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Inspiring Quilters, Stitch by Stitch
Started by Gail Johnson in Techniques. Last reply by Riana Noyes Nov 22. 2 Replies 0 Likes
Has anyone ever had a walking foot leak grease. I am working on a new project only to have 8-10 inches of the thread covered with dark grease, and of course it's on a light fabric, and it's Sunday (can't reach a sole).Fortunately, for me, my…Continue
Started by Gail Johnson in Having Fun. Last reply by Gail Johnson Nov 22. 2 Replies 0 Likes
I am registered for the Phoenix AQS Quilt Week. Has anyone been before? My question is - for the classes that are hands-on, will someone notify me before the event for a list of supplies to bring? I'm assuming that I will bring my machine, etc.Continue
Started by Jancy Muensterman in Quilting For Charity. Last reply by Denise Chalkley Nov 21. 22 Replies 0 Likes
After Pam Bono's untimely death the majority of her patterns have been unavailable. I would like to finish the quilt but it really needs the border.I purchased Australian Patchwork & Quilting Vol 16 # 12 which had the pattern for the center of…Continue
Started by rogue quilter Queen of the WIVSP in Welcome New Members. Last reply by rogue quilter Queen of the WIVSP Nov 13. 25 Replies 13 Likes
i tend to be overly wordy. but i have been asked again about navigating the site. we have a lot of new members, and bearing in mind that we are quilters, not cyber techies, i thought i would repost an old comment i made last year w tips for…Continue
Tags: help, navigation
Started by Linda Koller in Having Fun. Last reply by Kim Ireland Nov 12. 15 Replies 4 Likes
I would like to find out if there is any interest for a Secret Santa group?The group I belonged to previously had members complete questionnaires. Then everyone was assigned a person to be Secret Santa for. We spent the year making/buying things for…Continue
Started by rogue quilter Queen of the WIVSP in Having Fun. Last reply by rogue quilter Queen of the WIVSP Nov 12. 6 Replies 0 Likes
..sitting here cruisin' the web ...again :)), until time to leave for an appointment. one of my fave sites is ludlow quilting, a british site.…Continue
Tags: humor
Posted by Jennifer Schifano Thomas on December 1, 2015 at 1:04pm 2 Comments 0 Likes
Posted by Monica Schmidt on November 25, 2015 at 8:40am 0 Comments 1 Like
Here is the 2015 schedule for meetings of the ACTS Ministry (Arts, Crafts, Teaching & Sharing) at West Hills Baptist Church in Knoxville, TN. This is a group of people who get together to crochet, quilt, needle tat, knit, make jewelry, and enjoy each others company. We multiply our joys and divide our burdens while we meet with each other. Many members of this group are not members of this church, as we met through classes that I taught. Beginning quilters or crocheters or tatters are…Continue
Posted by Jane Gorder on November 17, 2015 at 11:05am 1 Comment 0 Likes
I am interested in the rooster quilt block exchange, How do I get the pattern?
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Mixology & Moreby Emilia |
Drink Dogma is a beverage blog that covers cocktails, beer, wine and more.
Drink Dogma is a beverage blog that covers cocktails, beer, wine and more.
Check out Chef David Chang's new magazine Lucky Peach, it does not disappoint. Great story on ramen in Japan, via The Atlantic.
Tomorrow, I review Modernist Cuisine: The Art and Science of Cooking for The New York Times, the heavily hyped and praised 6 volume, 2400-page romp through the whole world of cooking, a manifesto pronouncing the arrival of a new cultural movement. I'll be happy to answer questions here tomorrow about the book or the review and I'll look in on the Times food blog as well where I describe my first attempt at cooking from the book (photo below). I confess this was an incredibly daunting assignment. It's an honor to be able to hold forth on what some are calling, accurately, the most important cookbook in years (seven, by my count, since McGee's revised On Food and Cooking was published), in The Times, no less. A huge responsibility. I'd need as many degrees as Read On »

subset: commoncrawl


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Amanda's Pride 2015
Is this photo a winner?
Similar Photos: charity | participant teams | jdrf walk | jdrf walk to cure diabetesDesign Your Own Enter the Contest
comment by coco - May 11, 2014 - back to the top
so nice
Our t-shirt experts are ready to help until midnight, Monday - Friday.
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text: I see no need at all to apologize for using T-Max developer. T-Max developer and T-100 film make for an extremely flexible combination with nearly grainless negatives in most cases. My "normal" time for T-100 roll film is 10 minutes in 1:7 mixture. If I had a flat lighting situation such as you describe, I'd probably increase the time to 11 or 12 minutes. Good luck.


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As many of you may already know, Vietnam is a competitive outsourcing market. Foreign companies are looking outside of megalithic and increasingly expensive companies in China and India, and instead looking into countries in Southeast Asia – and Vietnam is usually on the top of the list for developers. One of the problems with this is the struggle to find people to deal with the ongoing demand for technical projects. That's why there are folks like VietnamGeeks, who've been working on basic online recruitment, and hackers like Geeky.vn building very unique recruitment models. In the midst of these two and other larger and smaller recruitment sites, ITviec is also looking to make its mark in the IT recruitment space. The site launched this month.
ITviec, which literally means IT jobs, could be easily interpreted in Vietnamese to mean "little" or "few" jobs, because "it" can also be written as "ít". This has made the branding the butt of many Vietnamese jokes. The founder and CEO, Chris Harvey, is optimistic though:
After I chose the name and created the logo someone told me that it looked like "it viec", which means "few jobs" in Vietnamese. It sure does. I felt pretty silly. But after I thought about it I decided that "it viec" works just fine. After all, we're not trying to have the most jobs on ITviec – just the best ones. And "ítviec" is easy to remember too!
But the branding aside, Chris has an impressive background, formerly working as the CEO of Vietnamworks for six years. Vietnamworks, the number one jobs site in Vietnam, was acquired by En-Japan earlier this year. Chris is looking to transfer his expertise to ITviec.
Unfortunately, the market is rather crowded with Vietnamworks, Vietnamgeeks, Geeky.vn, and more. What differentiates ITviec? Chris says there are three key things:
The first is we focus 100 percent on skilled IT jobs with salaries over 16 million VND per month. You won't find restaurant or secretary jobs on ITviec – only interesting IT jobs for experienced IT people. The second is that our site provides extra value for jobseekers and companies. Each job is tagged with "skill tags" (like .NET or Android development) so jobseekers can see and search on the most important skills needed in a job. Employers get valuable information on each candidate because jobseekers must answer a question from the employer in order to apply. The third is we will organize workshops and events on new technologies, team leadership, and career management for both jobseekers and employers.
Moving forward, it will be interesting to see how ITviec fares in a market that is quite small and niche compared to more general services from Vietnamworks and Kiem Viec (which was acquired by Career Builder). Like these sites, ITviec will be asking job posters to pay a fee, but it currently has free trials for a number of companies. So far, 50 companies are already using the site with 70 jobs live on the website.


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Tea Party Banners
* Custom Sizes
* Vinyl or Fabric Banners
Get ready for the perfect afternoon treat with our colorful and decorative tea party banners. What better way to spend a nice springtime day than with the classic English event of a tea party. Steaming hot tea complimented with tasty treats and cakes are found along with vibrant garden imagery on these custom size banners that are going
to make you throw a another delightful tea party as soon as possible. Pastel and sugar frosting colors adorn them alongside elegant porcelain and jars full of delicious ivory cream. Give yourself the pleasant feeling of an afternoon tea party anywhere you choose to hang our enchanting mesh and vinyl banners.
Nothing speaks of leisure like a table set with cookies and tea. Bright pink saucers sit next to strawberry cakes and chocolate cupcakes. Patterns of multicolored tea cups create an almost surreal pop art theme and your favorite characters from Louis Carroll's Alice in Wonderland also make an appearance. The silhouette of a woman gracefully sipping her cup is elegant and feminine, surrounded by rosy pink and her shopping bags that she has delicately set beside her small café table. Our mesh and vinyl banners also show the finest of retro and vintage styles to match your classy themed tea party.
Make sure your next tea party has the perfect decorations. Our custom size banners will make a wonderful addition alongside our other tea party items. Use our tea party fabric to create wonderful table clothes or other fun décor. Match them with our tea party themed wall murals and wall art for a truly complete setting. Your mesh or vinyl banners can be used for all kind of promotional purposes as well. Personalize them with custom text and use it above your next event, function or party, whether for business or personal purposes.


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[QUOTE=Poisson Du Jour;1171518]Atta, boy! Now you're talking!
AND, prey tell: why is the Zero Image "hopeless in [your] hands"?
I dont think the OP meant that the Zero Image was hopeless in his hands. I read it as his hands were hopeless in making a pinhole, thus the purchase of a Zero Image.


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Sort by: Price Name Featured Items
Items: 1 - 3
This Rider's International Fleece-Lined Dog Blanket offers winter warmth and protection for your dog. Nylon outer shell resists wind and weather; fleece lining holds in warmth.
The Rider's International Dog Turnout Sheet had a waterproof/breathable nylon outer shell with breathable nylon lining. The same protection you give your horse from the elements now for your dog.
The Rider's International Fleece Dog Blanket is sure to help keep your best friend toasty! Available in several sizes and colors, this 300-gram, anti-pill poly fleece coat will help keep your dog warm and comfortable. Nylon web front and belly straps fasten with hook-and-loop closures.
Sort by: Price Name Featured Items
Items: 1 - 3


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- Filed Under
United Way RSVP of Marathon County will host today, Oct. 10, its second annual 55+ VolunteerFEST.
This free event, a festival for those 55 and older to celebrate the contribution of volunteer service provided by older adults in our community, will be from 4 p.m. to 6 p.m. at the Howard Johnson Inn in Rib Mountain.
It features live music by JG Lightborne, local beer and wine tasting from Mountain Bay Winery, appetizers and door prizes. Meet, socialize and network with other community-minded people. Learn more about volunteering at information tables staffed by more than 20 nonprofit organizations and a short program at 5:15 pm.
For more information, call 715-848-2927.


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Applications for common carrier digital termination systems; applicability of ex parte rules to mutually exclusive groups.
Download OptionsReleased: July 10, 1985
Note: We are currently transitioning our documents into web compatible formats for easier reading. We have done our best to supply this content to you in a presentable form, but there may be some formatting issues while we improve the technology. The original version of the document is available as a PDF, Word Document, or as plain text.


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3 to 6 days
Free delivery when you spend over £75 (GBP).
Will be calculated at checkout
Complete sets - Black
You must select a size
PU bikini set by WONDERLAND. Twisted bandeau top with padding. Adjustable self-tie strap at the back and removable self-tie halterneck strap. Bikini briefs with elasticated waist and decorative string at sides. Lined. Hand wash recommended.
Made of 90% Polyester and 10% Elastane.
Be a beach babe in trendy bikinis and swimsuits from NLY Beach. Order flirty swimwear with fashionable details that will take you from sandy shores to pool parties in a flash.
Free delivery when you spend over £75. Standard shipping £3.95. Delivery time: 3-6 days. We deliver with UPS.
No reviews have been written yet.


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FiltersShow / Hide
- All Events
- Music
- Comedy
- Theatre & Shows
- Sport
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- Festivals
- Days Out
- Christmas VIP
- Anywhere In The UK
- Location: Anywhere in the UK
Radius: ... miles
Welcome to Chisenhale - a home for experimentation in dance and performance. For over 25 years Chisenhale Dance Space has been a centre for research and development in movement arts and independent dance. Based in Bow, East London, CDS has 2 studio spaces for hire, runs weekly dance classes for children and adults and delivers education and artistic projects throughout the year.
Their vision is to enrich the lives of individuals and communities through the exploration and experience of dance and to support dance / movement / live artists in the development of their creative practices.
'Chisenhale showcases edgy work' - The Guardian.
'A home for artists experimenting with ideas outside the mainstream' - Time Out.
1 upcoming event at Chisenhale Dance Space:
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Ents24 Widget
PutCustomisable, flexible tour date widget… Super quick set-up, get the code here: event listings on your web site
Venue Facts
Venue: Chisenhale Dance Space
64-84 Chisenhale Road
Website: chisenhaledancespace.co.uk
Enquiries: 020 8981 6617
→ Cambridge Heath 16 min walk
→ Hackney Wick 18 min walk
→ Mile End 12 min walk
→ Bow Road 14 min walk
→ Bow Church 16 min walk
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At Gemvara, we believe that the jewelry you wear should be as unique as you. Every beautiful Gemvara cushion september birthstone blue sapphire jewelry design will be made just for you. It's jewelry for all life's occasions, from a birthday or holiday to your own personal milestones and celebrations. Celebrate your anniversary with a brilliant gift of jewelry that will mark this moment forever. Gemvara uses only the highest quality materials to craft your cushion september birthstone blue sapphire jewelry with meticulous attention to detail. Our precious metals are recycled or responsibly mined. September's birthstone is sapphire, the ultimate blue gem. Gemvara also offers pink, yellow, and white sapphire for September birthstones to match every outfit. Cushion cut gems are definitely fashionable, with a vintage flair. Our wide selection of cushion september birthstone blue sapphire jewelry by David West, Carl Ansley, Jeet Palavwala, and other talented designers means you can find rings, earrings, and necklaces that are exactly your style. You can also shop by style, choosing our Twists & Curves, Antique-Inspired, or Contemporary Collections. When our work is done and you open that box, you'll see your design is even more beautiful when brought to life in the finest precious materials.
We can help right away. Chat with a jewelry expert now!


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Inspired by century's old story tellers and artists. Each action in the Story Tellers Collection provides complete control over depth of tone and processing to suite your editing taste. Compatible with Photoshop CS versions 3 and up and *Elements 9 and up. For requirements please see the faq page prior to purchase.
Purchase here:
Refund Policy: Refunds cannot be provided due to the nature of the products. Please be sure to read through all the requirements prior to purchasing.
*Actions have been run and tested in Elements 9 and up and are not compatible with earlier versions of Elements. Please be sure you are running version 9 or higher prior to purchasing. Actions will be modified to run properly in Elements and will have layer properties different from the full CS version.
Beautiful images provided by Rebecca Cooper of Simple As That and Rachel Clare of Rachel Clare Photography


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Running Back
Height: 5-foot-11
Weight: 207 pounds
Class Year: RS FR
Hometown: Pensacola, FL
High School: Tate HS
As a Recruit (profile)
Class: 2004 (High School)
Rating/Rankings: | NR
No Videos Available.
The Latest: Plenty to watch for in the Big East — 5/7/2008
Believe it or not, more happened in the Big East this spring aisde from Rich Rodriguez vs. West Virginia news. Here's a team-by-team look at the conference, including a peek at Louisville, where Hunter Cantwell is ready to finally step in at quarterback. [details]
Shawn Cannon College Videos
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Headlines from Rivals.com Network
Plenty to watch for in the Big East — 5/7/2008, from Rivals.com College Football
South Florida players face trouble — 8/27/2006, from JayhawkSlant.com
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Originally Posted by BrianShaw
When one lives in a multi-cultural, multi-lingual society then one needs to be a bit forgiving with regard to language skills. ... and add to that "multi-generational"...
Add to that the fact that a great number of native-born, English-as-a-first-language people can not spell, punctuate, or assemble a sentence correctly.
I do use a digital device in my photographic pursuits when necessary.
When someone rags on me for using film, I use a middle digit, upraised.


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Baker Beasley Puppet 8.06" Skateboard Deck
Item # 210163
Stash Points: 2,399
What is this?This is the number of points you get in The Zumiez Stash for purchasing this item. Stash points are redeemable for exclusive rewards only available to Zumiez Stash members. To redeem your points check out the rewards catalog on thestash.zumiez.com.
The Baker Beasley Puppet 8.06" skateboard deck is so fun to skate that it deserves to have its own Muppets song.
|More Details


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Quantity Available:
Vibia, headquartered in Barcelona, Spain, designs and manufactures modern and contemporary lighting and living accessories. The entire Vibia line features works by prominent designers known for superb European lighting.
The Sandwich Square Flushmount is available with the following:
- Provides diffused lighting
- UL Listed
Size: Small, Large
Light Option: Compact Fluorescent, Halogen
- Compact Fluorescent: Small and large each utilize two 13 Watt 120 Volt G24Q1 lamps (not included)
- Halogen: Small utilizes one 100 Watt 120 Volt T3, RSC, 4 11/16 in. lamp (not included); Large utilizes one 150 Watt 120 Volt T3, RSC, 4 11/16 in. lamp (not included)
Compare Brightness:
LumensThe amount of light that comes from a bulb, which has commonly been measured in watts. The more lumens, the brighter the bulb.
WattageA measurement of the power delivered to a component of an electric circuit (allowing a one-ampere current to flow through the component under the pressure of 1 volt.)
Bulb ShapeBulb shapes are denoted with a letter, which describes the shape, and a number, which indicates the size. The number indicates the diameter of the light bulb at its widest part in eighths of an inch.
BaseThe part of the bulb that connects to the fixture and its power supply. Bulb bases are denoted with the letter E, and a number which indicates the diameter of the bulb base at its widest part in millimeters.
VoltageIndicates how much voltage a bulb can accept via the fixture it's installed in.
Light Color TemperatureThe relative color from a light source, measured on the Kelvin temperature scale. Warm light is lower in color temperature (2700-3000 K) and cool, blue light is higher (5000 K).
Average Rated LifeThe average amount time that a bulb is expected to last.
CRICRI = color rendering index. This number, which can go from 0 to 100, measures the ability of a light or bulb accurately renders colors. The higher the number, the better, with most quality bulbs these days measuring at least in the 80s.
- Small Compact Fluorescent Option Fixture: Height 3.25", Width 14", Depth 14"
- Small Halogen Option Fixture: Height 4.75", Width 14", Depth 14"
- Large Compact Fluorescent Option Fixture: Height 3.25", Width 14", Depth 14"
- Large Halogen Option Fixture: Height 4.75", Width 19.75", Depth 19.75"
Ratings: Based on 1 reviews, this product is rated 3.0 out of 5.
Manufacturer IDs: view
Need help with some of our terminology? Check out Lumens' Lighting & Design Glossary.
Lumens Recommends
150W 120V T3 R7s Long Halogen 118mm BulbBy Satco Lighting$6.99{boxId:"compareuu519855", id:"uu519855"} See Comparison
13W 120V T4 GX24q-1 Triple Tube CFL 2700K BulbBy Satco Lighting$17.49{boxId:"compareuu518209", id:"uu518209"} See Comparison


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First of all: Nice plugin!
Simple to use / customize and implement. Great job.
I would have a question: how can i fix thhis problem?(alt attribute for the pictures displayed in the slider).
=> When i check with W3C validator, i have the following error:
Line 133, Column 163: An img element must have an alt attribute, except under certain conditions. For details, consult guidance on providing text alternatives for images.
..../wp-content/uploads/2012/08/testtesttest.jpg" />
I put a "alt" attribute for every pictures/thumbnail in the posts, but when i "check" the posts for the slider, this "alt" attribute is not "taken".
Thank you in advance for your answer.
[ Please do not bump, that's not permitted here. ]


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Bedrooms at The Craiglynne Hotel
The Craiglynne Hotel offers a selection of standard and superior guestrooms, many with views of the Cromdale Hills. The hotel offers a mix of hotel guestrooms, some of which are dog friendly.
Whether you are on a tour of the Highlands of Scotland, a singles holiday, or a romantic getaway, we have the accommodation to suit your needs at our Highland location in Grantown-on-Spey, near Aviemore. Ask us about our rooms with disabled access.
There are 83 traditional rooms in total, a mix of single, twins, doubles, family rooms and superior. Of the 83 rooms, 27 of these have views of the gardens and the Cairngorms. All guestrooms have the following amenities:
- En-suite bathroom
- Direct dial telephone
- TV with Freeview
- Hairdryer
- Ironing amenities (from reception)
- Welcome tea tray with shortbread
- Vanity desk and chair
Standard Twin/Double & Single Rooms
- Some rooms with garden views
Superior Double/King Rooms
- Large bay windows
- overlooks gardens
- Cromdale Hills view
- bathrobe & slippers
- iPod docking station
- fruit bowl
Additional amenities
- Single rooms have shower only
- Iron and boards are available from reception
- Bath mats are available on request
- One room has been modified as disabled friendly; please enquire for full details
- Rooms are dog friendly


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The efficacy of the H1N1 influenza vaccine relies on the induction of both humoral and cellular responses. This study evaluated the humoral and cellular responses to a monovalent non-adjuvanted pandemic influenza A/H1N1 vaccine in occupationally exposed subjects who were previously vaccinated with a seasonal vaccine.
Sixty healthy workers from a respiratory disease hospital were recruited. Sera and peripheral blood mononuclear cells (PBMCs) were obtained prior to and 1 month after vaccination with a non-adjuvanted monovalent 2009 H1N1 vaccine (Influenza A (H1N1) 2009 Monovalent Vaccine Panenza, Sanofi Pasteur). Antibody titers against the pandemic A/H1N1 influenza virus were measured via hemagglutination inhibition (HI) and microneutralization assays. Antibodies against the seasonal HA1 were assessed by ELISA. The frequency of IFN-γ-producing cells as well as CD4+ and CD8+ T cell proliferation specific to the pandemic virus A/H1N peptides, seasonal H1N1 peptides and seasonal H3N2 peptides were assessed using ELISPOT and flow cytometry.
At baseline, 6.7% of the subjects had seroprotective antibody titers. The seroconversion rate was 48.3%, and the seroprotection rate was 66.7%. The geometric mean titers (GMTs) were significantly increased (from 6.8 to 64.9, p < 0.05). Forty-nine percent of the subjects had basal levels of specific IFN-γ-producing T cells to the pandemic A/H1N1 peptides that were unchanged post-vaccination. CD4+ T cell proliferation in response to specific pandemic A/H1N1 virus peptides was also unchanged; in contrast, the antigen-specific proliferation of CD8+ T cells significantly increased post-vaccination.
Our results indicate that a cellular immune response that is cross-reactive to pandemic influenza antigens may be present in populations exposed to the circulating seasonal influenza virus prior to pandemic or seasonal vaccination. Additionally, we found that the pandemic vaccine induced a significant increase in CD8+ T cell proliferation.
Keywords:Pandemic influenza; H1N1; Vaccine; Cellular response; Proliferation; Humoral response
In the spring of 2009, the most recent pandemic of the A/H1N1 influenza virus originated in Mexico, eventually becoming a major worldwide public health threat [1]. With the goal of protecting high-risk populations, different vaccine formulations were produced that yielded high seroprotection and seroconversion rates in healthy subjects; high antibody titers were observed beginning on day 10 after vaccination and were sustained up to day 45 [2-4]. Mexican health authorities began by administering the vaccine to high-risk groups including hospital employees who had previously received the seasonal influenza vaccine. The employees of the National Institute of Respiratory Diseases in Mexico City were vaccinated with the non-adjuvanted monovalent pandemic influenza A/H1N1 vaccine manufactured by Sanofi Pasteur, a vaccine that was based on the virus strain recommended by the World Health Organization for the development of the influenza A (H1N1) vaccine [5]. The antibody response to the Sanofi Pasteur vaccine has been reported to range from good to moderate in different high-risk populations [6-9]. Nevertheless, our knowledge regarding the induction of cellular responses to this vaccine remains limited.
In addition to a humoral response, this vaccine is expected to promote the development of cell-mediated immune responses [10]. Cellular immune responses, mediated by CD4+ and CD8+ T cells, contribute to essential surveillance against the influenza virus via cytokine modulation and the cross-reactivity that exists among virus-specific cytotoxic T cells [11]. Moreover, the use of the IFN-γ ELISPOT assay has successfully demonstrated the existence of circulating memory CD4+ and CD8+ T cells that are cross-reactive with the pandemic virus in healthy donors irrespective of any prior seasonal vaccination or exposure to this novel virus [11-14].
The present study was initiated after the first pandemic wave in Mexico occurred and was conducted as a longitudinal study in employees of the National Institute of Respiratory Diseases in Mexico City. This study was conducted to evaluate the immunogenicity of a single-dose administration of a monovalent non-adjuvanted pandemic influenza A/H1N1 vaccine in individuals who had previously received the trivalent 2008 or 2009 seasonal influenza vaccine. We evaluated the level of protection of the pandemic A/H1N1 vaccine according to specific antibody titers as well as human influenza-specific T cell responses.
Study group
We recruited 60 healthy subjects at random who intended to receive the pandemic influenza vaccine through a public institutional vaccine program for employees of the National Institute of Respiratory Diseases in Mexico City; of these subjects, 45 (75%) had received the 2009 seasonal vaccine (Fluzone 2009–2010 trivalent A/Brisbane/59/2007 (H1N1)-like, A Brisbane/10/2007 (H3N2)-like and B/Brisbane/60/2008-like strains) in October 2009, and 5 subjects (8.3%) had received the 2008 trivalent seasonal vaccine (Fluzone 2008–2009 A/Solomon Islands/3/2006 (H1N1), A Wisconsin /67/2005 (H3N2) B Malaysia/2506/2004). The authors did not vaccinate the cohort, and this was not a trial study. The subjects were recruited from December 2009 to January 2010. All volunteers received a single dose of the non-adjuvanted monovalent 2009 H1N1 vaccine (Influenza A (H1N1) 2009 Monovalent Vaccine Panenza, Sanofi Pasteur). The volunteers consented to undergo venipuncture prior to and 1month after pandemic influenza A/H1N1 vaccination. We obtained paired samples for the isolation of serum and peripheral blood mononuclear cells (PBMCs). All participants signed an informed consent form, and the local Institutional Review Boards approved this protocol.
We used custom-designed peptides that were synthesized by Enzo Life Sciences (Ann Arbor, MI, U.S.A.) and designed on the basis of their conservation level for viral strain discrimination. The regions of the hemagglutinin (HA) sequences of the 2009 pandemic H1N1 and seasonal H1N1 and H3N2 viruses that were unique to these viruses were selected and analyzed. All HA sequences from the National Center for Biotechnology Information (NCBI) Influenza Virus Sequence Database available in 2009 were downloaded and aligned using the ClustalW (FASTA) tool, which is free and available on the NCBI website [15]. Protein consensus sequences were generated and independently analyzed for each virus subtype; the scores for conservation or synonymous substitutions were identified for each position. The selected sequences contained putative MHC class I and class II epitopes with low and high affinity for HLA alleles that are frequently found in the Mexican population [16]. These sequences were validated with the SYFPEITHI epitope prediction tool and the ProPred MHC class II binding prediction server [17] (see Additional file 1: Table S1).
Additional file 1: Table S1. Peptide sequences and predicted recognition by class I and class II HLA alleles frequently found in Mexicans.
Format: PPTX Size: 66KB Download file
Lyophilized peptides were dissolved in RPMI 1640 medium (Lonza, Walkersville, MD) containing 20% dimethyl sulfoxide (DMSO, Sigma-Aldrich, St Louis, MO), frozen at -70°C and diluted at a ratio of 1:1,000 with RPMI 1640 medium containing 2 mM L-glutamine (Sigma-Aldrich) and 50 μg/ml gentamicin sulfate (Lonza), herein termed "supplemented medium".
Sera and cells
After blood samples were collected from the volunteers, serum was obtained via centrifugation and stored at -70°C until use. PBMCs were isolated from heparinized blood diluted at a 1:2 ratio with supplemented medium and separated via centrifugation using a lymphocyte separation solution (Lonza). The PBMCs were washed, counted and cryopreserved in fetal bovine serum (FBS, Hyclone, Logan, UT) containing 10% DMSO at -70°C until use. For the cellular response analysis, cryopreserved PBMCs were thawed and re-suspended in supplemented medium (viability ≥ 90%).
Antibody detection
Antibodies specific to the influenza pandemic virus were identified using hemagglutination inhibition and microneutralization assays. Briefly, serial 2-fold dilutions of the previously inactivated serum were assayed for their ability to inhibit the agglutination of chicken red blood cells in the presence of the A/H1N1/California/07/2009 influenza virus. Serum dilutions (starting at 1:5) were tested in duplicate, and titers are expressed as the reciprocal of the highest dilution that produced complete hemagglutination or 50% neutralization, respectively [18]. The antibody response was assessed using the criteria of the European Agency for the Evaluation of Medicinal Products (EMA) for 18- to 60-year-old subjects and was based on the geometric mean titers (GMTs), seroprotection rate (percentage of subjects with HI antibody titers ≥ 1:40) and seroconversion rate (percentages of subjects with either pre-vaccination HI antibody titers ≤ 1:10 and post-vaccination titers ≥ 1:40 or pre-vaccination HI antibody titers ≥ 10 and at least a 4-fold increase in post-vaccination HI antibody titers). In accordance with the EMA, these criteria include a seroprotection rate ≥ 70%, a seroconversion rate ≥ 40% and a GMT fold increase of 2.5; these 3 parameters must be fulfilled for acceptable pandemic influenza vaccines [19]. We also determined the levels of anti-H1 hemagglutinin (HA1) IgG antibodies in the serum using a commercial ELISA kit (Cusabio, Biotech Co., Newark, DE) according to the manufacturer's instructions. The results are expressed as the OD at 450 nm. A sample was considered seropositive when its OD was ≥ 0.4.
Human IFN-γ ELISPOT assay
The frequency of antigen-specific IFN-γ-producing T cells upon stimulation with HA peptides was assessed using ELISPOT, as previously described [20,21]. In brief, multiscreen 96-well filter plates (Millipore Corporation, Billerica, MA) were incubated overnight at 4°C with anti-human IFN-γ antibody (Endogen, Woburn, MA). The plates were blocked with 1% bovine serum albumin (BSA, Calbiochem, La Jolla, CA), and 2.5 × 105 PBMCs/well were seeded and incubated for 48 h with individual peptides (10 μg/ml), a mix of peptides (2 μg/ml each) or the recombinant HA A/H1N1/California/06/2009 (Immune Tech., Foster City, CA). Phytohemagglutinin (10 μg/ml) (PHA, Sigma-Aldrich) was included as the positive control, and the medium alone culture served as the negative control (background). The cells were removed, and biotinylated-anti-human IFN-γ antibody (Endogen) was added and allowed to incubate for 2 h. Peroxidase-streptavidin (Dako, Glostrup, Denmark) was added, and the spots were visualized after the addition of 1% 3-amino-9-ethylcarbazole (AEC, Pierce, Rockford, IL). Spot-forming cells (SFCs) were counted using an ImmunoSpot reader (Cellular Technology Ltd, Cleveland, OH). The frequency of IFN-γ-producing cells was calculated by averaging the number of spots in duplicate wells after background subtraction. The results are expressed as SFCs/106 PBMCs. Subjects whose IFN-γ response exceeded the background response by at least 6 spots were considered specific responders.
T cell proliferation assay
To evaluate the proliferative response after pandemic A/H1N1 vaccination, we examined the percentage of proliferating peripheral CD4+ and CD8+ T cells following stimulation with H1N1 peptides. This analysis utilized the carboxyfluorescein diacetate succinimidyl ester (CFSE) dilution model, in which the CFSE signal is divided between daughter cells and shows peaks with diminishing fluorescence at an approximate ratio of 0.5 per cell division. We analyzed each round of cell division of CD8+ and CD4+ T cells in response to the H1N1 peptides. Briefly, the PBMCs were labeled with CFSE (Sigma-Aldrich), placed in a PBS/2% BSA solution for 15 min at 37°C and washed twice with PBS. The cells were then seeded in ultralow attachment 24-well plates (Costar-Corning Incorporated, Corning, NY) at 1 × 106 PBMCs/well and stimulated with 10 μg/ml of the individual influenza peptides. PHA (10 μg/ml) was included as a positive control, and medium alone served as the negative control. The plates were incubated at 37°C with 5% CO2 for 7 days. The cells were subsequently stained with monoclonal anti-human antibodies including CD3-PE-Texas Red (Invitrogen Gibco, Grand Island, NY), CD8-PE-Cy7 and CD4-APC-Cy7 (BioLegend, San Diego, CA). Then, 1 × 104 events were recorded for each condition using a FACSCanto II flow cytometer (Becton Dickinson), and the data were analyzed with the FlowJo proliferation platform (FlowJo 9.4.10, Tree Star, Inc., Ashland, OR). The peptide-specific proliferation of CD3+/CD8+/CFSE+ or CD3+/CD4+/CFSE+ cells was calculated by subtracting the number of proliferating cells in the negative control. Individuals with a positive proliferative response were defined as subjects with ≥ 2% proliferating cells (based on the summed responses to peptides 1 and 2 and the total proliferation).
Statistical methods
Differences in antibody production and IFN-γ responses elicited by the specific peptides and the proliferation of CD8+ and CD4+ T cells pre- and post-vaccination were analyzed using the Wilcoxon signed rank test. Differences in proliferation between the influenza serotypes were analyzed using the Kruskal-Wallis test, followed by Dunn's multiple comparison test. Associations of age, gender and area of work at the hospital with pre- and post-vaccination antibody titers were assessed using the chi-square test. We used the Spearman rank correlation test to assess whether age, gender or work activity at the hospital was associated with neutralizing antibody titers or T cell responses. To our knowledge there are no published data describing the mean difference in CD8+ T cells between pre- and post-H1N1 pandemic influenza vaccination. We therefore estimated our sample size based on an analysis of the first 10 pairs of subjects among whom we observed that the difference in response was not normally distributed (median 3.8, IQR (1.44-7.09). We calculated the sample size needed for a two-sample t-test (alpha = 0.05 and beta = 0.8) using a mean of 3.8 and standard deviation of 4, arriving at 33 pairs, and then adjusted the sample size based on the asymptotic relative efficiency of the Mann–Whitney U relative to the t-test (worst case scenario, dividing 33 by 0.864), arriving at 38 pairs [22].
The statistical analyses were performed using SPSS 15.0 for Windows (SPSS, Chicago, IL) and Prism 5.0 (GraphPad, La Jolla, CA). Two-tailed p-values < 0.05 were considered statistically significant.
Results and discussion
Description of the cohort
Sixty subjects were enrolled in the present study; all of the subjects were employees of the National Institute of Respiratory Diseases in Mexico City, which is a reference center for pandemic influenza patients. All subjects were actively working during the pandemic wave of the influenza A/H1N1 virus (2009), which originated in Mexico. Forty-five (75%) of the subjects were previously vaccinated with the trivalent influenza seasonal vaccine in October 2009, and 5 (8.3%) of the subjects were vaccinated with the 2008 trivalent influenza seasonal vaccine before October 2009. The occupations of the participants included research, clinical practice and administrative functions. None of the subjects had been diagnosed as having influenza prior to or after A/H1N1 vaccination. Table 1 summarizes the characteristics of the study group. The variables of age, gender, prior seasonal vaccination status and area of work were not associated or correlated with the humoral or cellular responses described below.
Table 1. Demographics of the study group
Antibody responses to the pandemic A/H1N1 vaccine
The immunogenicity of the vaccine against influenza A/H1N1 was assessed according to the antibody titer after vaccination. Here, we determined the serum levels of antibodies against the pandemic virus using a hemagglutination inhibition assay, which is a standard assay used in the process of licensing influenza vaccines. Prior to 2009 A/H1N1 virus vaccination, the baseline seroprotective rate of the subjects was 6.7%, and the GMT was 6.8 (Figure 1a and Table 2). The proportion of subjects with titers ≥ 1:40 in the hemagglutination inhibition assay at baseline was lower than expected for such an exposed population considering the previous vaccination with the 2008 and 2009 seasonal influenza vaccines in 83% of the subjects; these titers were also lower than those previously reported for health care workers [6]. Antibodies are expected to be present in healthy subjects prior to vaccination with the pandemic A/H1N1 vaccine [23,24] and are likely elicited by natural exposure to cross-reactive influenza strains [25].
Figure 1. Increased humoral responses after pandemic influenza A/H1N1 vaccination. Specific antibodies against the pandemic influenza virus A/H1N1 were measured via (a) hemagglutination inhibition and (b) microneutralization. The box plots show quartiles and medians. The dotted lines indicate a cut-off value of 1:40, with p ≤ 0.05 (pre-vaccination vs. post-vaccination), as determined using the Wilcoxon singed rank test (n = 60). (c) The presence of IgG antibodies against hemagglutinin A/H1N1 (HA1) was assessed in sera obtained prior to H1N1 vaccination using ELISA, with the dotted line indicating the cut-off value (n = 22). The antibody titers against the pandemic influenza virus A/H1N1 were assessed post-vaccination in sera from individuals with (n = 13) or without (n = 9) anti-HA1 antibodies prior to vaccination using the hemagglutination inhibition assay. The depicted box plots show the quartiles and medians. The dotted line indicates the protective cut-off value.
Table 2. Humoral response after pandemic H1N1 vaccination
After vaccination, the seroconversion (48.3%) and seroprotection (66.7%) rates increased, as did the antibody GMTs (p < 0.0001). Although pandemic influenza vaccination induced a humoral response with a high fold increase in the GMT (Table 2), our study most likely lacked sufficient power to detect the seroprotection rate required for vaccination success according to the international criteria [19].
Furthermore, we performed a virus microneutralization assay and observed a significant increase in the virus neutralizing antibody titers after vaccination (p ≤ 0.0001, Figure 1b). Although there are no standardized criteria to apply for this method, our results showed that pandemic influenza vaccination induced a limited humoral response in this study group.
It has been reported that recent seasonal vaccination can decrease antibody responses to the pandemic A/H1N1 vaccine [6,26,27], but the mechanism of such a phenomenon has not been explored. We investigated whether the pre-existence of anti-HA1 antibodies played a role in the decrease of the pandemic A/H1N1 vaccine antibody responses in a subgroup of our study cohort that included subjects who were seronegative for the specific pandemic antibodies and were vaccinated with the seasonal 2009 vaccine. We divided this group into individuals who presented anti-HA1 antibodies prior to pandemic A/H1N1 vaccination and individuals who did not. Our results showed that after pandemic A/H1N1 vaccination, the subjects without anti-HA1 antibodies prior to vaccination (n = 9) showed higher hemagglutination inhibition antibody titers compared with subjects with anti-HA1 antibodies prior to vaccination (n = 13) (GMT 108.9 vs. GMT 37.75, respectively, p = 0.14). However, this difference was not statistically significant. Thus, we cannot conclude that pre-existing antibodies to the seasonal vaccine played a role in the induction of antibodies against the pandemic A/H1N1 vaccine (Figure 1c).
T cell responses to pandemic influenza peptides
IFN-γ production
To evaluate vaccine-induced T cell reactivity, we assessed IFN-γ production using PBMCs stimulated in vitro with specific peptides from pandemic A/H1N1 and the seasonal virus using ELISPOT. The baseline frequency of the IFN-γ-producing cells was moderate and comparable to that reported by others [28,29]. Prior to vaccination, a specific response to viral serotype peptides was observed in a number of subjects and ranged from 22% for the seasonal H3N2 peptide to 49% for the pandemic A/H1N1 peptide 1 (Figure 2). Unexpectedly, after vaccination, IFN-γ production did not increase in response to the specific pandemic A/H1N1 peptides or to peptides from the seasonal strains.
Figure 2. Frequency of IFNγ-producing cells in response to pandemic influenza peptides. Pre- and post-vaccination PBMCs were stimulated with 10 μg/ml of pandemic H1N1 peptides 1 and 2, a common H1N1/H3N2 sequence, the seasonal H1N1 and H3N2 peptides (a-e), the whole HA protein (f), a mixture of all the peptides (g) or PHA (h) for 48 h. Cells producing IFN-γ were enumerated using an ex-vivo ELISPOT assay. The results are expressed as the number of SFCs per 106 PBMCs. Insets depict the percentage of subjects with a positive IFN-γ response pre- (dark) and post-(light) vaccination.
There is controversy in the published data regarding the specifics of IFN-γ production. For example, it has been reported that only CD4+ and not CD8+ T cells produce IFN-γ in response to specific peptides after vaccination and that this cellular response is low but steady [30]. In contrast, another study reported that subjects without confirmed exposure to the pandemic A/H1N1 virus could generate higher numbers of IFN-γ spots from both CD4+ and CD8+ T cells to either pandemic A/H1N1 infection with the whole vaccine virus or toward a peptide pool [31,32]. In any case, no correlation was observed regarding antibody production in these studies; we also failed to detect such a correlation in our study. In light of these findings, our observation of the absence of a post-vaccination response was unexpected and may be due to the selectivity of the immune response of antigen-specific cells that can produce cell mediators, such as cytotoxic effectors, in addition to IFN-γ [11].
CD4+ and CD8+ T cell proliferative responses
Prior to H1N1 vaccination, we observed proliferative responses in peripheral CD4+ and CD8+ T cells to pandemic A/H1N1 peptides 1 and 2. Following A/H1N1 vaccination, the proportion of proliferative CD8+ T cells significantly increased (p < 0.05); however, the proliferation of CD4+ T cells did not significantly increase (p = 0.149) (Figure 3). We do not believe that the lack of CD4+ T cell proliferation was associated with limited class II peptide recognition by these cells because the selected A/H1N1 peptides (1 and 2) are predicted to have a high affinity for class I and class II recognition in the Mexican population (Additional file 1: Table S1). In the case of proliferative responses to H1N1 peptide 2, a decreasing trend was observed in CD4+ T cell proliferation, although this was not significant (p = 0.45) (Figure 3).
Figure 3. Proliferative T cell responses to pandemic H1N1 and seasonal peptides. CFSE-labeled PBMCs (1 × 106) were stimulated with 10 μg/ml of pandemic A/H1N1 peptides 1 and 2 for 7 days. The cells were stained with anti-human CD3PE-Texas Red, CD8PE-Cy7 and CD4APC-Cy7 and then analyzed using flow cytometry. The plots show the percentages of proliferating CD4+ or CD8+ T cells prior to and after A/H1N1 vaccination (n = 32).
It is possible that the lack of a significant increase in CD4+ T cell proliferation after H1N1 vaccination may be due to a higher frequency of CD4+ T cells compared with CD8+ T cells prior to vaccination, which in turn could be induced by seasonal vaccination and/or natural exposure to the influenza virus. It is also possible that the absence of an adjuvant in the vaccine affected the proliferation of CD4+ T cells. Similar to our results, a previous report demonstrated that a non-adjuvanted H5N1 vaccine did not induce a robust expansion of CD4+ T cells and failed to increase specific antibody titers [33]. Therefore, our results indicate that either the A/H1N1 vaccine had low CD4+ T cell immunogenicity or that the A/H1N1 vaccine did not induce CD4+ T cell proliferation in individuals who had previously received the seasonal vaccine. In contrast to the CD4+ T cell responses, our results indicated that the A/H1N1 vaccine induced significant CD8+ T cell proliferation in individuals who had previously received the seasonal vaccine. Additionally, we did not find a correlation between CD4+ or CD8+ T cell proliferation and the antibody production induced by vaccination.
In summary, our results indicate that pandemic vaccination induces CD8+ T cell clonal expansion, as demonstrated by the increase in the proliferative response to A/H1N1 peptides. This result is consistent with previous reports demonstrating that CD8+ T cells proliferate after influenza vaccination [28,31]. We hypothesize that the extent of CD8+ T cell clonal expansion that we observed following H1N1 pandemic vaccination may be linked to the cytolytic effector functions of cells rather than the generation of antigen-specific long-lived plasma cells and the direct effector functions mediated by IFN-γ [34].
Furthermore, to analyze the cross-reactivity of seasonal serotypes, we evaluated the percentages of CD8+ T cells proliferating in response to specific peptides corresponding to seasonal H1N1 and H3N2 serotypes. We found that approximately 5% of the CD8+ T cells proliferated in response to pandemic and seasonal peptides prior to vaccination (Figure 4a). This finding may be associated with previous seasonal vaccination because most of the individuals had received a seasonal vaccination approximately 2 months prior to the pandemic vaccination. However, this finding could also be associated with the presence of cross-reactive virus-specific CD8+ memory T cells, as reported by others [35]. Our results also showed a significant increase in CD8+ T cell proliferation in response to pandemic and seasonal influenza-specific peptides after pandemic A/H1N1 vaccination (p < 0.05) (Figures 3 and 4a). No significant differences were detected in the percentage of proliferating CD8+ T cells between the pandemic and seasonal type A viruses. Among individuals with positive proliferative responses, 29%, 13% and 37% had pre-existing CD8+ T cells specific to the pandemic A/H1N1, seasonal H1N1 and seasonal H3N2 peptides, respectively. One month after pandemic vaccination, the percentage of positive subjects increased to 70.8% (p < 0.05) for the pandemic A/H1N1 serotype and to 43% (p < 0.05) and 47% (p > 0.05) for the seasonal H1N1 and H3N2 serotypes, respectively (Figure 4b). These data indicate that after pandemic A/H1N1 vaccination, the number of individuals with antigen-specific proliferating CD8+ T cells increased; this assessment may serve as a complementary parameter for evaluating the immunological success of influenza vaccines.
Figure 4. Pandemic H1N1 vaccination induced CD8+ T cell proliferation to pandemic H1N1, seasonal H1N1 and H3N2 peptides. CFSE-labeled PBMCs (1 × 106) were stimulated with 10 μg/ml of the pandemic H1N1 and seasonal H1N1 and H3N2 peptides for 7 days. The cells were harvested and stained with anti-human CD3PE-Texas Red and CD8PE-Cy7 and analyzed using flow cytometry. (a) Percentages of the CD8+ T cell proliferation pre-vaccination and post-vaccination in response to seasonal H1N1 and H3N2 peptides. The means and standard errors are shown, with p ≤ 0.05 pre-vaccination vs. post-vaccination, according to the Wilcoxon matched-pairs signed rank test. (b) Percentages of positive subjects responding to the pandemic H1N1 peptides 1 and 2 (p < 0.05) and the seasonal influenza A H1N1 (p < 0.05) and H3N2 serotypes post-vaccination (p > 0.05).
Our results showed that cellular immune responses that are cross-reactive to pandemic influenza antigens may be present in populations exposed to the circulating seasonal influenza virus prior to pandemic or seasonal vaccination. The pandemic vaccine induced a significant increase in CD8+ T cell proliferation.
HA: Hemagglutinin; PBMCs: Peripheral blood mononuclear cells; ELISPOT: Enzyme-linked-Immuno-Spot; SFC: Spot-forming cell.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
MTH, FHS and CC performed the experiments, data analysis and results interpretation. MEM and CS performed the data analysis. SGB designed the peptide sequences. MMT performed the clinical analysis. EJ and YG made valuable contributions to the study's design, analysis and interpretation of the data and the written manuscript. ES and LGG participated in the study design and interpretation of the data. MT participated in the study design and wrote the manuscript. All authors reviewed and approved the final manuscript.
Authors' information
Eduardo Sada and Martha Torres, are authors share senior authorship.
We thank Dr. Irma López and Rodrigo Aparicio from the Diagnostics and Epidemiology Reference Institute (INDRE) for their assistance with the antibody measurements. This work was supported by the National Council of Science and Technology (CONACYT) grants 140942 and 126693.
Role of the funding source
The study sponsor did not participate in the study design, the collection, analysis and interpretation of the data, the writing of the report or the decision to submit the paper for publication.
Chowell G, Bertozzi SM, Colchero MA, Lopez-Gatell H, Alpuche-Aranda C, Hernandez M, Miller MA: Severe respiratory disease concurrent with the circulation of H1N1 influenza.
N Engl J Med 2009, 361(7):674-679. PubMed Abstract | Publisher Full Text
Greenberg ME, Lai MH, Hartel GF, Wichems CH, Gittleson C, Bennet J, Dawson G, Hu W, Leggio C, Washington D, et al.: Response to a monovalent 2009 influenza A (H1N1) vaccine.
N Engl J Med 2009, 361(25):2405-2413. PubMed Abstract | Publisher Full Text
Nolan T, McVernon J, Skeljo M, Richmond P, Wadia U, Lambert S, Nissen M, Marshall H, Booy R, Heron L, et al.: Immunogenicity of a monovalent 2009 influenza A(H1N1) vaccine in infants and children: a randomized trial.
JAMA 2010, 303(1):37-46. PubMed Abstract | Publisher Full Text
Wu J, Li W, Wang HQ, Chen JT, Lv M, Zhou JC, Liang XF, Fang HH, Liu Y, Liu LY, et al.: A rapid immune response to 2009 influenza A(H1N1) vaccines in adults: a randomized, double-blind, controlled trial.
J Infect Dis 2010, 202(5):675-680. PubMed Abstract | Publisher Full Text
Virus strains recommended by the World Health Organization for the development of the influenza A (H1N1) vaccines.
http://www.who.int/csr/resources/publications/swineflu/2009_05_27_X179Aa.pdf webcite
Zhou Y, Ng DM, Seto WH, Ip DK, Kwok HK, Ma ES, Ng S, Lau LL, Peiris JS, Cowling BJ: Seroprevalence of Pandemic H1N1 Antibody among Health Care Workers in Hong Kong Following Receipt of Monovalent 2009 H1N1 Influenza Vaccine.
PloS One 2011, 6(11):e27169. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Phongsamart W, Sirisanthana V, Wittawatmongkol O, Maleesatharn A, Sudjaritruk T, Chearskul P, Aurpibul L, Sirisanthana T, Chokephaibulkit K: Immunogenicity and safety of monovalent influenza A (H1N1) 2009 in HIV-infected Thai children.
Vaccine 2011, 29(47):8705-8711. PubMed Abstract | Publisher Full Text
Van der Vliet D, Pepin S, Lambert M, Fauchoux N, Donazzolo Y, Dupuy M, Dakowski C, Denis M: Similar immunogenicity of the A/H1N1 2009 pandemic influenza strain when used as a monovalent or a trivalent vaccine.
Hum Vaccin 2010, 6(10):823-828. PubMed Abstract | Publisher Full Text
Plennevaux E, Blatter M, Cornish MJ, Go K, Kirby D, Wali M, Reeves-Hoche MK, Denis M: Influenza A (H1N1) 2009 two-dose immunization of US children: an observer-blinded, randomized, placebo-controlled trial.
Vaccine 2011, 29(8):1569-1575. PubMed Abstract | Publisher Full Text
Thomas PG, Keating R, Hulse-Post DJ, Doherty PC: Cell-mediated protection in influenza infection.
Emerg Infect Dis 2006, 12(1):48-54. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Brown LE, Kelso A: Prospects for an influenza vaccine that induces cross-protective cytotoxic T lymphocytes.
Immunol Cell Biol 2009, 87(4):300-308. PubMed Abstract | Publisher Full Text
Schanen BC, De Groot AS, Moise L, Ardito M, McClaine E, Martin W, Wittman V, Warren WL, Drake DR 3rd: Coupling sensitive in vitro and in silico techniques to assess cross-reactive CD4(+) T cells against the swine-origin H1N1 influenza virus.
Vaccine 2011, 29(17):3299-3309. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Ge X, Tan V, Bollyky PL, Standifer NE, James EA, Kwok WW: Assessment of seasonal influenza A virus-specific CD4 T-cell responses to 2009 pandemic H1N1 swine-origin influenza A virus.
J Virol 2010, 84(7):3312-3319. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Tu W, Mao H, Zheng J, Liu Y, Chiu SS, Qin G, Chan PL, Lam KT, Guan J, Zhang L, et al.: Cytotoxic T lymphocytes established by seasonal human influenza cross-react against 2009 pandemic H1N1 influenza virus.
J Virol 2010, 84(13):6527-6535. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
http://www.ncbi.nlm.nih.gov/genomes/FLU/Database/nph-select.cgi?go=alignment webcite
Falfan-Valencia R, Camarena A, Juarez A, Becerril C, Montano M, Cisneros J, Mendoza F, Granados J, Pardo A, Selman M: Major histocompatibility complex and alveolar epithelial apoptosis in idiopathic pulmonary fibrosis.
Hum Genet 2005, 118(2):235-244. PubMed Abstract | Publisher Full Text
Singh H, Raghava GP: ProPred: prediction of HLA-DR binding sites.
Bioinformatics 2001, 17(12):1236-1237. PubMed Abstract | Publisher Full Text
WHO: Manual for the laboratory diagnosis and virological surveillance of influenza. Geneva, Switzerland: WHO Press; 2002:153.
Guideline on influenza vaccines prepared from viruses with the potential to cause a pandemic and intended for use outside of the core dossier context In Committee for Human Medicinal Products, Doc Ref. EMEA/CHMP/VWP/263499/2006. London, United Kingdon: European Medicines Agency; 2007.
Schwander SK, Torres M, Sada E, Carranza C, Ramos E, Tary-Lehmann M, Wallis RS, Sierra J, Rich EA: Enhanced responses to Mycobacterium tuberculosis antigens by human alveolar lymphocytes during active pulmonary tuberculosis.
J Infect Dis 1998, 178(5):1434-1445. PubMed Abstract | Publisher Full Text
Duvvuri VR, Duvvuri B, Jamnik V, Gubbay JB, Wu J, Wu GE: T cell memory to evolutionarily conserved and shared hemagglutinin epitopes of H1N1 viruses: a pilot scale study.
BMC Infect Dis 2013, 13:204. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text
Randles RH: WD: Introduction to the Theory of Nonparametric Statistics. New York: John Wiley & Sons; 1979.
Wagar LE, Rosella L, Crowcroft N, Lowcock B, Drohomyrecky PC, Foisy J, Gubbay J, Rebbapragada A, Winter AL, Achonu C, et al.: Humoral and cell-mediated immunity to pandemic H1N1 influenza in a Canadian cohort one year post-pandemic: implications for vaccination.
PloS one 2011, 6(11):e28063. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Lagler H, Grabmeier-Pfistershammer K, Touzeau-Romer V, Tobudic S, Ramharter M, Wenisch J, Gualdoni GA, Redlberger-Fritz M, Popow-Kraupp T, Rieger A, et al.: Immunogenicity and Tolerability after Two Doses of Non-Adjuvanted, Whole-Virion Pandemic Influenza A (H1N1) Vaccine in HIV-Infected Individuals.
PloS one 2012, 7(5):e36773. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Li GM, Chiu C, Wrammert J, McCausland M, Andrews SF, Zheng NY, Lee JH, Huang M, Qu X, Edupuganti S, et al.: Pandemic H1N1 influenza vaccine induces a recall response in humans that favors broadly cross-reactive memory B cells.
Proc Natl Acad Sci U S A 2012, 109(23):9047-9052. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Choi YS, Baek YH, Kang W, Nam SJ, Lee J, You S, Chang DY, Youn JC, Choi YK, Shin EC: Reduced antibody responses to the pandemic (H1N1) 2009 vaccine after recent seasonal influenza vaccination.
Clin Vaccine Immunol 2011, 18(9):1519-1523. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Air GM, Feng J, Chen T, Joachims ML, James JA, Thompson LF: Individual antibody and T cell responses to vaccination and infection with the 2009 pandemic swine-origin H1N1 influenza virus.
J Clin Immunol 2011, 31(5):900-912. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Iorio AM, Bistoni O, Galdiero M, Lepri E, Camilloni B, Russano AM, Neri M, Basileo M, Spinozzi F: Influenza viruses and cross-reactivity in healthy adults: humoral and cellular immunity induced by seasonal 2007/2008 influenza vaccination against vaccine antigens and 2009 A(H1N1) pandemic influenza virus.
Vaccine 2012, 30(9):1617-1623. PubMed Abstract | Publisher Full Text
Greenbaum JA, Kotturi MF, Kim Y, Oseroff C, Vaughan K, Salimi N, Vita R, Ponomarenko J, Scheuermann RH, Sette A, et al.: Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population.
Proc Natl Acad Sci U S A 2009, 106(48):20365-20370. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Mahnke YD, Saqr A, Hazenfeld S, Brady RC, Roederer M, Subbramanian RA: Age-related changes in durability and function of vaccine-elicited influenza-specific CD4(+) T-cell responses.
Vaccine 2011, 29(47):8606-8614. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Scheible K, Zhang G, Baer J, Azadniv M, Lambert K, Pryhuber G, Treanor JJ, Topham DJ: CD8+ T cell immunity to 2009 pandemic and seasonal H1N1 influenza viruses.
Vaccine 2011, 29(11):2159-2168. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Roman F, Clement F, Dewe W, Walravens K, Maes C, Willekens J, De Boever F, Hanon E, Leroux-Roels G: Effect on cellular and humoral immune responses of the AS03 adjuvant system in an A/H1N1/2009 influenza virus vaccine administered to adults during two randomized controlled trials.
Clin Vaccine Immunol 2011, 18(5):835-843. PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Stephenson I, Hayden F, Osterhaus A, Howard W, Pervikov Y, Palkonyay L, Kieny MP: Report of the fourth meeting on 'Influenza vaccines that induce broad spectrum and long-lasting immune responses', World Health Organization and Wellcome Trust, London, United Kingdom, 9–10 November 2009.
Vaccine 2010, 28(23):3875-3882. PubMed Abstract | Publisher Full Text
Strutt TM, McKinstry KK, Dibble JP, Winchell C, Kuang Y, Curtis JD, Huston G, Dutton RW, Swain SL: Memory CD4+ T cells induce innate responses independently of pathogen.
Nat Med 2010, 16(5):558-564.
551p following 564PubMed Abstract | Publisher Full Text | PubMed Central Full Text
Boon AC, de Mutsert G, van Baarle D, Smith DJ, Lapedes AS, Fouchier RA, Sintnicolaas K, Osterhaus AD, Rimmelzwaan GF: Recognition of homo- and heterosubtypic variants of influenza A viruses by human CD8+ T lymphocytes.
J Immunol 2004, 172(4):2453-2460. PubMed Abstract | Publisher Full Text
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Fees: We do not charge any service charges or administrative fees.
Auto Transfer: We offer automatic transfers from another deposit account at The First into your IRA account free of charge.
FDIC Insurance up to $250,000 for each individual's total retirement plan.
For current IRA Rates, please click here
For information about Roth IRA accounts, please click here.
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Interested in recording music in our studio or editing your videos? Want to use our 3D printer or learn about Arduino? Want to learn how to make your own video games? Ready to sew or paint a masterpiece? Just want to hang out and play games? Drop by Teen Open Lab!
Learn how to use a web browser to access the web, and use Google to find information on the internet.
A staffed open lab for women to work independently or collaborate on subjects of their choice, from computer basics to job search to Facebook. Verification of attendance is available.
If you are a front-end designer, intense developer, writer, or a person that likes to poke around on the Dashboard, then come on by. Bring your WordPress work and questions.
Did you attend one of our classes or one-on-one appointments, but now you need to practice the skills you learned? Need help searching the internet, sending emails, or using MS Word? Drop by Open Lab, where we have instructors on hand to assist you with whatever you are working on.
Not sure where files go when you save them? Having trouble finding things you saved? Come to this class to find out how your computer is organized!
An open house/study group for anyone, at any level, with any interest in computer programming. Check out www.meetup.com/learntocodedenver for more details.
Interested in recording music in our studio or editing your videos? Want to use our 3D printer or learn about Arduino? Need to scan your drawings and clean them up with Illustrator or use Photoshop to improve your photos? ideaLAB is our digital media lab and makerspace and has a wide variety of hardware and software available for you to use to create whatever you can imagine.
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The buckles on the waist and shoulder straps can crack or break, posing a fall hazard to the child.
The Playtex Hip Hammock is an infant carrier designed to strap the baby against the caregiver's body at the hip. It is made of a soft, quilted fabric and intended for babies that are from 15 to 35 pounds. The child seat is attached with straps that wrap around the carrier's hips and shoulder. "Playtex Hip Hammock" is printed on a label sewn into the front of the carrier. All model numbers are being recalled. Model numbers 05300, 05301, 05302, 05306, 05307 and 05308 are sewn into the inside panel below the instructions for use. They come in basic and deluxe styles. The hip hammock's fabric is suede or ultra-suede in black or navy colors on the outside, and the inside lining is black, black and white check or burgundy.
They were sold at Burlington Coat Factory, Target, Walmart, juvenile product, baby and discount stores nationwide and online at Amazon.com from June 2004 through December 2008 and January 2010 in Canada for about $40 for the basic model and $60 for the deluxe model.
Consumers should stop using the carrier and contact Playtex for instructions on how to return the product for a full refund.
Consumer Contact: Playtex at (800) 522-8230 from 8 a.m. to 6 p.m. ET Monday through Friday or online at www.playtexproducts.com and click on Recall for more information.
Copyright 2015 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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Recently i updated my macbookpro software to mac os x 10.6.8, after update CPU fan is running non stop even when laptop is idle and laptop is getting more heat thn laptop is too slow,videos are playing very slowly.its very weird.
some one encountered same issue after update???is there a way to revert the software back to previous version??please help
my laptop configuration:-
Model Name: MacBook Pro
Model Identifier: MacBookPro7,1
Processor Name: Intel Core 2 Duo
Processor Speed: 2.4 GHz
Number Of Processors: 1
Total Number Of Cores: 2
L2 Cache: 3 MB
Memory: 4 GB
Bus Speed: 1.07 GHz
Boot ROM Version: MBP71.0039.B0B
SMC Version (system): 1.62f7
Retrieving data ...


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Marabou Ballerina Jewelry BoxMarabou Ballerina Jewelry Box6
Average rating:Read all reviews Write a review
from $19.99 - $22.99All the things little girls like, wrapped up in one fantastic little box. Compact box features a carrying handle accented with fluffy pink marabou feathers so it can be toted like a purse. Open the lid to discover a ballerina twirling to music in front of an oval mirror. Lift out tray features 2 rectangular compartments and a ring tray that can hold up to 10 rings. Below this trap is additional room for all things that sparkle and shine. Wind-up mechanism on the back. Plays Beethovens Fur Elise". Measures 8" high (w/ handle) x 7 3/4" w x 5 1/2". Sample shows our Princess" Design.
In Stock ITEM # JEWEM
Read all reviews Write a review
Featured Reviews:
Marabou Ballerina Jewelry Box
grand daughter so excited!!!02/23/2015
My grand daughter was so excited to receive this jewelry box....she called me so happy and wanted to thank her grandma marie!!! She made a special place on her dresser for it. It was a present for her seventh birthday! Then she called me thenext day and said she took her princess box to school for show and tell!!! Thank you for your expert advice and personalizing her jewelry box. She received it on time for her birthday....I am glad I chose to order with you!!! Would highly recommend you to my friends. As grandparents we get stumped on what to get the little ones, now I have found the perfect website!!!!
Marabou Ballerina Jewelry Box
What a charming ballerina jewelry box. Very pleased with the quality. The original box arrived with the name misspelled and I had the corrected box within four days right before Christmas. Great customer service.
Marabou Ballerina Jewelry Box
more decorations please!06/03/2014
bought this for my granddaughter's first birthday. It is so cute and perfect for a little girl. Only thing I wish my bambino would have done was put more of the decorations around the box, the sides and back were plain
Marabou Ballerina Jewelry Box
Marabou Ballerina Jewelry Box03/25/2014
I bought this item online for my geat niece's first birthday. Her parents loved it and my nephew said that the baby was so surprised to see the ballerina dance. Now all he has to do is fill it up with jewelry!
Marabou Ballerina Jewelry Box
Very nice07/03/2014
It's an awesome jewelry box for the price, cheapest one I found. It looks like it would cost a lot more. my daughter is going to love it. It shipped very quick as well.
Featured negative reviews:
Marabou Ballerina Jewelry Box
boxes coming apart07/14/2015
I bought 2 of these jewelry boxes @ Christmas the names are coming off and wood is pulling apart from frame I have tried twice to contact but never a response from your company if these can be replaced my grand daughters love these boxes but they are not a very good product maybe just got a bad batch but something needs to be done with this problem..please contact me asap......thank you


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I noticed that Star Trac makes commerical grade spinning bikes and was wondering if anybody knows of any other company that sells them.
I noticed that Star Trac makes commerical grade spinning bikes and was wondering if anybody knows of any other company that sells them.
LeMond makes one called the rev master. I don't know if it's commercial grade but it's suppose to be pretty good. You can check it out at www.lemondfitness.com.
there will come a time when there will not come a time.
star trac v-bike is what I have and it is great
Schwinn makes one, the gym I go to has a few of these schwinns and a lot of the Star Trac NXT's. The NXT's are far, far better. Much sturdier and more comfortable. Of course, it's also more expensive...
Here's a link to the Schwinn.
Just your average club rider... :)
I saw the Lemond the other day when we were getting a treadmill. I spent about 10 min on it, it's pretty good with alot of adjustability to it.
what kind of price range are these bikes in.. i've been thinking about getting one this winter.
Ultimate Cat -o- Meter
X-x0x-x-X - 40%
The Lemond and Star Trac have leather brakes, and if you oil soak the brake with 3in1,
the similarity to real biking is better than a real bike on a mag trainer, and better
than other spinbikes. very handy for 4 second sprint repeats. feels like the road.
keep it oiled up and it'll last forever (and get really hot during use) making the
tension curve perfect
I have yet to find any other braking or resistance system that comes close
to the real-feel of the Lemond or Star-Trac. I am talking about the ones with
the single brake on the circumference surface of the flywheel, activated with
a turn-screw dial
thanks for the advice... i might have to find one of these.
Ultimate Cat -o- Meter
X-x0x-x-X - 40%


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Kim Zolciak Opens Up About Kandi's Lawsuit, the Fallout with Her Parents and Her Growing Family
Kroy Biermann and Kim Zolciak | Photo Credits: Bravo
The Real Housewives of Atlanta's Kim Zolciak has had no problem putting her personal life — birth, wigs, catfights and all — on television. But for the first time, she's nervous about airing a very emotional battle she's having at home.
"I am not speaking to my parents," she tells TVGuide.com. "I've shared a lot of my life in front of the cameras ... and this is the first situation I've had to deal with publicly that is too close to home."
Who is NeNe Leakes' celebrity crush? Bravo stars play our cocktail shaker question roulette
On the season premiere of Don't Be Tardy... (Tues, 9/8c on Bravo), viewers will learn why Zolciak still hasn't spoken to her mom since their argument at her wedding. But despite intense fight with her parents, Zolciak promises plenty of laughs as she and husband Kroy Biermann welcome baby boy Kash Kade into a family that also consists of 14-month-old KJ and Kim's two daughters from a previous marriage, 16-year-old Brielle and 11-year-old Ariana. Plus: What does the outspoken blonde tell us she wishes she had said on Sunday night's Housewives reunion?
Your Real Housewives of Atlanta reunion interview just aired. How do you think it went?
Kim Zolciak: It ended great. I was a bit teary-eyed [after NeNe and I hugged] and I sent her a text message when I walked out to the car. So, I'm pleased and really happy with that, and I can't say that I won't return.
Is there anything you didn't get to say?
Zolciak: I really wish I could've had a conversation with Kandi regarding the lawsuit that she filed the day before and that I could've confronted. It's so dumb and pointless and there's a motive behind [it] to drum up publicity for her new show. That's why it's a publicity stunt and nothing short of that in my mind.
Bravo green-lights 17 new series, renews 18 shows and announces spin-off project for Phaedra Parks
Moving on to the premiere of Don't Be Tardy..., people say the first year of marriage is the toughest. Was that true for you and Kroy?
Zolciak: I would not say that's the case at all. Kroy and I just balance each other out. I know people say they have the perfect marriage, but I feel like Kroy and I are a perfect match. I'm feisty, he's calming, and it works. I've been with Kroy for three years and I've had two babies. [Even] with all the pregnancy hormones, he's just a chill person. Thankfully we haven't had any issues.
Have you learned anything new about him since last season?
Zolciak: He has a lot of patience, which I guess I always knew. But I had Kash when he was in football camp and he had to leave while I was at the hospital and go play a football game. And then he dropped me off with the baby at home, and then [went] back to camp. So he's just a hard worker. When I had KJ, it was during the NFL lockout so I didn't really see him having to juggle football and the baby. He's a motor that doesn't stop.
Has your favorite show been canceled?
The premiere shows him working with Ariana on a school project. Did you expect him to be such a hands-on dad?
Zolciak: When I first met Kroy, he loved kids and being around kids, and we never had a date by ourselves for the first four months. So, he was great to them from the very beginning. It could be hard for someone to fall in love with a mom and her kids as well, but he was painting Ariana's nails, which I think is so cute, and they paint his nails and he lets them. I'm really truly blessed.


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As of May 28, 2014, this shopping center is owned by Washington Prime Group, Inc. which is a publicly traded REIT (NYSE: WPG) that owns and manages 98 regional shopping centers & community lifestyle centers across the U.S.
Waterford Lakes Town Center offers easy access to popular stores, including Super Target, Bed, Bath & Beyond, ROSS Dress for Less, Best Buy and T.J. Maxx. Waterford Lakes is home to more than 100 specialty shops, a variety of restaurants, and ongoing entertainment in a park-like, open-air shopping environment. You'll find lakes, fountains, and lush landscaping throughout the center, providing you with a calm, welcoming shopping environment. Also, at this location, we have many exciting dining options from sit down places such as California Pizza Kitchen and Cooper's Hawk Winery & Restaurant to grab and go choices such as Fresh To Order and Five Guys Burgers and Fries. Make your visit complete by taking in a movie at the Regal Cinemas 20 theater. Conveniently located off SR-408 at Alafaya Trail in East Orlando, Waterford Lakes serves the nearby communities of Orlando, Winter Park, Oviedo and Titusville. So, from the entire team at Waterford Lakes Town Center, we hope that you will visit us soon!FEATURED STORES
T.J. Maxx, Best Buy, Victoria's Secret, Barnes & Noble Booksellers, Buckle, Sunglass Hut, Super Target, Massage Envy, Ulta Salon & Cosmetics
University of Central Florida (estimated time: 10 minutes)
 -Head SOUTH on N Alafaya Trail for 3.5 miles.
 -Mall entrance will be on left-hand side.

  Downtown Orlando (estimated time: 15 minutes)
 -Take FL-408 EAST (portions toll).
 -Take the Alafaya Trail exit, EXIT 21.
 -Turn LEFT onto N Alafaya Trail.
 -Mall entrance will be on right-hand side.

 Orlando International Airport (estimated time: 20 minutes)
 -Take FL-528 EAST/Beachline Expressway (portions toll).
 -Take EXIT 16 to merge onto FL-417 NORTH (portions toll).
 -Take EXIT 33A to merge onto FL-408 EAST toward Titusville (portions toll).
 -Take the Alafaya Trail exit, EXIT 21.
 -Turn LEFT onto N Alafaya Trail.
 -Mall entrance will be on right-hand side.

 Titusville (estimated time: 40 minutes)
 -Head WEST on South St/FL-405.
 -Turn RIGHT onto Cheney Highway/FL-50.
 -Continue to follow FL-50.
 -Turn left onto N Alafaya Trail.
 -Mall entrance will be on left-hand side.

 Cape Canaveral (estimated time: 50 minutes)
 -Head WEST on Astronaut Blvd/FL A1A WEST.
 -Stay straight to go onto FL-528 WEST/Beachline Expressway (portions toll).
 -Continue to follow FL-528 WEST (portions toll).
 -Take the FL-520 exit, EXIT 31.
 -Merge onto FL-520 toward Orlando.
 -Turn slight right onto E Colonial Dr/FL-50.
 -Turn LEFT onto N Alafaya Trail.
 -Mall entrance will be on left-hand side.

 Daytona Beach (estimated time: 1 ¼ hours)
 -Take 1-4 WEST toward Orlando.
 -Take EXIT 101B to merge onto FL-417 SOUTH toward International Airports/Sanford (portions toll).
 -Take EXIT 33A to merge onto FL-408 EAST toward Titusville (portions toll).
 -Take the Alafaya Trail exit, EXIT 21.
 -Turn LEFT onto N Alafaya Trail.
 -Mall entrance will be on right-hand side.

 Tampa (estimated time: 1 ½ hours)
 -Take I-275 NORTH toward I-75/I-4.
 -Keep right to take I-4 EAST via EXIT 45B toward Orlando.
 -Take EXIT 82A to merge onto FL-408 EAST toward Titusville (portions toll).
 -Take the Alafaya Trail exit, EXIT 21.
 -Turn LEFT onto N Alafaya Trail.
 -Mall entrance will be on right-hand side.
Wireless (Wi-Fi) Internet
We offer free wireless internet to our shoppers at this Simon mall. Any shopper with a Wi-Fi enabled laptop, tablet or smartphone can easily log onto the Wi-Fi network. All shoppers have to do is open their web browser or select "Simon WiFi" (the SSID name) from their available list of wireless networks to get to the Simon Malls Wi-Fi landing page. All shoppers that choose to use the Wi-Fi network at this mall must agree to Simon Wi-Fi Terms & Conditions of Use prior to using this free service. If there are any issues or questions, shoppers and tenants should contact the Wi-Fi network technical support hotline at (888) 726-5930 for assistance.
Foreign Currency Online Ordering with Travelex
Order your travel money online for convenient home delivery. Did you know that some Simon mall locations also include retail Travelex stores for your convenience. Travelex is the world's largest retail foreign currency exchange specialist, with over 1000 stores around the world. We can provide you with over 75 foreign currencies as well as a Cash Passport that can be pre-loaded with either Pounds or Euros and includes chip & PIN technology, a must when traveling in Europe. To get started, visit Travelex now.
Simon Giftcard®
Give the gift of shopping with a Simon Giftcard, available at the Property Management Office in denominations ranging from $20 to $500. There are no fees after purchase and the funds do not expire. The Simon Giftcard can be used anywhere Visa or American Express are accepted. See cardholder agreement for complete terms and conditions.
ATMs area available in the front parking lot area of Regal Cinema (Travelex ATM), at Chase Bank and Orlando Federal Credit Union.
Coca-Cola Vending
Thirsty for a Coke? Try a great Coca-Cola product from one of our Coca-Cola vending machines located throughout the center. Coca-Cola vending machines are located on property at the following locations:

 NEAR:
 Lenscrafters
 Lane Bryant / Aeropostale
 Kid*Lando near A+ Learning Academy
 Office Max / PetsMart
 Party City / Tilly's
 Dollar Tree / Payless
 TJ Maxx / Bath & Body Works

Directories (Mall Map)
Handheld Directory Brochures are available in racks at the Directory displays located near Jo~Ann's, Zales Jewelers and Sunglass Hut as well as at the Property Management Office.
Fax & Copies
Faxes and Copies availabe at our Office Max ( 407-482-3242) and Fedex (407-658-9518) stores located in the town center. Fees apply. See store for details .
iPhone® & Android™ App
The Simon Malls Mobile App can help you find your favorite stores, dining and entertainment options at the Simon Mall nearest you. You'll also be able to check out the latest deals and events available at your favorite mall right from your phone. And there are many more features designed to enhance your shopping experience including mall maps & gift card balance check. Download the free app from the App Store℠ for iOS powered devices or from Google Play™ for Android powered devices today. iPhone is a trademark of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. Android and Google Play are trademarks of Google Inc.
Lost and Found
Lost and Found assistance is available at the Property Management Office
Waterford Lakes Town Center offers plenty of convenient parking with over 5,000 spaces throughout the center
Shopper Assistance

The goal of the Waterford Lakes Town Center Security Department is to maintain a safe and pleasant shopping environment for our visitors and tenants.

Some of the ways security is working for you:

 <DIR>
Year-round vehicle patrols in the parking lot.
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Year-round foot patrols throughout the center.

Vehicle jump starts.

Assist in locating lost vehicles.

Assist in locating lost loved ones.

Escort visitors and tenants anytime upon request.

Plus, all Waterford Lakes Town Center Security Officers are trained in CPR and basic first aid.

Shopping Vouchers
The Style Savings book with over $350 in savings coupons from various stores located here in the town center can be picked up from the mall management office anytime M - F from 8 am - 5 pm.
Handicapped Parking
Handicapped accessible parking is available.


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Home | About CSN | CSN Help | Contact CSN
Mar 17, 2011 - 5:14 pm
Please if anyone had bilateral carotid body tumors resection which were the complications after, if any. My husband (34 years old) did a surgery 3 years ago for resection of a carotid body tumor on the right side and about a week ago a new carotid body tumor on the left side was discovered. We have read some studies about baroflex failure syndrom (high incidence
Mar 18, 2011 - 8:20 am
Hi my friend, I wish I could help but I don't know anything on this subject