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The term "Rome wasn't built in a day" is an old expression that may have a new meaning in our society, especially within the NFL. Athletes have time and time again suffered from career damaging issues with the law and some have made "triumphant" comebacks. But it is truly amazing to see a somewhat "Cinderella story" such as the one with Michael Vicks. Being committed of dog fighting charges in 2007 Vick, an athletic "phenom" out of college (Virginia Tech) and into the NFL, suffered a drastic blow. So many athletes with numerous criminal allegations and cases, and yet none have seen as public attack as the "Vick Dog Fighting" case. But one should as the simplest question why? Why did this case "shake the nation"? Why, even after almost five years past the incident, does this story stay prevalent?
In 1997 Michael Vick was not a name that surrounded by national recognition. "He was an obscure athlete as a senior" Michael Harris of the Washington Times stated, for good reason, he wasn't the best player in the country, or the state, or even on his team at the time. He wasn't in the limelight for a while (which took a complete 180 turn later on) because around this time, Ronald Curry, former NFL wide receiver, was the player every college coveted. It was after Vick made it to Virginia Tech that his career "took off".
In the 2001 NFL Draft Vick signed a six year $ 62 million contract with the Falcons to be their starting Quarterback. In 2003 an injury shortened his season but didn't end the show for this man. Vick led his team to the NFC championships in 2004 and eventually help his team to the title contention which he would later sign a $130 million contract warranting his title as the 100 million dollar man.
With the Dog Fighting case that occurred it would have seemed that the clock would strike twelve on Vicks "Cinderella story". Sentenced to 23 months in prison then filing for bankruptcy who could blame you for thinking that. Many would have argued that his career was over but they, of course, were wrong. With determination in 2009 Vick silenced the "Nay-Sayers" when he was reinstated into the NFL. Eventually signing with the Philadelphia Eagles, Vick has climbed the ladder from being the 3rd string QB to now starting. He has gone from the constant public scrutiny to creating a more positive light around him by leading the eagles. Although making it to the Super Bowl is questionable, he has taking the necessary strides for his career. Rome was not built in a day and Michael Vick's career is far from being over.


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Seeds of Friendship Angel Figurine
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Native American-Inspired Spirit of Tranquility Figurine
I Believe in Angels Cuff Bracelet

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48 Generic Smart Choice Carpet Pro Upright Vacuum Bags, BULK DEAL 48 Total Bags
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Smart Choice Carpet Pro CPU Upright Bags
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The Global FlyFisher - The Largest and Best Place to go for Online Fly Fishing and Fly Tying
GFF Videos
The Troutmen
Originator:Adam Mizrahi
Submitter:Martin Joergensen
|More great articles on The Global FlyFisher
|A couple of random articles
USD ShrimpThis is a fairly complex shrimp pattern, a little difficult to tie, but also durable. It fishes upside down and is tied by Danish Mads Schmidt who has had great success with the fly.
March 15th 2015


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Discuss fighters Jones Jr ducked in his prime
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Re: Discuss fighters Jones Jr ducked in his prime
Originally Posted by
First, I'm not going to say Ward ducked Bute because I dont think he did. That said, I do have some questions.
Giving Andre Ward the benefit of the doubt and saying that he was legitimately out for a year with an injury - it happens and we have no reason to assume that it wasn't a legitimate injury - why did Ward, almost the second Bute signed his two fight deal with Froch, go out of his way to say Bute had never attempted to arrange a fight him in the first place?
Why did Ward go public and say that he was dissapointed that Bute was fighting Froch after previously saying Bute had to beat a better class opposition to get a fight with Ward?
Why did Ward act as if Bute/Ward was there to be made if he was out injured at the time and then complain that Bute was facing the second best guy in the division when the best was unavailable because of an injury?
What injury kept him out for a year?
His broken hand was healed and given clearance in February to train
"Andre went to the doctor and the hand is healing up nicely, and now he is cleared to move forward utilizing the hand as he feels ready to use it," promoter Dan Goossen said.
Rafael's Boxing Blog
Get the latest scoop and ****ysis on the world of boxing from ESPN.com's Dan Rafael in his blog.
Ward, 27, took some time off after the fight, including a family vacation to Hawaii. Now, with the hand ready to go, Ward said he is anxious to return to the ring.
"It went well," Ward said of his recent doctor's visit. "The hand is much better, somewhere around 90 percent. The key is to let pain be my guide. If something hurts, don't do it."
Whether you want to use the word 'ducked' or not, that's up to you - but there was nothing stopping him from fighting Bute, other than the fact that he didn't want to
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Friday, July 3, 2015
Aruba vacation and travel information on Aruba hotels, beaches, restaurants and so much more
Friday, July 3, 2015
The hotels and resorts in Aruba, whether all-inclusive or not, are top-notch facilities that many Aruba visitors return to year after year. In fact, Aruba has one of the highest traveler return rates of any Caribbean island. People return for many different reasons. For some it is the constant "beach weather", for others its the fine, white sand, but most visitors return because of the friendly people and welcoming attitude of the hotel staff. Aruba has deemed itself "One Happy Island" and most visitors you talk to will agree.
While staying at one of the many all-inclusive hotels in Aruba, you will not only be treated like a local, but you will also benefit from the many extras and amenities you can only get at one of the Aruba all inclusive resorts. Most all-inclusive hotels include:
Many guests say that by staying at an all inclusive hotel they save money on their vacation. This is partly because tips and gratuities are included in the rate as well as the price of activities and entertainment. At an all-inclusive resort you don't have to budget, you just have to have fun.
Another benefit to staying at one of the Aruba all inclusive resorts is that guests can enjoy the convenience of having everything they need right at their fingertips.
Guests don't need to worry about transportation to and from the airport. Servers and bartenders are happy to accommodate your every need. If you forget something at home, chances are the resort you are staying at will be able to provide you with what you need.
If Aruba's all-inclusive resorts sound like an ideal vacation for you, keep reading and discover all that Aruba has to offer.


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Fudge Sundae Pie
|Corn syrup
|1⁄4 Cup (4 tbs)
|Firmly packed brown sugar
|2 Tablespoon
|3 Tablespoon
|Rice krispies cereal
|2 1⁄2 Cup (40 tbs)
|Peanut butter
|1⁄4 Cup (4 tbs)
|1⁄4 Cup (4 tbs) (for ice cream)
|Corn syrup
|3 Tablespoon
|Vanilla ice cream
|1 Quart, slightly softened but not melted
1. Grease a 9-inch pie plate with cooking spray.
2. In a 2-quart saucepan, mix 1/4 cup corn syrup, brown sugar and margarine.
3. Over low heat, cook with occasional stirring until the mixture begins to boil.
4. Remove the pan from heat and stir in RICE KRISPIES cereal into the hot mixture; stir until well coated.
5. Into the greased pie plate, press the cereal mixture at the bottom and sides to form a crust.
6. Refrigerate crust until well chilled.
7. Into the chilled crust, spoon softened ice cream and spread evenly.
8. Freeze the pie until firm.
9. In a saucepan, combine peanut butter, fudge sauce and the 3 tablespoons corn syrup; heat before serving.
10. Let the pie sit at room temperature for 10 minutes.
11. Slice pie into wedges and serve in individual serving plates.
12. Over each serving, drizzle hot sauce and serve.


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|On-Campus Housing
Spring 2015 Move-Out
Residence Halls will CLOSE for the Spring semester on Friday, May 15 at 12 PM (noon). Students are required to check out within 24 hours of their last final exam or by the time the residence halls close for the semester. Graduating students and those that are assisting with graduation must register with Residence Life Office no later than May 4, 2015.
Student athletes who are representing the College at Nationals must be on their Coach's roster in order to be approved to stay.
Summer Housing is available to our current residents only and in order to be considered, the student must schedule a meeting with the Director of Residence Life by May 5, 2015. Space is very limited and special conditions to stay apply.
Welcome Home!
Residence Halls will OPEN for Fall 2015 on Saturday, August 15
More detailed information regarding room assignement and specific move-in time will be shared with the housing applicants during the summer months through their CAC student email account.
Thank you for choosing Central Arizona College.
Please feel free to browse our site to learn more about living in the Residence Halls.
If you consider your college education an investment, beginning your career in CAC's residence halls will give you the best return. Students who choose to live on campus have the opportunity to truly enhance their college experience. We work to provide students with comfortable, convenient, and affordable housing—and to enhance opportunities for academic success, community, personal growth, and leadership development. We encourage each student who lives on campus to participate in the programs and events provided by Residence Life Staff and other departments across the College.
Feel free to stop by our office if you have questions, need assistance, or have a suggestion of how we can improve our services.
CAC Residence Life on Social Media:
On-Campus Housing Options
The Signal Peak Campus of Central Arizona College houses approximately 350 students. All of our rooms are double occupancy (2 students per room), however on occasion and as needed, we reserve the right to triple rooms. When and as occupancy allows, we may offer upgrades to a supper single for additional charge. For more information regarding the single occupancy, please call us at 520-494-5470.
Each room is furnished with a desk, a chair, closet space, a dresser, and a bed (with an extra-long twin mattress) for each student.
Central Arizona College offers three housing options:
|The room is accessible from the outside and conjoined with another room through a Jack and Jill bathroom. Each room houses 2 students.
A quad is accessible from the outside. It houses 8 students and it has a common lobby, two bathrooms and 4 rooms. Each bathroom is shared by 2 rooms.
|A traditional 3 story co-ed residence hall with rooms accessible through the inside hallway. The rooms are conjoined by a Jack and Jill bathroom. The hallways are co-ed with rooms that share a bathroom being single gender.
Inside the Tower building, we have 2 Theme Houses available for our students:
Honors House - designated space for our students who are committed to academic exellence and have a minimum GPA of 3.0
Global Scholar House - space for our students who are interested in learning more about diverse cultures of the world, are from out-of-state, or are from another country.
Photos: 1 2 3
Insurance Recommendations
Advantages to Living On-Campus
- Game room
- TV Lounge (extended satelite service)
- Computer Lab/Internet
- Laundry facilities
- Educational, recreational, and social programs
- Food service
- Vending machines
- Change machine
- Personal student mailboxes
- Movie and board games checkout
- Game Room
- Weekly Educational and Social Events
- Intramural Sports
- Movie Nights
- Game Nights
- Comedy Nights
- Open Mic Nights
- Cook-outs
- Special Events
What to Bring
- Bedsheets (twin, extra long; 36x80)
- Blankets/Bedspread
- Pillows
- Towels
- Wastebasket
- Shower shoes
- Alarm clock
- Phone
- Computer/Tablet
- TV/DVD/Blue Ray
- Video games and game consoles
- Fan
- Microwave (up to 1500 Watts)
- Microfridge (under 4.5 cubic feet)
- Area rug
- Posters and decorations
- Book bag
- Hangers
- Iron/Ironing board
- Surge protector
- Personal care items
- Desk supplies (pens, paper, paper clips, scissors, etc)
- Bowl, cup, plate, utensils
- Laundry basket and other supplies
Please do NOT bring
- Grills (George Foreman, hibachi, BBQ, etc)
- Toasters and toaster ovens
- Hot plates
- Candles
- Incense
- Halogen lamps
- Lava lamps
- Black lights
- String type lights (i.e. Christmas Lights)
- Hookahs
- Pets (except for fresh water fish in a tank under 10 gallons)
- Drugs (other than your prescription)
- Alcohol or empty alcohol bottles
- Weapons of any kind (including decorative knives, fireworks, BB guns, paint guns, etc)
Residence Hall Costs and Fees for 2015-2016
- Room & Board (per semester)
- Suites and Quads: $3,100.00
- Tower: $3,400.00
- Summer/Winter Break (when available, for current residents only) weekly room $150 + meals $261.25
- Refundable Deposit $150.00 *
- Room Lock Replacement Fee:
- $75 - Tower and Suite Rooms
- $100 - Quad Rooms
- $75 - Tower and Suite Rooms
How to Apply for On-Campus Housing?
In order to reserve your room, please submit the following: $150 refundable deposit*, proof of measles, mumps and rubella (MMR) immunizations, and a completed and signed housing application and the license agreement/contract.
Please note: Housing Applications will be web-based ONLY. You will need to enroll as a student prior to applying to live on-campus.
Applications available HERE!
Additional Residence Halls and Rooms Photos:
For additional information about the Residence Life Program at CAC, contact us directly at 520-494-5470 or firstname.lastname@example.com
* $150 Refundable Deposit: In order to receive your deposit back please follow the official check-out process as it is specified in your license agreement/contract. Students who do not complete the check out process or who move out mid semester will forfeit their deposit. After you complete the checkout process, CAC's Facilities and Residence Life Staff will inspect your room to see that there are no cleaning or damage charges that should be assessed to your account. Deposits are handlded through the Cashier's Office in the M Building and will be processed through your Higher One account 4 to 6 weeks after the student checks out.


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you or your doctor thinks you may be at risk for developing
osteoporosis, you may have a screening test to check
your bone thickness. A screening test may be advisable if you have:
U.S. Preventive Services Task Force recommends that
all women age 65 and older routinely have a
bone mineral density test to test for osteoporosis. If
you are at increased risk for broken bones caused by osteoporosis, routine
testing should begin at age 60.
Most experts recommend that the
decision to test women age 60 and younger be made on an individual basis,
depending on the risk of developing osteoporosis and whether the test results
will help with treatment decisions. To help you decide whether you should be
tested for osteoporosis, see:
Experts recommend that men who are older than age 70 and/or
have other
risk factors for osteoporosis have a bone mineral density test.1
For more information, see the topic
CitationsQaseem A, et al. (2008). Screening for osteoporosis in
men: A clinical practice guideline from the American College of Physicians.
Annals of Internal Medicine, 148(9):
Last Revised:
August 28, 2009
Healthwise Staff
Medical Review:
Adam Husney, MD - Family Medicine
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions
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These dies are designed for firearms with custom chambering that are tighter than SAAMI specifications.
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Mfr Part: 91355
Cartridge: 308 Winchester
Mfr Part: 91301
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Cartridge: 6 mm Rem BR (Benchrest)
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Hit the road with photographer Mikkel Aaland to learn how to tell the story of a road trip to a small seaside town.
Follow along with renowned photographer Mikkel Aaland as he assembles a photographic portrait of San Francisco's iconic North Beach neighborhood.
Get up to speed on the new and upgraded features in Adobe Photoshop Lightroom 4.
Shows you how to use the powerful slideshow tool FotoMagico and Adobe Photoshop to break the mold of simple sequenced images.
"My understanding of photography took a quantum leap in a short period of time as a result of Ben Long's exceedingly well-written and well-executed videos." —Nelson E.
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text:
Freaks (1932)
Remade as
Though uncredited and unacknowledged, this movie is a remake of Freaks.
Edited into
Referenced in
It is referenced.
Both films include performances from people who are deformed.
"Freaks" is briefly homaged.
still of Prince Randian from the film
The "One of us! One of us! One of us!" scene
A character in 'The Player' mentions that he recently saw 'Freaks' and quotes dialogue from it.
Sam Raimi mentions it.
jerry refers to a character looking like Zippy the Pinhead
"One of us! One of us!"
When Angela is chatting online, the two people she's chatting with say "We accept you" and "You're one of us". This a reference to the scene in "Freaks" where the freaks say to Cleopatra "We accept you, one of us."
Characters act out a scene from this movie.
mentioned once
"You're one of us!"
cited by Coleman as an influence
Bill Griffith mentions the film "Freaks."
In the fourth level, set in a demented circus, there is a sideshow tent. While trapped inside, you can faintly hear the chant "one of us, one of us" repeated continuously in the background.
Mark asks Robert if they are going to remake this film.
This film is a definite contemporary homage to "Freaks."
The two microcephalics appear (Zip and Pip) and they chant the "one of us" line several times.
Caitlin says she saw Tod Browning's "Freaks" and that it disturbed her.
The shots of pieces of robots crawling towards Bender onstage is made to look exactly like those of mutilated "freaks" in this movie attacking someone.
The nerdy kids chant "One of us"
"One of us! One of us!"
Lobby card on wall during interview with Johnny
prominently featured poster in apartment, Woody joke about after his marriage wife's family dances around him saying "We will make him one of us."
Crispin Glover references the film in an interview situation
When a large number of blank NS5's are interrogated about the presence of a rogue NS5 they all chant "one of us, one of us".
Documentary of this film.
Toward the end of the movie, Jack states, "You're one of us, now."
erin & ian use the nicknames pip and zip wich are caracters in the movie "freaks"
Videocassette seen as part of the collection in Neval's apartment.
BHG threatens to turn Lewis into a duck.
Dialog repeated in conversation in scene.
Wolowitz quotes the "One Of Us" song to Penny.
on movie marquee
Photograph is shown.
The scrapped robots chanting "One of us!"
Subject of a $1,000 clue in the category "Spoiler Alert!"
It is mentioned in a magazine.
"One of us, one of us"
"One of us! One of us!"
Clip from "Gooble Gobble" scene shown.
points out Angelo Rossitto, who was also in this film
Movie poster is shown.
While hypnotizing Film Brain The Cloaks chant "One Of Us".
When Holly and the boys are gather at the campfire, they tell "one of us, one of us" referring to the movie Freaks
Video case is shown.
"Gooble gobble, one of us!" scene is imitated by prison inmates
The carnival freaks make an appearance in the opening.
References classic "One of Us" chant while discussing throwing little people at target.
Small snippets are shown in the film.
"You're one of us" said in freakshow setting
another horror movie from 1932
The film that was going to be watched by the freaks.
Mentioned in dialogue and a scene imitates the climax
Title is referenced
Featured in
features scenes from Freaks while discussing Tod Browning
This shows some scenes from the movie
The shots of the microcephalic man and the legless man are both from the film Freaks.
clip included in the film
A clip of "Freaks" is shown to demonstrate how dwarfs were once viewed by the majority of "normal" people.
It is mentioned and discussed. Also, poster and footage of this movie are shown.
This film is fetured in this episode.
Clips are shown
movie is reviewed
Taking #4 worst wedding in movies
It is mentioned and discussed. Also, poster and footage of this movie are shown.
Clip of the film shown.
Clips shown and discussed.
film clip
Excerpts shown
Spoofed in
The segment "Carnival of the Darned" is a spoof of this movie.
O.J. Simpson, Gary Condit, and John and Patsy Ramsey all dance around and say, "Gooble, gobble. One of us!" like in the famous scene in Freaks.
"one of us" chant used by the Spiffies.
The final segment, "Freaks Not Geeks," is a spoof of this film
When Rick says, "You're a big kid now," it parodies the line, "You're one of us now."


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The Rhinestone Fashion Button is elegant, dignified, and perfect for your design project. This button gives off a mother of pearl-like sheen, with two small rows of rhinestones placed over gold metallic settings. Simply stunning, the rhinestone fashion button will make a great accent for cardigans, sweaters, button downs and more. With tunnel shank back attachment for easy sewing.
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text:
"No sooner had we set up our Dubai operation than the Tank World Expo promoters approached us to help publicize their upcoming conference, Tank World Expo 2014," said Scott Steele, Oilfield Directory CTO. "They came to us because of our prominence in the energy sector, which is primarily based on our web sites and mobile applications. It was rather ironic when the promoters asked us to supply printed copies of the directory for the Expo."
The "Tank World" conference was held at Sheikh Maktoum Hall, Dubai International Convention and Exhibition Centre Dubai, UAE (aka the Dubai World Trade Centre). The event brought together over 1,600 attendees and 70 exhibitors in the Tank Storage industry for two days of content, workshops and meetings.
Oilfield Directory's Dubai correspondent Renu Gihar attended the Expo to introduce the company's UAE web-based directory during the Tank World Expo 2014.
Keynote speaker Dr. Matar Hamed Al Neyadi, Undersecretary, Ministry of Energy, UAE, shown here with Ms. Gihar, was gracious enough to take a moment to examine and endorse Oilfield directory's AE print publication, "Oil Gas News."
The move two years ago from printed directory to dynamic online content has driven Oilfield Directory (http://oilfielddirectory.com/
The directory's main appeal lies in the ease of use. "The free listings for contractors and classified ads pair up jobs and job seekers, and the news and events keep everything up to date on what is happening in the industry," said Scott. "It is hard to put that in print."
Scott is also justifiably proud of the mobile applications that power a large part of their directory. The applications promote building relationships with instant messaging and geolocation built-in.
The directory apps allow users to build lists of favorite suppliers, partners or contractors. "When you have a need," says Scott, "you are a few clicks away from a solution." Users can select from the nearest suppliers, by specialty or availability.
To learn more about Oilfield Directory, visit http://oilfielddirectory.com/
Oilfield Directory
Oilfield Directory


text:
TSB Main Page
Some F-Super Duty vehicles equipped with a 6.7L diesel engine and built on or before 1/10/2011 may exhibit a malfunction indicator lamp (MIL) with DTCs P20E8 and P202D. These codes are set by a small diesel exhaust fluid (DEF) leak internal to the reductant pump assembly.
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Mike Shanahan keeps meeting private
Updated: August 24, 2010, 11:03 AM ETAssociated Press
ASHBURN, Va. -- Washington Redskins coach Mike Shanahan met with Albert Haynesworth on Monday and kept the conversation to himself, saying it's "completely ridiculous" to keep talking about it publicly.
"If you guys want to talk about football, we'll talk about football," Shanahan said. "But to keep on talking about things outside of football to me is completely ridiculous. I did have a conversation with him. If you want to talk about football, we'll talk about football."
So Shanahan ...
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- Rams: Can Bradford lead St. Louis?
- Cowboys: Big issues in front of Romo
- Bucs: Solid foundation emerging
- Falcons: New slogan, defensive attitude
- Vikings: Is Favre holding team back?
- Seahawks: Is easier camp better?
- Redskins: Shanahan, McNabb in it to win it
- Eagles: Kevin Kolb ready to rock
- Packers: Super Bowl or bust
- 49ers: New attitude permeates
- Lions: Stafford learning from mistakes
- Panthers: Solid to the core
- Cardinals: Eyes on Leinart
- Giants: Osi's return has ripple effects
- Bears: Offense must start fast
- Saints: Are they worth repeating?
- Titans: Fast start key for young roster
- Texans: Postseason still awaiting Houston
- Ravens: Can Flacco take next step?
- Jets: Can Sanchez handle the pressure?
- Chiefs: Time to unleash Cassel
- Pats: Are they finally vulnerable?
- Colts: Beware, they're even better
- Cleveland: Youngsters must deliver
- Denver: No excuses for Broncos
- Dolphins: Don't underestimate Miami
- Bengals: Expectations are high
- Jaguars: Thinking big in 2010
- Chargers: Moving on with confidence
- Steelers: Free fall or bounce back?
- Bills: Trying to make order out of chaos
- Raiders: Key to season is Campbell
- Outsiders: The Raiders' real black hole
- Fleming: 12 teams that won't repeat
- Paolantonio: Goodell sidesteps vote
- Clayton: Jackson wants to buck trend
- Chadiha: Kolb's ready to lead Eagles
- Clayton: Pros and cons of 18-game schedule
- Clayton mailbag: Coaching getting tougher
- Scouts' Eye: Colts' O-line suspect
- Scouts' Eye: Knox emerging
- Clayton: Sanchez in enviable position
- Merrill: Zimmer finds solace in coaching


text:
To determine the validity of a semi-automated segmentation of bone marrow lesions (BMLs) in the knee.
Construct validity of the semi-automated BML segmentation method was explored in two studies performed using sagittal intermediate weighted, turbo spine echo, fat-suppressed magnetic resonance imaging sequences obtained from the Osteoarthritis Initiative. The first study (n = 48) evaluated whether tibia BML volume was different across Boston Leeds Osteoarthritis Knee Scores (BLOKS) for tibia BMLs (semiquantitative grades 0 to 3). In the second study (n = 40), we evaluated whether BML volume change was associated with changes in cartilage parameters. The knees in both studies were segmented by one investigator. We performed Wilcoxon signed-rank tests to determine if tibia BML volume was different between adjacent BLOKS BML scores and calculated Spearman correlation coefficients to assess the relationship between 2-year BML volume change and 2-year cartilage morphometry change (significance was p ≤ 0.05).
BML volume was significantly greater between BLOKS BML score 0 and 1 (z = 2.85, p = 0.004) and BLOKS BML scores 1 and 2 (z = 3.09, p = 0.002). There was no significant difference between BLOKS BML scores 2 and 3 (z = −0.30, p = 0.77). Increased tibia BML volume was significantly related to increased tibia denuded area (Spearman r = 0.42, p = 0.008), decreased tibia cartilage thickness (Spearman r = −0.46, p = 0.004), increased femur denuded area (Spearman r = 0.35, p = 0.03), and possibly decreased femur cartilage thickness (Spearman r = −0.30, p = 0.07) but this last finding was not statistically significant.
The new, efficient, and reliable semi-automated BML segmentation method provides valid BML volume measurements that increase with greater BLOKS BML scores and confirms previous reports that BML size is associated with longitudinal cartilage loss.
Keywords:Knee; Magnetic resonance imaging; Osteoarthritis
Periarticular bone changes are integral to knee osteoarthritis (OA) progression [1-6]. More specifically, bone marrow lesions (BMLs), common magnetic resonance (MR) imaging findings in joints with OA, are related to OA progression and pain [1-7]. In fat suppressed MR images, BMLs are characterized as areas of high-signal intensity within bone [8,9]. Several methods can assess BML size in knees including semi-quantitative scoring [8,10], approximating BML size based on linear measurements [5,6,11,12], or manual/semi-automated segmentation [13-17].
While the current techniques have clarified the clinical relevance of BMLs in OA progression they may be limited by a lack of sensitivity to change, a dependence on the reader to identify BMLs, or the amount of time required to quantify BML size. One simple approach to measure BML size is to measure the greatest cross-sectional diameter of a BML [5]. This method is time-efficient and offers a quantitative outcome; however, only one dimension is under scrutiny; therefore, other changes may occur that go unnoticed. On the other hand, three-dimensional measurements, based on three cross-sectional measures [6,11,12], are a time efficient method to assess BMLs with good construct validity but include a lot of healthy bone. The most accurate method to assess BML size may be detailed image or volumetric segmentation [13,14] but to date accurate results require substantial user interaction and thus requires an extensive amount of time to complete. For example, semi-automated segmentation methods often use manual steps that may introduce measurement error or increase the burden on the assessor (e.g., manually delineating regions of interest, manually marking areas of health bone) [16,17]. Ideally, a new quantitative BML measurement would be accurate and time efficient.
The purpose of this study was to determine the validity of a new semi-automated BML segmentation method. We hypothesize that this new measure of BML size will increase with greater semi-quantitative scores and relate to articular cartilage loss (construct validity). This approach not only reduces the time involved in segmentation, but can also easily be deployed by researchers.
To assess the validity of the new semi-automated BML segmentation method we conducted two analyses using images and data obtained from the Osteoarthritis Initiative (OAI) databases, which are available for public access at http://oai.epi-ucsf.org webcite. The OAI is a multi-center observational cohort study of knee OA that collected longitudinal clinical and image data [18] as well as biospecimens over a nine year period. All BML measurements were performed using sagittal intermediate weighted, turbo spine echo, fat-suppressed MR sequences (field of view = 160 mm, slice thickness = 3 mm, skip = 0 mm, flip angle = 180 degrees, echo time = 30 ms, recovery time = 3200 ms, 313 X 448 matrix [interpolated to 512 X 512], phase encode superior/inferior. x resolution = 0.357 mm, and y resolution = 0.511 mm). All images were obtained using one of four identical Siemens Trio 3 T MR systems and a USA Instruments quadrature transmit-receive knee coil at one of four OAI clinical sites.
Semi-automated BML segmentation
The new semi-automated segmentation method detects, extracts, and quantifies the structure of BMLs in three major steps: bone segmentation, BML segmentation, and BML quantification. In the first step, boundaries of tibia and femur were identified using a process scheme that is automatic except for some coarse initialization provided by the user. The second, fully automated step segmented BMLs within the tibia and femur regions identified from the first step. The third step which is also fully automated eliminated some false positive regions identified in the previous step and calculated the BML volumes.
In the first step we used a custom graphical user interface (GUI; MATLAB, MathWorks, Inc., Natick, MA, USA) to manually identify the boundaries of the tibia and femur in each slice of the MR imaging data set by marking multiple points along the articular surface (see Figure 1a). For the border furthest from the articular surface the rater either marked the bone just prior to the epiphyseal line or at the edge of bone and soft tissue (images near the medial or lateral sides of the knee; Figure 1b). In addition, we omitted the central slices from the analyses (i.e., the middle 9 slices; 2.7 cm) to focus on BMLs adjacent to the tibiofemoral chondral surface and to improve reliability. Excluding these images improved reliability because the segmentation method was inconsistent at defining the border of the bone and there was increased signal-intensity heterogeneity within the bone. Manually marking the bone, the only part of this processing stage involving user interaction, required 8 to 24 min per pair of MR image sets (one knee at two time points) compared to approximately 30 to 45 min per pair of MR image sets using cross-sectional measurements to approximate BML volume [6]. After the tibia and femur boundaries were marked we used an edge-based curve evolution technique [19] to refine the initial estimate to more precisely identify the bone boundaries. An edge-based curve evolution technique [19] was considered optimal because bone typically has well defined boundaries. This process of refinement does not require the initial curves to be immediately adjacent to the bone boundaries (Figure 1a and c) [19].
Figure 1. Example of images from the bone marrow lesion (BML) segmentation process. (a) Manually marked bone border on a typical slice, (b) manually marked bone border on a slice near the edge of the bones, (c) the program's segmentation of the bone, (d) the segmentation results just based on thresholding, (e) the intermediate segmentation results with bone (red line) and BML (yellow line) by just using one time of thresholding- curve evolution process, (f) the final image with bone (red line) and BML (yellow line) segmented.
The second step, BML segmentation, automatically identified the boundaries of the BMLs within the bone region found in the first step by using a region-based curve evolution algorithm [20], which was considered an optimal algorithm because BMLs often have ill-defined boundaries. To segment the BMLs we needed to predefine two parameters (false discovery rate [FDR] [21] and length penalty parameter [μ] [20]). The FDR is the expectation of the ratio of false positives to all significant hypotheses. We used the FDR to determine a threshold between bright area and normal area within the bone region. A greater FDR leads to a lower threshold and therefore more pixels would be identified as a BML. The length penalty parameter (μ; usually between 0 and 1) was used to control the curvature of the segmented BML boundaries. A greater μ leads to smoother the curves and the more frequently relatively small areas of discrete bright pixels would be eliminated. We set FDR = 0.05 and μ = 0.28 in all of our experiments throughout this paper. We tuned up FDR and μ based on the consistency in the results of 10 pairs of knee data.
Based on the FDR, a rough segmentation was obtained for the BMLs by a thresholding approach applied to the MR images (Figure 1d). From the thresholded binary image, we constructed initial curves of the BML boundaries and then a region-based curve evolution method [20] refined the initial curves to obtain an accurate BML border (Figure 1e). In order to capture BMLs whose contrasts vary considerably, we performed the thresholding and curve evolution process a second time while excluding the segmented BMLs identified during the first curve evolution step. Finally, we used the combination of those two BMLs sets as the final BML volumes (Figure 1f). The volumetric measurements of specific BMLs, based on this segmentation approach, have been reported to have a good correlation and agreement with manual measurements of approximate BML volume [6].
The third step of this method, BML refinement and quantification, automatically excluded false positive regions (e.g., connective tissue, imaging artifacts) and measure BML size. Currently we are using two criterions to eliminate the false positive regions: (1) the distance between a BML to the articular surface should be no more than 10 mm [6,14,22] and (2) a BML should span more than one MR image. Finally, we stacked the processed 2-dimensional MR images into one 3D stack data and used criterions above to exclude the false positive regions and obtain the BML volumes. BML volumes are calculated for four discrete regions: medial femur, lateral femur, medial tibia, and lateral tibia.
Intra-tester and inter-tester reliability were assessed for two investigators (JP and GD). To assess intra-tester reliability the investigators segmented 10 (JP) or 12 (GD) knees (baseline and follow-up) from the progression subcohort of the OAI (had symptomatic OA in at least one knee). The investigators repeated their segmentations at least 72 h after performing the initial segmentations. After independently verifying their intra-rater reliability they were provided a data set of 20 knees from the OAI progression subcohort. Each investigator independently segmented the knees. Intra-tester reliability for BML change was good to excellent for investigator one (JP; ICC [3,1 model] = 0.79 to > 0.99) and investigator two (GD; ICC [3,1 model] = 0.95 to 0.96). Inter-tester reliability for BML volume change was good for the lateral femur and tibia as well as the medial femur (ICC [2,1 model] = 0.83 to 0.93) but low for the medial tibia BML volume change (ICC [2,1 model] = 0.59).
Study 1: comparison to semi-quantitative BML size
We compared data generated by the semi-automated BML segmentation method to Boston Leeds Osteoarthritis Knee Scores (BLOKS) [10] for BMLs (semi-quantitative grade 0 to 3) to assess the construct validity of the new outcome measure. We selected a convenience sample of 80 right knees with area of denuded cartilage from a subset of 160 participants that were members of the progression subcohort (had symptomatic OA in at least one knee) and had acceptable quality fixed-flexion knee radiograph and MR imaging sequences (identified as read project 4 in the public OAI data files entitled kmri_qcart_ecksteinXX [version 0.4 and 3.3]). This sample was convenient because there is extensive image assessment data publicly available among these participants and BLOKS scores were previously assessed by one investigator (GH; weighted kappa = 0.88 [1]). We selected BLOKS scores, instead of other BML scoring methods, based on our experience with BLOKS scoring and prior research which indicated that BLOKS was comparable with Whole Organ MR Scoring (WORMS) method in cross-sectional studies [23].
One investigator (JP) performed the segmentation using the new approach among 80 knees using OAI baseline sagittal intermediate weighted, turbo spine echo, fat-suppressed MR sequences [18]. The variables of interest were medial and lateral tibia BML volume as well as BLOKS BML scores in the medial and lateral tibia. Analyses were restricted to the tibia since the BLOKS system provides a score for the entire medial or lateral tibia region, similar to the region of interest for the segmentation method. Since only a small number of BMLs were detected in the lateral tibia we collapsed medial and lateral tibia for analyses and considered each region to be independently assessed. Therefore, we performed 3 Wilcoxon signed-rank tests to determine if tibia BML volume was significantly different between adjacent BLOKS BML scores (e.g., 1 versus 2, 2 versus 3). Based on these analyses we reported the z statistics and p-values with statistical significance defined as a p-value ≤ 0.05. We did not pursue ordinal logistic regression because the models had significant score test for the proportional odds assumption.
Study 2: association between BML size and cartilage morphology
We evaluated whether data from the new semi-automated BML segmentation method would replicate findings from previous studies that documented an association between BMLs and cartilage parameters [6,10,24-26]. We selected a convenience sample of 40 knees from 196 knees in the baseline and 24-month OAI visit datasets (kmri_qcart_eckstein [version 0.4 and 3.3]) that had full thickness cartilage loss on the tibia and femur in the index compartment (defined as the tibiofemoral compartment with greater denuded area). In order to have a heterogeneous sample, 20 knees were selected from the medial tibiofemoral index compartment and 20 knees were selected from the lateral tibiofemoral index compartment: knees that had the least change in femur denuded area (n = 5), greatest change in femur denuded area (n = 5), the least change in tibia denuded area (n = 5), and greatest change in tibia denuded area (n = 5). The sample size was selected based on the strength of significant correlations we observed in our previous study that explored an association between BML volume and cartilage parameters (r = 0.48 to 0.63) [6].
One investigator (JP) performed the segmentation using our new method on the 40 knees using baseline and 24-month sagittal intermediate weighted, turbo spine echo, fat-suppressed MR sequences. The variables of interest were the change in tibia and femur BML volume as well as change in tibia and central femur cartilage thickness and denuded area. The central region of the femur was defined as 60% of the distance between trochlear notch and posterior edge of the femoral cartilage. All of the analyses were limited to the index compartment. We calculated Spearman correlation coefficients to assess the relationship between 2-year BML volume change and 2-year cartilage morphometry change. A significant association was defined by a p-value ≤ 0.05. Potential outliers were explored based on a 95% prediction eclipse. We did not adjust these analyses since the goal was to replicate previously reported associations between two measurements to determine the construct validity of the new BML segmentation method.
Comparison to semi-quantitative BML size
Among the 80 right knees 48 knees had BLOKS BML scores. In the medial tibia, most knees had no to medium size BMLs based on BLOKS: 11 (23%) knees with BML = 0, 19 (40%) knees with BML = 1, 10 (21%) knees with BML = 2, 8 (17%) knees with BML = 3. In the lateral tibia, most knees had no to medium size BMLs based on BLOKS: 25 (52%) knees with BML = 0, 13 (27%) knees with BML = 1, 4 (8%) knees with BML = 2, 6 (13%) knees with BML = 3. Figure 2 shows the distribution of tibia BML volume across BLOKS BML scores. Overall, the tibial BML volume ranged from 0 mm3 to 3204.07 mm3 (only 2 knees had BML volume = 0 mm3). BML volume was significantly greater among knees with BLOKS BML score = 1 compared to knees with BLOKS BML score = 0 (z = 2.85, p = 0.004), and among knees with BLOKS BML scores = 2 compared to knees with BLOKS BML score = 1 (z = 3.09, p = 0.002). There was no significant difference between BLOKS BML scores 2 and 3 (z = −0.30, p = 0.77).
Figure 2. Box plots showing the distribution of tibia BML volume across Boston Leeds Osteoarthritis Knee Scores (BLOKS). Each knee contributed two regions (medial and lateral tibia) which were considered to be independently assessed. Boxes represent interquartile range and whiskers represent minimum and maximum medial tibia BML volume.
Association between BML size and cartilage morphology
We evaluated the association between 2-year change in BML volume and change in cartilage morphometry among 38 knees with denuded area (1 knee was excluded because of poor image quality and another was classified as having collapsed post avascular necrosis). Table 1 provides an overview of the sample characteristics for these analyses.
Table 1. Descriptive characteristics of knees used to examine the association between Bone Marrow Lesion (BML) size and cartilage morphology (n = 38)
An increase in tibia BML volume was significantly related to an increase in tibia denuded area (Spearman r = 0.42, p = 0.008) and a decrease in tibia cartilage thickness (Spearman r = −0.46, p = 0.004). Furthermore, increases in tibia BML volume was associated with increased femur denuded area (Spearman r = 0.35, p = 0.03) and possibly decreased femur cartilage thickness (Spearman r = −0.30, p = 0.07) but this last finding was not statistically significant. No associations to femur BML volume change were statistically significant (Spearman r = −0.15 to 0.15).
In this manuscript we described the validity of a novel semi-automated method to quantify BML size. This method has several advantages compared to existing methods. First, our method yields quantitative BML volume unlike manual linear measurements (e.g., greatest diameter [5], approximate BML volume [6,11]) or semi-quantitative scoring methods (e.g., BLOKS [10], WORMS [8]). Second, unlike manual segmentation methods [13,14] our method does not require expert readers since the reader's primary responsibility is to mark the border of the bone, thus automating the BML segmentation step. There are some other semi-automated methods [16,17] to quantify BML volume, however their methods are based on thresholding while our method performed some refinement on thresholding results by eliminating small isolated bright areas, as well as merging and evolving closed bright areas (See Figure 1d and e). We found that the quantitative measure of BML volume increased across semi-quantitative scoring and related to changes in cartilage thickness and denuded area, confirming previous reports of this association (construct validity).
Compared to BLOKS, the new measure of BML volume increased across grades in the tibia, with the exception of between grades 2 and 3. This suggests that our approach yields consistent results with BLOKS scale system in the evaluation of BMLs. The lack of statistical significance between BLOKS BML scores 2 and 3 in the medial tibia may be related to the available sample size or the semi-quantitative nature of BLOKS BML scores (e.g., potential for misclassifications). While some issues arise from the semi-quantitative readings another issues may be that the BML segmentation algorithm detects any region of high signal intensity within the bone that appears on multiple adjacent images (e.g., bone marrow lesions, subchondral cysts, blood vessels). This limitation led us to hypothesize that the BML segmentation method should be used primarily for detecting longitudinal change in BML volume since static structures will not change over time. Since longitudinal studies of BML size may be the main use of this program the next step was to assess the construct validity of BML volume change.
Our second study agreed with previous reports that change in BML size relates to longitudinal increases in denuded area and decreased cartilage volume [5]. More specifically, we found that increases in tibia BML volume were related to tibia cartilage loss while no associations were detected in the femur. The lack of association between femur BML and femur cartilage loss may be because the cartilage was assessing the central weight-bearing region of the medial femur while the BMLs were assessed throughout the medial femur (e.g., posterior femoral condyle, trochlear region).
Based on these findings, the new semi-automated BML segmentation method appears to be a valid assessment of BML volume, particularly BML volume change. There are several advantages of our method compared to existing methods. Firstly, this new approach can accurately measure volume rather than rough indices (e.g., greatest diameter [5], approximate BML volume [6,11]). In addition to improved accuracy, the semi-automated BML segmentation method offers good intra-rater reliability and adequate inter-rater reliability to allow for multiple raters if a quality assessment step is in place to ensure consistent bone segmentation. This extra quality assessment procedure is not uncommon in other areas of knee segmentation [27]. It is important to note that raters only mark the edges of the bone and therefore raters are not responsible for adjusting the contrast or identifying the boundary of a region that is not well delineated. The boundary of unclear BMLs would be located by the active contour driven by pixel intensity distribution automatically. Our approach should be more consistent than prior methods because it segments the BMLs from the bone region directly based on the intensity of the MR images without doing any preprocessing.
In addition to good reliability, our approach is a very time efficient method to quantify the BMLs. The current approach requires about 4 to 12 min for raters to initially segment the bones, depending on the number of images. The major reason for improved time efficiency is the reduction of manual operation. Only the first step needs manual operation and the remaining two steps are fully automated and take about 4 to 5 min using Matlab code on a personal computer with an Intel Core 2.66 GHz CPU and 2.0 GB RAM. Moreover, bone boundaries have distinct patterns and are less subjective to segment than BMLs. Based on the inter-rater and intra-rater reliability as well as the reduced manual operation time the semi-automated method can be used to more efficiently investigate larger MR imaging data sets.
While the new semi-automated BML segmentation method has many advantages that make it appealing for implementation there are some limitation and opportunities for improvement. Once the bone initialization (the first step) is finished, various algorithms could be proposed to perform bone segmentation and BML segmentation which might be faster and yield more robust and consistent results. For example, the current algorithm for BML segmentation only uses the mean and standard deviation of the pixel intensity in the MR images, but some other statistical variables of the intensities or even location information of BMLs could be incorporated to improve the segmentation results. In addition, once the segmentation of the bone and the BMLs is finished in a larger data set, other features of BMLs can be investigated besides BML volume. For example, users could extract the distance, intensity distribution, or other features of the BMLs. Moreover, the current algorithm for bone segmentation could be improved by more advanced algorithms. Those more advanced algorithms could further reduce or even omit manual operation which would make our approach more efficient and robust.
Optimizing the algorithms may improve the segmentation results in the central region of the knee, which was excluded in these analyses, as well as help differentiate BMLs and subchondral cysts. This region was omitted because of technical challenges in accurately identifying the border of the bone and increased signal-intensity heterogeneity. Excluding this region may bias the BML results by under representing BMLs associated with patellofemoral joint changes but may be advantageous for evaluating the tibiofemoral joint. Previous research has suggested that centrally-located BMLs do not typically influence tibiofemoral cartilage unless they extend into the medial tibiofemoral compartment [28]. New algorithms may also lead to the ability to discriminate BMLs and subchondral cysts, which could facilitate studies that clarify the etiology of both lesions and how they change over time. In the current analyses, we considered BMLs and subchondral cysts as one classification of subchondral changes since subchondral cysts often develop in regions with BMLs [29,30] and both types of lesions are associated with pain and structural changes [1-7,31,32]. When interpreting results with this BML segmentation method it is important to consider that these results primarily reflect tibiofemoral BMLs that may include cystic changes.
While these validation studies demonstrated the validity of the new semi-automated BML segmentation methods there are some important limitations to these analyses. For example, we compared the new BML volume to BLOKS, a well validated measure of BML size but BLOKS is not a gold standard and does not offer a quantitative comparison. Ideally, the new BML volume would have been compared to another accurate quantitative outcome or histology but these methods also introduce various limitations (e.g., lack of agreement on the histological presentation of BMLs, lack of gold standard quantitative BML measures). Furthermore, the validation studies were all conducted using sagittal intermediate weighted turbo spin echo with fat suppression images collected at the four OAI clinical sites using 3 T Siemens scanners. The BML segmentation approach may need to be reevaluated when deployed in new data sets using different MR scanners, MR sequences, or study populations (e.g., knees without full thickness cartilage loss). The limited generalizability of these validation studies does not limit the usefulness of this new method particularly because any new method would also need to be reevaluated when deployed in a new study protocol or population.
In summary, we proposed a novel semi-automated method to quantify BML sizes. We validated our new method by demonstrating that the new BML volume measurement increases with greater BLOKS BML scores and confirming previous reports that BML size is associated with longitudinal cartilage loss among knees with full thickness cartilage loss. In addition, our method is time efficient (about 7 min per knee MR scan) and yields adequate intra- and inter-rater reliability to allow multiple raters to process the MR sequences if an additional quality assessment step is performed to help ensure consistency between raters. This new method will enable researchers to assess larger MR data sets in a time efficient manner.
BLOKS: Boston Leeds Osteoarthritis Knee Scores; BML: Bone marrow lesion; FDR: False Detection Rate; ICC: Intra-class correlation coefficient; MR: Magnetic resonance; OA: Osteoarthritis; OAI: Osteoarthritis Initiative; μ: Length penalty parameter.
Competing interests
FE is CEO of Chondrometrics GmbH, a company providing MR image segmentation services. He provides consulting services to MerckSerono, Novartis, Sanofi-Aventis and Perceptive, and has recently received speaking honoraria from Merck, Genzyme, Glaxo Smith Kline, Synthes, and Medtronic. No other authors declare that they have no competing interests.
Authors' contributions
JP contributed to the conception and design, acquisition of data, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. JBD contributed to the conception and design, acquisition of data, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. GD contributed to the acquisition of data, drafting/revisions of article, as well as final approval of the article. EM contributed to the conception and design, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. GHL contributed to the conception and design, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. RJW contributed to the conception and design, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. LLP contributed to the conception and design, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. JAL contributed to the acquisition of data, interpretation of data, drafting/revisions of article, as well as final approval of the article. CBE contributed to the acquisition of data, interpretation of data, drafting/revisions of article, as well as final approval of the article. FE contributed to the acquisition of data, interpretation of data, as well as final approval of the article. TEM contributed to the conception and design, analysis and interpretation of data, drafting/revisions of article, as well as final approval of the article. All authors read and approved the final manuscript.
The Role of Bone in Knee Osteoarthritis Progression is supported by NIH/NIAMS (grant 1R01AR054938).
The OAI is a public-private partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-2-2260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators. Private funding partners include Pfizer, Inc.; Novartis Pharmaceuticals Corporation; Merck Research Laboratories; and GlaxoSmithKline. Private sector funding for the OAI is managed by the Foundation for the National Institutes of Health. This manuscript has received the approval of the OAI Publications Committee based on a review of its scientific content and data interpretation.
This work was supported in part by the Houston VA HSR&D Center of Excellence (HFP90-020).
The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs.
Lo GH, McAlindon TE, Niu J, Zhang Y, Beals C, Dabrowski C, Le Graverand MP, Hunter DJ: Bone marrow lesions and joint effusion are strongly and independently associated with weight-bearing pain in knee osteoarthritis: data from the osteoarthritis initiative.
Osteoarthr Cartil 2009, 17:1562-1569. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Tanamas SK, Wluka AE, Pelletier JP, Pelletier JM, Abram F, Berry PA, Wang Y, Jones G, Cicuttini FM: Bone marrow lesions in people with knee osteoarthritis predict progression of disease and joint replacement: a longitudinal study.
Rheumatology (Oxford) 2010, 49:2413-2419. Publisher Full Text
Sowers MF, Hayes C, Jamadar D, Capul D, Lachance L, Jannausch M, Welch G: Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis.
Osteoarthr Cartil 2003, 11:387-393. PubMed Abstract | Publisher Full Text
Yusuf E, Kortekaas MC, Watt I, Huizinga TW, Kloppenburg M: Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review.
Ann Rheum Dis 2011, 70:60-67. PubMed Abstract | Publisher Full Text
Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Abram F, Choquette D, Haraoui B, Beary JF, Cline GA, Meyer JM, Pelletier JP: Correlation between bone lesion changes and cartilage volume loss in patients with osteoarthritis of the knee as assessed by quantitative magnetic resonance imaging over a 24-month period.
Ann Rheum Dis 2008, 67:683-688. PubMed Abstract | Publisher Full Text
Driban JB, Lo GH, Lee JY, Ward RJ, Miller E, Pang J, Price LL, McAlindon TE: Quantitative bone marrow lesion size in osteoarthritic knees correlates with cartilage damage and predicts longitudinal cartilage loss.
BMC Musculoskelet Disord 2011, 12:217. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text
Zhang Y, Nevitt M, Niu J, Lewis C, Torner J, Guermazi A, Roemer F, McCulloch C, Felson DT: Fluctuation of knee pain and changes in bone marrow lesions, effusions, and synovitis on magnetic resonance imaging.
Arthritis Rheum 2011, 63:691-699. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, Kothari M, Lu Y, Fye K, Zhao S, Genant HK: Whole-organ magnetic resonance imaging score (WORMS) of the knee in osteoarthritis.
Osteoarthr Cartil 2004, 12:177-190. PubMed Abstract | Publisher Full Text
Xu L, Hayashi D, Roemer FW, Felson DT, Guermazi A: Magnetic resonance imaging of subchondral bone marrow lesions in association with osteoarthritis.
Semin Arthritis Rheum 2012, 42:105-118. PubMed Abstract | Publisher Full Text
Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG: The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score).
Ann Rheum Dis 2008, 67:206-211. PubMed Abstract | Publisher Full Text
Roemer FW, Bohndorf K: Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI.
Skeletal Radiol 2002, 31:615-623. PubMed Abstract | Publisher Full Text
Bining HJ, Santos R, Andrews G, Forster BB: Can T2 relaxation values and color maps be used to detect chondral damage utilizing subchondral bone marrow edema as a marker?
Skeletal Radiol 2009, 38:459-465. PubMed Abstract | Publisher Full Text
Anandarajah AP, Schwarz EM, Totterman S, Monu J, Feng CY, Shao T, Haas-Smith SA, Ritchlin CT: The effect of etanercept on osteoclast precursor frequency and enhancing bone marrow oedema in patients with psoriatic arthritis.
Ann Rheum Dis 2008, 67:296-301. PubMed Abstract | Publisher Full Text
Roemer FW, Khrad H, Hayashi D, Jara H, Ozonoff A, Fotinos-Hoyer AK, Guermazi A: Volumetric and semiquantitative assessment of MRI-detected subchondral bone marrow lesions in knee osteoarthritis: a comparison of contrast-enhanced and non-enhanced imaging.
Osteoarthr Cartil 2010, 18:1062-1066. PubMed Abstract | Publisher Full Text
Frobell RB, Le Graverand MP, Buck R, Roos EM, Roos HP, Tamez-Pena J, Totterman S, Lohmander LS: The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year.
Osteoarthr Cartil 2009, 17:161-167. PubMed Abstract | Publisher Full Text
Li X, Ma BC, Bolbos RI, Stahl R, Lozano J, Zuo J, Lin K, Link TM, Safran M, Majumdar S: Quantitative assessment of bone marrow edema-like lesion and overlying cartilage in knees with osteoarthritis and anterior cruciate ligament tear using MR imaging and spectroscopic imaging at 3 Tesla.
J Magn Reson Imaging 2008, 28:453-461. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Mayerhoefer ME, Breitenseher M, Hofmann S, Aigner N, Meizer R, Siedentop H, Kramer J: Computer-assisted quantitative analysis of bone marrow edema of the knee: initial experience with a new method.
AJR Am J Roentgenol 2004, 182:1399-1403. PubMed Abstract | Publisher Full Text
Peterfy CG, Schneider E, Nevitt M: The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee.
Osteoarthr Cartil 2008, 16:1433-1441. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Pang J, Miller E, Driban J, Tassinari A, McAlindon T: A curve evolution method for identifying weak edges with applications to the segmentation of magnetic resonance imagings of the knee. 2011 IEEE International Symposium; 1410-1415. [Biomedical Imaging: From Nano to Macro]
March 30, 2011 to April 2, 2011
Chan TF, Vese LA: Active contours without edges.
IEEE Trans Image Process 2001, 10:266-277. PubMed Abstract | Publisher Full Text
Benjamini Y, Hochberg Y: Controlling the false discovery rate: a practical and powerful approach to multiple testing.
Roemer FW, Frobell R, Hunter DJ, Crema MD, Fischer W, Bohndorf K, Guermazi A: MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis.
Osteoarthr Cartil 2009, 17:1115-1131. PubMed Abstract | Publisher Full Text
Lynch JA, Roemer FW, Nevitt MC, Felson DT, Niu J, Eaton CB, Guermazi A: Comparison of BLOKS and WORMS scoring systems part I. Cross sectional comparison of methods to assess cartilage morphology, meniscal damage and bone marrow lesions on knee MRI: data from the osteoarthritis initiative.
Osteoarthr Cartil 2010, 18(11):1393-1401. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Davies-Tuck M, Wluka AE, Forbes A, Wang Y, English DR, Giles GG, O'Sullivan R, Cicuttini FM: Development of bone marrow lesions is associated with adverse effects on knee cartilage while resolution is associated with improvement - a potential target for prevention of knee osteoarthritis: a longitudinal study.
Kothari A, Guermazi A, Chmiel JS, Dunlop D, Song J, Almagor O, Marshall M, Cahue S, Prasad P, Sharma L: Within-subregion relationship between bone marrow lesions and subsequent cartilage loss in knee osteoarthritis.
Roemer FW, Guermazi A, Javaid MK, Lynch JA, Niu J, Zhang Y, Felson DT, Lewis CE, Torner J, Nevitt MC: Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis.
Ann Rheum Dis 2009, 68:1461-1465. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Eckstein F, Hudelmaier M, Wirth W, Kiefer B, Jackson R, Yu J, Eaton CB, Schneider E: Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the Osteoarthritis Initiative.
Ann Rheum Dis 2006, 65:433-441. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Hernandez-Molina G, Guermazi A, Niu J, Gale D, Goggins J, Amin S, Felson DT: Central bone marrow lesions in symptomatic knee osteoarthritis and their relationship to anterior cruciate ligament tears and cartilage loss.
Arthritis Rheum 2008, 58:130-136. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Carrino JA, Blum J, Parellada JA, Schweitzer ME, Morrison WB: MRI of bone marrow edema-like signal in the pathogenesis of subchondral cysts.
Osteoarthr Cartil 2006, 14:1081-1085. PubMed Abstract | Publisher Full Text
Crema MD, Roemer FW, Zhu Y, Marra MD, Niu J, Zhang Y, Lynch JA, Javaid MK, Lewis CE, El-Khoury GY, Felson DT, Guermazi A: Subchondral cystlike lesions develop longitudinally in areas of bone marrow edema-like lesions in patients with or at risk for knee osteoarthritis: detection with MR imaging–the MOST study.
Radiology 2010, 256(3):855-862. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Tanamas SK, Wluka AE, Pelletier JP, Martel-Pelletier J, Abram F, Wang Y, Cicuttini FM: The association between subchondral bone cysts and tibial cartilage volume and risk of joint replacement in people with knee osteoarthritis: a longitudinal study.
Arthritis Res Ther 2010, 12:R58. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text
Hayashi D, Xu L, Roemer FW, Hunter DJ, Li L, Katur AM, Guermazi A: Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis.
Radiology 2012, 263:206-215. PubMed Abstract | Publisher Full Text
Pre-publication history
The pre-publication history for this paper can be accessed here:


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Winter!: Prepare for holiday gaming!
Always been a favorite of mine. Every iteration of Civ has continually gotten better and Civ 3 was no exception. While I may have Civ 4 now my friends still have Civ 3 and we always come back to it at one time or another.
Game Traits applied to Sid Meier's Civilization III: Complete (PC) by ScotlandTom
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Written on: 17/07/2012
New version of Little Ones pull ups are inferior, they leak easily during the night and the blue band at the side causes a rash if any part of it comes into contact with the skin. I used to buy this brand on a regular basis, was very happy with it, but no longer since this new version came out.
" Worst Nappies Ever " Read More
" Dry Baby @ Night " Read More
Written by mojoba
" Beat diapers ever used for my own self " Read More
" Wonderoos V3 Tomato Minky " Read More
Written by Bird123
" Useless " Read More


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Halldis Apartment Rentals in Rome
It may be too late but I have already put down my deposit before realizing I have not done the proper research. Does anyone know if Halldis is a reliable rental company for Rome, Italy. I have put down a sizable deposit and even though it is etched in stone I would rather not have a surprise when I got to Rome as it relates to quality of the place. The pictures on the site show a gorgeous apartment in a great area. How can I be sure that this is the case? Any experiences would be greatly appreciated.


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The man had been driving along Rosevale Road, Dumfries, with his son in the car at around 3.30pm on Saturday. He then pulled over and got out of the car to speak to a friend.
However, the toddler took off his seat belt and stepped out into the road, where he was struck by a red Peugeot.
His condition is described as serious but stable in hospital. The Peugeot driver was not hurt.
Officers from Dumfries road policing unit are urging witnesses or anyone with information to contact them on 101.
A spokesman said: "Officers from Road Policing in Dumfries are appealing for information."


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The young theater ensembles around town haven't cornered the market on the edgy or the avant-garde.
The Vagabond Players, more readily associated with mainstream (or at least near-mainstream) repertoire, is closing its 95th season with a decidedly offbeat item, "Abducting Diana," by Italian playwright Dario Fo, the 1997 Nobel Prize laureate for literature.
It's a gutsy choice for the company, but the play, a combination of satire, farce and a dash of commedia dell'arte, seems to suffer in the translation. (The adaptation used here is by Stephen Stenning.)
The setting has moved from Italy to the D.C. area. The plot involves the amateurish kidnapping of a media mogul, the Diana of the title — at least the kidnappers think she's Diana. Whoever she is, she's a handful, especially when, focused on the publicity value of her plight, she turns the tables on the abductors.
Fo's writing takes aim at big media, big money and the political class. He goes in for some rough stuff along the way, verbal and physical (torture devices include electric shock and, yes, ice cream). But many would-be zingers are rather clunky.
It doesn't help that the production, directed by Michael Spellman, is a few watts short of optimum fire power. A more propulsive pace and snappier delivery by the actors would be welcome.
That said, Andrea Bush gives a mostly effective portrayal of the title role. And Tim Craighead, seemingly inspired by the nerdy Screech from TV's "Saved by the Bell," makes a particularly colorful contribution as Kidnapper No. 2.
"Abducting Diana" runs through June 26 at Vagabond Players, 806 S. Broadway. Tickets are $15. Call 410-563-9135 or go to vagabondplayers.org.
—Tim Smith
Review: Vagabond Players present 'Abducting Diana'
Nobel laureate's work offers satire, farce
Dario Fo's "Abducting Diana" continues at Vagabond Players through June 26. In this shot, Andrea Bush, as the kidnapped woman, turns the tables on a kidnapper (Tim Craighead). (Ken Stanek, Handout photo / June 2, 2011)


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8ft mr. Billiards pool table for sale. includes accessories.
The table is in great condition but has several stains on the felt.
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Valley Cougar, 7' Pool Table - Valley has built a rugged commercial grade billiard table that's hard to beat or beat up! Built with cabinet grade ¾" plywood on sides and bottom, unitized composite fast ball return Assembly. Table Converted from coin operated use to home use. No longer has coin mechanism assembly. Built to give years of reliable service, The Valley Pool Table has the finest ...
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This is a 7' pool table from sears. It has 2 pool cues the traingle and all balls and a wall rack. It's in good shape just very dusty . The legs come off so it can be moved . It's still heavy even though it's not a slate top. It's in the basement and will take at least 2 strong people to carry it out. I have the tools needed to disassemble . You just need to bring the $ and the people to ...
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Product Type:Standard pool table already set up
Frame Finish:Mahogney
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David, Canada – 27 May 2011
I had an AWESOME first stay in Barcelona. The Be Sound Hostel had perfect location and the staff was VERY nice, with a special mention to the night guy (sorry bro, forgot your name) who has been just amazingly cool with us. By the way, the rooftop terrace is just plain awesome, great view and greater way to meet people and start the party early (and cheaply…). Thank you so much!
Previous Entry: Great social atmosphere!
Next Entry: Loved everything!


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Town Square
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STATE, NATIONAL, INTERNATIONALLooks like the Obama glow is wearing off
Interesting piece by Associated Press about the presidency of Obama being at a potential crossroads. http://news.yahoo.com/s/ap/us_obama_s_moment_analysis...Original post made by Arnie on Sep. 24, 2009
Last comment by anita, on Sep 25, 2009 at 2:52 pm | 16 comments | 1119 Views
STATE, NATIONAL, INTERNATIONALDemocrats Sponsoring Bill for Defeat in Afghanistan...
It should come to no one's surprise that Democrats - the Party of Surrender -- are sponsoring HR3699 to withhold troop surge...Original post made by not surprised on Oct. 5, 2009
Last comment by Stay Cool, on Oct 6, 2009 at 9:01 am | 16 comments | 1136 Views
COMMENTS ON STORIESIt seems that Prattle & Tattle is taking over the Town Forums
Prattle and Tattle seems to be taking over the Town Forums. Whats going on?...Original post made by Tango on Oct. 7, 2009
Last comment by Cholo, on Oct 10, 2009 at 1:34 pm | 16 comments | 3509 Views
COMMENTS ON STORIESCity seeks volunteers for downtown holiday parade
Halloween is still more than a week away, but already Pleasanton is looking for a few good volunteers for its Hometown Holidays...Original post made on Oct. 22, 2009
Last comment by VS, on Nov 28, 2009 at 7:33 pm | 16 comments | 1523 Views
AROUND TOWNPolice Action in Val Vista
What happened on Robin Ct. in Val Vista today at about 2-3pm. Rumor says it was a suicide. Does anybody know for sure....Original post made by Michael on Oct. 24, 2009
Last comment by Jerry, on Oct 31, 2009 at 12:26 am | 16 comments | 1250 Views
SCHOOLS & KIDSWhy a Search Firm ? I don't know...
Why a search firm ?, I don't know, you tell me: By Robert Jordan/Contra Costa Times "Pleasanton-Pleasanton school trustees...Original post made by Original Joe on Nov. 9, 2009
Last comment by john, on Nov 12, 2009 at 12:25 pm | 16 comments | 1436 Views
AROUND TOWN'Spare the Air Day' ordered for today - 3rd day in row for ban on woodburning fireplaces
The Bay Area Air Quality Management District has issued another Spare the Air today. Read the full story here http://www.pleasantonweekly.com/news/show_story.php?id=3296...Original post made on Jan. 10, 2010
Last comment by ToBePositvie, on Jan 13, 2010 at 11:40 am | 16 comments | 1542 Views
STATE, NATIONAL, INTERNATIONALLesbian daughter changed view of San Diego mayor on same-sex marriage
A federal trial on same-sex marriage moved into its second week in San Francisco today with testimony from the mayor of San...Original post made on Jan. 19, 2010
Last comment by PToWN94566, on Jan 20, 2010 at 11:45 pm | 16 comments | 1098 Views
SCHOOLS & KIDSDoes anyone know why our district has so much debt compared to other districts?
I heard from a friend that our district carries 18-20% debt while most other districts carry 3-4%. Why is this? What is...Original post made by Resident on Feb. 3, 2010
Last comment by an old mom, on Feb 4, 2010 at 9:12 pm | 16 comments | 1223 Views
STATE, NATIONAL, INTERNATIONAL10 steps that would destroy American Society...
If you were a science-fiction writer, think of 10 major events - short of an atomic bomb - that would destroy the American...Original post made by Mark on Feb. 3, 2010
Last comment by Gunslinger, on Feb 5, 2010 at 11:55 am | 16 comments | 960 Views
STATE, NATIONAL, INTERNATIONALTorrico introduces legislation to place officers at high schools
California Assembly Majority Leader Alberto Torrico, whose district includes a portion of Pleasanton, this week introduced...Original post made on Feb. 11, 2010
Last comment by Stacey, on Feb 17, 2010 at 9:54 pm | 16 comments | 1202 Views
STATE, NATIONAL, INTERNATIONALNo longer DEM vs GOP
I was slightly stunned to hear, all in the past three days, Beck, Hannity and Savage all three going after the Republicans....Original post made by jimf01 on Feb. 24, 2010
Last comment by AR, on Mar 14, 2010 at 7:36 pm | 16 comments | 1586 Views
STATE, NATIONAL, INTERNATIONALDublin to get government-paid electric car charging station
The Bay Area Air Quality Management District announced Wednesday that it is funding more than 200 electric vehicle charging...Original post made on Feb. 25, 2010
Last comment by Smart Meters being rammed in place, on Mar 3, 2010 at 2:21 pm | 16 comments | 1049 Views
AROUND TOWNPleasanton Spa Closed!
Yesterday, I arrived at the Pleasanton Spa for my day of relaxation that I scheduled over a month ago. When I arrived around...Original post made by KK on Mar. 5, 2010
Last comment by Eve, on Jun 15, 2010 at 3:05 pm | 16 comments | 3151 Views
COMMENTS ON STORIESAnother Hosterman helping to make downtown thrive
Another Hosterman has taken a leadership position in Pleasanton. Michael Hosterman, an attorney with offices downtown and...Original post made on Mar. 5, 2010
Last comment by Cholo, on Mar 8, 2010 at 7:53 pm | 16 comments | 1648 Views
SCHOOLS & KIDSSeniority-only Based Layoffs Hurt Students
At the end of this PDF link is a suggestion for an alternative system that can be implemented based upon the results of the...Original post made by Stacey on Mar. 8, 2010
Last comment by Kathleen Ruegsegger, on Mar 15, 2010 at 6:50 am | 16 comments | 7220 Views
CRIMES & INCIDENTS'Dilbert' cartoonist planning custom home here
In addition to crafting cartoons for his nationally-syndicated "Dilbert" comic strip or managing two local eateries, Scott...Original post made on Mar. 9, 2010
Last comment by cialis eli lilly, on Jun 17, 2010 at 8:37 pm | 16 comments | 2529 Views
STATE, NATIONAL, INTERNATIONALPG&E Smart Meters
Just watching the news and they talked about the new "Smart Meters" PG&E is using. People are complaining about the new...Original post made by ptownfreckle on Mar. 12, 2010
Last comment by Fact Checker, on Mar 15, 2010 at 8:29 am | 16 comments | 1486 Views
AROUND TOWNWhat you need to know about the Pleasanton Patriots and Tea Partiers today!
Friday Rally at Jerry McNerney's, "The Pelosi of Pleasanton" We are down to the wire on the (never ending) healthcare...Original post made by jimf01 on Mar. 18, 2010
Last comment by jimf01, on Mar 19, 2010 at 2:05 pm | 16 comments | 1115 Views
STATE, NATIONAL, INTERNATIONALDemocrats Ignoring the Will of the American People, They Don't Stand with "We the People!"
"Madam Speaker, this is not the president's house. This is not the Democrats' house. This is the peoples' house, and the...Original post made by Kelly on Mar. 21, 2010
Last comment by Stacey, on Mar 23, 2010 at 12:13 am | 16 comments | 900 Views
The Kentucky Gubernatorial Derby
By Tom Cushing | 1 comment | 1,495 views
'General Lee' banned; political correctness gone too far?
By Gina Channell-Allen | 9 comments | 779 views
Special session to tackle two key issues
By Tim Hunt | 5 comments | 614 views
When Students Consider Non-Portfolio Design Schools
By Elizabeth LaScala | 0 comments | 530 views


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BrightonandHoveJobs.com are currently Sussex's naming rights partner for The BrightonandHoveJobs.com County Ground.
BrightonandHoveJobs.com has rapidly become the local hub for all of the city's best jobs and employment challenges.
Representing the city of Brighton & Hove and all of its commutable areas, BrightonandHoveJobs.com has been created to become the city's one stop shop for all local job opportunities, employment, volunteering and training information.
The LV=County Championship season is upon us once again! There's plenty of news and previews about the new season and the fantastic LV=CC Catch-Up ..read more »
Sussex Cricket is saddened to hear the news that former player Ted James passed away last week. Ted played as a seam bowler for Sussex during ..read more »


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Enhance the sports feel of the F-TYPE's interior detailing.
These nubuck-edged Jet Black mats feature a unique carpet pile that helps keep your F-TYPE interior sleek and sporty.
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Job Overview
Position: Nursing Instructor (one-year temporary, non-tenure track) – Job # T1207
Location: Nursing Program, Pierce College Puyallup
Salary: Depending on Experience
Posting Date: 6/12/2012 Closing Date: 7/12/2012
Anticipated Start Date: 9/14/2012
About the District:
The Pierce College District is part of the 34 Community and Technical College System in Washington State. The District includes two colleges. Pierce College Fort Steilacoom located in Lakewood and Pierce College Puyallup located in Puyallup, and a Military Education Program at Joint Base Lewis-McChord. Boasting majestic views of the snow-capped Olympic Mountains and Mt. Rainier, the district offers the benefits of rural, suburban and urban life in the Pacific Northwest. We invite applications from qualified individuals interested in working within a diverse, innovative, outcome focused, learning-centered environment.
About the Program:
The successful candidate will join a nursing department that offers the generic and Licensed Practical Nurse (LPN) student an opportunity to obtain an associate of science degree in nursing. The program also offers students the opportunity to matriculate to the University of Washington's Bachelor of Science in Nursing completion program. The program is innovative and designed to attract non-traditional students.
About the Position:
The successful candidate will demonstrate current content knowledge and experience with innovative teaching and assessment strategies in both grounded and online environments and utilize student success data and information to improve achievement of learning outcomes. Candidates will be expected to teach nursing didactic/theory and clinical skills to students in lecture, lab, acute, and long-term care settings. Supervising students in off-campus clinical experiences on medical, surgical, critical care and ambulatory units of local hospitals, in long-term care facilities of in community agencies for clients across the life span from birth through death, is imperative. Teaching assignments will vary and may include a combination of didactic and clinical responsibilities. The successful candidate will be expected to provide dedicated leadership in one of the following clinical areas of expertise based on training and experience; mother/baby, medical surgical nursing, mental health, pediatrics, critical care and ambulatory nursing care. The person in this position will work collaboratively with colleagues across disciplines; be engaged in ongoing professional development; participate in shared governance and contribute to a positive learning environment.
Expected Outcomes:
Pierce College faculty are expected to: 1) engage in teaching and learning; 2) advise and mentor students; and 3) participate in shared governance of the department, division, college and district.
Teaching and Learning Outcome
Faculty design quality educational experiences in order for each student to have the opportunity to apply core abilities, fundamental areas of knowledge, disciplinary and interdisciplinary skills, toward achievement of their education/career goal.
• Prepare, instruct and assess teaching and learning in order to maximize student achievement of learning outcomes and competencies to include:
- The publication of a course syllabus that contains, at a minimum, the elements listed in the Faculty Handbook
- Accessibility to students during posted office hours that are distributed over the week
- The preparation and submission of a course outline with core abilities, fundamental areas of knowledge and/or course content competencies
- The assessment of student progress toward learning outcomes and competencies at the course, program and degree level as appropriate to the discipline and in a manner consistent with the college's Institutional Assessment Plan
- The use of data on student learning from classroom assessment, program/degree assessment, student engagement surveys, student evaluations, peer observations and Advisory Committees (when appropriate) to adjust course content and pedagogy
- The engagement in ongoing course/department/program review as determined by the department/program and that is consistent with the college's accreditation guidelines
- Remaining current within their field and teaching through appropriate professional development activities which may include:
• Participation in local and regional discipline-specific or appropriate educational conferences that align with Professional Growth and Development Plan;
• Engagement with department, division, district colleagues and those at neighboring institutions in the development and enhancement of teaching and learning;
• Engagement with community, regional and statewide partners in the development of teaching and learning.
Advising Outcome
Faculty provide quality advising/mentoring in order for the student to acquire the information necessary to plot an efficient career path to his/her learning goal.
• Provide advising/mentoring for assigned advisees
• Assist advisees in the preparation of an Educational Plan
Shared Governance Outcome
Faculty participate in the shared governance of Pierce College in order to promote faculty voice and engagement in college decisions
• Participate in department, division, college and district meetings as required
• Participate in planning and discussions through a variety of means which may include:
- Representation on CLASS
- Membership on college and district committees
- Participation in regional and statewide committees
Responsibilities to meet the Expected Outcomes include:
• Facilitating a learning space that is student centered
• Encouraging and participating in an environment that emphasizes Student-Faculty interaction
• Designing learning experiences in a variety of instructional modalities (grounded, hybrid, online)
• Contributing actively to the student advising program and district-wide efforts to improve student retention and success
• Maximizing student achievement of learning outcomes and competencies through active and collaborative learning opportunities
• Collaborating with colleagues in the development of curriculum and programs that create a cohesive learning experience
• Engaging students who possess varying levels of academic preparation, knowledge and/or course competencies and having a wide variety of interests, ages, and backgrounds
• Possessing strong knowledge of disciplinary content, theory, and current advances to ground students in fundamental areas of knowledge
• Connecting with students during office hours over the week
• Collaborating with district/department colleagues in the development and assessment of course, program, and degree level learning outcomes
• Contributing to district instructional planning and activities
• Playing an active role on instructional committees
• Working collaboratively and effectively with colleagues and with all areas of the college community
• Participating in district shared governance activities, division, and department meetings
• Participating in college-sponsored professional development activities
• Participating in ongoing professional development activities related to one's field of study
• Participating in professional development opportunities aimed at improving teaching and learning
Required: Master's degree in Nursing, or enrollment in Master's in Nursing program with expected completion by September 2012; current Registered Nurse (RN) licensure in Washington State or ability to obtain license prior to date of hire; two years' experience as an RN; evidence of current clinical skills in nursing; documented successful teaching experience; experience relating to complex healthcare settings, such as acute care hospitals; current CPR certification; and currently hold or be able to attain vocational certification.
Preferred: Successful teaching experience at the community college level; experience relating to multiple healthcare settings, including Obstetric, Pediatric and Critical Care settings; evidence of successful use of technology in the classroom, use of innovative teaching strategies and participation in ongoing professional development; experience/coursework in curriculum development and related professional experience and/or activities in addition to teaching.
Terms of Employment:
This position is a full-time, one-year, non-tenure track, temporary assignment of 173 contracted days per year, anticipated to begin September 2012. The academic year work calendar is developed in order to respond to peak service and advising needs of students.
Pierce College District employees may be assigned to either Pierce College Fort Steilacoom or Pierce College Puyallup. Evening, split schedule and/or work at more than one site may be included in the assignment. Initial salary placement is based on the current full-time faculty salary schedule, and is dependent upon education and experience.
Application Requirements:
To be considered for this position, you must:
• Meet the required qualifications as outlined in the job announcement.
• Complete the online application profile at www.pierce.ctc.edu/hr.
• Apply for the specific job opening.
• Upload (attach) a cover letter describing how your educational background and experience align with the responsibilities and qualifications of this position.
• Upload (attach) your response to the following questions: "Describe the ways you determine whether your students have learned and the unique strategies you employ to ensure that they have."
• Upload a detailed curriculum vitae (c.v.) of all educational and professional experience, which includes a list of courses taught.
• Upload an image of all college and university transcripts.
• SPECIAL NOTE: All application materials must be submitted by 5 p.m. on the closing date. Note: Official transcripts will be required for the successful candidate at the time of hire.
Reasonable Accommodation:
Applicants with disabilities who require assistance with the application and employment process will be accommodated to the extent reasonably possible. Requests should be made to the District Human Resources Office by calling 253-964-7342. A telecommunication device for the deaf is available at (253) 964-6228.
Screening & Interview Process:
Only those candidates who have complied with the application process and meet the required qualifications will be considered. The most desirable candidates will be contacted for an interview.
Please visit the Pierce College benefits web page at http://www.pierce.ctc.edu/dist/hr/benefits.php for detailed benefits information.
Conditions of Employment:
• Agency Shop, Full-time Faculty: As a condition of employment, all full-time faculty bargaining unit members must either join the Pierce College Federation of Teachers or pay a representation fee.
• Physical Work Environment: Work is performed in an instructional setting and requires the ability to communicate clearly. Work also includes the ability to use a personal computer.
• In compliance with the Immigration Reform and Control Act of 1986, proof of authorization to work in the United States will be required at the time of hire.
• Pierce College has adopted a Drug Free Workplace policy. As a condition of employment, employees must agree to abide by the requirements established in that policy.
For more information or assistance, contact Human Resources at: firstname.lastname@example.com


text:
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