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Tumor Marker Tests [1]
Tumor markers (also known as biomarkers) are substances found at higher than normal levels in the blood, urine, or body tissue of some people with cancer. Although cancer cells often produce tumor markers, other healthy cells in the body produce them as well.
Tumor markers and cancer
Along with other diagnostic tests, testing for tumor markers can indicate the presence of cancer and help doctors make treatment decisions. Tumor markers are most commonly used to do the following:
Screen high-risk individuals. Doctors may test for tumor markers to help find cancer in healthy or high-risk people before symptoms develop.
Confirm the diagnosis. Tumor markers may be used to confirm the results of other tests and procedures. However, the presence or amount of a tumor marker alone is not enough to diagnose cancer.
Predict prognosis. Tumor markers can help the doctor predict the cancer's behavior and response to treatment, as well as a person's chance of recovery.
Guide treatment decisions. Some tumor markers help doctors decide whether to add chemotherapy [3] (the use of drugs to kill cancer cells) or immunotherapy [4] (biologic therapy; treatment designed to boost the body's natural defenses to fight the cancer) after surgery and/or radiation therapy. Other tumor markers help doctors choose which drug(s) or regimens (schedules for these drugs) will be most beneficial for an individual patient.
Monitor treatment. Doctors may use changes in the presence or amount of one or more tumor markers to assess how the cancer is responding to treatment.
Predict or monitor for recurrence. Tumor markers may be used to determine the chance that the cancer will come back after treatment. For some patients, looking for changes in the amount of a tumor marker may be part of their follow-up care plan and may help detect a recurrence sooner than other methods.
Limitations of tumor markers
Tumor markers are not foolproof. Usually doctors need results from other tests, such as an x-ray or biopsy [5] (the removal of a small amount of tissue for examination under a microscope), to determine whether the presence of a particular tumor marker is a cause for concern. This is because:
- An elevated tumor marker level may be caused by a condition or disease other than cancer.
- Some tumor marker levels may be high in people without cancer.
- Tumor marker levels may vary over time, making it hard to get consistent results.
- The level of a tumor marker may not rise until a person's cancer is advanced, which is not helpful for early detection, screening, or monitoring for recurrence.
Testing for tumor markers
To test for tumor markers, the doctor will take a sample of blood or urine and send it to a laboratory for analysis. A biopsy sample or surgical specimen may also be used to test for tumor markers. Some tests must be repeated because the levels of tumor markers can change from month to month. This is called serial testing.
As with other laboratory tests, a reliable tumor marker test must be both specific and sensitive.
Specificity. If either the tumor marker itself or the test used to detect or measure it is not specific enough, there is a chance that the results could suggest a tumor is present, or growing despite treatment, when it is not (a false positive). In this case, a healthy person may go through unnecessary tests and anxiety.
Sensitivity. If the tumor marker or the test is not sensitive enough, the results may suggest a tumor is not present when it actually is or that it is responding to treatment when it is not (a false negative). In this case, a person who may benefit from additional testing and treatment may not receive it.
Examples of tumor markers in cancer
The following are examples of tumor markers often associated with cancer. Please talk with your doctor or another member of your health care team to learn more about specific tumor markers.
Human epidermal growth factor receptor 2 (HER2). This tumor marker is a specialized protein on breast cancer cells that helps control cancer growth and spread. Women with tumors that have high levels of HER2 benefit from certain drugs, including trastuzumab (Herceptin). Learn more about HER2 testing for breast cancer [6].
Carcinoembryonic antigen (CEA). This tumor marker may be found at elevated levels in people with different types of cancer, but it is most often associated with colorectal cancer. Read more about CEA and other tumor markers for gastrointestinal cancers [7].
Prostate-specific antigen (PSA). PSA is a protein made by the prostate gland. PSA levels are high in men with prostate cancer, prostatitis (inflammation of the prostate), or benign prostatic hyperplasia (BPH, a condition in which prostate cells grow and block the flow of urine). A PSA test can be used to screen for prostate cancer; however, the value of this screening test for men who have no symptoms of prostate cancer remains under debate. In addition, PSA tests are used to find out if prostate cancer has returned after treatment. Learn more about PSA testing [8].
KRAS. This tumor marker (pronounced kay-rass) is a gene that is changed, or mutated, in 30% to 40% of colon tumors. ASCO recommends that people who have colon cancer that has spread outside the colon to other areas of the body should have a test to find out if the tumor has mutations in the KRAS gene. The test helps predict which patients may benefit from specific drugs.
Cancer antigen 125 (CA 125). This protein is found on the surface of many ovarian cancer cells and can be detected with a blood test. Although women with ovarian cancer often have an elevated level of CA 125, an elevated CA 125 level doesn't always mean you have ovarian cancer. An increase in CA 125 may be caused by another type of cancer, including endometrial, peritoneal, or fallopian tube cancer, or a non-cancerous condition, such as uterine fibroids, endometriosis, pelvic inflammatory disease, cirrhosis, pregnancy, or normal menstruation.
Questions to ask the doctor
Consider asking your doctor or another member of your health care team the following questions:
- Do you recommend that I have any tumor marker tests? If so, which ones?
- Which ones have you already performed, if any?
- How are these tests performed? How often should I have them?
- Can you explain the test results?
- If I have abnormal levels of a tumor marker, what does that mean? How does it affect my treatment?
- Where can I get more information about tumor markers?
Cancer survivors should also ask how tumor marker tests may be used in their follow-up care.
More Information
What to Know: ASCO's Guideline on Tumor Markers for Breast Cancer [10]
Understanding Targeted Treatments [11]
Dealing With Cancer Recurrence [12]
Additional Resource


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|Ashe Schools Struggle with Calendar
|Written by Gary Childers
|Friday, 14 September 2012 05:45
After recognizing Ms. Anita Ferguson as their September Employee of the Month during Monday evening's meeting, the Ashe County Board of Education took several items under consideration. One item of note was the approval for Ashe County High School's Marching Band
and Steel Drum Band students to attend the Disney Performance Tour in Orlando, Florida on April 2-6. Two additional items were discussed but both will require more information before action can be taken. The first pertained to the Board's policy of administering medicines to students. Amy Quesinberry, Northwest Region School Nurse Consultant, presented information about administering EpiPens, an injection kit containing epinephrine, used for allergic reactions. The current policy allows qualified staff to administer an EpiPen if the parent provides a prescription. The question under consideration is whether a qualified staff member can administer an EpiPen to a student if the parent has not provided a prescription calling for its use. Nurse Quesinberry and Superintendent Reeves will be gathering more information on this topic to present to the Board in a future meeting. The other item needing more information is the development of next year's school calendar. Superintendent Reeves is hopeful that the legislature will provide more flexibility to local school systems next year, "You can't start school unless August 25th unless you get a waiver because of weather—and we should qualify—but then you can't start before August 19th –on or around that date, and you have to finish by June 10 or 11th. If we have an elongated winter like we did two years ago with 23 days missed, I can see us going beyond that." Reeves said they may have to create two calendars—each with their own options, and hope for changes from Raleigh.
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Exchange Dates to Remember
Spring 2016 Applications
Applications Due:
September 21, 2015
September 22-26, 2015
September 29, 2015
Academic Year 2016-2017
Applications Due:
February 15, 2016
February 22-26, 2016
March 2, 2016
Studying abroad was, by far, one of my best (if not THE best) experiences in law school. I recommend it to absolutely every student no matter what their future career plans may be. Not only did I get the opportunity to take courses that are not offered here at UConn, but I was exposed to a much broader perspective of the law while studying at Tilburg. The school draws hundreds of international students each semester, so it is more of a truly international environment than I ever expected. I made friends from around the world and learned more than I ever imagined, not just about law, but politics, business, culture, etc.
Spending a semester abroad at Tilburg University was the opportunity of a lifetime. In my six months in The Netherlands I was fortunate enough to gain valuable knowledge both inside and outside the classroom that will provide me with an edge in achieving my lifetime goals.
Founded in 1927, Tilburg University, located in the Netherlands, is a fully accredited, government financed university that specializes in the social sciences. There are almost 10,000 students completing degrees in five different faculties: Economics and Business Administration, Law, Social and Behavioral Sciences, Philosophy and Arts. The university is small and easy to navigate.
The Tilburg University Faculty of Law was founded in 1963. The faculty offers four degree programs: Dutch Law, Tax Law, Administrative Law and Public Administration, and European Law. The law faculty is comprised of 30 professors, 15 senior lecturers, and 150 junior lecturers.
Students choosing to study at the University of Tilburg can opt attend the university for the full academic year or for one semester in the fall or spring.
|Fall Semester
|End of August to mid-December, orientation in mid to late August
|Spring Semester
|Mid-Januarary to mid-May
|Full Year
|End of August to mid-May until coursework completed
Our program with Tilburg University is designed to give students a chance to study Business or Administrative Law in a diverse international setting. Because Tilburg encourages foreign exchanges and has over 350 international students annually, the classroom is as diverse as the student center and the dormitories.
Internal Market Law
This course aims at presenting the foundations and the functioning of the EU internal market in a comprehensive manner. The internal market is one of the centerpieces of European integration, making up its core provisions and original raison d'être. The rules on internal market have spawned not only a considerable amount of EU legislation and case-law but also intense political and academic debates. At first sight, internal market law might seem like a sprawling mix of conflicting ECJ cases and perplexing secondary legislation. Through a case-based approach, this course provides the student with a solid basis to understand this area of EU law and to form a critical and well-reasoned opinion on it. It also deals with some key issues of market integration in Europe which are of both practical and political relevance. The core of the course relates to the mechanics of the four freedoms (goods, services, capital and persons) which form the cornerstone of the internal market. It analyses the way in which market integration is achieved within the EU (and the European Economic Area), discussing both negative integration - the abolishment of national obstacles - and positive integration - integration through harmonization of national laws. Specific issues that are covered include: institutional aspects of harmonization (different forms, New Approach) the direct effect of the free movement provisions, the concept of public (economic) services, social aspects of the internal market regarding consumer protection, fundamental rights etc.
Human Rights Law
The course starts with a general introduction into the historical and judicial background of this emerging body of international human rights law. The main characteristics and the 'peculiarities' of international human rights law will be discussed. It also deals with the major issues of substantive law, the universality/relativism debate, and the so-called three generations, as contained in the various universal and regional instruments and the state obligations under human rights law. This part also concerns the procedural aspects of the international law of human rights, i.e. its implementation and the supervision thereof. Non-judicial or political mechanisms of supervision as well as quasi-judicial and judicial mechanisms are surveyed, i.e., on the basis of case-law. The efforts undertaken in this area by the major international and regional organizations namely the United Nations, the Council of Europe, and the EU will be dealt with. The role of actors other than states will also be examined. Furthermore, specific rights will be studied, for instance, the rights to non-discrimination, to health and development.
International Relations in Historical Perspective
The purpose of this class is to gain an understanding of recent historical developments in international relations with regard to great power politics and security. Apart from a brief introduction about the major schools of thought in 20th-century International Relations Theory (classes 1-2), two themes will be covered. The first, and most extensive, part of the course covers the Cold War (1947-1991). Over 6 classes (3-8), the major phases and crises of the Cold War will be studied chronologically. The focus therefore will not so much be on events, but on the analysis of the security policies
Tilburg is the Netherlands' sixth largest city, located in the Province of Brabant. Its population is just over 205,000 and it's located about 1.5 hours by train from Amsterdam, 2 hours by train from Brussels.
The city grew up around a confluence of herding roads, which carried the great flocks of Dutch sheep to and from the pasturelands. Laborers, tradesmen, and manufacturers built their homes along these connecting roads, ultimately shaping the town. Wool was the city's primary industry for centuries. By 1881 Tilburg had over 145 wool mills and was a chief exporter of raw materials for weavers. Wool remained vital to the city until its collapse in the 1960s.
Fortunately, the University of Tilburg was growing and expanding around the same time, and it began to contribute to modern intellectual society. In 1962 the University of Tilburg moved its campus west of the city center so it would have more area to expand. This also allowed for modern business development in the vacated factory grounds. The city shifted to a knowledge-based economy, which continues to bolster business in Tillburg through numerous collaborations with the city's universities.
Most of the shops, hotels, restaurants, and cafes are conveniently located in the city center not far from the University campus and there are a number of unique neighborhood events such as the Art in Open Space, which provides for artworks throughout the city.
Each year the International Programs department and the Office of Financial Aid work together to create an appropriate semester or year budget for the program.
Below is the budeget for 2014-2015 for one semester.
|Tuition paid to host school
|Tuition paid to UConn
|UConn Fees***
|UConn Law School Abroad Fee
|Books and Supplies
International Affairs Office
Ms. Tessa Barten
Room M-101b
Phone: 011-31-13- 4668377
Fax: 011-31-13-4663143
Email: email@example.com
Prepare for Arrival: http://www.tilburguniversity.edu/education/exchange-programmes/practical...
Upon Arrival: http://www.tilburguniversity.edu/education/exchange-programmes/practical...
Daily Life in Tilburg: http://www.tilburguniversity.edu/education/exchange-programmes/practical...


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India celebrates 64th Republic Day
School children performing a dance during the 64th Republic Day... Nieuwsfoto'sDansen,Delhi,Horizontaal,India,Kind,New Delhi,Optocht,Politiek,Republic Day,Uitvoering,VieringPhotographer Hindustan TimesCollection: Hindustan Times 2013 Hindustan TimesNEW DELHI, INDIA - JANUARY 26: School children performing a dance during the 64th Republic Day parade celebration at Raj path on January 26, 2013 in New Delhi, India. India marked its Republic Day with celebrations held under heavy security, especially in New Delhi where large areas were sealed off for an annual parade of military hardware. (Photo By Sonu Mehta/ Hindustan Times via Getty Images)


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Giant Bombcast 10/13/2015
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The Beginner's Guide offers a personal and sometimes eerie perspective on amateur game development.
Destiny's biggest expansion to date makes the game a whole lot more enjoyable and easier to recommend.
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"Our task must be to free ourselves... by widening our circle of compassion to embrace all living creatures and the whole of nature and its beauty."
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Hiya! Mackenzie here. I'm one of the biggest animal lovers you'll ever meet. I'm always trying to do things to help animals and involve myself in getting active for animal rights. I have 4 awesome animal buddies living with me- a dog, ferret, mouse, and leopard gecko. Animals are my world, and I live to speak up for them.
Looking good is my thing.. Vegan clothing and cosmetics are always in style! ;)
Let me just start out by saying, I'm not perfect, But sometimes I try to be. I've made mistakes. I've taken the easy way out. I've lied to my friends. I've hidden the truth so many times from so many people. I've hurt people, and I've even done it on purpose. I've left people behind. I've spread rumors. I've said things that I didn't mean. I'm no better than anyone, anywhere. I'm human. I have faults, and I'm not afraid to admit that. I want to change, but I can't. Because that's what we do. That's what we've always done. We list our faults like a grocery list, and we move on, expecting everything to somehow change itself. It never will. I will never change. I will never be perfect. I will always make mistakes. I'll, more often than not, take the easy way out. I will lie, hide the truth, hurt people, leave people behind, spread rumors, and say things I don't mean for the rest of my life. But when you come to accept the fact that you do it too, we can see past it all.
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ETHEL joined Suzanne in the studio for an interview and performance.
(Photo by James Ewing)
ETHEL is America's premier post-classical string quartet. Ethel is in Maine this week for several performances. They were at Hannaford Hall, on January 30 and will be at The Collins Center in Orono at 8:00 pm on February 1, and at The Camden Opera House at 7:00 pm on February 2.
Ethel's website.


text: Miss Gilberti | IBDB: The official source for Broadway Information IBDB: The official source for Broadway Information Official Broadway League sites: - sites - broadway.org broadwayleague.com broadwayfanclub.com kidsnightonbroadway.com stagespecs.org tonyawards.com Quick Search For: In This Category: All Show People/Org. Theatre Season Miss Gilberti Performer Female Productions ProductionsDate of ProductionsA Night in Paris[Musical, Revue, Original] Performer: Miss Gilberti Jul 26, 1926 - Oct 30, 1926 Find out where Miss Gilberti and are credited together © 2001-2015, The Broadway League, All Rights Reserved. (Copyright and Disclaimer)


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|Area fuel prices remain high
|Written by Richard Anderson
|Thursday, 22 November 2012 10:31
High Country fuel prices remain among the highest in North Carolina. On Wednesday, the Quick Shop in Newland had a posted price for diesel at $4.25 per gallon. The price at the Valero in Newland was $3.99. High diesel prices are especially painful in Avery County due to the increased number of large trucks servicing the Christmas tree business.
We continue to recommend gas price websites for people traveling to and from our area. Websites like GasBuddy.com can help you pick more economical fuel stops for your trips off the mountain and back.
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- Northern New York Newspapers
- Watertown
- Ogdensburg
- Massena-Potsdam
- Lowville
- Carthage
- Malone
- NNY Business
- NNY Living
- NNY Ads
LISBON State police on Wednesday charged Christopher J. Prue, 41, of 33 Spring St., Norwood, with driving while intoxicated.
Troopers said at 1:45 a.m. on Bull Run Road, they responded to a suspicious-person complaint. It is alleged that Mr. Prue was knocking on a residents door. He later was located at 649 Bull Run Road sitting in his vehicle. Following a breath test, troopers said he had a blood alcohol content of 0.16 percent. Under state law, a BAC of 0.08 percent or more is considered proof of intoxication.
Mr. Prue was issued an appearance ticket for Lisbon Town Court.
Thousands of readers like you have made Northern New York Newspapers the number one ranked website* for local news and sports coverage in the north country.
You can continue on to this article in a few seconds, or you can visit one of our websites:


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Flighty Tank (Women's) (out-of-stock)
Out of Stock Product Number: 29437
The women's Horny Toad Flighty Tank is comfortable and looks good on any woman. The Flighty Tank features bra-friendly straps and adjustable drawcords at the sides.
- Scoop neck
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- Woven fabric front, knit fabric back
- Gathered detail at back knit panel
- Adjustable drawcords at sides
Gender: Women's
Material: Firefly is 100% organic cotton
Season: S12
Vendor ProductId: H1112130
Review ProductId: 29437


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Fresh kiwi soap, great for all skin types
A fresh fruit salad of a soap, each green piece of sudsy delight is packed with enough fruit inside and out to fill your basket (and then some!). We make each batch of Miranda by hand with fresh, organic kiwi fruit to gently cleanse, tone, and brighten your skin. We add in gorgeous bergamot for its soothing, orange-scented effects. To clear up congested skin and to refresh weary spirits we blend in ylang ylang and juniperberry. Simply fruit-tastic, it's the perfect way to start your day!
VeganThis product does not contain animal products of any kind.
For hands, and use all over naked bodies. Get sudsy in the bath and shower. For optimal longevity, keep LUSH soap in a well-drained soap dish (away from water) between uses.How to use
Feeling Fruity: Our soap is named for the famous Samba singer who had a penchant for fruity headpieces.
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- "because the app store updates your apps automatically" <-- Um, how about no? I like making that choice myself after OTHER PEOPLE beta test.Monday, June 10 2013
- I like Control Center though -- all the flashlight app developers are going to commit suicide. Most useful feature in iOS 7!Monday, June 10 2013
- Wow. I HATE the new iOS Safari "tabs" interface. Hate, Detest, Despise, Loathe, Abhor, and Revile. All at once.Monday, June 10 2013
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Willa Cather
(1873 – 1947)
American Writer
Born in Virginia and living most of her adult life in Pittsburgh, New York City and the island of Grand Manan, Canada, Cather is probably best known for writing about the vast landscape of the American heartland and those who immigrated and settled there in the late nineteenth and early twentieth centuries. In 1883, the Cather family moved to Nebraska, where she lived until a year after graduating from the University of Nebraska in 1895. The Nebraska landscape had a profound effect on her writing, especially her fascination for detail. This is most vividly expressed in her two most famous novels, O Pioneers! (1913) and My Ántonia (1918), the latter winning critical acclaim in the US and Europe.
Cather commented that art was something not extraneous to life, but 'must spring out of the very stuff that life is made of'. Yet the 'stuff' of her own life, and those for whom she felt the 'deepest affection' both in her life and in her work, have traditionally been ignored or overridden. This tension between same-sex desire and growing awareness of the building momentum of homophobia in the early twentieth century is evident not only in Cather's public rebuke of Oscar Wilde in one of her columns in 1895, but also in her short story 'Paul's Case' (1905), one of her most often republished and frequently taught stories. Cather herself taught English in a Pittsburgh high school from 1901 to 1906 which coincided, in part, with her 12-year relationship with Isabelle McClung. By concealing her relationships with the women she loved, including Louise Pound, McClung (whose later marriage devastated Cather) and Edith Lewis, with whom she shared a 40-year relationship, Cather also concealed, as Lillian Faderman notes, the ways in which these women contributed to and nourished her creative abilities.
Lesbian studies have questioned interpretations of Cather's work and her identification with her characters, particularly readings of My Ántonia as a classic heterosexual love story. Lesbian readings suggest, for instance, the strong possibility that the novel was not a capitulation to convention in spite of Cather's lesbianism, but a resistance to heteronormative relations. Judith Fetterley has argued that unlike Ántonia, who has traditionally been idealized as the pioneer heroine, the character of Lena Lingard, who resists marriage as restrictive to women, elicits desire in the fictional narrator and in the narrative voice (i.e. Cather's) that describes her. To merely focus on Cather's masculine masquerade in narrating the novel is to miss important connections to Cather as a lesbian novelist. Given homophobic speculation and suspicion of so-called 'female friendships' in the early twentieth century, Cather's use of the masculine fictional narrator may also have been a subversive way to write about women as objects of desire.
Cather wrote other novels including The Professor's House (1925) and Death Comes for the Archbishop (1927), and numerous poems and essays. She was awarded the Pulitzer Prize in 1923 for One of Ours and held honorary degrees from various universities. She was elected to the American Academy of Arts and Letters in 1938 and received a gold medal from the National Institute of Arts and Letters in 1944. She died in New York City; Edith Lewis, author of the biography Willa Cather Living (1953), died in 1972 in the apartment the couple had shared there.


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Twins Shorts
Muay Thai shorts are beautiful works of functional art that are cut higher than the standard MMA board shorts to allow for a full, unencumbered range of motion when throwing kicks. You'll notice this the first time you throw a shin into someone's teeth. On top of that, they're just plain comfortable. Light and airy, you'll wonder how or why you've trained in anything else once you pull on a pair of Muay Thai shorts. Twins Special has been making Muay Thai gear for over sixty years—they're essentially woven into the history of the sport itself. They produce spectacular shorts that embody the bold, proud heritage of Muay Thai and Thailand itself. With a pair of Twins Muay Thai shorts on, you'll feel like you're trading leg kicks with Buakaw himself (not a wise thing to do, btw), even if you're just hitting the Thai bag at the gym. The designs are as functionally durable as they are visually stunning. Who doesn't want a Red Bull logo'd, blue pair of Thai shorts? We know we do. What makes it more awkward is when we all show up to the same training session with the same awesome Twins shorts on, but that's a story for another time… In any case, if you're a Muay Thai athlete, or if you want to rock Thai shorts in the cage, Alan Belcher-style, then take a good hard look at the shorts that Twins Special has to offer. Their designs are as unique as the person wearing them. The wide variety of flames, camo, and angry eyes all allow you to express your individuality in the gym, in the ring, and in the cage. Get your Twins shorts from MMA Industries, we offer a variety of designs that most retailers can only dream of.
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Submission Steam Offering Free-to-Play Games-> 1
donniebaseball23 writes: Valve's digital Steam service is going strong with 30 million active accounts and now the developer has further boosted its offerings by adding free-to-play titles, reports IndustryGamers. Steam is kicking off its support of the free-to-play model with five titles (which will include in-game Steam exclusives): Spiral Knights, Forsaken Worlds, Champions Online: Free for All, Global Agenda: Free Agent, and Alliance of Valliant Arms. Valve's support of free-to-play shows just how widely accepted it's become.
Link to Original Source
Link to Original Source


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You are here
Major Achievements Since Department Formation
On July 1, 2000, all fleet authority transferred to the Fleet Services Department. Several major construction projects, programs, and other enhancements were needed in preparation for this major change, including the following:
- A new 18,000 square foot central City maintenance facility opened in March 2001.
- Complete renovation of the Sanitation Maintenance Garage in October 2001.
- A new central City Fuel Site opened in March 2000.
- A new fuel site at the Bus Maintenance Garage opened in December 1999.
- Technician staff certification became a requirement for employment. In May 2000, Automotive Service Excellence (ASE) awarded their Blue Seal of Approval designation to the Memorial Avenue Maintenance Garage. The six technicians and Shop Superintendent possess a total of 74 ASE certifications. Professional certification goes beyond the shop area - the Director holds four fleet certifications with one from the Wharton School of Business and the others from NAFA, APWA and AEMP.
- A new fleet management information system was installed to capture all fleet information such as maintenance, fuel, acquisition cost, etc. The software (known as FASTER) is furnished by CCG. The system went live in October 1999.
- A fully automated fuel management system was installed at the new fuel sites that allows customers to activate the system via a special key (Prokee). Once personal and vehicle identification information is entered into the system, the dispenser is activated allowing the customer to obtain fuel. The dispensers are Gasboy and the fuel software system is called FuelMaster.
- An internal service fund has been established that allows Fleet Services to mirror the private sector with respect to accounting, billing, and benchmarking. The operating budget is broken down into cost centers (Activity Based Accounting) and billing is based on a fully burdened labor rate supplemented by markups for parts, fuel and contractual services.
- A new large truck wash opened in December 2009.
- The average age of the fleet is 69 months.


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Was nervous to purchase this item at first because of the reviews by people who owned the product longer than 1-2 years.The good reviews were all from new users. All I have to say is so far so good...I have back and neck issues and this mattress really sincerely helps! This mattress is exactly as pictured, I allowed it 1 full day to retain it's shape after unpacking, and it feels so good. The quality is the same a mattress that costs double. The delivery was very fast! You have to purchase the memory foam according to your usage, environment and level of maintenance. I travel back and forth from one town to another for business, and some days, I am not actually sleeping on my bed. When I go back and forth from a firmer mattress to this one, I feel sore after sleeping on this one, I don't know why? The mattress is BEST the second day after my return and not the first?? AFTER THAT, it is like sleeping on a cloud that cradles you. With regular daily usage, the mattress is amazing A couple things to consider with a memory foam mattress that I learned from family members and friends who own them: * MEMORY FOAM can be HIGH MAINTENANCE, but well worth the investment * How high does the mattress sit against your bed frame, headboard, etc. * memory foam mattresses are better on a flat, hard surface for the best support. Box springs are ok, Bunkie boards are better, and a thick Plywood cut to the size of the bed and covered is the best apparently(advice from my brother who has a much higher end mattress than this one)...However, If you are considering one in the price range over $1000 like my folks invested in (over this one)--then you don't have to do squat!! My brother actually stumbled on this theory after purchasing another competitors memory foam that started to lose its comfort after only 1 year. His wife insisted on purchasing another mattress. While they waited for the other one to arrive, they set their memory foam on their hardwood floor in a guest room and slept on it on the floor. They were shocked at how comfortable it was and are emphatically against box springs for memory foam now. The new mattress is now in the guest room. * You must allow the memory foam to "BREATHE" so that you can maintain it's resilience (for med end and lower end- it makes no difference). You do not want the mattress to actually "memorize" your body contours or it won't support the body as well as when you first purchased the mattress. I remove the covers, unzip the mattress cover and open the windows to allow the mattress to truly aerate while I do laundry. * Moisture/humidity/sweat is memory foams worst enemy. If you live somewhere humid, if your husband is sweaty or his gums spring a leak when he sleeps, if the master bed is close to the bathroom and you love steamy showers INVEST in a moisture proof cover. This comes from family and friends with at least 7 years of memory foam mattress usage experience. Hope this helps someone.
We needed a relatively cheap and comfortable mattress before the holidays since my cat decided to ruin the one we had in our guest room. I couldn't believe what I found...a queen size memory foam mattress with decent reviews for a little over *** bucks, and, bonus, it's shipped right to your door! When it arrive, it was in a heavy cardboard box that was pretty easy to move into the guest room. The mattress was shrink wrapped, but not in the "M" way the enclosed instructions stated. No worries, it opened up easily, and took about a day to fully "expand" and that's about how long the funky foamy smell took to dissipate, too. I had to sleep on it the other day due to a migraine(it's in a dark room) and at first it was cool, then became warm with my body heat. Others have complained that this type of mattress gets too hot, but I thought it was comfortable and my back felt wonderful after sleeping on it. Also, it did NOT sag in the middle as one reviewer commented, and I'm "big-boned", if you catch my drift. The mattress is on the previous boxspring which seems to be doing a great job of supporting it. I would definitely recommend this...what could you lose for a little over *** bucks. Definitely a bargain.
When I first got this mattress I was a little nervous because it seemed firmer than I liked. But after setting it up and testing it out the first night, It was awesome. I slept better than I had in a long time! If you do want some very soft or plush like this is not for you. But I have some back and neck problems and this mattress curves perfectly to support them. Would recommend!
This matress is super, very confortable just like a tempurpedic, but way less money $$$ My husband & I are very happy with the bed, even our dogs they love it too! we all fit perfect.
After seeing the great price of this mattress while browsing the o.co iPad app, I had to take a further look, even though I wasn't really in the market for a mattress. I bought the mattress after reading over 90 positive reviews (yes, i read them all ;-) I decided to buy the mattress, which was on a Tuesday. The mattress arrived at my front door on Friday morning. Very FAST shipping. The mattress came in a fairly small box considering this is a queen size. Inside the mattress was compacted within a sort of compression band, so I just lifted that onto the bed foundation. Then, I just cut down the side of the band with scissors, and watched as the bed immediately started expanding (it was folded in half lengthwise and then rolled into a cylinder shape).I just had to pull out one side of the mattress to help it unfold and it expanded to fit the foundation. I have to admit it was pretty exciting to see a mattress do this. The minor odor didn't take too long to air out w/ open windows, and it was tolerable.. not that strong in the first place. Laying on the bed for the first time was wonderful.. I can't tell a major difference between this and the much more expensive Tempurpedic/memory foam mattresses in stores. It's feel just perfect.. not too soft, not too firm. You can feel your body adjust into perfect alignment. After sleeping on a coil mattress forever, my wife first admitted that although she did feel a little bit of a slight pain when first laying on it, it was only because her spine was not used to being aligned straight haha This is a great mattress and if you are unsure about buying this mattress because its on the web and you can't try it out, GET IT. I heard the lectures from others about needing to try out mattresses before purchasing, but I am very glad I did. I saved A LOT of money on a mattress built just as great as the expensive brands. If you are looking for a memory foam mattress this is a GREAT choice. I LOVE mine!
I've had this for over 3 years now. Still loving it. It expanded to the full 8" in about a day. Odor was minimal, and gone by the time it was fully expanded and ready to use. As some reviews state, it can seem a little warm but I like that. If you tend to run hot when you sleep this may not be best for you. Support feels medium, just as the descripition says. I sink in just enough to feel like I'm not lying completely on top of the mattress, but nothing like a feather bed or similar. Movement is minimal also so you're not disturbing your partner when you move or get in/out of bed. I'd buy another if I needed to, even if it was more than the $240 I paid for this one.
I am happy with the result, once together it is a sturdy bed platform. But, it took me (and I am considered handy) over four hours to assemble. Granted I was working alone but I attribute the problem to 2 poorly engineered items. 1. predrilled holes in slats versus bed rails don't match up well so screws go in on an angle and various angles at that. 2. screws included (39, 3 for each slat) are poorly made and break and strip easily. So the combination of these two related issues were a real problem and time waster. I ended up using some quality one inch screws I had in my tool shed and that solved my issues. I consider this a manufacturer problem and could easily be fixed with an inexpensive upgrade.
I got the firm and it's great. I love crawling into bed at night!
Queen size fit my queen bed great. I find the density is good, just a little on the firm side, but after you lay on it, you sink in a little and it is comfortable. I have a waterproof mattress cover, the Cotton Rich Terry Top Waterproof Mattress Protector from O.com, and a sheet and the cover that comes on the mattress and do not notice it being "hot". I am very happy with this mattress and would recommend.
Have had this for 3 years now and it works great.
Usually leaves our warehouse in 1-2 business days. *
Mattress Sets are non-returnable upon signature at delivery. Mattresses are non-returnable if opened or taken out of their plastic wrapping.
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* For your safety, some orders go through our loss prevention department. If we select your order for this process, we will immediately notify you that there may be up to a 3-day delay on your order.


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Sub-Saharan Africa
The below collection of photographs were captured from USTDA-sponsored events and activities. In order to read a detailed description, please hover over the enlarged photographs below.
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South Africa Rail Workshop - March 2012
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East Asia and Eurasia
Kazakhstan Healthcare Equipment and Leasing System Reverse Trade Mission - June 2012
China Mecury Emissions Control Technologies Reverse Trade Mission - April 2012
Kazakhstan Gas Utilization Reverse Trade Mission - February 2012
Latin Amererica and the Caribbean
Colombia Road Infrastructure Opportunities for U.S. Companies Forum March 2013
Brazil Airport Modernization Reverse Trade Mission - June 2012
Mexico Intelligent Transportation Systems Reverse Trade Mission - March 2012
Middle East, North Africa and Europe
Turkey Smart Grid Reverse Trade Mission - April 2012
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India Efficiency and Clean Energy Exchange Program Reverse Trade Mission - June 2012
U.S. - India Aviation Summit - November 2011
Vietnam Air Traffic Management Reverse Trade Mission - October 2011
Sub-Saharan Africa
South Africa Rail Workshop - March 2012
East Africa Financial Integration Reverse Trade Mission - January 2012
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From the candy to the costumes, Halloween is a fun-filled time for kids and parents alike. But it's also a holiday that can pose dangers to young revelers. "Halloween is so much fun because it's not like any other night. With the chance to dress up in costume and stock up on sweets, it's the highlight of the year for many kids," says Kate Cronan, MD, medical editor for KidsHealth® and an emergency room pediatrician at the Alfred I. duPont Hospital for Children in Wilmington, DE. "However, accidents do occur and parents need to take precautions to ensure their kids stay safe."
KidsHealth.org, the most-visited website for children's health information, offers these safety tips to help make this year's festivity a trick-free treat:
Choose costumes wisely. Here are some pointers.
â¢Choose a light-colored costume - it helps kids be seen more easily.
â¢Masks make it difficult for kids to see and breathe, so use nontoxic face paint or makeup instead.
â¢Make sure that costume props, such as wands or swords, are flexible, in case kids fall.
â¢Put a nametag, with your phone number, on your children's costumes.
Here are some ideas for trouble free trick or treating.
â¢Accompany young children under the age of 10 on their rounds and try to go early before it gets too dark.
â¢For older kids going out on their own, be sure they carry a cell phone, if possible, go in a group and stay together, only go to houses with porch lights on, and carry a flashlight with new batteries.
â¢If kids want to visit neighborhoods other than your own, be sure to stress the rules about strangers.
â¢Check all treats to make sure there are no signs of tampering and throw out loose candy, spoiled items, and any homemade treats.
â¢Make sure your home is safe by removing anything that might obstruct your walkway, providing a well-lit entrance, and keeping pets away from trick-or-treaters, even if they seem harmless to you.
Even carving pumpkins can have its risks.
â¢Children should never handle knives. Instead, let them draw their designs on the pumpkin and then you do the carving.
â¢If your kids beg to remove the guts of the pumpkin, as many do, let them get messy by scooping out the flesh with their hands or an ice cream scoop instead of a knife.
â¢A burning candle in a pumpkin may become a blazing fire if left unattended. Use a glow stick (available in many colors) to safely illuminate your jack-o'-lantern.
"One of the challenges of being a parent is to teach your kids to be cautious without filling them with fear or anxiety," says Dr. Cronan. "Although some dangers do exist, you lessen your kids' risk by teaching them safety rules early on."
For more information about helping your little ghosts and goblins have a hauntingly happy and safe Halloween, visit KidsHealth.org.