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Innovation is the New Value
By: Daniel Abramowicz
Posted: March 2, 2012, from the March 2012 issue of GCI Magazine.
page 2 of 2
In addition to innovation, sustainability continues to be top of mind for brands when designing packaging. The green movement is making companies be more conscious about the materials they use in their products and packaging, as well as how they transport the end products to stores. At the same time, with retailers such Walmart continuing to emphasize the score card model, the demand for sustainable packaging continues to grow.
Finally, packaging's role in a brand's overall marketing mix continues to evolve. Many companies include quick response (QR) codes on their packaging to encourage consumers to visit the brand's website, Facebook page or Twitter feed. Commonly, this is coupled with an offer for free coupons or other types of incentive. This marketing tactic capitalizes on modern consumers' desire for enhanced interaction and instant gratification. At the same time, it presents new channels and opportunities to educate customers and keep them engaged with a brand. Ultimately, of course, the goal remains the same—to build brand loyalty through a positive initial experience.
As packaging technology continues to advance and consumer demands continue to change, brands must always match the two to maximize success.
Daniel Abramowicz is the executive vice president of technology and regulatory affairs at Crown Holdings, Inc., with global responsibility for innovation and technology development across Crown's business platforms. Abramowicz received a Bachelor of Science degree in chemistry, and a Bachelor of Arts degree in mathematics and computer science, from St. Francis University. He earned a master's degree and doctorate in physical chemistry from Princeton University.


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President's Excellence Society and Deans' Circle members honored at reception
Published: May 01, 2014 by Teresa C. Kreiner
Members of the President's Excellence Society and Deans' Circle were honored at a reception on April 9, 2014.The event, hosted at the home of The University of Texas Health Science Center at Houston (UTHealth) Development Board member and past chair David Grimes and his wife, Windi, celebrated and thanked friends of the university who made annual fund gift commitments of $1,000 or more in the past year. "We are grateful that David and Windi opened their home to host such a wonderful evening for us. This is a unique opportunity that gives university leadership a chance to personally thank those donors who provide a critical advantage to UTHealth," said Kevin J. Foyle, vice president of Development. This year's contributions have helped retain leading faculty researchers and other projects, including the community outreach dental care program, which provided an estimated $840,000 in care for more than 1,200 patients.
The President's Excellence Society and Deans' Circle, in their fourth and third years, respectively, were designed to raise unrestricted funds for university leadership. This premier donor society has expanded in membership and philanthropic impact every year. Gifts made to these funds allow the president and the deans of the individual schools flexibility as new and unexpected possibilities to improve human health arise throughout the year.

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Looking ahead to intriguing playoff matchups
These Friday rain forecasts are really starting to drown the buzz of Friday night football. (In a drought, I love the rain as much as the next person, but does it all have to come on Friday night?) But what the rain tries to wash away, playoff fever is more than making up for.
Unfortunately, it hasn't been a bang up year for most local teams. Anderson County squads, for example, are a combined 23-33, the worst collective season easily since the 1990s. Pendleton is the only Anderson area team above .500, and only Palmetto is at .500 among the other six teams.
So barring a colossal turnaround, most area teams will be starting the playoffs on the road, if they make it, as they're currently fighting for third and fourth spots in most of their regions.
So it's up to undefeated D.W. Daniel and Abbeville to carry the local flag into the playoffs, which is good because they have two of their best teams in years. And that carries some weight for the tradition-rich programs.
So barring an upset in the next two weeks, we can whet our playoff appetite by looking ahead to potential playoff matchups.
While Belton-Honea Path fans were clamoring for a rematch after last week's 24-7 Daniel win, which all but locked up the Western 3A title, the Bears' offense simply isn't diverse enough to secure a third-round meeting. Even with that stellar defense.
The more realistic matchups for the Lions on their path to Death Valley are Greer or J.L. Mann. A potential Greer meeting is interesting on several levels.
If they meet in the third round, it'd be a rematch of last year's season opener, a 35-21 Daniel win. That game started the Daniel resurgence under then-second year coach Randy Robinson, in part because the Lions picked off three passes that game, a flurry of interceptions that was the identity of that season.
The Yellow Jackets' have only lost once (to Byrnes) and are a bit of a Cinderella story following their late summer practice rules violation that first led to probation, then was rescinded. They're also coached by Will Young, a Daniel alumnus, and childhood friend of Daniel offensive line coach Jamie Wilson.
J.L. Mann is another team ranked in the top five of most polls where Daniel is No. 1. The Patriots are 7-1 (lost to South Pointe), and have had only three of their seven wins decided by a touchdown or less.
To find the best competition for Abbeville, take a trip to the Lowcountry. Outside of Woodruff and Chesnee, the best AA teams next to Panther Nation hail from Timberland, Central, and Strom Thurmond, two of which moved from AAA this season.
All are undefeated and have yielded no more than 54 points (less than a touchdown per game). But since Abbeville will have to tangle with the Upstate's finest to get to Death Valley, the Wolverines and Eagles are plenty formidable. And the good news for Panther fans is they probably won't have to handle both since they hail from the same region, and play on Halloween.
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Visit Bic on Facebook every morning during the moth of August. They are giving away 130 FREE Bic pens on the hour every hour from 10:00 AM – 8:00 PM Eastern for the entire month.
Here's their Facebook update:
Hi Everyone! The Pen Giveaway has officially kicked off! Here's how it works: 1. Visit The Cork Board every hour on the hour between 10AM and 8PM EST for the next 30 days 2. Click on the giveaway information and enter in your information 3. Please remember that we are only giving away 130 pens every hour on the hour. 4. You can only win once! Good luck to all of our BIC Pen Pals:)
You'll have to "Like" their page to participate.
I highly recommend signing up for Facebook just for the samples and FREEbies, if you don't already have an account. While you're there, don't forget to "Like" In Good Cents while to get and share great deals with your friends!
Thanks Joan!


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Top plants to see in summer at Hidcote
You'll never forget experiencing the garden in summer. Be inspired by breath-taking planting schemes, smells that fill the senses and the gentle hum of summer fun.
Enjoy the long sunny days by getting out and about among the summer flowers. Take a wander along the unmissable Rose Walk, where the fragrant scent of old fashioned roses fills the air. Find a quiet spot in the dappled shade of the Wilderness, perfect for a bit of contemplation and relaxation.
Don't miss our rose display in June - from old French varieties along the Rose Walk to the rambling rose 'Paul's Himalayan Musk' that tumbles out of the yew tree in the Maple Garden.
Our unforgettable lace-cap hydrangeas are at their best from late July.
A visit to the garden wouldn't be complete without seeing the famous lavender 'Hidcote Giant'. Nestled in the Pillar Garden it is believed to have been planted by Johnston himself.
Mounds of hypericum 'Hidcote' light up the ground beneath the tall palms in Mrs Winthrop's Garden. The perfect complement to a summer's day.
Commonly called the blue Himalayan poppy, its cool colour complements the Bathing Pool perfectly during August.
The Red Borders are at their most sumptuous by late July with the bold clumps of the orange day lilies in full bloom.
During August the Red Borders are filled with red-flowering dahlias. The most famous being 'Bishop of Llandaff'.
Take time to visit the Fuchsia Garden during August. The beds are filled with colour from the small hardy fuchsias of 'Tom Thumb' and 'Lady Thumb'.


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Call of Duty
Call of Duty v1.2 Small Linux Server Patch
The Linux dedicated server binaries for Call of Duty, updated to work with version 1.2 of the Windows client. Download either the small or large ONLY.
Call of Duty v1.2 Windows Patch
Patches the Call of Duty Windows Client to version 1.2.


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Phone Numbers
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Website http://www.cuhcc.umn.edu
EmailSend an email to CUHCC with your comments, concerns, and other inquiries. The basic email server is not a secure method for sending patient information. Please DO NOT use email for: billing, scheduling, or other patient information. For these inquiries, please contact #612-638-0700. MAP AND DIRECTIONS
Community-University Health Care Center2001 Bloomington Avenue Minneapolis, MN 55404CUHCC is located on the corner of Franklin and Bloomington Avenues in Minneapolis. We are located on the 2, 9, and 14 bus lines; and within walking distance of the Franklin Station Stop on the Hiawatha Light Rail and the 22 and 8 bus lines.
Map of 2001 Bloomington Ave South Minneapolis, MN 55404-3074, US
From University of Minnesota Campus:Take Washington Avenue west to the Cedar Avenue Exit, turn left onto Cedar. Follow Cedar south as it winds around; turn right on Franklin. Follow Franklin to Bloomington Avenue.
From the North:Take 35W to the Washington Avenue Exit, turn left on Washington to Cedar Avenue, go right onto Cedar. Follow Cedar south as it winds around; turn right on Franklin. Follow Franklin to Bloomington Avenue.
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Chronic hepatitis B (CHB) is a clinical concern in human immunodeficiency virus (HIV)-infected individuals due to substantial prevalence, difficulties to treat, and severe liver disease outcome. A large nationwide cross-sectional multicentre analysis of HIV-HBV co-infected patients was designed to describe and identify parameters associated with virological and clinical outcome of CHB in HIV-infected individuals with detectable HBV viremia.
A multicenter collaborative cross-sectional study was launched in 19 French University hospitals distributed through the country. From January to December 2007, HBV load, genotype, clinical and epidemiological characteristics of 223 HBV-HIV co-infected patients with an HBV replication over 1000 IU/mL were investigated.
Patients were mostly male (82%, mean age 42 years). Genotype distribution (A 52%; E 23.3%; D 16.1%) was linked to risk factors, geographic origin, and co-infection with other hepatitis viruses. This genotypic pattern highlights divergent contamination event timelines by HIV and HBV viruses. Most patients (74.7%) under antiretroviral treatment were receiving a drug with anti-HBV activity, including 47% receiving TDF. Genotypic lamivudine-resistance detected in 26% of the patients was linked to duration of lamivudine exposure, age, CD4 count and HIV load. Resistance to adefovir (rtA181T/V) was detected in 2.7% of patients. Advanced liver lesions were observed in 54% of cases and were associated with an older age and lower CD4 counts but not with viral load or genotype. Immune escape HBsAg variants were seldom detected.
Despite the detection of advanced liver lesions in most patients, few were not receiving anti-HBV drugs and for those treated with the most potent anti-HBV drugs, persistent replication suggested non-optimal adherence. Heterogeneity in HBV strains reflects epidemiological differences that may impact liver disease progression. These findings are strong arguments to further optimize clinical management and to promote vaccination in HIV-infected patients.
Keywords:Genotype; HBsAg variants; HBV-HIV co-infection; Resistance mutations; Liver lesions
Due to common routes of infection, hepatitis B virus (HBV) and immune deficiency virus (HIV) are found concomitantly in approximately 9% of HIV-seropositive patients in Europe [1]. The natural history of HBV infection is complicated in such setting with an increased rate of chronic hepatitis, greater levels of HBV replication and increased incidence of cirrhosis and liver disease-related mortality. Persistence of HBV replication is regarded as a deleterious situation in the setting of HBV-HIV coinfection, and recent guidelines recommend to include, in highly-active antiretroviral therapy (HAART), at least one drug active on HBV and preferentially tenofovir disoproxyl fumarate (TDF) [2-4].
In HBV low-endemic countries several epidemiologic patterns may be identified: patients who lately acquired HBV are usually infected with HBV strains circulating in their living country, whereas patients originating from highly HBV endemic countries are often infected with an HBV strain acquired during childhood in their original country [5,6]. In France, the two main characteristics of HBV infection in the general population are a large diversity of epidemiologic patterns and therefore HBV genotypes, and a low vaccine coverage rate, around 40% [5,7-9]. Since around 7% of HIV-positive patients are infected with HBV, characterization of parameters associated with disease severity and viral resistance is of major importance to optimize therapeutic management [10]. Nevertheless, no nationwide study of HBV genotypic and clinical features in HIV-positive patients has been conducted. A large nationwide cross-sectional multicentre analysis of HIV-HBV co-infected patients was designed to specifically address these issues.
Materials and methods
Ethics statement: As recommended by "la Pitie-Salpetriere Hospital" Institutional Review Board, written information was given to patients for participation to the study. In compliance with the French law regarding clinical studies, when this work was initiated, and since this study was performed on stored samples obtained in the standard of care (no need for any additional blood draw), all patients were provided written information and gave verbal consent. All data were anonymously collected and analyzed. The study was conducted in accordance with the ethics principles of the Declaration of Helsinki. Two hundred and thirty four patients from 19 French hospitals were prospectively included from January to December 2007. Participating centres were distributed in major French regions in order to gather data from a representative sample of patients, independently of their place of living. Inclusion criteria were based on virological parameters. Guidelines regarding HIV and HBV treatment were those reported at that time [11]. Any sample addressed to one of the participating virology laboratories that showed HBV replication over 1000 IU/mL in an HIV-infected patient, whatever the HIV replication level, led to proposition for patient's inclusion. Only one sample per patient was studied.
Data collection
Clinical and treatment data were retrospectively collected on patients' clinical files. Final analyzed figures are indicated wherever needed. All data were anonymously collected and analyzed. The study was conducted in accordance with the ethics principles of the Declaration of Helsinki.
A particular attention was made on treatment history for drugs active on HBV replication whether given for treating HIV or HBV infection. Patients were classified as having never received any of these drugs if, in their clinical history, they had not received either interferon (IFN), lamivudine (3TC), emtricitabine (FTC), adefovir (ADV), tenofovir (TDF), telbivudine (LdT) or entecavir (ETV), whatever the indication.
HBV viral loads expressed as IU/mL were determined by commercialized standardized techniques. Seventeen laboratories used real-time PCR assays, either Cobas-Taqman with a lower limit of detection (LLOD) of 12 IU/mL (Roche, Meylan, France) or HBV-RealTime with an LLOD of 10 IU/mL (Abbott, Rungis, France), 2 laboratories used either bDNA3.0 with an LLOD of 357 IU/mL (Siemens, Eragny, France) or Cobas-Monitor v2.0 with an LLOD of 60 IU/mL (Roche, Meylan, France).
HBV sequencing methodology was left at investigators discretion but a previously described consensus technical approach, along with a selected set of 37 HBV genotypes A to G Genbank sequences, was distributed and biologists in charge were encouraged to apply this technique to sequence the pol/S genes [12]. Finally, all sequences were centralized to one laboratory in order to confirm the genotyping analysis. Phylogenetic evolutionary analyses were conducted using MEGA-4.0 [13]. In parallel to this approach, all sequences were also submitted to the "HBV-tool" accessible from http://www.hiv-grade.de/cms/grade/hbv-tool.html webcite.
Statistical analysis
Qualitative data were expressed as numbers and percentages, quantitative data were expressed as mean ± 1 standard deviation or median [1st quartile-3rd quartile], depending on the distribution. Relationships between categorical data were tested by means of the chisquare or Fisher's exact test when necessary. Means or medians were compared using non parametric tests, Mann Whitney test for two groups, or Kruskal Wallis test for 3 or more groups. To study the independent factors related to an event, a logistic regression analysis was performed, and the adjusted odd ratios (OR) are presented with their 95% confidence intervals. A p value of 0.05 or less was considered significant.
Study population
Table 1 describes the main characteristics of the patients included in the study. 223 patients with virological and clinical information forms could be analyzed. Bioclinical data were missing in 1 to 20% of cases, depending on the item. Most patients (178; 80%) were males and mostly of French origin (64.1%) while most women (58.3%) were from African sub-Saharan countries. The main risk factors for male were first, homosexuality (56.8%) followed by intravenous drug use (IVDU, 10.8%) whereas women mostly acquired their infection through heterosexual intercourse (75.6%) and as often as males through IVDU (14.6%).
Table 1. Patient's characteristics according to HBV genotype
Treatment information was available for all included patients. Most (n = 180, 80.7%) patients benefited or had previously benefited from an anti-retroviral treatment. Among them, past or current HAART included an anti-HBV active drug in 175 (97.2%) patients. However, 106/223 (47.5%) of the patients were not receiving any anti-HBV active antiviral at the time of the study and 17.9% (40/223) had never received any anti-HBV active drug (Table 2). Among those treated with a drug active on HBV (n = 117), 83% (n = 97) were receiving a 3TC or FTC-based treatment either as monotherapy (n = 23, 19.7%) or as combination therapy with TDF in the majority (45/76; 47.9%) of the cases. ADV and ETV were given to 13.7% (16/117) and 1.7% (2/117) of the patients, respectively. Eighteen patients (8.1%) had received or were receiving IFN.
Table 2. Main patient's characteristics according to HBV treatment history
There was a significant propensity for males (85.4%) to benefit from any HBV-active treatment as compared to women (68.3%) (p = 0.018) and treated patients were older than untreated (42.6 vs. 38.7 years; p = 0.03).
Patients from Europe were more often treated (88%) than Sub-Saharan African patients who received less often (73.1%, p = 0.03) anti-HBV drugs.
Among 94 patients with documented liver fibrosis lesions; 5/51 (9.8%) with metavir ≥ F2 were not receiving any treatment at the date of sampling. Conversely, among 17 patients with cirrhosis, only one (5.9%) was not receiving any HBV active treatment at the date of sampling.
Viral parameters
As expected, HIV viral load was significantly lower in patients receiving ARV treatments and was undetectable by realtime-PCR in 42% (75/180). Surprisingly, anti-retroviral treatment was not associated with a significant difference in median HBV-viral load (HBV-VL) with values of 4.5 log IU/mL [IQR 3.64–7.05] for untreated versus 5.6 log IU/mL [IQR 3.97–7.49, p = 0.09] for treated patients. The CD4-cell count was also not significantly different between HAART-treated or -untreated patients and the median values were 397 (IQR 205–606) and 322 (IQR 154–511) cell/mm3, respectively (p = 0.24).
Thirteen (7.9%) patients were co infected with HDV and 28 (13.5%) with HCV. Seven patients presented with serological evidence of HCV and HDV co-infection, 5 of them being IVDU.
HBV Genotypic analysis
223 sequences were generated, enabling genotype determination and characterization of drug resistant or HBsAg immune-escape mutants. Genotype distribution (Table 1) shows a vast majority of genotype A (52%) followed by E (23.3%), D (16.1%) and G (6.7%). Data obtained through the phylogenetic approach and the web-based tool were 100% concordant.
Several parameters were directly linked to the genotype. Genotype E was found more often in women (51.2%, p < 0.001) and was significantly associated with heterosexual exposure (87.5%), a younger age (mean 37.2 year, p < 0.001) and a sub-saharan Africa origin (90.9%, p < 0.001). As expected, the prevalence of HBeAg-status was genotype-dependent.
HBV resistance mutations
All nucleotide sequences (n = 223) were translated into the polymerase and HBs reading frames to analyze for the presence of specific resistant and immune-escape variants (Tables 2 and 3). Previously described resistant mutations i.e. rtV173L, rtL180M, rtA181V/T, rtT184G, rtS202I, rtM204V/I, rtN236T and rtM250V were first studied and then, others residues with changes present in at least two patients were further considered. The most prevalent resistant mutations were rtL180M (28.7%; 64/223) and rtM204V/I (26%; 58/223). Amino-acid change rtM180L was found in 87.5% of the cases associated with rtM204I or V but was found as an isolated mutation in 8 remaining cases. Obviously, resistant-mutations were almost exclusively detected in patients who ever received an antiviral treatment. Overall, only 1 patient who had never received 3TC or FTC for HBV- or HIV-infection presented M204V and L180M mutations. Patients presenting with a 3TC-resistant variant had been treated for a longer period of time as compared to those with a wild-type strain, 44 [20–86] versus 31 [12–60] months, respectively (p = 0.025). Half of patients developed 3TC-resistance mutations (M204-change) less than 2 years after starting 3TC treatment (Figure 1). ADV resistance rtA181T associated mutations were detected in 5 (2.2%) cases; among those, 3 had never received ADV. Noteworthy, all of them had ever received 3TC or FTC. Fourteen patients had received or were receiving ETV but genotypic resistance for this drug was not detected in any patient. HBeAg status was not linked to the development of LAM resistance.
Figure 1. Cumulative selection of 3TC resistant (rtM204V/I) strains over time in patients who ever received 3TC or FTC. The number of patients at risk is indicated under the graph. For each patient, the length of 3TC or FTC treatment at the time of sampling was taken into consideration. In half of patients with rtM204 mutation, the duration of treatment was less than 2 years.
Table 3. Main HBs amino-acid changes observed in treated and untreated patients
A multivariate-analysis (Table 4) was conducted to define what parameters were independently associated with the emergence of 3TC resistance. Tested parameters were demographic (age, sex, geographic origin, mode of contamination), 3TC-treatment, HBV-genotype, CD4-count and HIV-viral load. As predicted, 3TC treatment was significantly associated with emergence of resistance mutation but surprisingly, and confirmed by multivariate-analysis, a younger age, lower HIV-viral load and higher CD4-cell count were all protective for the development of 3TC resistance, independently of 3TC treatment.
Table 4. Uni- and multivariate analysis on risk factors associated with emergence of rtM204 change
HBsAg variability
Specific mutations within the HBsAg reading frame were sought for, especially those known to influence protein immunogenicity within the major hydrophilic-loop and the a-determinant (Table 3). Amino-acid change sG145R was found in only one patient but sG145A, less frequently described, was detected in 5 sequences (2%). Changes occurring at position s100, 114, 125, 127, 131, 134 140 and 143 were not associated with HBV-treatment and statistics could not be performed for the other residues as changes did not occur at a sufficient frequency. All significant changes (sP127, sT131, sT140) associated with HBV treatment could be explained by genotype-linked polymorphism.
Disease severity
Liver disease activity was available for 94 patients as assessed by liver biopsy (56%) or surrogate scores validated in the setting of HIV-HBV co-infection such as Fibrotest® [14]. According to Metavir-classification, 45.7% (43/94) had a mild liver damage while the others were classified with lesions equal to or higher than F2. Patients with more severe liver disease (above F2) were older with a mean age of 43.9 vs. 39.8 years (p = 0.043) and had lower CD4-cell counts with a mean value of 344 vs. 458 cell/mm3 (p = 0.046). By contrast, viral load and HBV-genotype were not associated with disease severity. Reliable evaluation of the impact of other hepatitis virus co-infection could not be performed due to missing information on liver histology.
This nationwide collaborative study describes epidemiological, virological, and clinical patterns related to HBV infection in HIV-positive patients with HBV viremia in the era of fully active antiviral treatments in France. Recommendations from international scientific societies have been published and point to an initiation of treatment at a lower HBV-VL than previously recommended [15-18]. Thus nowadays, only very few patients should not be considered for HBV-treatment [19]. Contrary to previous studies, this collaborative work was initiated from a virology laboratory network and patients were randomly selected on the basis of their analytical values.
On a pure technical point of view, our study clearly demonstrates that diffusion of a consensual protocol for HBV-sequencing to multiple laboratories along with a reference sequence library was efficient to generate high quality information regarding HBV genetic variability. We also validated the web-based algorithm proposed on " http://www.hiv-grade.de webcite" that can be largely recommended for any laboratory dealing with HBV sequence.
Unequal distribution of genotypes according to the mode of HBV acquisition has been previously described in a small study from Perez-Olmeda et al. and more recently in the large EuroSIDA study group with comparable conclusions to our study and to recent work in France [5,6,20]. From the genotype distribution and the epidemiological data, identification of very distinct populations may lead to different clinical managements. For instance, genotype D or A infected individuals are most likely IVDU or MSM, respectively, who have certainly acquired both infections either concomitantly or in a short-time interval. By contrast, most HIV-positive women with genotype E HBV infection have likely acquired HBV perinatally and in highly endemic countries. These different sequential events may have a profound impact on the natural history of the disease, particularly since they occur in patients of different gender, age, and immunological status. Very few data are available on the chance to spontaneously clear the virus in these different situations but one may expect very different outcomes in each of them as recently shown in a large US HIV-infected patient cohort [21]. With regards to these observations, it is interesting to note relatively mild liver lesions in genotype E infected patients compared to patients infected with genotype A or D. Thus, natural history of chronic hepatitis B during co-infection should be analyzed with scrutiny as it may largely differ according to the population that is considered and may influence treatment options.
HBV-VL is one of the main criteria to initiate antiviral treatment. In our cohort, HBV-VL was not influenced by HBV genotype but by the presence of HBeAg. Contrary to what observed for HBV mono-infected patients, HBeAg is often present (66%) in HIV co-infected patients, as previously reported [22,23]. Interestingly, HBeAg-negative patients were less often treated, reflecting the current recommendations not to treat patients with low viremia [16].
Among the 15 genotype G infected patients, all but two were HBeAg-positive, which is surprising as genotype G naturally carries the G1896A stop-codon mutation that prevents HBeAg translation from the pre-C start codon [24]. Co-infection with another wild-type viral strain whose genome encodes for HBeAg likely explains a rescue for production of this protein, as reported earlier [25]. Contrary to a recent report from Lacombe et al., we only found a tendency for a more severe liver fibrosis in genotype G infected patients, without statistically significant association [22]. Reasons for this divergence might be due to size differences in the studied populations and also to missing information regarding liver histology in few cases from our study.
One major finding of the present study is the relative low rate of 3TC-resistance mutations. This observation is somewhat surprising as 3TC, or its derivative FTC, is very often a key component in the HAART backbone. As shown on Figure 1 and as previously demonstrated, 3TC treatment induces very rapid emergence of resistance in HIV co-infected patients [26]. The distribution of 3TC-resistance mutations was very similar to what was previously reported even though rtL180M (29.1%) was found more often than rtM204V/I (26%) [27]. Even in previously treated or in currently treated patients, the rate of 3TC-resistance reached only 35%. These data could be explained by a low viral replication before treatment initiation, as low viral replication or an HBe-negative status was shown protective for resistance development in a previous study [28]. The cross-sectional nature of our study did not allow us to collect this information. This relatively low prevalence of resistance is incentive in considering the possibility of low level of compliance to anti-HBV drugs in our cohort.
Adefovir resistance mutations were exceptionally detected (rtA181T-change in 2.2%) and no change was observed for rtN236. Even if one considers that the rtA181T-strains have a slight decreased sensitivity to TDF, it is reassuring to observe a very low prevalence of ADV-resistance, leaving the opportunity to treat these patients with TDF [29]. The rtA181T or -V change is rarely selected by 3TC treatment and one can not exclude that this was not the case for these patients [30,31]. HAART often contains TDF, in addition to FTC or 3TC, a drug that has not been associated with selection of resistant strains so far [32,33]. The use of 3TC in association with TDF in patients from our cohort likely explains the low rate of resistance in patients receiving 3TC and strengthens the benefit of using potent antivirals such as TDF.
Consequence of drug-resistant variant selection on HBs reading frame has been extensively analyzed in our study. Contrary to what has been reported elsewhere, we did not observe significant changes on residues known to affect HBs "a" determinant [34]. In our hands, HBV genotype was the most influencing parameter to explain HBsAg variability and past or current treatment did not seem to particularly affect HBs antigenicity [35]. Key amino-acid changes known to particularly affect HBsAg detection by current immuno-assays or escape vaccination induced antibodies were found in less than 3% of patients [36]. Even though HBV vaccination is less immunogenic in HIV-infected individuals, the low prevalence of immune escape variants in this population should certainly be a strong argument for vaccination campaign to avoid further contamination in at-risk situations [37].
The recognition of significant liver fibrosis in more than half of co-infected and HBV viremic patients in this series, along with a surprising high rate of suboptimal anti-HBV therapy use in this population, point out suboptimal clinical management of HBV infection in HIV-positive patients in France. Such observation was previously reported in several developed countries and highlights the need to promote and improve the education of physicians in charge of HIV-HBV infected individuals [38].
Our study has some limitations due to the recruitment design. It is a transversal study that included patients on the basis of an HBV replication over 1,000 IU/mL whereas no information was collected on the reason for HBV virology assessment. Yet, these patients are clearly those who should benefit from an HBV-antiviral treatment and are those encountered daily in our practice. Noteworthy and contrary to what has been shown by several studies, no direct link was found between liver disease and HBV-VL [39]. This discrepancy might be explained by the relatively low number of patients with complete liver disease assessment in our study or by a different impact of HBV-VL in the context of HIV infection.
In conclusion, our study gives a new insight into the current epidemiology and clinical features of HBV-HIV infection in France. The strong link between the modes of contamination, the contamination event timeline by both viruses and the targeted population suggests that clinical management may be optimized according to this information. Even though potent active drugs with activities against both viruses are available, many patients have not received any anti-HBV treatment despite being treated by HAART and having for half of them advanced liver fibrosis. In addition, persistent HBV viremia in TDF treated patients suggests either non-compliance or suboptimal drug efficacy in this cohort. Finally, the low prevalence of circulating HBsAg immune-escape variants strengthens the need for an active promotion of anti-HBV vaccination of non-immune HIV-infected patients.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
VT, CGG, PC, JG, NS, PT, CP, KS, MB, MC and the AC11-ANRS members carried out the molecular genetic studies, participated in the sequence alignment and collected patients' clinical information. CGG and VT were in charge of phylogenetic studies and web based analyses. VT and FRT participated in the design of the study and performed the statistical analysis. VT within the AC11-ANRS group conceived the study and coordinated the study. VT, CGG, PC, JG drafted the manuscript. All authors read and approved the final manuscript.
Members of the ANRS-AC11 HBV group who also participated in this study are listed below. A. Ducancelle, F. Lunel-Fabiani (Angers); C. Henquell (Clermont Ferrand); S. Larrat, A. Signori-Schmuck (Grenoble); S. Alain (Limoges); F. Zoulim (Lyon); L. Ollier (Nice); P. Soussan, Tenon Hospital (Paris); E. Schvoerer (Strasbourg); A.-M. Roque-Afonso (Villejuif). Supported in part by grants from AC11-VHB ANRS (Agence Nationale de Recherche sur le SIDA et les Hépatites Virales).
Konopnicki D, Mocroft A, de Wit S, Antunes F, Ledergerber B, Katlama C, Zilmer K, Vella S, Kirk O, Lundgren JD: Hepatitis B and HIV: prevalence, AIDS progression, response to highly active antiretroviral therapy and increased mortality in the EuroSIDA cohort.
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AIDS Res Hum Retroviruses 2003, 19:657-659. PubMed Abstract | Publisher Full Text
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Balinska MA: Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: how should we raise infant immunization coverage rates?
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Larsen C, Pialoux G, Salmon D, Antona D, Le Strat Y, Piroth L, Pol S, Rosenthal E, Neau D, Semaille C, Delarocque Astagneau E: Prevalence of hepatitis C and hepatitis B infection in the HIV-infected population of France, 2004.
French Experts group's recommendations for medical management of HIV infection highlights and recommendations. 2006.
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Villeneuve JP, Durantel D, Durantel S, Westland C, Xiong S, Brosgart CL, Gibbs CS, Parvaz P, Werle B, Trepo C, Zoulim F: Selection of a hepatitis B virus strain resistant to adefovir in a liver transplantation patient.
J Hepatol 2003, 39:1085-1089. PubMed Abstract | Publisher Full Text
Tamura K, Dudley J, Nei M, Kumar S: MEGA4: Molecular Evolutionary Genetics Analysis (MEGA) software version 4.0.
Mol Biol Evol 2007, 24:1596-1599. PubMed Abstract | Publisher Full Text
Bottero J, Lacombe K, Guechot J, Serfaty L, Miailhes P, Bonnard P, Wendum D, Molina JM, Lascoux-Combe C, Girard PM: Performance of 11 biomarkers for liver fibrosis assessment in HIV/HBV co-infected patients.
J Hepatol 2009, 50:1074-1083. PubMed Abstract | Publisher Full Text
Alberti A, Clumeck N, Collins S, Gerlich W, Lundgren J, Palu G, Reiss P, Thiebaut R, Weiland O, Yazdanpanah Y, Zeuzem S: Short statement of the first European Consensus Conference on the treatment of chronic hepatitis B and C in HIV co-infected patients.
J Hepatol 2005, 42:615-624. PubMed Abstract | Publisher Full Text
European Association For The Study Of The L: EASL Clinical Practice Guidelines: management of chronic hepatitis B.
J Hepatol 2009, 50:227-242. PubMed Abstract | Publisher Full Text
Lok AS, McMahon BJ: Chronic hepatitis B: update 2009.
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Rockstroh JK, Bhagani S, Benhamou Y, Bruno R, Mauss S, Peters L, Puoti M, Soriano V, Tural C: European AIDS Clinical Society (EACS) guidelines for the clinical management and treatment of chronic hepatitis B and C coinfection in HIV-infected adults.
HIV Med 2008, 9:82-88. PubMed Abstract | Publisher Full Text
Hoffmann CJ, Seaberg EC, Young S, Witt MD, D'Acunto K, Phair J, Thio CL: Hepatitis B and long-term HIV outcomes in coinfected HAART recipients.
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Soriano V, Mocroft A, Peters L, Rockstroh J, Antunes F, Kirkby N, de Wit S, Monforte A, Flisiak R, Lundgren J: Predictors of hepatitis B virus genotype and viraemia in HIV-infected patients with chronic hepatitis B in Europe.
J Antimicrob Chemother 2010, 65:548-555. PubMed Abstract | Publisher Full Text
Chun HM, Fieberg AM, Hullsiek KH, Lifson AR, Crum-Cianflone NF, Weintrob AC, Ganesan A, Barthel RV, Bradley WP, Agan BK, Landrum ML: Epidemiology of Hepatitis B virus infection in a US cohort of HIV-infected individuals during the past 20 years.
Clin Infect Dis 2010, 50:426-436. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Lacombe K, Massari V, Girard PM, Serfaty L, Gozlan J, Pialoux G, Mialhes P, Molina JM, Lascoux-Combe C, Wendum D: Major role of hepatitis B genotypes in liver fibrosis during coinfection with HIV.
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Zarski JP, Marcellin P, Leroy V, Trepo C, Samuel D, Ganne-Carrie N, Barange K, Canva V, Doffoel M, Cales P: Characteristics of patients with chronic hepatitis B in France: predominant frequency of HBe antigen negative cases.
J Hepatol 2006, 45:355-360. PubMed Abstract | Publisher Full Text
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J Gen Virol 2000, 81:67-74. PubMed Abstract | Publisher Full Text
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Benhamou Y, Bochet M, Thibault V, Di Martino V, Caumes E, Bricaire F, Opolon P, Katlama C, Poynard T: Long-term incidence of hepatitis B virus resistance to lamivudine in human immunodeficiency virus-infected patients.
Hepatology 1999, 30:1302-1306. PubMed Abstract | Publisher Full Text
Delaney WE, Yang H, Westland CE, Das K, Arnold E, Gibbs CS, Miller MD, Xiong S: The hepatitis B virus polymerase mutation rtV173L is selected during lamivudine therapy and enhances viral replication in vitro.
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Miailhes P, Trabaud MA, Pradat P, Lebouche B, Chevallier M, Chevallier P, Zoulim F, Trepo C: Impact of highly active antiretroviral therapy (HAART) on the natural history of hepatitis B virus (HBV) and HIV coinfection: relationship between prolonged efficacy of HAART and HBV surface and early antigen seroconversion.
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van Bommel F, de Man RA, Wedemeyer H, Deterding K, Petersen J, Buggisch P, Erhardt A, Huppe D, Stein K, Trojan J: Long-term efficacy of tenofovir monotherapy for hepatitis B virus-monoinfected patients after failure of nucleoside/nucleotide analogues.
Hepatology 2010, 51:73-80. PubMed Abstract | Publisher Full Text
Warner N, Locarnini S: The antiviral drug selected hepatitis B virus rtA181T/sW172* mutant has a dominant negative secretion defect and alters the typical profile of viral rebound.
Hepatology 2008, 48:88-98. PubMed Abstract | Publisher Full Text
Yatsuji H, Noguchi C, Hiraga N, Mori N, Tsuge M, Imamura M, Takahashi S, Iwao E, Fujimoto Y, Ochi H: Emergence of a novel lamivudine-resistant hepatitis B virus variant with a substitution outside the YMDD motif.
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Heathcote EJ, Marcellin P, Buti M, Gane E, De Man RA, Krastev Z, Germanidis G, Lee SS, Flisiak R, Kaita K: Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B.
Gastroenterology 2011, 140:132-143. PubMed Abstract | Publisher Full Text
Zaaijer HL, Bouter S, Boot HJ: Substitution rate of the hepatitis B virus surface gene.
J Viral Hepat 2008, 15:239-245. PubMed Abstract | Publisher Full Text
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Antivir Ther 2007, 12:1255-1263. PubMed Abstract
Sheldon J, Ramos B, Garcia-Samaniego J, Rios P, Bartholomeusz A, Romero M, Locarnini S, Zoulim F, Soriano V: Selection of hepatitis B virus (HBV) vaccine escape mutants in HBV-infected and HBV/HIV-coinfected patients failing antiretroviral drugs with anti-HBV activity.
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Landrum ML, Hullsiek KH, Ganesan A, Weintrob AC, Crum-Cianflone NF, Barthel RV, O'Connell RJ, Fieberg A, Chun HM, Marconi VC: Hepatitis B vaccination and risk of hepatitis B infection in HIV-infected individuals.
Aids 2010, 24:545-555. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Jain MK, Opio CK, Osuagwu CC, Pillai R, Keiser P, Lee WM: Do HIV care providers appropriately manage hepatitis B in coinfected patients treated with antiretroviral therapy?
Clin Infect Dis 2007, 44:996-1000. PubMed Abstract | Publisher Full Text
Chen CJ, Yang HI, Iloeje UH: Hepatitis B virus DNA levels and outcomes in chronic hepatitis B.
Hepatology 2009, 49:S72-84. PubMed Abstract | Publisher Full Text


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Here's a bit of conspiracy grist for the crazies' mill:
With ratings down this season, the head of 19 Entertainment's parent company said Fox is looking to contest the Nielsen ratings -- something Fox denied and Nielsen said it had no knowledge of. The top executive also said Thursday that he expects Fox to begin negotiating this summer an extension on its deal to carry "Idol," which has two years remaining.
Robert F.X. Sillerman, CEO of CKX, Inc., said a meeting between Fox and Nielsen is scheduled for Monday, or thereabouts, to deal with an issue he called "oxymoronic": "Idol" ratings have fallen, yet other indicators show that viewership is up.
Furthermore, he suggested that Fox has some grist in its argument, having identified a home with 14 people watching the show -- which it was not given proper ratings credit for.
"There's a meeting I understand on Monday between -- I believe it's Monday -- with Fox and Nielsen," Sillerman said on a call with investors. CKX owns 19 Entertainment, a co-producer on "Idol."
"It's oxymoronic," he added, "that (Nielsen is) reporting gross numbers of viewers (that are) down, yet all other measures -- like, for instance, the number of people who are voting -- are up."
via MediaPost


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October 13, 2015
Many people are getting ready for one of the biggest shopping days of the year.
Not everyone is waiting for Black Friday.
Friday may be the big shopping day, but many people here at Middlesboro Mall Wednesday aren't waiting until then. They're getting jump on holiday sales that have already started.
The holiday shopping season is here.
In fact, many shoppers we talked to say they have been shopping for a while.
The manager of the Middlesboro Mall says he expects sales here to be much better than what's expected nationally.
Despite a couple stores in the process of closing, the space vacated by Dawahares, is already filling up.
The manager at Traditional Touch says there was still a need for UK apparel.
Many shoppers are getting what they can now, while others plan on coming back for more.
While many sales are already underway, WYMT's Jeff Allen talked with several retailers at the Middlesboro Mall who say they'll be rolling out the big sales, the Doorbusters, early Friday Morning.
Click Here to access the online Public Inspection File
Viewers with disabilities can get assistance accessing this station's FCC Public Inspection File by contacting the station with the information listed below. Questions or concerns relating to the accessibility of the FCC's online public file system should be directed to the FCC at 888-225-5322, 888-835-5322 (TTY), or firstname.lastname@example.com.


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Sound Off
Run Bill: If Bill Clinton would run for president again, I'd vote for him in a skinny minute. Signed, a Republican.
Guarantees: We are guaranteed the right to the "pursuit" of happiness. That doesn't mean the government "owes" you happiness. It means you are allowed to get off your behind and go after it yourself.
Dear Dennis: Hardworking, middle-class people are not being exploited by cold-hearted right wingers, but by their own government, cold-hearted, blood-sucking politicians — from the top down — who fritter away their hard-earned dollars on pork barrel projects to ensure their own re-election — Republicans and Democrats alike! (Shelley Laurin)
What will happen? Has anyone in this misguided administration thought to ask what will happen when sarin gas containers are blown apart? Loss of consciousness, convulsions, paralysis and respiratory failure (which is fatal). But maybe Obama supporters think this is justified to "save face" for our president.
Find them first: Before you retaliate for a deadly chemical weapons attack, it might be wise to locate the perpetrators and retaliate against them only. Warmongers make as much sense as the feud between the Hatfields and McCoys.
There's a difference: Honda, Toyota, Nissan, BMW, MB, and Kia do not have automo- tive factories in this country. They are simply assembly plants where a small force of American workers assemble parts that were manufactured overseas, by cheap foreign labor, using foreign materials, and brought to this country in foreign ships. There is a big difference between manufacturing and assembling.
Buy American: Your response about the cell phone proves my point. If American corporations used American labor to manufacture products in America rather than moving the factories overseas for cheap labor, then you would be able to buy an American cell phone. When you purchase a foreign-made product you are simply creating more unemployment in this country.
What about the Dems? Why do you blame only the Republicans for legislation not passing? Have you forgotten the Democratic-led Senate has to go along, too? Always calling for the Republicans to compromise, and forgetting the Democrats who don't want to compromise. They both need to work toward the common good.
Balanced budget: Bill Clinton balanced the budget by borrowing the money from Social Security. I call that robbing Peter to pay Paul!
What about this? The Obama Administration is accusing Syria's leadership of killing 1,429 people in a chemical attack. I agree with the administration that this is a terrible thing. I wish, however, that the administration would be equally concerned about the 100,000 babies that are aborted each month in our country.
Racist? If I promise not to mention the president's middle name, can I call him Nobel Peace Prize winner Barack Obama? Or is irony racist now, too?
State your case: Republicans sound like teenagers living with their parents. They know more than their parents and have all the answers clear up till it's time to move out. How about putting forth any sensible solution to just one problem you're carping about?


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Breaking News: Mitt Romney can be passionate, sincere, eloquent.
Mitt Romney nails tough question.
"All people are children of God."
I've expressed dismay about this many times—twice this week in conversation. So I was relieved to see Romney answer this important question.
"Thirty-one years old and your Church was discriminating against blacks..?!"
And, obviously, I'm no fan of Romney. But he nails this—with passion, heart and an appreciation for a complicated, too-slow evolution. I've frankly never seen him seem sincere at all—so I'm surprised, and gladdened, to see it here.
(This is from a few years ago)
Don't think he's truly sincere? That's your call. Given that he doesn't match his words, then, to his view on Gay Rights, now…you may have a point. Still, credit where due: he gives a thoughtful, fair answer here.
Incorrect source, offensive, or found a typo? Email us (please put title in subject bar of email so we'll be able to fix). Or do you want to write for Elephant?
{Waylon H. Lewis C Enterprises 2015: Use Rights in perpetuity. Ownership remains with author.}
22 Responses to "Breaking News: Mitt Romney can be passionate, sincere, eloquent."
To be fair, let's acknowledge he shows he's capable of some degree of passion and eloquence. Sincerity, as in the absence of duplicity, not so much. The question of whether his "faith" was wrong in excluding blacks was never answered and, more importantly, his father did not march with Martin Luther King, Jr. While it's true George Romney is said to have "supported" King, no evidence has been found that his father marched "with" King. Of course, like sincerity, I suppose it depends on what your definition of "with" is.
Oof. Thanks for that! So he didn't march with King?
Mitt Romney is full of chit, like usual. His dad never "marched with Martin Luther King". That is straight BS. This guy just won't stop lying! I don't find him sincere, eloquent, passionate or even believable. I don't think even he believes what he is saying. I think he is repeating what he was told to say. He's a bad actor. He's a lousy politician. He's a horrible campaigner. Nobody likes him very much because he has a thick air of elitist snob around him at all times. Even in this interview he can't stop smirking when Russert is asking questions. He does the best he can to stick to the script that his focus groups, handlers and polls told him to use, and he is not very good at it. I find him, insincere, dull, bland, unconvincing and lifeless.
The Obama That I Used to Know http://youtu.be/yJnAp3YxCCw
EJ is bullshit for not posting this video! This is a pro obama blog that refuses to criticize assassination and illegal wars. How can you call yourselves Buddhists/Yogis? Ahimsa anyone?!
You want a Romney presidency with the assassination policy? Maybe he'll bring back torture.
Ej doesn't post one partisan video you like and suddenly it becomes a "pro-obama" blog? Your post does not pass the laugh test.
I suggest you look up the word "Partisan" in the dictionary. Then watch the video.
How about EJ posting one video on Obama? Just one. Your post doesn't pass the fact check. It's all Romney all the time, but no Obama critiques. It's our job to uphold whoever the next president may be to higher standards.
Also, this video has 300,000 views and is "viral." It's controversial, a clever, fair critique on Obama, that will garner this blog a lot of traffic. So I'm challenging them to post it in order to expose that EJ refuses to post any well thought out critique of Obama. It's not like I'm asking them to post anything by Chomsky.
We've posted on Chomsky before—but I'm sure you've checked that before commenting.
It appears you do not grasp the simple concept that not posting one video you like does not make this a pro-obama blog. One video.
I do not know how to make that concept any simpler.
Looking at your comments, you are just trolling. Since you have nothing intelligent to offer I will bow out now.
"reluctant to acknowledge correctness on the part of their political opponents in almost any situation."
Can you find "one" post taking obama to task on something? "One post."
Well, not posting a single video certainly isn't enough to make this a pro-Obama blog. However the totality of posts makes it rather silly to think that this is anything other than a non-critical pro-Obama blog. All one needs to do is search posts that have been related to Obama. Not one critical word.
He didn't answer the question.
He talked about his parents' Civil Rights records but could offer nothing of his own.
He talked about equality before God in the "hereafter" but did not address equality amongst all people in the here and now.
Romney was 31 years old when his Church had a convenient 'revelation'. (It was concerned about losing its tax-exempt status because of its racist policies.) There is no record of him ever saying or doing anything about his faith's systemic racism either as a child or as an adult.
Can anyone name a black senior adviser on the Romney campaign staff?
He would equally sell anyone of any race the shirt off their own back. Not impressed.
Huh. The book of mormon says that black people are the children (seed) of lucifer.
Its still there, he's just ignoring it for polical purposes.


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Best of News
Palabras clave
Indian Internet and facebook users shout anti-government slogans as... Fotografía de noticiasAgarrar,Antigubernamental,Cartel,Derecho,Estudiante,Facebook,Gritar,Horizontal,India,Internet,Manifestación,Nueva Delhi,Redes sociales,Seguir,Tecnología,Vertical,Violencia sexualPhotographer RAVEENDRANCollection: AFP 2012 AFPIndian Internet and facebook users shout anti-government slogans as they hold placards during a protest in New Delhi on December 21, 2012, following the gang-rape of a student in the Indian capital. Indian police have arrested the driver and four others of a bus after a student was gang-raped and thrown out of the vehicle, reports said, in an attack that has sparked fresh concern for women's safety in New Delhi. The attack sparked new calls for greater security for women in New Delhi, which registered 568 rapes in 2011 compared with 218 in India's financial capital Mumbai the same year. AFP PHOTO/RAVEENDRAN (Photo credit should read RAVEENDRAN/AFP/Getty Images)


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This photo is awaiting approval and will be posted soon.
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All Comments
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20 McCain AuditoriumKansas State UniversityManhattan, KS 66506-4701785-532-5851
MANHATTAN, Kan. -- Each year since 1944, the third week of September has been recognized as National Farm Safety & Health Week. This year, Gov. Sam Brownback has also proclaimed Sept. 15-21, 2013 as Kansas Farm Safety and Health Week, too.
It's no coincidence that national attention turns to safety during the busiest season of the year for agriculture, said John Slocombe, farm safety specialist with K-State Research and Extension. The push to get crops in and out of fields hits full speed in the fall. Livestock are moved from summer pasture to fall and winter locations. Tractors and farm implements become more common on rural roads in Kansas and throughout rural America during the fall. Sharing the road becomes increasingly important as farming season peaks and days become shorter.
"This year's theme Farm Safety & Health Week, 'Working Together for Safety in Agriculture', really gets to the core of safety on the farm and on rural roadways," Slocombe said. "Each of us, whether we work on the farm or not, has a responsibility to work safely and this is especially true as farm vehicles share the road with other motorists during the busy fall farming season."
Most crashes involving farm equipment on public roads involve a passenger vehicle and a farm implement. Too often these crashes result in fatality and most are preventable.
Tips for motorists:
Tips for farmers:
One final tip for farmers – never transport extra passengers on a tractor designed for one person. It's unsafe for the passenger and is a distraction to the tractor driver. Extra riders are at tremendous risk of falling from the tractor, which could place them in the path of a towed implement if one is attached to the tractor. If the tractor is equipped with an extra seat the rider should be seated and buckled while the tractor is moving.
It takes time to prevent farm accidents, Slocombe said. Unfortunately, it takes only seconds to become a farm accident victim. Plan ahead. Think safety first.
MANHATTAN, Kan. -- Small farm businesses are plentiful in Kansas. The Affordable Care Act (ACA) improves health insurance options for small businesses, employees, and their communities, according to Roberta Riportella, Kansas Health Foundation Professor of Community Health at Kansas State University.
National Farm Safety and Health Week, Sept. 15-21, 2013 is a good time to remind farm business owners that Kansas residents can begin enrolling in the health insurance marketplace on Oct. 1, 2013 for coverage that will begin Jan. 1, 2014.
For more information about the Affordable Care Act contact your local K-State Extension office or visit the K-State Research and Extension website.


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Bacteriocins are proteins that are biologically active against members of the same species or species closely related to the producing bacterium. Some noteworthy bacteriocins those produced by lactic-acid bacteria (LAB), as they have been used to prepare fermented food, improve quality, and extend the average duration of many foods for centuries.
The work presented in the doctoral thesis approaches the molecular aspects of the permeabilization that AS-48 exerts on bacterial membranes. "We designed a strategy to carry out site-directed mutagenesis on the as-48A gene, the one which generates enterocin AS-48", the researcher from Granada pointed out, "and we have studied the role of seven amino acids that could be involved in biological activity and in the hydrophobic nature and thermodynamic stability of the molecule. We made this study by changing the amino acids into others with different properties."
The results of this work made it possible to conclude that while some of the mutated amino acids are essential for biological activity, others improve AS-48 biotechnological characteristics. During the process of obtaining mutated amino acids, it was also determined that three out of the ten genes involved in the production of AS-48 express themselves together. The research also determined the way of that these genes are regulated and expressed as well.


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Add Command in Context Menu?
Posted 23 July 2014 - 02:20 AM
Broken link on MSFN? You may try this. Looking for SEARCH on MSFN? Click here.
Posted 23 July 2014 - 08:18 AM
OMG, I went back to the office today and the printer started shooting all of my Listing.txt files from yesterday. What a waste. I did not mean for it to actually print, I just wanted to create the text file with the list of the files within the selected directory so that I can later manipulate in excel or access.
So here's the code: what it currently does is to create a txt file within the selected directory, this file Listing.txt has the names of all the files contained in that directory; it then sends this file to the printer. I want to stop sending the file to the printer. – help me save some trees.
@ECHO OFF SETLOCAL ENABLEEXTENSIONS DIR "%~1\*.*" /ogn /-p > "%~1\Listing.txt" notepad.exe /p "%~1\Listing.txt"
Windows Registry Editor Version 5.00 [HKEY_CLASSES_ROOT\Directory\Shell] @="none" [HKEY_CLASSES_ROOT\Directory\Shell\Print_Directory_Listing] @="Print Directory Listing" [HKEY_CLASSES_ROOT\Directory\shell\Print_Directory_Listing\command] @="Printdir.bat \"%1\"" [HKEY_CLASSES_ROOT\SOFTWARE\Classes\Directory] "BrowserFlags"=dword:00000008 [HKEY_CLASSES_ROOT\SOFTWARE\Classes\Directory\shell\Print_Directory_Listing] @="Print Directory Listing" [HKEY_CLASSES_ROOT\SOFTWARE\Classes\Directory\shell\Print_Directory_Listing\command] @="Printdir.bat \"%1\"" [HKEY_CURRENT_USER\Software\Microsoft\Windows\Shell\AttachmentExecute\{0002DF01-0000-0000-C000-000000000046}] @="" [HKEY_CLASSES_ROOT\SOFTWARE\Classes\Directory] "EditFlags"="000001d2"
Posted 23 July 2014 - 10:32 AM
Sure .
If you invoke notepad with the /p switch, it will
1) open the file (but NOT display it on screen)
2) send it as is to the printer
3) close the file and terminate the running notepad
Just remove the /p from :
Or remove the whole line above from the batch if you don't want the file to be opened in notepad.
Sorry for your paper (and for the trees).
Broken link on MSFN? You may try this. Looking for SEARCH on MSFN? Click here.
Posted 23 July 2014 - 11:23 AM
Works perfectly... and I'm learning something too.
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Journal Sentinel TV and film critic Duane Dudek looks at life on the small and big screen, and some of the cool stuff on both.
This summer's most overused movie gimmick
I've seen many to most of the summer movies so far and noticed several of them feature a variation on the same scene that guarantees they will not be shown by airlines - the breaking apart of an airplane in mid-air sending passengers plummeting to their deaths.
All seem to be a variation of a similar scene in "The Dark Knight Rises," in which the villain Bane proceeds to destroy and escape from the plane on which he is held a prisoner.
So far this year there has been:
- "Iron Man 3," in which the title character forms a daisy chain to save a group of people who fell from plane destroyed by a megalomaniac played by Guy Pearce.
- Coming this week is "World War Z," whose trailers include a tense scene where Brad Pitt scrambles across rows of seats to discover a zombie attack. Somehow the cabin of the plane is ripped open and people tumble out the hole
- And next week is "White House Down," in which terrorists shoot a rocket at what looks like Air Force One, tearing off a wing and ripping open the plane.
Have there been others? What have I missed?
While you ponder this watch the "White House Down" trailer, below.
Comments »
Read and share your thoughts on this story.


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For the first time in UTG history, two staff photographers had the chance to attend the same concert date: November 9, 2011, at the Compuware Arena in Plymouth, Michigan. Take a deep breath and brace yourself as we express our thoughts and reveal photos of D.R.U.G.S., We Came As Romans, Boregore, Asking Alexandria, and Hollywood Undead.
world war 3
UTG PHOTOS – DOUBLE FEATURE!: World War III Tour (11/09/2011)
MUSIC VIDEO: Madina Lake – Hey Superstar
The long-awaited music video for Madina Lake's "Hey Superstar" has finally been released! The song comes from the Chicago band's new album World War III which drops on September 13. Madina Lake always seem to include their fans in everything they do, and in this case, the fans are featured in the music video just as much as the band members are.
Madina Lake premiere "Hey Superstar"
Alternative Press has partnered with Madina Lake to premiere the first song off their upcoming album, World War III. Click here to stream the song, which is entitled "Hey Superstar."
Here's what frontman Nathan Leone had to say about the track:
"It feels like everything is becoming completely plastic and contrived lately. From cosmetic adjustments like Botox to technological 'fixes' like Photoshop, Auto-Tune, etc., there's this implication that to be accepted you have to be anything but yourself. That's way too much pressure. I think most people are pretty kickass just as they are, and removing that pressure would
Madina Lake sign, announce "World War III"
Madina Lake have announced they've officially joined the Razor & Tie Records roster. Additionally, the band announced plans to release their new album, World War III, this Fall. Congrats guys, let's hope 2011 is your best year yet!


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After letting A-Trak and Surkin remix his "Odd Look," electronic music's favorite zombie Kavinsky has teamed up with The Weeknd for the latest rendition of the cut. It should not come as a surprise as the result is quite overwhelming as Abel Tesfaye's vocals go hand in hand with the synth-heavy production. This could become an instant favorite on your playlist so tune in above.
Kavinsky featuring The Weeknd – Odd Look (Remix)


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16 U.S. Code § 6011 - United States Park Police
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(a) Appointment of task force
Not later than 60 days after November 13, 1998, the Secretary shall appoint a multidisciplinary task force to fully evaluate the shortfalls, needs, and requirements of law enforcement programs in the National Park Service, including a separate analysis for the United States Park Police, which shall include a review of facility repair, rehabilitation, equipment, and communication needs.
(b) Submission of report
Not later than one year after November 13, 1998, the Secretary shall submit to the Committees on Energy and Natural Resources and Appropriations of the United States Senate and the Committees on Resources and Appropriations of the United States House of Representatives a report that includes—
Source(Pub. L. 105–391, title VIII, § 801,Nov. 13, 1998, 112 Stat. 3521.)
LII has no control over and does not endorse any external Internet site that contains links to or references LII.


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I'm a neglectful mother, at least to the fruits and vegetables in my garden of late. My poor zucchini were abandoned for a month in a tangle of tomato plants and grew into something better suited to hitting baseballs than being cooked into a tender saute. Just last week, I harvested three of them, determined to coax their firm flesh and seedy interiors into something worth eating.
My first experiment was at the suggestion of a neighbor who told me that overgrown zucchini can be cooked down with brown sugar and cinnamon and then mashed into a sweet compote, akin to applesauce. I dutifully cubed and cooked up 10 whole cups, excited that I was onto something BIG. Once finished, the kids and I eagerly dug in, but stopped short after one bite. "Squashsauce" was a total bust and found it's way pretty quickly into the compost.
Luckily, my next attempt more than made up for that first failure, resulting in these Double Chocolate Zucchini Cupcakes. Moist, chocolatey, just sweet enough, the kids loved them. If you take a bite with your eyes closed, you'd never suspect vegetables were part of the equation (as an aside, eating chocolate with your eyes closed is highly underrated).
The treats are decadent enough to qualify as a birthday cupcake, but wholesome enough for an afternoon snack along with a glass of milk (the mini size are good for littler appetites). A full cup and a half of zucchini goes into the batter, along with whole wheat flour, yogurt, and just enough chocolate chips for good measure. Shower the finished cakes with confectioners' sugar to pretty them up or spread with frosting if you're looking for a dressier affair. You can also bake the batter in a loaf pan and drizzle it with melted chocolate.
To be honest, I wasn't sure whether to call these cupcakes or muffins; I suppose they could qualify as either. Whatever they are, Chocolate Zucchini Cupakes are bound to be an improvement over store bought, particularly on the nutrition front. These weigh in at about 200 calories each (80 for the mini size), which isn't bad, especially when you consider that a chocolate muffin from Starbucks is nearly 500 calories, the ones from Dunkin' Donuts and Costco, top 600.
With late-season zucchini abundant in markets, now is a good time to get baking. A couple of medium zucchini will more than suffice for the recipe. And don't worry, you needn't scare up a neglected, overgrown one to make it, but if you'd like, I've got plenty to go around. Come over.
Note: You might also like this Sneaky Chocolate Bundt Cake made with beets and zucchini.
Double Chocolate Zucchini Cupcakes
If little ribbons of green zucchini in these cupcakes will be a turnoff to your kids, feel free to peel the squash before grating it. If you want to get a little more decadent, frost them with a classic buttercream. You can find a good one at Savory Sweet Life , but be sure to cut the recipe in half. That should still yield plenty of frosting. Leftover frosting is excellent spread between whole grain graham crackers.
• 2 eggs
• 1/3 cup nonfat plain yogurt
• 1/3 cup canola oil
• 1 cup sugar
• 1 teaspoon vanilla extract
• 3/4 cups whole-wheat pastry flour
• 3/4 cups all-purpose flour
• 1/3 cup unsweetened cocoa powder
• 1/2 teaspoon ground cinnamon
• 1 teaspoon baking soda
• 1/2 teaspoon salt
• 1½ cups coarsely grated zucchini (about 2 medium zucchini)
• 1/2 cup bittersweet or semi-sweet chocolate chips
• Confectioners' sugar for dusting
Preheat oven to 325 degrees. Line 1 dozen regular-size muffin tins or 36 mini muffin tins with paper liners or generously grease with oil or butter. If you want to bake this in a loaf pan, generously grease a 9×5-inch pan well with oil or butter.
Put the grated zucchini in a colander set over the sink and use your hands to squeeze out some of the liquid. Leave in the sink until ready to use.
In a large bowl, beat the eggs with an electric mixer on high until foamy and light yellow, a minute or so. Add the yogurt, canola oil, sugar, and vanilla and beat again on medium until one even color and consistency, another minute. Set aside. You can also do this with a whisk and a little elbow grease.
In a medium bowl, combine the whole-wheat pastry flour, all-purpose flour, cocoa powder, cinnamon, baking soda, and salt. Stir well with a fork to blend all the ingredients.
Add the dry ingredients to the wet and beat on medium just until evenly mixed together, scraping down the sides as needed.
Add the zucchini and chocolate chips to the batter. Mix until just combined.
For full-size cupcakes, fill each tin with a scant ¼ cup of batter. For mini cupcakes, figure about 1 ½ tablespoons of batter each (although this can vary depending on the size of your muffin tins).
Put into the oven and bake until a toothpick inserted into the center comes out clean, 25 to 28 minutes for full-size cupcakes, closer to 20 minutes for minis, and about an hour for a loaf.
Remove from oven and leave on the counter until completely cool. Finish with a light dusting of confectioners' sugar, your favorite chocolate frosting, or 1/4 cup of melted chocolate chips (in the case of the loaf).
Will keep up to 4 days in the fridge or wrapped well, will freeze for up to 1 month.
Makes 12 regular, 30 mini cupcakes, or 1 loaf.


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True Facts About The Fruit Bat
SUMMARY: This amusing video shares a few facts about the amazing megabats -- the largest flying mammals alive in the world today.
Orphaned baby fruit bats. Screen capture.
Once again, it's caturday, so let's watch some animals doing stuff!
Today's animals are megachiropterans, or "big winged" bats -- more commonly known as megabats or fruit bats. Unlike the bats that pop into most people's minds when they hear the word, the megabats are frugivorous (fruit-eaters) or nectarivorous (nectar-eaters) that don't use echolocation to find their food sources. They are important pollinators or seed dispersers, especially on remote oceanic islands. Most species of megabats locate their meals by sight, so they have large eyes, keen eyesight. At least some megabat species are migratory. True to their name, "megabat", this group include the largest flying mammals alive today, with wingspans of 1.5 metres (5 feet).
There are more than 900 species of bats on Earth, which makes the Chiropterans more species-rich than any other mammalian group, except rodents. They inhabit nearly every habitat available, except for the polar extremes. Tragically, due to habitat destruction and other forms of human exploitation, particularly hunting, most megabats are in danger of extinction. (Microbats have their own set of partially overlapping problems that are threatening their existence.)
Whilst taking university zoology courses, I learned about the controversy that the two groups of bats, the megabats and the microbats (microchiropterans) might be distinct, with the megachiropterans being more closely allied in deep time with primates than to microchirpoterans. This hypothesis was based upon strong similarities in megabat and primate visual systems (doi:http://dx.doi.org/10.1098/rstb.1989.0102). However, fossil studies (doi:http://dx.doi.org/10.1038/nature06549) and more recent molecular phylogenetic analyses (doi:http://dx.doi.org/10.1093/molbev/msi180) have revealed that megabats and microbats really are each other's closest relatives.
This amusing video shares some information about the megachiropterans, specifically, the flying foxes:
Simmons N.B., Jörg Habersetzer & Gregg F. Gunnell (2008). Primitive Early Eocene bat from Wyoming and the evolution of flight and echolocation, Nature, 451 (7180) 818-821. doi:http://dx.doi.org/10.1038/nature06549 [$]
Pettigrew J.D., S. K. Robson, L. S. Hall, K. I. McAnally & H. M. Cooper (1989). Phylogenetic Relations Between Microbats, Megabats and Primates (Mammalia: Chiroptera and Primates), Philosophical Transactions of the Royal Society B: Biological Sciences, 325 (1229) 489-559. doi:http://dx.doi.org/10.1098/rstb.1989.0102 [OA]
Eick G.N. (2005). A Nuclear DNA Phylogenetic Perspective on the Evolution of Echolocation and Historical Biogeography of Extant Bats (Chiroptera), Molecular Biology and Evolution, 22 (9) 1869-1886. doi:http://dx.doi.org/10.1093/molbev/msi180
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NOTE: this piece is slightly modified from the original, written by GrrlScientist and published on The Guardian.
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Grrlscientist can be found on on her eponymous Guardian blog, and she sometimes lurks on social media; facebook, G+, LinkedIn, Pinterest. She's quite active on twitter: @GrrlScientist


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Bone Bracelet with Square Beads, Zebra Pattern
Features & Benefits
Unique, recycled Fair Trade bracelet, featuring delicately crafted square bone beads with a zebra pattern.
• Made from waste cow bone. A sanding machine is used to shape the bone.
• The beads are then dyed and the patterns are created by hand with hot wax - a technique known as Batik.
• TIny black Maasai beads are threaded between each section, enhancing the detail of the item.
• The bracelet is elasticated, so is easy-on, easy-off and will fit most wrist sizes comfortably.
• Why not complement the look with a matching necklace and earrings, also available from our range? (See below)
This Fair Trade bracelet with square bone beads was hand crafted in Kenya - bringing you a distinctive product inspired by natural materials and displaying the vibrancy of African culture.
Dimensions - width 2 cm approximately.
Meet the Artisans
Excel Concepts specialises in waste cow bone bead making.
It was started in 2005 by 4 young street boys who were trained on project start-up programmes. They have recently moved into a new premises in Kibera slum, on the outskirts of Nairobi, Kenya.
The aim of the project now is for it to become self sustainable.
They are now designing jewellery, manufacturing the actual beads and assembling the pieces, such as our beautiful Batik bone bracelet.
This project involves bringing change to the cow bone jewellery industry in Kibera slum, Nairobi. This craft industry has been around since the late 70's and employs over 500 people in Nairobi. These workers are almost always underpaid and work with dangerous machinery and in dirty and unsafe workshops. Most of these workshops are based in the slums, including the workshop this project helped to start.
The work is highly skilled, yet the workers of this industry are often exploited, with middle men taking advantage of the fact many buyers are too scared to visit workshops in the slum.
The idea of this project is to set up and run an example workshop making Kenyan jewellery so that others locally can see the benefits of adhering to Fair Trade principles.


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JACKSONVILLE, Fla. -- The morning of Wednesday, October 10, Biltmore Elementary will host the 5th Annual Muffins for Moms.
The event is open to mothers, grandmothers, sisters, cousins and female role models -- all women. The event is a celebration and opportunity to spend quality time with Biltmore's students, according to a news release from Duval County Public Schools.
The keynote speaker for this year's Muffins for Moms is Jacksonville's First Lady Santhea Brown, wife of Mayor Alvin Brown.
The Jacksonville Jaguars Foundation and Communities in School are this year's sponsors.
The event will take place Wednesday, October 10, from 7:45 a.m. - 8:30 a.m.
Biltmore Elementary School is locatd at 2101 West Palm Avenue.


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"An independent, standard approach to scientific peer review is long overdue," said Keith Collier, Rubriq's co-founder and former Vice President at Thomson Reuters. "And unlike other proposals to revamp peer review, the Rubriq system will not only preserve the value of rigorous pre-publication review, but also can be used effectively by any publishing model, including traditional subscription journals, as well as Green and Gold Open Access journals. "
Rubriq is actively recruiting reviewers in all fields, and is now accepting manuscripts for a beta version of its service in the fields of immunology, cancer biology and microbiology. Visitors to the web site (www.rubriq.com) can sign up to participate as an author, reviewer and journal editor with a single account. The Rubriq system seeks to serve the scientific community with innovation that improves the process of peer review and journal matching.
"We are actively seeking input from the research, publishing, and funding communities," said Shashi Mudunuri, Rubriq's other co-founder and CEO of Research Square. "Through discussions and our beta tests, we hope to engage all the different stakeholders in the publishing process to create a new approach that benefits everyone and ultimately puts time and money back into research."
About Rubriq
Rubriq introduces a streamlined yet rigorous model for scientific research peer review and journal matching. By incentivizing reviewers, compressing the process from months to a few weeks and assigning an independent, quantitative score (R-Score) to research papers, the Rubriq model benefits authors, reviewers and publishers. Rubriq—whose name embodies a well-established set of parameters and the process of review—is an independent, for-benefit division of Research Square (www.researchsquare.com), and was fou
|SOURCE Rubriq
Copyright©2012 PR Newswire.
All rights reserved


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Latest weather
The latest weather forecasts for the Border region.
The latest weather forecasts for the Border region.
Snow showers continuing to affect eastern areas.
Drier with clear spells towards the west.
A widespread frost and risk of ice on untreated surfaces.
Light easterly winds. Minimum temperature -6 °C.
According to provisional Met Office statistics this has been the coldest March for 50 years.
A selection of you pictures showing this weekend's windy weather
As High Pressure and settled weather south & east, milder and (eventually) more unsettled conditions develop from the south and west.


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PuchiBag ...because you should never have to leave home without your best friend. PuchiBags are functional, fashionable and fabulous bags designed to give the fashion conscious pet owner a viable alternative to the pet carrier of old. No animal skins are used in the creation of these totebags, backpacks and slings and Each year hundreds of bags are donated to various non-profit organizations for use in fundraisers that benefit animals worldwide. Fabrics and styles will be changed accordingly with the seasons and trends, but basic styles will be available year-round.
Carrier Chocolate and Pink Giraffe
Black and White Stripes Carrier
Black and White Zebra Maya Bag Pet Carrier
Black Canvas Tote Carrier
Black Ostrich Tami Elite Pet Carrier
Black Patent Bowling Ball
Black Sleek Tote Carrier
Blue Pleather Pet Carrier
Brown Canvas Tote PetSak
Chocolate Giraffe Carrier
Chocolate Snake Maya Bag Pet Carrier
Pet Carrier PupSak Pumpkin Spice
Katie jumped right in it and as far as her breeder knew she had never been in one before. It is the most georgious carrier...Thank you so much for your kind, expert service.
Kind regards Jackie, NY
I received the bomber jacket, its soooo cute! Love it! thank you so much. thanks.
Kathryn, CA
Thank you very much. And thank you for your time and everything - you have been very kind.
Ika, Slovenia
Thanks for your prompt service and sorting out the delivery. If any of my friends enquire as to where I acquired it from I'll have no hesitation in giving them your web details along with my recommendation.
Regards and many thanks Dave, England
thanks so much for doing a great job with our Notre Dame football jersey. It got to St Louis today, and below are 2 pictures of Maxx modeling it. It looks awesome!
Terry, MO


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Forward-Looking Statements
This announcement contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. Actual results may differ significantly from management's expectations. These forward-looking statements involve risks and uncertainties that include, among others, risks related to competition, management of growth, new products, services and technologies, potential fluctuations in operating results, international expansion, outcomes of legal proceedings and claims, fulfillment center optimization, seasonality, commercial agreements, acquisitions and strategic transactions, foreign exchange rates, system interruption, inventory, government regulation and taxation, payments and fraud. More information about factors that potentially could affect HealthWarehouse.com's financial results is included in HealthWarehouse.com's filings with the Securities and Exchange Commission, including its most recent Annual Report on Form 10-K and subsequent filings.
About HealthWarehouse.com, Inc.
HealthWarehouse.com, Inc. (OTC: HEWA) is a trusted VIPPS accredited retail mail-order pharmacy based in Cincinnati, Ohio. HealthWarehouse.com offers 300 prescription drugs for $3.50 with 100% FREE shipping and is a 2009 & 2010 winner of the BizRate Circle of Excellence Award for outstandin
|SOURCE HealthWarehouse.com, Inc.
Copyright©2010 PR Newswire.
All rights reserved