Then save the document (crtl+x / y) and exit the text editor. After a reboot of the pi, you can test it by creating a simple text document. If everything went smoothly, when the Pi is shutdown and the USB drive is removed the document should be able to be opened on another computer.


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- ITV Report
Live updates
- ITV Report
Wales weather: A soggy end to a super week!
Well a fabulous day today has ended on a spectacularly soggy note for some! Heavy rain, hail and thunder will work northwards overnight!Read the full story ›
- ITV Report
Wales weather: Brace yourselves!
Much of Wales is bathed in warm sunshine at the moment, but be warned! It is about to come to an abrupt end overnight!Read the full story ›
Severe weather warning for the whole of Wales
The Met Office says isolated heavy, and possibly severe, thunderstorms are expected to develop on Friday evening across parts of Wales.
It says some torrential downpours are possible leading to localised surface water flooding.
Hailstorms and frequent lightning are also possible hazards.
It says the public should be aware that there is a chance of some very localised significant disruption.
The yellow 'be aware' warning is in force from 7pm to midnight.
- ITV Report
Wales weather: The calm before an overnight storm!
You have been warned! Friday gets off to a lovely start, but there is a band of very wet weather waiting to put a real spoiler on things!Read the full story ›
- ITV Report
Wales weather: Fresher overnight!
It feels much fresher out there than it has done recently. So hopefully a much more comfortable night's sleep all round.Read the full story ›
- ITV Report
Wales weather: All change!
From sizzling heat to storms.... our weather is all change! Looks like we could be in for something of a bumpy ride over the next few days!Read the full story ›
- ITV Report
A cloudy start to Thursday with risk of showers
Showers clearing early on to leave a fine morning with light winds and sunny spells.Read the full story ›
- ITV Report
Largely dry overnight and feeling muggy
After a fine evening with late sunshine, largely dry overnight before cloud thickens later with the threat of showers across Wales.Read the full story ›
Blood and worm ice lollies go down well at the zoo!
It's not just people having a hard time in hot weather - animals are struggling to stay cool too.
Monkeys, meerkats and others at Folly Farm in Kilgetty, west Wales are being treated to some homemade blood and worm ice lollies.
- ITV Report
Wales weather: Warm with a risk of thundery showers
After a cloudy morning sunny spells are expected this afternoon. A 'be aware' warning for heavy rain has been issued for parts of the north.Read the full story ›