text:
Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
your express consent. For more information, please refer to our Privacy Policy.
You currently have no recent searches
Lococo, Filippo MD*; Cesario, Alfredo MD*†; Cardillo, Giuseppe PhD‡; Filosso, Pierluigi MD§; Galetta, Domenico MD‖; Carbone, Luigi MD‡; Oliaro, Alberto MD§; Spaggiari, Lorenzo PhD‖; Cusumano, Giacomo PhD*; Margaritora, Stefano MD*¶; Graziano, Paolo PhD#; Granone, Pierluigi PhD*
*Department of General Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy; †Deputy Scientific Director, IRCCS San Raffaele Pisana, Rome, Italy; ‡Unit of Thoracic Surgery, San Camillo-Forlanini Hospital, Rome, Italy; §Department of Thoracic Surgery, University of Turin, Turin, Italy; ‖Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy; ¶Unit of Thoracic Surgery, Centro Oncologico Fiorentino, Firenze, Italy; and #Anatomic Pathology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Disclosure: The authors declare no conflicts of interest.
Address for correspondence: Filippo Lococo, MD, Department of General Thoracic Surgery, Catholic University, Largo F. Vito n 1, Rome Italy. E-mail: email@example.com
Introduction: Available data on the malignant solitary fibrous tumor of the pleura (mSFTP), a very rare neoplasm with unpredictable prognosis, are scarce. The aim of this study is to collectively analyze the aggregated data from the largest series in the English literature to date, a multicenter, 10-year study of 50-cases.
Methods: We retrospectively reviewed the clinical records of patients who underwent surgical resection for mSFTP in the period between January 2000 to July 2010. Long-term survival (LTS) and 5-year disease-free survival were analyzed in detail.
Results: There were 24 men and 26 women (median age, 66 years; age range, 44–83 years). Thirty-two patients (64%) were symptomatic. A malignant pleural effusion was diagnosed in 12 cases. Surgical resection included isolated mass excision in 13 patients and extended resection in 35. In the remaining two cases only biopsies were undertaken. The resection was complete in 46 cases (92%). Adjuvant treatment was administered to 15 patients. Median follow-up was 116 months (range, 18–311 months). Overall LTS and disease-free survival were 81.1% and 72.1%, respectively. Fifteen patients (30%) experienced a relapse of the disease. Complete resection yielded much better LTS than partial resection (87.1% versus 0%; p < 0.001). At the Cox regression analysis, incomplete resection (hazards ratio [HR]: 39.02; 95% confidence interval [CI]:4.04–380.36; p = 0.002) and malignant pleural effusion (HR: 3.44; 95%CI: 0.98–12.05; p = 0.053) were demonstrated to be risk factors for earlier death. At multivariate analysis, chest-wall invasion and malignant pleural effusion increased the risk of recurrence (HR: 4.34; 95%CI: 1.5%–12.6%; p = 0.007 and HR: 3.48; 95%CI: 1.1%–11.0%; p = 0.038, respectively).
Conclusions: Surgical resection remains the treatment of choice for mSFTP. Relapse is common (approximately 30%). Incomplete resection and malignant pleural effusion at diagnosis impact LTS negatively.
The solitary fibrous tumor of the pleura (SFTP) is a rare neoplasm that accounts for less than 5% of all pleural tumors.1 Its incidence is approximately 2.8 cases out of 100,000 registered hospitalized patients, and it usually occurs in all age groups with a peak incidence in the fourth and sixth decade of life.2,3 Since Klemperer and Rabin4 first described its pathologic characteristics in 1931, more than 900 cases of SFTP were reported in the literature up to 2005.5 According to several different authors, SFTPs have been characterized by dishomogenous taxonomies.6,7 The absence of a clear nomenclature has only added to the confusion about these tumors, where uncertainty exists with regard to their clinical behavior; also, a sound classification with diagnostic and prognostic potential remains far from reach. The development of electron microscopy in the early 1980s and the introduction of immunohistochemistry techniques in the standard pathologic assessment of neoplasms have clarified that the tumor does not originate from the mesothelial layer but from the submesothelial, noncommitted mesenchymal layer.8,9 Thus, the various names used for this disease have slowly become unified, and the disease is now referred to as solitary (or localized) fibrous tumor of the pleura. Although the majority of these neoplasms have benign features (histological and clinical), approximately 10% to 20% of the cases reported in literature are malignant.10,11 Criteria for distinguishing pathologically benign forms from malignant ones have been established by England and colleagues,11,12 and these are now widely accepted. Easily controlled by surgical resection, benign forms have been reported to recur locally14 (this has been hypothesized as related to a malignant transformation). Surgery, as well, remains the standard of treatment for malignant forms. The clinical decision-making process in malignant (m) SFT (mSFT) management is supported, so far, by series of single-case reports.1,12–15 To the best of our knowledge, in fact, the number of mSFTP reported cases is far too small for a substantial analysis of recurrence or survival rates: these, in fact, are inconsistently reported. The result is that no established treatment modality or follow-up plan has been yet agreed to. Also, the prognostic features of mSFTP do not seem to correlate with its histological characteristics and this remains a point to be further clarified.11,16,17
We established a multicenter collaboration among high-volume thoracic surgery centers to collect a consistently homogeneous population (the largest so far in the English literature); we analyzed this population by reviewing its clinical presentation, histopathologic characteristics, treatment modalities, and long-term survival (LTS) results. The outcome of this analysis is reported herein.
In the period between January 2000 and July 2010, 50 patients were surgically treated for malignant SFTP in the four centers involved in the present analysis (Catholic University of Rome [n = 9], Forlanini Hospital of Rome [n = 17], European Institute of Oncology of Milan [n = 8], and University of Turin n = 16]) and these formed the basis for this retrospective analysis. Before undertaking our data analysis, we obtained the approval of the Catholic University (Promoting Centre) Institutional Review Board for research use of retrospectively collected data (observational) stemming from standard clinical practice. Data related to sex, age, tumor location, signs and symptoms, surgeons' notes, pathological features, postoperative therapy, recurrence patterns, and long-term follow-up were systematically reviewed and recorded (see Table 1).
In all the patients, the preoperative evaluation included history, physical examination, routine blood tests, standard chest radiographs, and thoracic computed tomography (CT) scan. Fiberoptic bronchoscopy was performed in case of lesions located proximally to major airways. Electrocardiography, spirometry, and arterial gas analysis were routinely performed and noted. Perfusion lung scan was performed only in selected cases as for echocardiography, which was carried out only if a history of cardiovascular disease was present or if a pneumonectomy was anticipated. 18-Fluorodeoxyglucose positron emission tomography/CT was performed in two cases only. At pathological evaluation, tumors were eventually reclassified as malignant when one or more of the criteria reported by England et al.9 were met: (1) mitotic count more than 4 mitoses/10 high-power fields; (2) presence of necrosis; (3) hypercellularity as judged by nuclear crowding and overlapping; and (4) presence of nuclear atypia.
Flow-cytometric analysis was performed on fresh material. Immunostaining for a panel of cell markers including bcl-2 (apart from two cases), CD34 was routinely done in all four centers. Upon pathological re-review, immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue, using the streptavidinbiotin immunoperoxidase method, in addition to standard hematoxylin and eosin staining (three sections for each case). In fact, the following antibodies were not routinely used: cytocheratin (AE1–AE3) and vimentin.
A centralized pathological revision of the samples was performed by an expert—dedicated in lung pathology—pathologist (PG) to avoid any variation in pathological diagnosis and to achieve a concordance on the histopathological characteristics of the samples reviewed.
Postoperative radiotherapy and/or chemotherapy were performed under the care of referring oncologists: although a certain degree of homogeneity was present within the four centers, this was lost when the centers are compared among themselves. After completion of the study (July 2010), information about the health status of patients was obtained by the clinical records of outpatient clinics.
The t test, the χ2 test and the Fisher's exact test were used where appropriate. Actuarial patient survival and disease-free survival (DFS) were obtained by the Kaplan-Meier method. Comparisons between survival curves were done with the log-rank test. The Cox multiple regression analysis was subsequently applied and the risk factors for both the mortality and the relapse of the tumor were identified. Differences were considered significant at the level at which the p value was less than 0.05. All statistical analyses were conducted by using SPSS 13.0 for Windows (SPSS, Chicago, IL).
Demographics and clinical and pathological features are summarized in Table 1. There were 26 women and 24 men with age ranging 44 to 87 years (mean ± SD: 66.0 ± 10.4 years). The tumor was right-sided in 29 patients (58%) and left-sided in 18 (36 %); in two cases the neoplasm was located in the mediastinum, and one patient presented with bilateral pleural lesions. At the time of diagnosis, 32 patients (64%) presented symptoms related to pleural fibroma, although no history of asbestos exposure was recorded; when symptoms were present, the predominant ones were dyspnea, chest pain, and coughing. Eight patients (16%) had more than one symptom. Mild-to-severe hypoglycaemia (Doege-Potter's syndrome) was observed in three cases (6%), and in one patient it was associated with weight loss, fatigue, and dysarthria. Eighteen patients (36%) were totally asymptomatic and pleural fibroma was incidentally found on a chest radiograph or more rarely on a CT scan performed for other reasons.
Chest radiographs were obtained for the entire study group. In all patients but one, a preoperative CT scan was carried out. Usually, the density of the neoplasm was quite low (30–45 UH) and heterogenous to different extents in large tumors because of myxoid degeneration and localized hemorrhage or necrosis (Fig. 1A). Magnetic resonance imaging was obtained in four patients (8%) only.
A moderate-to-large malignant pleural effusion was observed in 12 patients (24%) (bloody fluid except in two cases). Material for cytological examination by transthoracic fine needle aspiration biopsy (FNAB) was obtained in 32 cases (64%). The analysis showed the presence of malignant mesenchymal cells compatible with an mSFTP in 16 cases. This assessment provided a generic diagnosis of mesenchymal tumor with no other specifications in eight cases and failed to provide any result in the remaining eight.
Bronchoscopy was performed in 10 patients (20%). No abnormalities were found in seven cases; an extrinsic compression was present in three, and cytology on transbronchial biopsy confirmed the diagnosis of mSFT in one of them. Overall, a certain diagnosis had been obtained in 17 patients (34%).
All the patients were treated in one of the four institutions as reported above. The operative approach and surgical procedures are summarized in Table 1. Tumors arising from the parietal pleura were more difficult to resect than those from the visceral pleura because they were large, affixed to the chest wall, and required extrapleural resection or extended resection.
When reviewing the surgical behavior in the four participating centers it was clear that the extent of resection was decided on a case-by-case basis when the situation was appraised intraoperatively. In particular, an isolated mass excision was performed in 13 cases (26%) only whereas an en bloc resection of surrounding structures was carried out in all the remaining cases, as reported in Table 1. In six patients, a formal lung resection (lobectomy [n =2] and pneumonectomy [n = 4]) was necessary because of large tumors extending deeply in the lung parenchyma. A chest-wall resection was needed in 10 cases (20%) whereas in two cases the lung resection was extended to the diaphragm and/or the pericardium. In the three cases in which the neoplasm was deemed unresectable or inoperable (extension to adjacent structures/pleural malignant colonization—not previously detected at the preoperative workup) only a biopsy was performed.
Intraoperatively, a polypoid/pedunculated lesion (Fig. 1B) was observed in 11 cases (27%); 31 (73%) presented with sessile tumors. In eight cases the surgical report did not contain any indication about the gross morphology of the tumor and this could not be understood from the final pathology. The visceral pleura was considered the point of origin in 30 patients (60%); and the parietal pleura in 16 (32%). In eight cases (16%) it was not possible to discriminate the exact point of origin of the disease because it extended largely into the pulmonary parenchyma and infiltrated the chest wall. Margins were intraoperatively confirmed free of tumor in all those cases (especially in the sessile morphology group) in which a doubt regarding the completeness of resection was present: a complete resection was achieved, as confirmed by final pathology, in all but four cases (92%) with three (6%) gross residual tumor (R2) situations (2 pleural carcinosis and 1 infiltration of the aortic arch) and one microscopic (R1), in a case where the neoplastic mass measured 25 cm circa in its maximum diameter and largely infiltrated the chest wall.
The postoperative recovery was uneventful in 37 patients (74%); complications occurred in 13 patients (26%) and these included: atrial fibrillation (n = 3), pneumonia (n = 3), bleeding (n = 3), which in one case required a reintervention, pulmonary embolism (n = 2), persistent air leak (n = 1), and wound infection (n = 1). Two patients (4%) died in the perioperative period. One patient (a 78-year-old man) with no prior history of coronary artery disease died suddenly on postoperative day 3 because of a myocardial infarction after a left extended pneumonectomy with pericardial reconstruction for a very large tumor (24 cm of maximum diameter). The second patient (a 77-year-old woman) died on postoperative day 9 because of pneumonia complicated by massive pulmonary embolism after a right upper lobectomy with combined chest-wall resection.
Fifteen patients (30%) underwent adjuvant treatment (radiotherapy in 11, chemotherapy in 3, and combined radiochemotherapy in 1 case). Clearly, the adjuvant treatment was substantially not homogeneously administrated in the cohort of patients analyzed in this report in which the clinical decision-making process was established by each single center.
The tumors measured from 30 × 18 × 22 to 320 × 250 × 170 mm (mean maximum axis =12.8 ± 6.5 cm; range, 2–32 cm) and the largest one weighed 2130 g (Fig. 1C). Grossly, the majority of the tumors were well circumscribed, lobulated in appearance, and firm in consistency; the cut surface was vaguely nodular storiform, occasionally microcystic and myxoid, and white-gray. On cut sections, tumors showed a whorled appearance, sometimes alternating with some myxoid areas.
Microscopically, the typical pathological findings of mSFTs were confirmed in all the specimens; in particular, a patternless pattern characterized by a proliferation of uniform elongated spindle cells with a various amount of connective tissue was detected in most of the cases. Sometimes, specifically fibrous or hypercellular patterns, along with mixed bundles of tissue with marked amounts of blood vessels were seen in different sampled areas of the tumor (Fig. 2A). The diagnosis of malignancy was based on the four criteria by England et al., which we evaluated and eventually matched one by one, also arbitrarily extracting a risk-score (0–4) (Table 1) thereafter to be correlated with prognosis.
The mitotic count was also evaluated in all patients and this ranged from 1 to 36 mitosis for 10 high-power fields (mean 10.02 ± 8.2). The proliferation index ki-67% was calculated in 38 of the 50 patients (mean ki-67% = 14.8% ± 11%, range, 1%–60%).
The immunohistochemical analysis showed in all tumors a positivity for vimentin and CD-34 (Fig. 2B and C), although no expression of low molecular weight cytokeratin and of desmin was detected. A clear positivity for bcl-2 was found to be present in almost the entire cohort of patients (96%).
The follow-up was completed in 100% of the cases at the time of writing this report (median 52.5 months, range, 1–194). Censoring found 40 patients alive and 10 dead. The overall LTS (Kaplan–Meier) was 81.1% (95% CI: ± 10.2%) at 5 years and 66.9% (95% CI: ± 18.6%) at 10 years (Fig. 3A).
The most significant prognostic factor in our series proved to be the completeness of resection. In fact, patients with an R+ disease did not reach the 5-year survival, with a striking difference with R0 ones (overall: 87.1%, p < 0.001) (Fig. 4A). Interestingly, no differences in LTS was found when attempting a stratification of patients according to (1) the size of the tumor, (2) its pleural pattern (tumor arising from visceral versus parietal pleura), or (3) the pedunculated versus sessile morphology (Table 2). No evidence of different survival functions was found, similarly, stratifying for age and sex. Moreover, as stated above, we calculated a score (0–4) based on England's criteria (Table 1); no significant differences were found when comparing the four classes with a trend for better survival in scores 1 and 2 (100% alive at 5 years) if compared with scores 3 and 4 (90% and 79.6% alive at 5 years, respectively) (Table 2).
LTS was significantly worse for those patients with malignant pleural effusions if compared with those without (5-year LTS, 85.5% versus 69.4%; p = 0.04; (Fig. 4B). No further statistically significant difference was found, considering the other characteristics of the population, and this is very probably because of the relatively small number of observations.
As reported in Table 3, the Cox multiple regression analysis confirmed that the incomplete resection represents a risk factor for earlier death. In particular, it was estimated that patients with R+ resections had a risk of death 39.02 times higher than patients in whom an R0-resection was achieved (95% CI: 4.04–380.36; p = 0.002). The presence of malignant pleural effusion had a heavily negative impact on survival with an estimated HR of 3.44 (95% CI: 0.98–12.05) and a p value almost statistically significant (p = 0.053). No other additional risk factors were evidenced.
During the follow-up period, 15 patients (30%) experienced a recurrence of the tumor (mean time to recurrence: 34 months, range: 2–128). The recurrence pattern was localized (intrathoracic) in six patients (40%) and diffuse (metastatic) in nine (60%). Interestingly, in the entire population, no significant differences in the survival functions were observed between patients who experienced a recurrence versus those who did not (p = 0.371). In four patients with localized recurrences a re-resection was performed (in one case 3 further iterative resections were needed in a 4-year-long period). In all the other cases (2 with local relapse and 9 with metastases) chemotherapy was administered (in 2 combined with radiation therapy). The chemotherapeutic protocol was not uniform: most patients underwent single-agent treatment (doxorubin) or a combination of doxorubicin and ifosfamide; the clinical response was substantially unsatisfactory in almost all cases.
For the entire population, the 5- and 10-year estimated DFS rates were 72.1% (CI 95%: ± 15.6%) and 60.5% (CI 95%: ± 20.0), respectively. (Fig. 3B). The visual inspection of the disease-free curves suggested four factors potentially associated with the recurrence rate (Fig. 4C and D). In particular, the log-rank test confirmed that the patients who had an mSFTP involving the chest wall showed a lower rate of 5-year DFS (no chest-wall invasion 79.5% versus chest-wall invasion 50%; p = 0.003); similarly, the analysis of survival demonstrated a significantly worse DFS in patients with malignant pleural effusion (no pleural effusion 78.9% versus pleural effusion 55.6%; p = 0.023). Differently, no further pathological or immunohistochemical features were associated with different DFS.
The Cox multivariable regression analysis confirmed that the presence of chest-wall invasion and the malignant pleural effusion both increased the risk of recurrence (HR: 3.48, 95% CI: 1.1%–11.0%, p = 0.038; and HR: 4.34, 95% CI: 1.5%–12.6%; p = 0.002, respectively) (Table 3).
SFTPs are uncommon neoplasms (with just over 900 cases reported in the English literature in decades),5,6 but a pattern of augmented incidence could be detected in the recent years. Although the majority of these neoplasms are benign, approximately 10% to 20%10,11 show a more aggressive biological behavior, with pathological findings of invasiveness, appearance of distant metastases, and local relapse after resection. Sung et al.5 reported that the incidence of malignant SFTP varies from 7% to 60% in the English literature, a variation attributed to slight differences in the pathologic criteria differences used in each institution.
SFTs with malignant morphology and behavior are generally larger (mean tumor size of 12.8 cm in our series) if compared with benign ones,18,19 significantly so in some studies,20,21 though very large tumors can be also benign. Some authors suggest that larger tumors are more likely to be malignant because they have had time to undergo genetic changes.22
Furthermore, the symptoms, if any, are more frequently associated with malignancy.5 Intrathoracic symptoms are usually nonspecific and include cough, chest pain, and dyspnea. Possible causes may be: (1) the irritation of adjacent structures by invasion or peritumoral adhesion, (2) the paracrine action of unknown factors secreted by the mSFTP, or (3) the presence of pleural effusion (which is generally more frequent in those malignant tumors). Indeed, according to England and colleagues,11 pleural effusion affects 16% of the patients, with a higher prevalence (32%) among those with mSFTP (8% in those with benign tumors). In the present series, we could detect a malignant pleural effusion in 12 patients (24%) and, very interestingly, these patients had a significantly worse prognosis in terms of LTS (69.4% versus 85.5%, p = 0.04) and DFS (55.6% versus 78.9%, p = 0.023) if compared with those without any sign of pleural effusion. This finding probably reflects a more advanced stage of the disease in which the presence of pleural fluid can be considered the expression of a pleural direct invasion or dissemination (M+ disease).
There is also evidence that the hypoglycemia has a paraneoplastic syndromic appearance and is related to the production of insulin-like growth factor II by the tumor cells; in fact, it normally resolves after the removal of the tumor itself.5,23 The incidence of hypoglycemia varies from 2% to 4%3,8,14 and topped at 6% in our series (possibly because of the greater representation of malignant forms).
Although the chest CT scanning remains the test of choice, the radiological differentiation between the benign or malignant nature of the neoplasm remains difficult. However, the following findings could suggest malignancy: a diameter exceeding 10 cm, central necrosis, and ipsilateral pleural effusion, according to criteria described in the work by Ferretti et al.24 Nuclear magnetic resonance may provide some help, showing the fibrous character of the lesion25 and by providing a topographic and differential diagnosis and differentiating the tumor from surrounding structures. Although FDG/positron emission tomography-CT has been demonstrated to be useful in selected mSFTP cohorts because it provided some differential diagnostic elements to distinguish benign and malignant variants of the tumor,18,26 further evidence is needed for this methodology to be routinely inserted in the mSFTP clinical workup guidelines. Even the cytological assessment of these neoplasms in the preoperative setting is invariably unsatisfactory because the accuracy of the CT-guided FNAB procedure ranges in levels below 50%.18,20,26,27 We share the opinion that FNAB should be reserved for those cases in which the clinical condition contraindicates surgery (for functional and/or oncological reasons).
Surgery is the first step treatment of choice for mSFTPs and the completeness of the resection represents its primary objective.11,12 An extended resection through standard thoracotomy should be performed to warrant completeness of the resection. Video-assisted thoracic surgery procedures have been sometimes used (in 10% only of our population) because these approaches cannot guarantee the completeness of the resection, especially in large and invasive/malignant tumors. However, in those cases in which the pedunculated morphology is accompanied by the absence of pleural dissemination and/or chest-wall clear infiltration, we believe that video-assisted thoracic surgery can be reasonably used. We suggest intraoperative checking of the surgical margins to confirm the radicality of the excision when this approach is used. In the present series, pulmonary wedge excision was the most common surgical procedure, whereas formal anatomic lung parenchymal resections alone were performed in only six patients (12%). Chest-wall resection alone was required in three patients (6%) whereas in seven patients (14%) it was combined with additional lung parenchymal resection. The operative approach and extent of surgical excision is clearly dictated by the mSFTP's size, location, and attitude toward surrounding structures.
The final diagnosis of malignancy in the cases reported in this review was established on the basis of histological criteria suggested by England et al.11 These criteria are currently widely accepted and have been employed in the most recent surgical series,12–15,27 and their usefulness is also suggested by the American Registry of Pathology.28 In our series we did not observe the pleomorphic variant as described by Perrot et al.,6 in which isolated pleomorphism can be detected without any other sign of malignancy (England score 1) and that is generally considered as an intermediate form, borderline with frank malignancy.
Regarding the long-term outcome after surgical resection, we may assume that LTS after resection of mSFTPs is possible because it ranges from 46% to 100% in the main surgical series reported until now (77.6% in the present series; Table 4).
In agreement with other authors,5,11,15,18,20,27 our data demonstrated an LTS is dramatically better (84.9% versus 0%) when a complete resection is achieved (Fig. 3A). Univariate analysis shows that patients with invasion of neighboring structures and with malignant pleural effusion have a worse DFS; furthermore, the multivariate analysis confirmed the invasion of neighboring structures as the only independent factor impacting significantly on the recurrence rate of the disease (Table 3). Regarding the tumor size, differently from some studies,11,17,21 we could not confirm the tumor size as a factor significantly impacting survival, in agreement with other authors.18,29 Similarly, we found that prognosis was not affected by the site (visceral or parietal pleura) of origin or by the gross morphologic features of the tumor (sessile versus peduncolated) (Table 2). In this setting, Perrot and colleagues6 classified SFTP on the basis of a combination of gross morphologic features and pathologic subtype (benign pedunculated, benign sessile, malignant pedunculated, and malignant sessile). The authors reported significant differences in the recurrences and survivals of these subgroups and in particular, the recurrences were reported to occur in 63% of those patients with sessile mSFTPs and in 14% of patients with peduncolated mSFTPs. Of all the patients enrolled in the present study, morphopathologic information could be obtained in 42 cases: 31 were sessile mSFTPs and 11 pedunculated. Local recurrence occurred in seven patients (21.6%) and four patients (36.4%). Although our data are not completely in line with those from Perrot et al.,6 we should also consider that: (1) our sample is composed basically by a surgical series, (2) all patients were surgically treated in high-quality and high-volume surgical centers with a very high resection completeness rate (< 92%). The significant differences of the analyzed series could justify this observation. We are of the opinion that the Perrot morphopathological classification, although useful, should be further validated regarding its prognostic potential in large prospective series. On a different note, when data from our cases are matched with England's criteria, we could detect a linear correlation with DFS shortening according to the increase of the score; in fact mSFTPs with scores 3 to 4 were associated with a DFS rate of 78.8% and 66.4% whereas all cases of mSFTPs with scores 0 to 1 were 100% free from recurrence at the moment of the follow-up.
Therefore, our results, although based on a relatively small cohort of observations, allow us to confirm that England's criteria may have a prognostic value. Adjuvant treatment did not induce, in our series and in agreement with others,12 any significant benefit to the overall survival of operated patients. On the contrary, we could detect a trend showing a negative impact. Nevertheless, we believe that this observation is clinically irrelevant because of the great heterogeneity of criteria that led, in each center, to the indication of adjuvant treatment. Finally, we could confirm the fact that SFTP, despite their tendency to grow locally, have a malignant behavior that justifies a full long-term follow-up. In the surgical R0 population, the recurrence rate (local plus distant) ranges from 14% to 86%5,12,27,30 (30% in our series, 15 cases of which 9 with evidence of distant metastasis). This behavior also justifies an aggressive surgical strategy where redo resection should be performed in all cases in which it is reasonably possible. Our long-term results on the four redo surgery cases, in line with others,15,31 support this attitude.
This is a retrospective analysis and, as such, has significant limitations in solving the uncertainties regarding the SFTPs. However, the relatively large number of observed cases, the homogeneity of the cohort, the long-term follow-up information (10 years), and the comprehensive analysis of the prognostic factors we have performed support the conclusion that radical surgery and redo surgery, if performed in selected high-volume centers, are able to achieve a more-than-satisfactory disease control in a biological setting, in which so far, alternative treatments (radio and chemotherapy) have failed to provide significant benefits.
Surgical resection, when technically and medically feasible, is recommended for the treatment of localized mSFTP, and long-term survivals could be expected. Additional prognosis stratifiers must be further investigated and validated.
Solitary fibrous tumor; CD34; Malignant solitary fibrous tumor; Localized fibrous tumor
This article has been cited 3 time(s).
© 2012International Association for the Study of Lung Cancer
Colleague's E-mail is Invalid
Your Name: (optional)
Your Email:
Colleague's Email:
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Journal of Thoracic Oncology.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
Folder Name:
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Forgot Password?
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Keyword Highlighting
Highlight selected keywords in the article text.
Search for Similar Articles
You may search for similar articles that contain these same keywords or you may
modify the keyword list to augment your search.
Visit JTO.org on your smartphone. Scan this code (QR reader app required) with your phone and be taken directly to the site.
For additional oncology content, visit LWW Oncology Journals on Facebook.


text:
Peter Island
Peter Island Travel Guide
Articles about Peter Island
By Travel + Leisure Staff
By Donna Heiderstadt
See the slideshow of the Most Romantic Caribbean Sunsets. The Caribbean islands are famous for their sunshine—and rightly so. Is there anything more daydream-worthy, more symbolic of languor and ease, than those ubiquitous images of sugary white ...
By Karen Schaler
Hotels in Peter Island
This private-island retreat is all about serenity and catering to classic desert-isle fantasies. The resort is committed to delivering in quantity everything the genre is known for, especially peace and privacy.
Things to do in Peter Island
The Scene: Don't let the name scare you off. Sure, legend has it Blackbeard marooned 15 mutinous men nearby and it didn't end pretty (rum and a sword were involved), but that just makes this Caribbean hideaway more interesting.

subset: commoncrawl


text:
November 29, 2015
Mrs. Kinney was born April 7, 1928 in Parkersburg, W.Va., a daughter of the late Carl and Elizabeth Stribling Stanley.
Many years ago, Frances had been employed at the C & P Telephone Co. She was a 1946 graduate of Parkersburg High School. She enjoyed bowling and had been a member of several bowling leagues. She was a member of All Saints Catholic Church, Dallas.
She is survived by her husband, Forrest B. "Sam" Kinney; two daughters, Karen Schadegg (Richard) of Frisco, Texas and Lisa Fox (Mark) of Carmel, Ind.; three sons, Steve Kinney (Penny) of Cincinnati, Ohio, Samuel Kinney (Debbie) of Dallas, Texas and Craig Kinney (Heidi) of Naperville, Illinois; one brother, Carl "Jr." Stanley (Eva) of Parkersburg, W.Va.; fourteen grandchildren; and seven great-grandchildren.
In addition to her parents, she was preceded in death by one sister, Betty Conger.
What a beautiful difference a wife/mother's life has made!
Mass of Christian Burial will be celebrated at 10 a.m., Friday, November 16, 2012 at St. Margaret Mary Catholic Church, 2500 Dudley Ave., Parkersburg with The Reverend Monsignor Joseph L. Peterson as celebrant. The family will receive friends from 4-7 p.m., Thursday at the Vaughan Funeral Home, 1010 Murdoch Ave., Parkersburg.
A guestbook is available for sending condolences to the family at www.vaughanfh.com
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.


text: > View Product Details Please select the size of the product. Please enter valid quantity. Rotenier sterling silver tiered 3 swirl and diamond earrings overview details Retail: $995.00 Reduced: $403.99 40% Off : $242.39 color : We're sorry. This style is sold out. Silver With exquisite, handcrafted designs and covetable stones, Rotenier jewelry exudes true elegance in its purest form! Color: Silver Handcrafted sterling silver Three tiered swirl marquis pendants Faceted round diamond studs throughout; 18 total stones with approximate .18cttw Post backs Measures 2⅜'' long x ⅜'' wide All measurements are approximate 14 Day Return Policy; returns must be received within 14 days. No returns will be accepted on international orders. See FAQ for more details. Sterling Silver / Diamond; U.S.A; style#320963901


text:
The Scorecard
Seeking balance in his life and avoiding power seems to be the result of the inner journey and contemplations of Rahul Gandhi. He is now supposed to be leading the Congress into the future. But hear his Jaipur speech carefully and we must contemplate what Rahul will possibly do or not do, and how his dynastic turn at leading the affairs of the nation's pre-eminent party could turn out. We must ask: is Rahul Gandhi for real or is he just the latest strand of an idea of a national beginning once made by his great grandfather? Is he just the emblem of a party now structurally tied at the Centre to the strings of dynasty? Or the apprenticeship over, is he rolling up his sleeves to get into the nitty gritty, the dirt and the grime, of politics in the age of coalitions?
At the end of his speech in Jaipur, largely seen as his coming-of-age address, Rahul Gandhi spoke of balance. He said that he loved to play badminton as a little boy because it gave him balance. He learnt the game from two security guards who later shot his grandmother and took away the balance in his life. Having moved the captive audience to emotion and some tears, he then went on to speak of power. He said that his mother understood that "the power so many seek is actually a poison". The only antidote to this poison, he said, "is to not become attached to it. People should not chase power for the attributes of power." Three days later, Rahul, now vice-president of the Congress, showed up at the party headquarters on Delhi's Akbar Road and met all the functionaries. He told the media he only intended to raise "positive issues".
Critics call the charming vagueness and apparent shunning of power a deliberate tactic. If the Congress does well, he's the face of party and government; if they do badly, he tried his best! That is why Pinaki Misra, BJD MP, says Rahul has learned the art of wielding power without responsibility. "As long as the prime minister of India reports to him, why would he choose to take that responsibility and come into the direct line of fire? He enjoys his private life as well and I don't think he wants to compromise with the space of his private world."
Talent Pool? NSUI members celebrate at AICC headquarters
But a veteran Congressman stresses that Rahul has never been inclined towards any government post and even in the future he does not see him as hankering after becoming the PM. "That is why other senior leaders still hope they can be the Manmohan Singh to his Sonia," he adds. Perhaps having learned from his mother, Rahul too would seek no office, but he already has great power. And if Modi does indeed emerge from the other corner with his unbridled ambition, Rahul would be showcased as the contrasting figure reluctant to have power but with all the noblesse oblige instinct of a dynasty that has always used rhetoric about the poor and the powerless. If the plan around Modi is to highlight his corporate-friendly credentials, show him as the efficient epitome of an aspirational leader, the supporting plan for Rahul is the direct cash transfer scheme and pushing the food security bill. In short, he will be showcased as the gentle Prince of the Poor.
Yet there are many who believe Rahul can deliver nothing on the ground, just a sense of well-being at the Congress headquarters. Congress functionaries at times say this off the record, other parties say it openly. Ram Achal Rajbhar, the UP state chief of the BSP, says that the Congress has celebrated Rahul's new role with crackers and sweets in Jaipur but there is no welcome or warmth for his new role, "at least not in UP, the state he claims he belongs to. Nothing would change at the ground level. He was never a charismatic leader nor do we see any possibilities in the future."
The first step Rahul filing his papers at Amethi in 2004
Before the general elections next year, there is a slew of assembly polls where the Congress takes on the BJP and its prospects are not believed to be good in Madhya Pradesh, Chhattisgarh, Rajasthan and Delhi. It does fancy its chances in Karnataka, though. The reality of politics also is that the impact of central politics on the states is diminishing. A former Congress minister from the state attending the Jaipur meet told Outlook, "At the state level, Rahul campaigning or not will not matter. But it is important in the context of the Lok Sabha if he proves himself by then."
D.P. Tripathi, the general secretary of NCP, makes an interesting point. "It is very good that Rahul Gandhi has taken bigger responsibility in the party," he says, "but please don't forget that whenever a vice-president was appointed there were serious problems within the Congress. I am merely drawing your attention to the history of Arjun Singh and Jitendra Prasada who were given those posts by then Congress chiefs Rajiv Gandhi and Sitaram Kesri respectively."
Rahul rebelling against his own party is an interesting prospect as his speech was rather unusual in critiquing a system largely created and upheld by the Congress. For instance, he spoke passionately about people who are kept out of the system because they are not connected and on the need to empower them. But surely, the Congress across India has perpetuated the rise of clans while its most prominent younger leaders are all children of political heavyweights?
Rahul also spoke of a more decentralised system, and power being shifted to the states. Again, it is the Congress that has been the most resistant to this and strong regional leaders have traditionally been cut to size by the national leadership, most famously during the reign of Rahul's grandmother Indira Gandhi, but also by his mother Sonia—for instance when Jaganmohan Reddy was shortchanged in Andhra Pradesh.
Still, we must take Rahul's word for it that he is inclined to break some old patterns in the Congress. But whether he will be able to do so and if it will all add up to anything really new or transformative remains to be seen. As of now, he has merely changed the mood in the party and lifted its spirits at a troubled time when opinion polls predict a slide for the ruling party. Rahul's long-overdue coronation is only the beginning of a story that presumably will have more substance beyond the token presence of a dynast.
Photograph by Reuters, From Outlook 04 February 2013
Coming Up Next: Rahul Vs Modi?
Neither the Congress nor the BJP has announced their prime ministerial candidate for the next general election yet, and probably won't, but the hot money is that it is going to be a head-to-head encounter between Rahul Gandhi and Narendra Modi.
By Saba Naqvi in Jaipur with Panini Anand


text:
Looking for the latest news, photos, and video from Jimmie Johnson, Chad Knaus, and Team Lowe's Racing? Then put your car in park because you're in the right place. Check back often to see what's new!
Visit Team Lowe's Racing on Facebook and Twitter
TUNE IN: Sprint Unlimited: 8 p.m. FOX Sports 1 / MRN/ Sirius XM NASCAR Radio
Jimmie Johnson will make his 12th start in the Sprint Unlimited this Saturday, Feb. 15 at Daytona (Fla.) International Speedway. The driver of the No. 48 Kobalt Tools Chevrolet SS won the exhibition event in 2005 and qualified for this year's race by winning three pole positions during the 2013 season.
This year for the Sprint Unlimited, fans will vote upon the following specifics: race format, the starting order and the restart order for the final segment. Votes can be cast on NASCAR's official mobile app – NASCAR Mobile – or at NASCAR.com/SprintUnlimited. All votes made through the NASCAR Mobile app will count twice.
Johnson could line up first in Saturday's Sprint Unlimited if the starting order is determined by the 2013 championship standings. Johnson finished ranked first in those standings to win his sixth NASCAR Sprint Cup title. If fans choose to set the field by career pole positions, then Johnson would start the non-points event third.
Crew chief Chad Knaus has selected Hendrick Motorsports Chassis No. 48-756 for Saturday's Sprint Unlimited. Johnson, who will drive the No. 48 Kobalt Tools Chevrolet SS in the exhibition event, most recently tested this car during Preseason Thunder in early January at Daytona International Speedway.
DAYTONA HALF: Johnson will follow up his run in the Sprint Unlimited by participating in the Daytona Beach Half Marathon the next day. This is the second straight year Johnson will compete in the 13.1-mile event, which starts around 6 a.m. local time on Sunday, Feb. 16 and precedes Daytona 500 qualifying. The half marathon course features a beach segment and concludes at Daytona's start-finish line. Last year Johnson averaged a 6:51-minute mile and crossed the line fourth in his age group with a time of 1:29:49.
Johnson is encouraging fans to use #TeamJJF to connect with the Jimmie Johnson Foundation on Twitter (@TeamJJF), Instagram (@TeamJJF) and Facebook (www.facebook.com/JimmieJohnson). All fans are encouraged to use the hashtag #TeamJJF particularly when sharing their experiences in personal fitness.
JOHNSON ON THE RETURN OF TONY STEWART AFTER SERIOUS INJURY: "I've missed Tony on many levels. He has a certain presence that we all know and see and appreciate. It's been great getting to know him as a racer and a team owner and understand his passion for racing. It was really weird with him not being around last year. It was a big void. I'm going to be glad to be racing against him again."
JOHNSON ON RUNNING THE DAYTONA BEACH HALF MARATHON: "Last year I ran in the Daytona Beach Half Marathon and had an absolute blast. It's done very well from an event standpoint, and it's very well attended. I had a blast running down and across the bridge. I am going to be running it again this year representing TeamJJF and would love to have others join in and participate with me. More importantly, I encourage fans to come out and just have fun. It's such a great event."


text: A method that is declared static is called a class method. A class method is always invoked without reference to a particular object. An attempt to reference the current object using the keyword this or the keyword super in the body of a class method results in a compile-time error. It is a compile-time error for a static method to be declared abstract. A method that is not declared static is called an instance method, and sometimes called a non-static method. An instance method is always invoked with respect to an object, which becomes the current object to which the keywords this and super refer during execution of the method body.


text:
I had a mare I spent tons of time with, broke myself, took everywhere! She rode perfectly, had impeccable manners, could be trusted anywhere with anybody, and was a good looking mare. I never thought twice about selling her when the option came up. There was no connection and to me she was "just a horse".
Poco was my love from day one. We Just "clicked" from the get go. He was only affectionate with me and seemed overall happier when I worked with him. He always gave his 110% and was willing to do anything asked. He is DEFINITELY not like this with everyone.
Some people an horses just don't "click". Just like you may not be best friends with every person you meet. Or you may be indifferent toward some dogs or other peoples horses. You haven't failed at all! I received TONS of compliments on my mares obedience which proved I did well with her. But with Poco people specifically compliment that ever present connection between us and that makes me glow. :)
Posted via Mobile Device


text:
How to Get Internet in the Desert: A Look Inside Paul Salopek's Backpackhttp://www.outofedenwalk.com/blog/foot-notes/2013/03/internet-in-the-desert/http://www.outofedenwalk.com/
Edited by Doug.H on 03/05/2013 12:49:09 MST.
Where's the backpack? T's a shame not to show it. But I suspect Paul is anything but a UL traveler -- and had a team of men and animals to carry his stuff.
Edited by ben2world on 03/05/2013 13:19:10 MST.
You must login to post.
MEMBERSHIP IS REQUIRED TO POST: You must be a Forum, Annual or Lifetime Member to post messages in the backpackinglight.com forums.


text:
About Brenda
Brenda Burgett is a psychic medium, intuitive healer and animal
communicator from the Great Pacific Northwest. For almost two
decades Brenda has been using her gifts to help others. Whether it
be through media programs, books, CDs, social media, personal
classes, one on one sessions or personally designed oracle cards
her focus does not waiver, her mission is to help people in a positive
way. Brenda's journey has allowed her to touch the lives of people all
over the USA, Germany and even Ireland. She is most certainly a
spiritual force and looks forward to continuing her work, expanding
her reach and continuously learning and honing her gifts as she
stays connected to Spirit.
LIKE Us on Facebook!


text:
Captain America Casting Thread
View Single Post
September 25 2009, 07:12 PM
Temis the Vorta
Fleet Admiral
Location: Tatoinne
Re: Captain America Casting Thread
I heard a rumor they've already cast the other Winchester as Steve. It's probably bullshit though.
Jensen Ackles isn't big and hunky enough for the role (tho I would have liked him as Kirk.)
I know he's a little too old, but i thought Ben Browder might have done well with this part.
He needs some high-profile role, that's for sure. But I see him more as a snarky Tony Stark type.
Temis the Vorta
View Public Profile
Find More Posts by Temis the Vorta


text:
- Filed Under
Readers voice their opinions on Source
Dear Editor:
The zoning administrator (ZA), paid expert for the town in interpreting town ordinances, and the town attorney's office clearly stated that it was permissible for me to move a resident and Source, into 402 Montreat Road. Source has the equivalent of 2.3 full-time practitioners. The ZA specifically testified and stated into evidence that the number of employees, neighborhood impact, traffic, parking, and noise are NOT relevant factors in this case.
The ZA testified that she did not make the second, contradictory, decision that we were not in compliance, but rather her superior ordered the violation document. The town manager did not consult with the zoning administrator about her prior correspondence with me, carry out a formal investigation, or follow the rules and regulations set forth by the Town of Black Mountain necessary to bring forth such action.
Should Town officials be allowed to arbitrarily change their interpretation of an ordinance after the fact, in our case after we made a $248,700 investment, based on information from his office?
This is the appeal that we have presented to the ZBA.
Whitney & Blake Madden
Black Mountain -
Dear Editor:
If the citizens of the Town, including the educated ones, are expected to know the nuances of the zoning ordinances and building codes, then the planning and zoning administrators, and the building inspector, all become incidental.
Richard Gulliver
Black Mountain -
Dear Editor:
I am in full support of the Source in its current location. It is a small business with quiet practitioners with a fence behind it where parking does not create noise or distractions. The allowance of parking at the Unitarian Church is also much less than the church's own full parking lot on Sundays and their spring sidewalk/yard sale.
The noiseless Source is also near the Saturday tailgate market where people park along a residential street and residents do not complain. Neither do residents around Lake Tomahawk complain about the parking and noise from the summer concert series. Clients of the Source are neither noisy nor create a parking problem.
I frankly do not understand why the Town board has created such a hullabaloo over one complaint when 96 percent of the population responding on Facebook support this unobtrusive business, especially since the owners put much work into improving a formerly decrepit looking building in that neighborhood.
The Town board should pay more attention to the sleazy apartments up Montreat Road whose transient residents are on the lookout for cars with out of state license plates to rob, and the vagrants who sit in empty woodlots with alcoholic beverages......
Noelle Uebele
Black Mountain -
Dear Editor:
I attended the zoning board hearings on Source's business usage of the rehabilitated residence on N.C. Highway 9/Montreat Road in the hope that they would produce a clear picture of the facts and truth on which fair and open minded people could reach a just solution.
Instead what emerged was a muddle of half-truths, misrepresentations, mistakes, inaction, bias, incompetence, and even spite on the Town's part. Source's owner was obviously mistaken in committing her family's life savings in reliance upon the pre-purchase/rehabilitation representations of the Town officials with whom she dealt.
If the board rules against her, the owner will have no alternative but to seek judicial review. The Town (and the owner) can ill-afford the expense and time of continued litigation. Instead of a board ruling the Town should avoid this unnecessary cost and have the board clarify the problematic zoning guidelines with Source being grandfathered so it can remain in place.
Alternatively the Town council should rezone the properties along Montreat Road for mixed use which would in fact reflect their current nature and allow Black Mountain to continue having Source as a valuable contributor to the Town's local economy and our citizens' health and well-being.
Bob Hanning, Retired Attorney
Black Mountain -
Dear Editor:
After attending the Source hearing on June 20, these things were made clear to me:
Town staff have made several errors in handling this case, from the initial advice given by zoning officials, through the permitting process, to the order halting Source's activities. These hearings seem to be an attempt by the Town to backpedal and cover these missteps, at the expense of Whitney's business and livelihood.
Some members of the zoning board appear to have no respect for due process, are unprepared to hold such proceedings, and have already made their decision, independent of these "hearings." I witnessed words and actions that were immensely unprofessional and rude - personal attacks, interrupting/discounting testimonies of witnesses, and use of position and opinion to influence the direction of the hearing. I'd like to see an investigation into the way the Town has handled this matter, overseen by parties outside of its "good ole boy" politics. I love living here, but think our Town needs to conduct itself in a more professional and consistent manner.
It's sad this issue has made it this far, and I hope other small business owners aren't dissuaded from making Black Mountain their home and place of business.
Amanda Riley
Black Mountain -
Dear Editor:
It is perplexing to me that a town like Black Mountain that is so engrained in spiritual belief has difficulty deciding on whether to allow a business like the "Source" to continue to operate on busy Montreat road. Many residents have come to the "Source's" side and voiced their support, but we are all still debating the issue.
I am living just off of Montreat Road that is busy with traffic all day and night long. Cars zooming past. Emergency vehicles with sirens pass often. Vagrants sit in empty lots. It is not a quiet Black Mountain road.
I was awakened this week by two police cars taking a theft report from my neighbor about her car being broken into and property stolen during the night. There is constant foot traffic on Montreat from transient people living in run-down apartments down this street. All of this is going on less than a mile from the "Source."
The "Source" business is not a threat to the community. The community needs to focus on other problems on this road. I question the priorities and motivation of running a lovely business like the "Source" off this street.
Susan Sorrentino
Black Mountain -
Dear Editor:
Our community is in danger of losing Source for Well-Being, and I believe it is time that we begin to think collaboratively.
At the zoning meeting Thursday, I was impressed by the eloquence both of the Source practitioners who spoke in favor of continued occupancy of the building, as well as by the neighbors who spoke against it. They acted as if all parties in this case deserve respect.
I did not get a similar sense from the zoning board. The Maddens deserve for their case to be heard fairly.
This is a complicated case, and much is at stake. The Maddens have two options: to bankrupt their business, or to continue to litigate. The Town has made enough errors in the evolution of the Source property that if the Maddens were forced to sue, they probably would have a good case. As a taxpayer, I beg the zoning board to try to find a more logical solution.
Source for Well-Being has long provided not only healing, but green jobs and a sense of community for both residents and tourists. This is the kind of business that we want to encourage in our community, not destroy.
Cinnamon Kennedy
Black Mountain -


text: POPSUGAR Celebrity Candice Accola Pictures of Vampire Diaries by Celebrity 7/01/10 42 Shares Like us on Facebook Sign up for our daily newsletter > Follow us on Pinterest Previous Photo 1 of 11 View on One Page ADVERTISEMENT ( more slides) Next Share This Link Copy 1 Pictures of Vampire Diaries Previous Photo 1 of 11 View on One Page ADVERTISEMENT ( more slides) Next Read More Steven R. McQueenCandice AccolaVampire Diaries Candice Accola Vampire Diaries Star Candice Accola Is Pregnant — See Her Cute Announcement! Candice Accola's Stunning Honeymoon Snaps Will Make You Want a Vacation Candice Accola's Wedding Is a Star-Studded Vampire Diaries Affair Candice Accola Keeps Up the Bikini Fun in Hawaii POPSUGAR, the #1 independent media and technology company for women. Where more than 75 million women go for original, inspirational content that feeds their passions and interests. Be in the Know With OurCelebrity and Entertainment Newsletter Personalize TV Young Hollywood A-Listers Movies Sign up with facebook or By signing up, I agree to the Terms and to receive emails from POPSUGAR.


text:
Radical Fighters® is a high quality formula based on in depth scientific research in gerontology and cell biology. B-complex vitamins are added to support overall health and wellness. B vitamins are also important for cellular maintenance.
No tablet diluent' binders' colors' flavors' sweeteners or preservatives added.
These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not meant to diagnose' treat or cure any disease or medical condition. Please consult your doctor before starting any exercise or nutritional supplement program or before using these or any product during pregnancy or if you have a serious medical condition.
Serving Size: 2 Capsules
Servings Per Container: 50
Amount Per Serving / % DV
Vitamin A (as beta carotene) 8000 IU / 160%
Vitamin C (as ascorbic acid' ascorbyl palmitate) 450mg / 750%
Vitamin E (as d-alpha tocopheryl acid succinate) 150 IU / 533%
Thiamin (as thiamin mononitrate) 50mg / 3333%
Riboflavin 30mg / 1765%
Niacin (as niacinamide' nicontinic acid) 50mg / 250%
Vitamin B6 (as pyridoxine hydrochloride) 40mg / 2000%
Folic Acid 200mcg / 50%
Vitamin B12 (as cyanocobalamin) 75mcg / 1250%
Biotin 50mcg / 16%
Pantothenic Acid (as d-calcium pantothenate) 150mg / 1500%
Zinc (as zinc gluconate) 6mg / 40%
Selenium (as sodium selenate) 70mcg / 100%
L-Cysteine 150mg / *
L-Glutathione 8mg / *
PABA 100mg / *
Inositol 60mg / *
Choline (as choline bitartrate) 60mg / *
*Daily Value not established.
Other Ingredients: Gelatin' magnesium stearate' purified water' medium chain triglycerides' silica' vegetable stearic acid.
Take one or two capsules three times daily' preferably with meals.
If you are pregnant or nursing' taking any medication or have any medical condition' consult a health care professional before use.
Keep out of reach of children.
Allergy / Dietary Needs
- Binders Free
- Diluents Free
- Made in the USA
- Preservative Free
Ratings & ReviewsReview This Item Be the first to review this item.
Questions About This ItemAsk a Question
Please ask any questions you may have about this specific product in the field below.
Your question(s) and our corresponding answer(s) will not be confidential and will be posted publically on this specific product page.
Additionally, PureFormulas is unable to directly recommend products in relation to specific health conditions. Please contact your trusted healthcare practitioner for direct product recommendations.
If you have any general questions regarding orders or our policies and programs, please contact our Customer Happiness Team @ 1.800.383.6008
If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use. Your healthcare professional is the best source for guidance before beginning an exercise or nutritional supplement program.


text:
Best Uses
By Pop Bair
from New Holland, PA
About Me Pro Photographer
Very good lens for the money.
Very well pleased with this lens. It works well on my D-200. I've experienced no hesitation with the VR as I have read in other reviews. Also very little focus searching. I have taken some excellent bird pics with this lens. With any long lens you have to be careful with the auto-focus. It will focus where you point it but that may not be the best choice so I use the manual focus ring to touch up the focus. The ring is nicely placed right under where you balance the lens which makes it easy to use.
Bottom Line Yes, I would recommend this to a friend
By claynpotter
from Los Angeles, CA
About Me Photo Enthusiast
Sharp Lens!
According to various magazines, including one dedicated for Nikon, this lens is sharp (sharper than Nikon 80-400mm VRII), and I needed zoom lens for taking picture of birds. So I decided to use all my tax refund savings on this lens. The lens came with a big case, tripod collar, big lens hood, and Sigma UV filter (thank you Abe's of Maine for the free filter). The Lens is big and heavy, but not so heavy that I have no issue shooting 500mm handheld. The built in Optical Stabilization works very well, so under day light, no issue hand shooting lens/camera. The picture are very sharp through out the zoom range, but a bit soft at 500mm. Autofocus was fairly fast, but I don't think it's fast enough for shooting fast paced sporting events. The manual focus ring works in conjunction to autofocus, and I really like this feature - won't lock the focus ring even in autofocus mode (I heard Canon 3D MarkII has this feature built in the camera). Bokeh is very good. You'll never happy with the zoom range and will always want more. Although 500mm gives you pretty good zoom power, I tested with 2X Kenko teleconverter. I shoot some birds and the moon. It is SHARP! For the moon shots, I could hardly see chromatic aberration. The zoom is amazing and picture quality is better than attaching my Nikon to 90mm refractor telescope or 150mm Newtonian telescope via T-Mount. I also shoot at LAX from about 1.5 miles away from my office building using the lens and 2X teleconveter. I was brown away to see numbers and letters on a sign of the building which looks small dot in 35mm lens. The lens barrel was stiff at first so it did not creep, but after a couple of weeks of use, it started to creep. There is lens lock switch to lock the barrel. I really like the lens and you get more bang for the buck than Sigma 50-500 (Bigma) or Nikon 50-400mm VR II.
By Singh
from Cicninnati, OH
Great lens for a great price
I use it on my travels to different places and to photograph people in their natural setting...
By Mr Weather
from Carlisle, MA
Nice piece of glass!
This is so much better than an old f8 500mm mirror lens that I owned. I shot a bunch of pictures at my daughter's school concert and they were remarkably good. The only negative is that the zoom ring goes the 'wrong' way -- i.e. it is opposite to other nikon lenses. Oh, and it is heavy, but does balance nicely on the tripod adapter.
By ****
from North Carolina
Very Happy
Used this lens on Nikon d90 for taking pictures of surfers. They came out sharp and the color was accurate. I did not have any of the problems people complained about. I hope to find a camera bag to use that I can fit all my stuff and this lens that isnt a giant bag.
By blu9146
from Alto, New Mexico
(1 of 1 customer found this review helpful)
Good Value for the Price
My primary interest in this lens was long distance bird (and other wildlife) photography. I use it only mounted firmly on a heavy tripod, and was able to focus sharply on the eyes of cranes at quite a distance, for sharpness on subject and with blurred background. At the extreme of 500mm at a long distance, it takes some getting used to, but a comparable Nikon lens was not in my budget. Using the 500mm on closer creatures was much easier to focus and more quickly. The lens takes some getting used to, but is a good value for the money.
By Cellomangler
from Iuka, MS
About Me Semi-Professional
Not bad for the cash outlay.
I have taken some great photos with it so far. Also some very bad photos. Tough getting sharp focus unless there is tons of light. At least with digital you can take a lot of shots at varying ranges. That's the secret. Only show off the two or three great clicks out of the five hundred.
By ASK
from Fairfax, VA
About Me Hobbyist/Enthusiast
(2 of 2 customers found this review helpful)
Greatest for the Price
I use the Sigma OS 150 - 500 mm lens with a Nikon D300. It focuses very quickly and permits me to photograph birds in flight with reasonable focus and panning techniques. I set the D300 to aperature mode to try keep the aperature between f8 - f16 and achieve at least a 200 or faster shutter speed with ISO 800. Although there is a slight buzz when the OS kicks in, it is not objectionable and actually is comforting to know the OS is engaged. Although it has great reach, I have learned not to expect great results if the subject does not fill most of the frame with the Sigma or any other lens; however, the image even at very great distances (subject smaller than the point focus box) provides good enough results to identify the bird. There is no lens creep in any position, but the lens is new. The lens is heavy but not unreasonable. For the price I could not find a comparable. I previously used a 400 mm variable without OS at comparable cost. The Sigma is many times better. Overall I am very enthusiastic about the lens.
By Aunt Kaki
from Hawaii
Great lens!
I haven't gotten to try this lens out at night or for a fast moving sports event yet, but it worked great for sharp close-ups of flowers in my backyard. I even shot a picture of the quarter moon that turned out impressive, considering you could see the mountains and valleys on the moon!! CAN'T WAIT TO USE THIS LENS MORE AND REALLY PUT IT TO THE TEST!!!
By Gary
from Jacksonville, Florida
What a telephoto lens!
I actually tried to use this on an assignment and found it too powerful. Having the option to zoom in close is a great tool. This is a long lens that will magnify any shake, so I recommend having a monopod to help steady the image, even though this has image stabilzation.
By aris
from fairfield,ca
This is one great lens
Performs well with my D300. I love this piece.
By Crowbar
from Stillwater, NY
An excellent lens for the money
Works very well for distance compression when shooting landscape at 500mm, with all distances in sharp focus. Must stop down to f-11 for good results. On a bright day, the 86mm bell gathers enough light for shots at 1/30 to 1/60 sec f-11 at ISO 400. The OS helps reduce any shake. Can be used off hand at f6.3 ISO 400 with good results. Not unbearable to hold or carry. No cons as it isn't a $4000.00 lens and excells for the price.
By LG
from Brooklyn, NY
superb sports lens
Used this lens to photograph soccer. It give me an excellent reach throughout the field with very consistent high image quality. So far very happy with it
By DAN
from YOKOTA AIR BASE, JAPAN
About Me Casual user
Great ens, Great Servce!!
[...] Anyway I'm very happy with my purchase, I'm a beginner in Photography, I use my Sigma 150-500 lens primarily for sports events, air shows and wildlife photography. The focus is very fast and my pics are absolutely fantastic quality. I have taken several pics with the Image Stabilization (IS) and it works very well hand held. Everyone says its heavy, but I knew that before purchasing it, but it is not too heavy to use hand held for me anyway, I do have a monopod I use when I'm at one place for an extended time, or need a steady shot without using the IS. I did have a salesman call me at home and sold me a UV filter at a 50% discount, but I needed that as well. Overall I was very impressed by the service and the product and will not hesitate to purchase from Abes in the future
By Shanna
from Farmington, ME
(1 of 2 customers found this review helpful)
Should have researched this lens more
This lens does not focus well at all-and the resulting photo's are "muddy"-no crispness to them. I have a Nikon D60 with a 300mm Nikon lens that is "lightyears" beyond this Sigma Lens.I'm very disappointed.
Bottom Line No, I would not recommend this to a friend


text:
The Troubled Hunt for the Ultimate Cell
Capturing the human embronic stem cell might change the face of medicine. But to get there, a small band of researchers and biotech firms must endure a federal funding ban and ethical controversy.
John Gearhart's lab is closed to outsiders.
Rather than happening there, an interview brokered by a university public affairs officer takes place in a windowless lecture room in the bowels of the Johns Hopkins University School of Medicine. Outside, seedy east Baltimore vibrates with the energy of a bright spring day. Gearhart appears and takes a seat under the fluorescent lights. Time is short, and no tape recorders, please.
With reddish blond hair and a direct gaze, Gearhart speaks with excitement about the vast medical potential of the research going on in his lab. He describes the early stages of human life and an elusive cell found only in embryos. But there's much about this conversation that's fleeting, incomplete and evasive. Suddenly his voice turns defiant and he's scowling deeply. He relates how he and his family have received threats, how other scientists have criticized his failure to publish and his close ties with industry. And then he is gone, sprung by the clock-conscious PR man.
If awards were given for the most intriguing, controversial, underfunded and hush-hush of scientific pursuits, the search for the human embryonic stem (ES) cell would likely sweep the categories. It's a hunt for the tabula rasa of human cells-a cell that has the potential to give rise to any of the myriad of cell types found in the body. If this mysterious creature could be captured and grown in the lab, it might change the face of medicine, promising, among other remarkable options, the ability to grow replacement human tissue at will. The ES cell could, scientists hope, be a factory-in-a-dish that turns out cardiac muscles to patch heart attack victims, neurons to mend paralysis or pancreatic cells to battle diabetes. "It's a treasure house of opportunity for developing fundamental knowledge and medical applications," says Michael McClure, chief of the National Institute of Child Health and Human Development's Reproductive Sciences Branch in Bethesda, Md.
That all sounds so promising. Why, then, is John Gearhart besieged? The answer is that these cells are found only in embryos or very immature fetuses, and pro-life forces have targeted the researchers who are hunting for ES cells, hoping to stop their science cold. In addition, the federal government has barred federal dollars for human embryo research, pushing it out of the mainstream of developmental biology. To make matters worse, human ES cells could conceivably provide a vehicle for the genetic engineering of people, and the ethical dilemmas surrounding human cloning threaten to spill over onto this field. Deprived of the federal funds that power most basic biomedical research and surrounded by fierce controversy, the hunt for the ES cell is being undertaken only "by a few brave souls," says Colin Stewart, a colleague of McClure's at the National Institutes of Health (NIH).
Extensive reporting by TR suggests that in the United States, those brave souls are drawn from fewer than a half-dozen research groups. There are also a few others in the United Kingdom, Australia and Singapore. Even this intensive survey may have missed some researchers, since some probably prefer to do their work in silence. "We're constantly wondering what our competitors are doing, and even who they are," says Gearhart, director of research at the Johns Hopkins department of gynecology and obstetrics.
Taming the human ES cell wouldn't just be a huge scientific coup-it would also be a potential gold mine for the biotech firm that took out an enforceable patent on the tabula rasa cell. But the same secrecy and controversy that dogs the researchers has also limited the open involvement of industry. Just one company is openly chasing the human ES cell-Geron of Menlo Park, Calif. This young Silicon Valley firm has aggressively signed collaborations with leading ES researchers, including Gearhart and Roger Pedersen, a reproductive biologist at the University of California, San Francisco (UCSF). A search of the U.S. patent filings also shows that a small startup in White Plains, N. Y., called Plurion, is building up intellectual property around the ES cell. But Plurion executive Mark Germain declines to comment further.
"It's a taboo area," says Doros Platika, CEO of the Cambridge, Mass.-based startup Ontogeny, a rising star in the developmental biology business. "Big pharmaceutical companies are afraid to touch it. And the field needs to sort itself out before we'd get into it."
In spite of all these difficulties, there is a healthy scientific competition to catch the human ES cell-driven both by the desire for scientific glory and by the riches that might come with controlling the fabled stem cell itself. "It's a race. I lose sleep," Gearhart says. And despite many technical difficulties, several labs-including Gearhart's-believe they may already have captured the ES cell and are working to characterize and control the cells, furiously filing patent applications as they go.
Furious scientific competition, threats of violence, huge medical potential, fear and secrecy. Welcome, behind closed doors, to the topsy-turvy world of the human embryonic stem cell.


text:
Posted by Teacher Ria in Uncategorized | 4 Comments
An Open Letter To Students.
Dear Students,
I love being your teacher most of the time, for reasons that I myself cannot explain. I just do. However, there are times when this love can be challenged and be put to the test. I have already accepted and embraced the fact that my job is a thankless job, and yet I take it on for the mere fact that I love being a teacher. I hope you know, though, that when you come to class late despite my harried efforts to meet you on time I feel bad. Do know that when I see you doing your homework in class, I feel insulted because it shows you do not care much for what I am doing for you. When you talk to your classmates while I stand in front and try to teach you, I try my best not to feel disgruntled and simply try to understand and remember what it was like when I was you. I figured, maybe you just don't know how I feel, so I decided to write this letter.
On the other hand, do know that you guys bring a lot of joy to my life. You make me laugh and think in many ways I never thought I could. I love it a lot when you laugh at my jokes, no matter how corny they may be. I like it when you complement me, especially when it comes to our activities. Little things like saying "I enjoyed today" makes me feel my job is so worthwhile. Also, when I see how much effort you put into your assignments, my heart fills with pride.
So there my dear Students, this is how I feel as your Teacher.
Teacher Ria
If you found this post interesting, informative and educational, feel free to take home my notes by subscribing here.
check out my other blogs! yapatoots | Fat Girl No More | Daydream Believer | Teacher Ria | OnADietDaw
ang sweet nmn ni Teacher Ria…
Guilty yta ako sa first paragraph. ganyan ako nung student pko. sorry sa mga naging teacher ko.
From one teacher to another: I hope tomorrow will be a better day for you
- Earthlingorgeous.com » Blog Archive » My Top 10 Emerging Influential Blogs For 2009 - [...] I love how she writes about her thoughts as a teacher especially her recent post where she wrote an …
- Dear Students, Part 2. | TheAccidentalTeacher - [...] here it goes: like in my last letter to you, I'd like to remind you that while I may …


text:
Save Listing | | Print Listing | Notify Me of Similar Listings
Subdivision: Piney Creek 9th Flg
Property Type: Single Family
Year Built: 1994
HOA Fee: $83 - Monthly
County: Arapahoe
Zoning: M-U PUD
Property Tax: $4,099
Terms: Conventional, FHA, VA, Cash
Total Square Feet: 4,538
Finished Square Feet: 4,352
Basement finished percent: 87
Basement Square Feet: 1,425
Listing broker representing seller: Re/Max Alliance
Measurement Source: Builder
Car Spaces: 3
Beds: 5
Beds On Upper Floor: 3
Beds On Main Floor: 1
Beds In Basement: 1
Baths: 5
Baths in Basement: 1
Primary Style: Two Story
Style: Two Story
Type: Detached Single Family
Master Bedroom Location: Main Level
Family Room Location: Main Level
Laundry Location: Main Level
Basement Description: Cellar, Full
Subfloor: Slab
Elementary School: Indian Ridge
Middle School: Laredo
High School: Smoky Hill
School District: Cherry Creek 5
HOA Name: Westwind Management
HOA Phone: 303-369-1800
HOA Fee Includes: Clubhouse, Community Pool, Tennis Courts, Trash Removal, Grounds Maintenance
Builder: Richmond
Model: Tiffany
Construction: Frame/Brick
Subfloor: Slab
Roof Material: Composite Shingle
Heating: Gas, Forced Air
Water: Public
Sewer: Public
Fireplaces: 2
Directions: Parker Road to Orchard go East to 2nd stop light at Joplin turn left, 1st stoplight is Memphis turn right, take first left into entrance to Terrace. Go 2 blocks which will T into Joplin, house is third on the left
Date property was added to this site:
Sign in
Date listing was updated: Sign in
Listing Status: Sold on Mar 15, 2013
To schedule a private showing of 5490 South Jasper Way Centennial, CO 80015 (MLS #1155431) with a 8z Real Estate Buyer's Agent who will represent your best interests in purchasing this property or any other property on the market.
Our team of Client Care Coordinators is standing by 7 days a week to arrange a personal showing of 5490 S Jasper Way Centennial, CO 80015 or any other property on the market with a REALTOR on the 8z Real Estate Team.
A local Centennial expert REALTOR on the 8z Real Estate team is ready to assist you. Our REALTORS are hand-picked agents from each Colorado city and town based on their experience, local market knowledge and great client service.
Our Guarantee: You will receive great service from your REALTOR. There is no obligation or cost for this service.
Note: If you are an agent, please contact the listing agent's showing desk to set a showing for 5490 S Jasper Way. If you are a home buyer already committed to an agent who is not on the 8z Real Estate Team, please contact your real estate agent for more information about or a showing of MLS #1155431.
It's important to consider the quality of the local schools in choosing an area and a specific property.
Whether or not you you have school-age children, the local schools can have a big impact on real estate values and ultimately your investment when purchasing real estate. Areas with highly rated schools tend to hold their value and attract strong demand when it comes time to sell your home.
View Cherry Creek 5 School District And School Performance Reports (you may have to look for "Cherry Creek 5" in the list)
Indian Ridge Elementary School
Laredo Middle School
Smoky Hill High School
8z Real Estate has partnered with top local and national lenders to give you the best mortgage options. Call toll free (800) 231-9153 or local (303) 543-3083 to get a mortgage rate quote, or contact us for more information regarding a mortgage quote.
Check out our new mortgage page with calculators to help you figure out how much home you can afford, whether you should rent or buy, and more.
Mortgage Payment Calculator
Note: the default rates above are typical in today's market. Call for a detailed quote based on your situation.
Complete Metrolist Disclosures and Copyright for MLS #1155431
This website, COhomefinder.com, displays listings from all real estate brokerage firms participating in the IDX programs of several different Colorado MLS services. IDX is a program endorsed by the National Association of REALTORS that allows competitive brokerage firms to display each other's listings on their own website. Currently 99% of all MLS listings across the Colorado front range, including 5490 S Jasper Way Centennial, CO 80015, are available on COhomefinder through this program. This is substantially more than Realtor.com with just 94% of Colorado homes for sale.
The purpose of COhomefinder is simple: to provide you the best Colorado Real Estate website and a team of the best Colorado REALTORS. Give us a call when you are ready for the assistance of an exceptional REALTOR who is an expert in your local Centennial market. We are available seven days a week at (303) 543-3083 or toll free (800) 231-9153 to assist with 5490 South Jasper Way Centennial, CO 80015 or in buying or selling any Colorado home.
Licensed Colorado real estate brokerage • A Colorado company with local neighborhood offices across the state
Headquartered at 4041 Hanover, Suite 200, Boulder, CO 80305 • Call toll free (800) 231-9153 or local (303) 543-3083 for assistance
Copyright © 2011 8z Real Estate


text:
Due to spam and off-topic content, these forums are being phased out and replaced with new great books forums. Please join us!
Posted by lea on November 28, 1999 at 23:50:35:
Any information on the value of the following books would be greatly appreciated:
New Physiognomy
by Samuel R. Wells
Fowler & Wells Co. Publishers, 1891
The Law of Psychic Phenomena
by Thomson Jay Hudson, PH.D, LL.D
A.C McClurg & Co.
copyright 1893
Follow Ups:
Post a Followup


text:
Gloves are a must when preparing kimchi, as I quickly realized while preparing the spicy paste.
January 2013
Some content licensed under a Creative Commons Attribution 3.0 License.
© 1997–2015 Viator, Inc. CUR015 - 330208 All rights reserved. Viator is a registered trademark of Viator, Inc.
is a Service Mark of Viator, Inc. Travel with an Insider is a Service Mark of Viator, Inc.
Use of this website constitutes acceptance of Viator's Terms & Conditions.
Viator uses cookies to improve your experience on our website. Learn more about how we use cookies and how to change your cookie settings | Close message


text:
About This Activity
Location: Plaza Racquet Club, Division: MW(Op)sd,SE; X(Op)d,SE; NMW(2.5,3.5,4.5)sd,SE; NX(2.5,3.5,4.5)d,SE, Notes: Open Mens Prize Money Guaranteed. Singles:Winner-$1200, Finalist-$600, Semis-$300, Quarters-$150. Open Mens Doubles-Winner$500, Finalist-250. Opens Womens Prize money is based on return of 50% of entry fees. This tournament will use block seeding for the Mens Open Singles and Doubles divisions. The Top 8 seeded singles players and top 2 doubles teams will not play the first weekend. The remaining field will participate in a qualifying tournament on the first weekend for 8 singles spots and 2 doubles teams. Hotel accommodations will be paid for the top 8 seeds in the Mens Open Singles Division for friday and saturday nights of the 2nd weekend. Don't forget to join us for the players barbeque Saturday December 1st at 3:00pm! Smaller draws will be completed on the first weekend of play. Free players hats and gift bags for all competitors.
USTA - Men's Open Singles, Women's Open Singles, Men's Open Doubles, Women's Open Doubles, Mixed Open Doubles, NTRP Men's 2.5 Singles, NTRP Men's 3.5 Singles, NTRP Men's 4.5 Singles, NTRP Women's 2.5 Singles, NTRP Women's 3.5 Singles, NTRP Women's 4.5 Singles, NTRP Men's 2.5 Doubles, NTRP Men's 3.5 Doubles, NTRP Men's 4.5 Doubles, NTRP Women's 2.5 Doubles, NTRP Women's 3.5 Doubles, NTRP Women's 4.5 Doubles, NTRP Mixed 2.5 Doubles, NTRP Mixed 3.5 Doubles, NTRP Mixed 4.5 Doubles


text:
Home and Away: 2013 Begins - 16/01/13
After packing up their suitcases while still digesting their Christmas dinner, on Boxing Day of 2012 a new generation of Rapha Condor JLT riders headed off on the 24-hour flight to Australia for an eight-week training camp.
There are many ideas on how best to prepare a team for a season, where to have camps, how to train and what to try to focus on. Team training camps take place all over the world, the location often dictated either by tradition or cheap accommodation, however Rapha Condor JLT's 2013 Australian training camp is a little different.
While the two and a half month camp will keep all bar three of the team's riders out of the worst of the European winter weather until the middle of February, keeping out of the cold is in fact only a pleasant sideline of the mission statement for Australia. The real draw of the Southern Hemisphere for John Herety's team is to profit from the opportunity for his young riders to cut their teeth racing in the thriving Australian domestic scene.
Adam Buggle and Luke Mellor get stuck into the new season on the first day of the new year
The beauty, if you want to look at it that way, of the globalistation of cycling is that the cycling season is now so long that that it can almost see where it starts from where it ends. Almost as soon as the action dies down on one hemisphere the other one sparks into life. 2013 has been no exception, starting as it did on the 1st of January at the Bay Series in Melbourne. Being 'down under' at the start of the year means that the fresh legged riders will be able to get ten to fifteen days of quality days racing under their belts before the European season begins, something Herety considers vitally important for a number of reasons.
"I want our riders to race, because I want them to start thinking about winning races, and learning to do that. Essentially these riders came into the sport because they have seen something at some stage that has excited them and made them want to take up cycling. I can almost guarantee you that moment had nothing to do with wattage, power outputs or data- it would have been about winning a bike race. Young guys want to become bike riders because they want to win bike races but it can be easy for many to get lost in the process at times. The factors that go into getting fit for performance are of course important, but at this stage in their development winning has to be their goal."
"I want this team to win bike races, and put simply the way you learn to win bike races is to do them. Here in Australia, being as it is a really busy period in their racing calendar, we have a number of opportunities to work on that. It also gives me the opportunity to see these riders actually performing before the season begins, so I know what I am working with."
"These riders have come recommended to me, so as is the case with a few of them I've not yet actually seen them on a bike. I only know them by their racing results and their test scores. Normally as a manager you'll get a first good look at the riders you've signed riding on a training camp, but by throwing ourselves at the racing straight away I've been able to get a much better insight into the new guys very quickly."
What Herety is looking for is a sort of primal instinct in the riders: he wants to see if his riders are bike racers or not. It sounds ridiculously straight forward, but its not. It is something that has to be witnessed and not measured, and it isn't as simple as a rider saying that they want to win, or being needlessly aggressive in a race, it is much more subtle than that.
"One of the things I saw that impressed me the most on the first day of racing here was a tiny thing but it was very important. On the second or third lap of his first race I saw Ed (Laverack) coming round a hairpin bend underneath another rider, he took one hand off the bars while leaning right over and moved the other rider out of his line. It's a small detail, but in that moment I was seeing something instinctive from Ed that showed me firstly that he's determined and he won't give way easily- something that really counts in bike racing- and secondly that he is a confident bike handler already. When you take into account his limited race experience this becomes quite significant. You could spend three weeks with a rider in Spain training in the pre-season doing all sorts of drills and you would never see that kind of instinct on display."
Richard Handley in the action at the Jayco Herald Sun Tour
Time away
At this stage of their careers there is a lot more than just bike riding that needs to be learned for the young hopefuls in Rapha Condor JLT. The riders have to start understanding all the intricacies of being in a team. That means understanding about being on the road together, looking after themselves physically in foreign environments, looking after their diet, and just as importantly getting used to being away from home.
A cycling career at best involves ten to fifteen years of extended absence from the home, wherever that place may be. This lengthy first camp for the Rapha Condor JLT team is a good way for the riders to start getting used to that reality.
Time away from home is something that any cyclist with ambition will have to get used to. As the girlfriend of a World Tour rider reminded me the other day, the commitment to racing at the top level involves increasingly long periods away from home. Her partner, she told me, was due to be away for thirteen of the next eighteen weeks on various training camps and races. For most of the young riders in the team the eight-week training camp in Australia will be there first long trip away from home, and a first test to see how they cope with a lengthy period away.
Herety explained:
"It is something that you get a lot with British riders (not wanting to be away from home), but since we've arrived, in Australia you can tell from the way this lot are behaving that they are still in the honeymoon period; they are all still quite excited still."
"We've been pretty busy with racing, but now though we are settling in to the camp proper I think it might get harder for some guys. There are little things you see and that need addressing. I've seen riders start to get a little stressed about not having an Internet connection so they can easily call a girlfriend, or be in contact with home."
Kristian House has been a regular visitor to Australia over the past ten years
33 year-old Kristian House is one rider who has proved that he has the mental fortitude to deal with long periods away from home, having done trips like this often throughout his career. Almost ten years ago to the day he was on a flight heading out for his first ever three-month training camp in Australia, with the GB track endurance squad.
"For me it was always a bit different. I always travelled, and I spent a lot of time away from home, or away from family. When I finished high school I packed up straight away and moved myself to Belgium. I already had a lot of life experience by the time I first came here, which these guys don't have yet."
"You've got to be able to cope with being away to succeed in this sport, or any sport in fact. I think it's important that these guys get used to being away and not even thinking about it, you need that kind of determination."
As Herety explained, Australia is an 'easy' trip in that regard. Things could be very different in another time and place when perhaps the location for a lengthy stay isn't quite so appealing.
"Because it's an English speaking country that makes a difference. I think if I'd said we are off to Spain for six weeks on Boxing Day, and we were starting racing on New Years Day out there, then it might have been a bit different. There are a lot of changes to get used to being here, but most of them are upgrades if you like. Changing seasons from winter to summer is a challenge, but it is a nice one. That makes a big difference and it's why Australia is ideal for this kind of camp."
Back in the UK
While the Australian summer will be testing most of the team's riders, Will Stephenson, one of the squad's young new recruits, will be preparing for his season back the UK.
In Will's case the reason that he couldn't attend the camp was a good one, due to his birthday falling late in the year he is still at school, and is currently studying for A-Levels in Maths, Chemistry and Biology. Eight weeks away at the start of term time would have been too much for the 18 year-old, and so he has missed out on the opportunity to prepare for the season in the Australian summer. Instead he is fitting his training around his school timetable on his local roads around Bournemouth.
"I finish at one on most days so I have the afternoons (to train). Normally I train alone in the week because it's quite nice to be able to do your own thing and do exactly what I need to do. There was a week before Christmas when I was stuck on the Turbo but it's not too bad now. I don't really mind the rain that much, once you're out in it its not too bad."
Despite missing out on the Australian sun, Stephenson is determined to be in top shape at the start of the new season
Winter is tough enough as it is, but with social media allowing people to constantly pump out images and updates from all over the world, it's now near impossible for anyone to avoid knowing what everyone else is up to.
"I'm pretty jealous! It's tough, when I'm at home and I know that all my teammates are out riding in the sun, getting tanned and wearing just shorts and a short sleeve jersey. It's almost the complete opposite for me."
Stephenson though, instead of ruing his luck has displayed the only kind of mental approach to the situation that can have a positive outcome for him: resolving to work harder.
"Its almost put me on the back foot a little bit, especially because they've started racing already so they'll be getting a lot of good efforts in, so I'm sure they'll come back in February flying. But I find its almost motivating me to keep trying to keep up with them."
"Its good motivation because I know that they are out there doing 4 hours in the sun and if I just get my head down I can try to do as much work as they are, and strive to get myself in a similar condition."
For Herety leaving Will behind to finish his studies was a must, not only does he recognize the importance of Will's education, but in itself seeing how he deals with the winter alone will be a test of character.
"There is no pressure but it will be good to see how Will comes out of the winter, he is a young guy and by staying home and working hard he is showing a maturity and commitment that will be important to him in the long run."
While Will is going to have to do his best to stay focused through the grim weather while his team mates work under blue skies, by the time the riders arrive at their first races in February one thing is certain, the riders themselves, as well as their manager, will have developed a valuable understanding of their capabilities both on and off the bike. For the Rapha Condor JLT team, the 2013 season has long since begun.Tweet
< Baptism of fire for RCJ in the Australian summer · Bendigo Grand Prix >


text:
It is a seven-volume report which describes the events of September 27, 2006 when Duane Morrison took seven girls hostage at Platte Canyon High School. Morrison killed sophomore Emily Keyes and then killed himself. The report by the Colorado Bureau of Investigation describes in detail what happened. The report still has to be redacted, County Attorney Steve Groome told 9Wants to Know, and portions of it will never be released. A news conference is tentatively scheduled for Tuesday, March 27 when the report is expected to be released to the general public. Parents of the hostages will be able to access the report prior to that.
(Copyright KUSA*TV, All Rights Reserved)


text:
Android engineer confirms Ice Cream Sandwich as next version
updated 05:45 pm EDT, Mon May 2, 2011
Android Ice Cream Sandwich identified by engineer
Google's first post-3.0 (Honeycomb) release of Android was given a formal name this weekend after an e-mail from Android engineer Romain Guy. A response to an outstanding bug promised that it would be fixed "in Ice Cream Sandwich." The name had surfaced in rumors, but until the Droid-Life copy had just been named Ice Cream by Google or nothing at all.
The OS had already been confirmed by Google as the first to bring some of Honeycomb's features to phones and other devices smaller than tablets. Little else has been mentioned of what Ice Cream Sandwich would do.
Google is rumored to have already made the OS code complete and ready to show at the Google I/O conference next week. With the exception of the Nexus S and possibly the Nexus One, however, it might not show on production hardware until significantly later. Most phone makers have yet to upgrade hardware to Android 2.3.