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Now Booking Fall 2016!
Six Figure Box Offices Across the US
Proven Success in Major Markets, Even In Recession
As the leading internationally touring, independent Russian ballet company, Moscow Ballet has set the standard for artistic excellence and box office success. Called "Expansive… brimful with feeling …. elegantly generous" by New York Times' Chief Dance Critic Alastair Macaulay, the company features multi-award winning artists and a company of forty Russian dancers.
With an annual tour of over 100 performances in the top markets and venues across North America, Moscow Ballet's Great Russian Nutcracker delivers hard tickets as well as value for high rollers. Even in the middle of market panic, year-to-date sales are consistently ahead. After over 20 years of touring success, Moscow Ballet's Great Russian Nutcracker has proven that tradition trumps recession every time.
Combining the pinnacle of classical Russian ballet with a Broadway style stage show, Moscow Ballet delivers tens of thousands of ticket sales each season.
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Use promo code JOY for savings up to $12.50!
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Moscow Ballet performs Russian ballets in over 70 cities across North America annually. In addition to the widely popular Great Russian Nutcracker, company repertory includes the time- honored Swan Lake, Sleeping Beauty, Romeo and Juliet, Cinderella and more. For over twenty years Moscow Ballet has performed in a majority of the top twenty demographic markets including New York City, Los Angeles, Chicago, Washington D.C., Dallas, Minneapolis, San Francisco and Tampa Bay. In addition to performances, the company's mission, and national platform, enables it to share the renowned Vaganova training with over 5000 American and Canadian dance students annually in the "Dance with Us" program. "New Horizons - A Children's Program for Life" is Moscow Ballet's cultural immersion project that benefits school children of all ages and on-going programs such as Musical Wunderkind, Master Classes and Summer Intensives also touch the lives of many children and young adults.
Moscow Ballet's Great Russian Nutcracker features Acclaimed Dancers, Stunning Costumes, and Set Designs by Academy Award Nominee – only at the Kings
Called "A Christmas tale from a faraway Land of Snow and Ice" by New York Times Dance Critic BrianSeibert in 2014, Moscow Ballet's principal dancers and production values raise the ante for the performance experience every year. In 2015 multiple award-winning principal ballerina Ekaterina Bortiakova and principal danseur Akzhol Mussakhanov, hailing from one of the world's best ballet academies, deliver outstanding performances for audiences of all ages. "Danced exquisitely by veteran dancer Ekaterina Bortiakova...[her]technical prowess, especially in her footwork and turns, coupled with an endearing smile and girlish innocence, was…truly "great," said Cleveland Plain Dealer's Steve Sucato, 2014.
New in 2015 are set designs created by Academy Award nominee Carl Sprague. Sprague - whose work can be seen in Martin Scorsese, Steven Spielberg and Wes Anderson films to name a few - created Act I Party Scene (pictured above) Grand Salon with wall panels of iconic Russian scenes foreshadowing the story to come. In Act II his new romantic Waltz of the Flowers design creates a deep perspective reminiscent of the gardens of the Grand Palace of Peterhof. Sprague comments, "This was not my first Nutcracker, so I thoroughly enjoyed the different take of the Russian-ness of it, and the demand for authenticity of the setting. I am very pleased with the Russian scene shop's renderingof my designs."
Resident Costume Designer Arthur Oliver created new costume designs for Act I in 2015 and just recently returned from St Petersburg where he oversaw the Russian artisans bringing his intricate designs to life. Critics agree on the high quality of Oliver's work. "The costumes are exquisite…dusted with sparkling jewels and rhinestones...created by Arthur Oliver, they are works of art, tailored to each individual adult cast member's body," D.C. Metro Theater and Arts, Wendi Winters, 2014. The "Great Russian Nutcracker is…filled with...Macy's-sized animals…marvelously precise dancing …beautiful costumes" Sioux City Journal, 2014.
Brooklyn Chamber of Commerce members are invited to the Brooklyn premiere of Moscow Ballet's Great Russian Nutcracker at the beautifully restored Kings Theatre Saturday, December 5 for a 3:00pm matinee. Treat clients, prospects and employees to a one-of-a-kind holiday show. Groups of 10 or more receive the best savings! Call Tim at 800-320-1733 x12 or go to www.nutcracker.com/buy-tickets. Tickets start at $40.00.
Brooklyn Chamber of Commerce members are invited to use code SANTA when ordering and save up to $20 per ticket!
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August 5, 2014
Jay G. Tate
AUBURN | Joshua Holsey tore a ligament in his left knee last October and hasn't made a tackle since that night.
Make that hadn't.
Auburn held its first full-pads practice of the fall Tuesday afternoon, which gave all players their first chance to collide with aggression. Holsey, who earned full medical clearance six weeks ago, perhaps was the team's most eager player.
"I did a little tackling drill just to get back into it," Holsey said. "Still had some jitters in there, so I had to get them out of my system. It felt good."
Holsey started the first six games of 2013 before suffering the injury during a non-contact drill. He struggled to make sense of the injury initially, but eventually made peace with his circumstances. ...More... To continue reading this article you must be a member. Sign Up Now!
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One of the most memorable scenes in "Concussion" is a brief and wordless one: Just a few seconds of a high school football team going through its drills.
We don't know who these young, determined, helmeted kids are, but the message is sobering, especially if you're a parent: Concussion-related brain damage from football is not merely a threat to the professionals featured in the film. It's a threat to our football-playing kids, too.
NEW YORK | Alexander Wang's Fashion Week runway show was a LOT more than just a runway show.
First, it was an anniversary: the 10th of Wang's namesake brand. It was also a homecoming, of sorts: Wang has just ended his prestigious stint as creative director of Balenciaga in Paris after three years, and is turning his focus solely to his own company, rather than splitting his time between continents.
And it was a big party — as in, women pole-dancing the night away, while attendees sipped vodka and munched on mini sandwiches.
NEW YORK | Think of Audrey Hepburn and your mind will likely conjure up an extraordinarily elegant woman in a boat-necked black dress, huge sunglasses, gloves to the elbow, and a chic updo.
It's doubtful you'll picture a woman in jeans and T-shirt settling down in front of the TV with a plate of penne and — gasp! — ketchup.
NEW YORK (AP) — It was Pharrell Williams who was being honored as a fashion icon, but it was another music superstar who got a lot of the attention at the annual Council of Fashion Designers of America awards on Monday night.
Introducing Pharrell, the producer-singer-songwriter who was receiving the evening's Fashion Icon award, Kanye West took the opportunity not just to praise his friend, but to express some frustration at the fashion industry — for, he suggested, its cool reception to his efforts to be a serious fashion designer.
NEW YORK | Peter Copping had hoped to work alongside Oscar de la Renta, but it was not to be: Just days after Copping was hired last October as artistic director of the luxury label, the legendary de la Renta passed away from cancer.
In February, Copping presented his debut collection at New York Fashion Week, and on Saturday — barely two months later — he showed his first bridal line, a big occasion for a label known for dressing high-profile brides like Amal Clooney.
NEW YORK | Stephen Colbert came to the Tribeca Film Festival to interview filmmaker George Lucas, but the "Star Wars" creator had a question of his own.
"The perfect choice to replace that Jon Stewart fellow would have been you," Lucas told Colbert on Friday. Why, he wanted to know, wasn't he replacing him?
Colbert, who replaces David Letterman in September as host of "The Late Show" on CBS, tried to explain.
"Trevor Noah is a very funny guy," he said of Stewart's recently named replacement.
NEW YORK (AP) — Many people remember Mariel Hemingway best from her portrayal of the sweet teenager Tracy in Woody Allen's "Manhattan," where she delivered the film's uplifting closing line, a reminder that "You have to have a little faith in people."
But Hemingway herself, then only 16, was living a life with much darkness in it; her family was plagued by alcoholism, drug addiction and mental illness. And suicide: seven of her family members have taken their own lives, including her famous grandfather, Ernest Hemingway, in 1961, and sister Margaux, the former supermodel, in 1996.
NEW YORK (AP) — The Oscar de la Renta luxury label on Tuesday held its first Fashion Week show since the designer's death in October, with his successor, Peter Copping, sending a bevy of luxurious, ultra-feminine looks down the runway on what he called "an emotional day for the house."
NEW YORK | On a recent Saturday afternoon, Bradley Cooper took his curtain call at Broadway's Booth Theater, where he's starring in "The Elephant Man." He then had to race to a meeting, give an interview for this article, and find time to eat and nap before taking the stage again for his 8 p.m. show.
NEW YORK | Hugh Jackman hopping his way into the theater, Neil Patrick Harris licking the eyeglasses of Samuel L. Jackson. A little history, and a slew of genuinely heartfelt speeches. The Tonys are often the most entertaining awards show of the year, and this year, again, they didn't disappoint. A look at some of the evening's most memorable moments, including some you didn't see on TV:
Athens, GA • Athens Banner-Herald ©2016. All Rights Reserved.


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how to build a house (Continued)
find someone whose eyes shine
bright; artificial contacts work as well –
they're there to replace stars that
you have already forgotten.
raise two.five kids,
watch them revel in that patch of
grass out front and never
tell your antsy little boy
about the forest out back (and a
couple of years ago).
feed them a steady diet of
marshmallow puffs and corn puffs
and cheese puffs and pray to yourself
they don't end up puffing a pipe.
follow the end of your youth,
through their beginning –
substitute sugarcane for the saccharine
goodness of daytime TV,
math + math = 2(math).
Continue Reading »


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Port Howard
From Wikitravel
Falkland Islands : Port Howard
Revision as of 19:19, 24 March 2012 by 184.108.40.206 (Talk)
Port Howard [1] is a small settlement located on the island of West Falkland in the Falkland Islands. The settlement is the center of a 200,000 acre sheep farm, with twenty permanent residents and over 42,000 sheep. Visitors to Port Howard are offered a glimpse of camp life along with excellent fishing and hiking opportunities.
Get in[edit]
Nearly all visitors to Port Howard arrive on a FIGAS flight, landing on a grassy runway which will almost certainly need to be cleared of sheep and other livestock!
There is also daily sailings from New Haven on East Falkland to Port Howard allowing easy access to Port Howard by road from Stanley.
Get around[edit]
The lodge offers a small bar that works on an honour system.
Get out[edit]


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- Title: Indogreen Forestry Expo 2015
- Date : April 15-18, 2015
- Venue: Hall B, Jakarta Convention Center
- Organizer: PT. Wahyu Promo Citra
- In cooperation with: The Ministry of Forestry of the Republic of Indonesia
- Exhibition schedule:Day 1-4 opened for public Opened form 10.00 a.m. to 19.00 p.m.
Researchers and academic activists 25%
Businessmen and professionals 24%
Public 36%
Government officials 15%
"Indogreen Forestry Expo" is the largest forestry exhibition organized in Indonesia since 2009, presenting great potencies in the sector of forestry: its management, exploitation, conservation, forest land using, forestry industry in the form of wood and non-wood forestry products, processed products and forest exploitation equipment and technology. The exhibition also socializes the best programs and real actions of the government and private sector in the management of sustainable forest areas including reclamation of forests and mine-out land as well as the exploitation of geothermal energy.
"7th Indogreen Forestry Expo 2015" is organized to support the government program "Sustainable Growth with Equity in Forest Sector towards 2020 Sustainable Forests, Self-Sufficiency Economy" and support efforts to materialize "Green Living Concept towards Green Indonesia". For that purpose, during exhibition days, the event will showcase forestry products and services which are friendly to environment and also a number of interesting and important activities such as workshops, talk shows, forestry introducing simulations with an aim to generate great ideas badly used for make real the green Indonesia.


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Irish Coffee
Irish Coffee
Recipe by Noel McMeel found at Good Food Ireland
Serves 1
1 oz Irish Whiskey
1 teaspoon of brown raw cane sugar
1 tablespoon of whipped pouring cream
1 hot double espresso with a small measure of hot water to fill the glass
- Use warmed coffee glasses and add the whiskey.
- Add the sugar and dissolve in the whiskey.
- Add the coffee and stir well.
- Whip the cream lightly but still able to pour.
- The lightly whipped cream is carefully poured over the back of a spoon initially held just above the surface of the coffee and gradually raised a little as you pour, the cream should float on top.
- Serve and enjoy this all Irish Classic.
© 2011 – 2013, The Foodies' Kitchen. All rights reserved.


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GARDEN DINNER PREPARATION: Volunteer gardener Mick Allison dressed in Victorian costume with chef Matthew Lockwood at the Ripon Workhouse Museum garden
Ashley Barnard, Reporter (Richmond) / / News
A PRISON museum's Victorian kitchen garden is to be put back to full usage after a local chef designed a menu incorporating its rare produce.
Ripon Workhouse Museum gardens, established in 1850, is tended by volunteers using traditional methods and grows a variety of heritage fruits and vegetables including Dog's Snout apples and Fat Lazy Blonde lettuce.
This summer, Ripon chef Matthew Lockwood of Lockwoods Restaurant in the town – located just 200 metres from the garden – will create a dinner party menu for a special outdoor supper night.
The Workhouse Garden Dinner Party is planned within the kitchen garden on the evening of Saturday, August 16.
The outdoor supper will feature a three course platter style menu designed and prepared by Lockwoods' chefs which will showcase the best of heritage seasonal produce picked straight from the garden.
Matthew Lockwood said: "Expect a menu which will delight the taste buds with a summer feast of fresh, healthy and wholesome local heritage fruit, herbs and vegetables.
"This exciting collaboration allows us to demonstrate different ways of using heirloom vegetables to create contemporary seasonal cuisine."
The evening starts at 6pm and costs £35 per person, and guests are invited to bring their own drinks.
To book call 01765-607555.
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Full CoverageBreaking News
Lobos, Aggies Head To The Big DanceUPDATED 12:38 PM MDT Mar 12, 2012
For the second time in three years, the New Mexico Lobos are headed to the NCAA tournament.
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LAST DAY FOR SHIRT IS JUNE 3!Third year for the Jackal Trail Marathons. This will be first in the five marathon series in consecutive days. This one is on a fair trail that is covered with foliage that will heat up like an oven as the day progresses.The trail is 3.75 miles and the race will consist of running this loop 7x. The S/F will have a place you can have a drop bag.Water/Gatorade will be provided along with some ultra foods that you'll see once ever loop. A self-serve water cooler will be placed about half way along the loop as well.
June 13 - The Jackal Trail Marathon: https://ultrasignup.com/register.aspx?did=32271June 14 - Backass Jackal Trail Marathon: http://ultrasignup.com/register.aspx?did=32272June 15 - Asphalt Jackal Marathon: http://ultrasignup.com/register.aspx?did=32274June 16 - Dragonfly Jackal Marathon: http://ultrasignup.com/register.aspx?did=32276June 17 - Native Jackal Trail Marathon: http://ultrasignup.com/register.aspx?did=32277


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"When in Wolfsburg..." Wolfsburg by garridogal
Wolfsburg Travel Guide: 57 reviews and 211 photos
Although I'll bet there are other attractions, I can't imagine why else anyone would go to Wolfsburg other than to visit The Autostadt. To summarize, it's the Volkswagon plant/world headquarters/theme park. It's kind of like a world's fair for cars.
The place is huge and filled with fun, funky and uber-modern bridges, walkways and buildings. Highlights being the rotatating Rosemary plant bridge, the doorway that looks like a car's hatchback and tram tour through the actual plants.
It's a car lover's dream....
Neither of us own a car. I don't really know all that much about them except that I do know how to drive one - as long as it's automatic - and really do like driving.... But I live in the city and am a slave to public transportation so I've never really had the yearning to learn a lot about them.
So I guess then you may be wondering WHY we went? Well....our gracious hostess in Hannover who loves architecture thought we'd enjoy it! And well....we did! It's fun to see and do new things and the company could not be beat!
- Pros:Great architecture and lots of fun for the car enthusiasts
- Cons:We are not all car enthusiasts....
- In a nutshell:Now I can say I've been there
Reviews (1)
The one; the only........the Autostadt!! more travel advice
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"Tourists don't know where they've been. Travelers don't know where they're going. - Paul Theroux"
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HN-MSH838 Sterling Industries
Sterling 8H in. Commercial at Sign - DO NOT USEItem # HN-MSH838
Roll over to zoom
Click for full screen
- Made of composite material
- Commercial '@' sign in pimenta finish
- Easy-to-hang design
- For indoor and outdoor use
- Dimensions: 1.5L x 7.5W x 8H in.
Full Description
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Sterling Industries
Sterling 8H in. Commercial at Sign - DO NOT USE
The Sterling 8H in. Commercial at Sign makes the perfect gift anyone who tweets like it's their job. Hang it up or place it or your desk, the aged wood appeal is sure to catch attention. Take the tech age in a new direction.About Sterling IndustriesThrough its vision of developing creative concepts into successful products, Sterling has Maked a diverse range of home furnishings, evoking the essence of its founder. Sterling Industries' corporate office and main warehouse is located in Nor


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The Smart Option Student Loan information is for borrowers attending degree-granting institutions only. Applications are subject to a requested minimum loan amount of $1,000. Current credit and other eligibility criteria apply.
1 Explore federal loans and compare to ensure you understand the terms and features. Smart Option Student Loans that have variable rates can go up after consummation. Federal student loans are required by law to provide a range of flexible repayment options, including, but not limited to, income-based repayment and income-contingent repayment plans, and loan forgiveness and deferment benefits, which other student loans are not required to provide. Federal loans generally have origination fees, but are available to students regardless of income.
2 Interest rates for the Fixed and Deferred Repayment Options are higher than interest rates for the Interest Repayment Option. Graduate student pricing on the Smart Option Student Loan is limited to students enrolling in a Masters/Doctorate level degree program. Graduate Certificate/Continuing Education course work is not eligible for graduate student pricing. Variable rates may increase after consummation. Interest is charged while you are in school and during the 6-month separation period. Unpaid Interest will be added to the Current Principal when you enter principal and interest repayment.
3 Only the borrower may apply for cosigner release. Borrower must provide proof of graduation (or successful completion of certification program), income, and citizenship (if it has changed since you applied). Borrower must also be a U.S. citizen or permanent resident; meet the age of majority in their state; be current on all Sallie Mae serviced loans and make 12 consecutive on-time principal and interest payments on each loan requested for release immediately before applying; not have been reported to a consumer reporting agency as 90+ days delinquent in the past 24 months; not be in hardship forbearance or a modified repayment program; have no student loan(s) in default; and pass a credit review that demonstrates a satisfactory credit history and the ability to assume full responsibility of the loan(s) individually when the release request is processed. Requirements are subject to change.
Smart Option Student Loans, Residency and Relocation Loans, and Bar Study Loans are made by Sallie Mae Bank or a lender partner.
Information advertised valid as of 1/25/2016.


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Electronic Banking
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To get started, log in to online banking at the top of the page then go to Bill Pay. If you are a registered user, click on the Popmoney tab, or register for Tradition Bank Online Bill Pay and begin using Popmoney! There's a $.55 transaction fee to send money and never a fee to receive money.
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The Eternal Rivalry by HaychelWatch
©2011-2016 Haychel
OMG This took up my whole day! The worst thing is that my computer is crazy slow when it is handling big arts like this one. I had wasted sooooo much time waiting for it to save... Oh, and did I mention I hate drawing scaled creatures? DX Though, I've got to say I like how this turns out~
Mario and Bowser have got to be my favs of all time. Just ask who doesn't know them in the 2000s!
Painting Process: [link]
Around 7 hrs with breaks and stuff
Sai Painter
Wacom Bamboo Tablet
Mario and Bowser belong to Nintendo~
More Mario arts:
Mario and Bowser have got to be my favs of all time. Just ask who doesn't know them in the 2000s!
Painting Process: [link]
Around 7 hrs with breaks and stuff
Sai Painter
Wacom Bamboo Tablet
Mario and Bowser belong to Nintendo~
More Mario arts:
XDDDDD awesome!
Epic. o_o
This is incredible.
Impressive!!! The most Epic battle EVER!!! Great work
sorry to hear wonderful pic though
that looks awesome
This is one of those photos you listen to Your Going Down by Sick Puppies while viewing haha
it's awesome
there are no words to describe how epic this is!
This is freaking BEAST!
SO BEAST. or koopa, whichever comes first. XD Very amazing job!
Oh nice one. I love the shading and the textures, especially on Bowser. I've experienced it with scaly creatures. They take forever to draw... lol. But they usually end up looking pretty good.
Thank you, and I agree that scaled creatures will actually turn out looking good~ worth the time used eh?
very nice artwork of a timeless battle that will probably never end... gotta feel sorry for bowser. although he manages to get what he wants for a short period of time, it doesn't take mario long to come for him and take it away again
HOLY MOTHER OF BACON. This is cool. I have to stalk-I MEAN WATCH you for this.
Instafavourite and wallpapered! Great work!
I never thought paintings with this kind of resolution could serve as wallpapers... but thank you anyways~~
They work if you set your wallpaper to be "Fit to screen" instead of going full size. Still looks amazing even at a slightly reduced resolution.
Mario : most badass plumber ever.
Awesome work! I love the detail put into the clothing on Mario and the scales on Bowser. I especially appreciate the resolution of the work, all too often is a piece I like in a painfully small resolution. Fav'd for sure.
Seriously epic.
Seriously epic.
Super freaking awesome job.
Giga Bowser. Nice
This is, AMAZING, but Mario's placement kinda bugging me. But that's just me.
Overall, friggin' amazing.
Overall, friggin' amazing.


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We have created a FB app which suggests gifts for friend's birthday using information from friend's likes.We want to create a greasemonkey script which will enable this functionality on third party websites.
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We are looking for a Greasemonkey and a Facebook Developer who will be responsible for the design, development and deployment of our web applications. Here's what you need to know.
Your responsibilities:
- Review business requirements working with other team members
- Perform a technical analysis of requirements
- Produce a solid, detailed technical design
- Write clean, modular, robust code to implement the desired requirements with little or no supervision
- Work with the QA and Customer Support teams to triage and fix bugs with rapid turnaround
- Contribute ideas for making the application better and easier to use
Your qualifications:
- Programming language(s): Facebook API
- Greasemonkey
- Additional Skill(s): HTML, CSS, JavaScript, PHP
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Democratic Presidential Candidates Debate
Harlem's Apollo Theatre hosted this lively debate between the two Democratic Presidential nominees.
They answered audience, media, and Internet questions on a variety of issues.
People in this video
- Bill Bradley U.S. Senator (Former) [D] New Jersey
- Al Gore Jr. U.S. Vice President United States
- Al Sharpton Jr. Founder and President National Action Network
- Bernard Shaw Correspondent CNN
Hosting Organization
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Democratic Presidential Candidates Debate
Featured on October 12 Road to the White House. At the Orpheum Theatre, Democratic candidates debated and discussed…
Michael Jackson Radio Show
Michael Jackson transmitted interviews of the presidential candidates over the airwaves. Several other guests…


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My review
Original recipe yields 4 servings
Based on a 2,000 calorie dietSee full nutrition
WOW! What an excellent idea. It works well with non-canned cranberry leftovers, and tastes great as it's own dish rather than being merely topping. A fantastic and easy way to use cranberry re...
This is very simple to throw together and tasty as well. I used leftover homemade cranberry compote. I was out of pie to serve this with, so I chose to break up ginger snaps and layer them with ...


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- Table View
- List View
Developing and Sustaining Successful First-Year Programsby John N. Gardner Gerald M. Greenfield Jennifer R. Keup
First-year programs and interventions have become critical launching pads for student success and retention in higher education. However, these programs often flounder not because of what they are trying to do, but because of the ways in which they are implemented. Copublished with the National Resource Center for The First-Year Experience and Students in Transition, this is a comprehensive, practical, how-to guide to developing new first-year programs and enhancing existing programs. It identifies and discusses the multiple elements that contribute to sustained student success and to programs that have the capacity to continue to meet student needs and make efficient use of resources. Discussion is included on critical partnerships, organizational structures, personnel, and fiscal issues as they relate to the design, delivery, and assessment of effective interventions.
Step by Step to College and Career Success (3rd edition)by John N. Gardner Betsy O. Barefoot
This book was created to provide an accessible book that would be useful to all students, whatever their backgrounds or their college goals. Students are most likely to succeed if they follow the twelve steps covered in this text.
Students Helping Studentsby Steven C. Ender Fred B. Newton John N. Gardner
This practical guide is considered the standard for training the thousands of college students who serve as leaders, tutors, counselors, and advisors for their peers. Beginning with a fundamental discussion of student growth and development and current research on the topic, the authors go on to provide learning objectives and exercises to help prepare peer educators for such tasks as tutoring, student orientation, residence hall advising, crisis intervention, coaching, and more.
Your College Experience: Strategies for Success 11th editionby John N. Gardner Betsy O. Barefoot
While maintaining its hallmark theme of goal setting, the Eleventh Edition reflects a focus on practical strategies across all topics of the book to help students be successful from the start. Chapters on Time Management, Communication and Information Literacy, and Careers and Majors have all been thoroughly updated to fully incorporate the tools and strategies students use on campus right now.
Your College Experience: Strategies for Success (8th edition)by A. Jerome Jewler John N. Gardner Betsy O. Barefoot
Offering guidance to students navigating their way through the challenges presented by college life, this handbook offers strategies for intellectual, physical, and emotional health and success, including thinking critically, managing time, developing values, appreciating diversity, managing stress, and handling money, among others. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Your College Experience: Strategies for Success (Tenth Edition)by A. Jerome Jewler John N. Gardner Betsy O. Barefoot
Written by the leading authorities on the first-year seminar and grounded in research, Your College Experience by John Gardner and Betsy Barefoot offers today's diverse students the practical help they need to make the transition to college and get the most out of their time there. Goal setting has always been central to this text, and the Tenth Edition has been revised with added coverage and activities to strengthen this material throughout. In addition, a new focus on self-assessment of strengths will help students see where they are already succeeding so that they get off to a great start and stay in college. A full package of instructional support materials -- including an Instructor's Annotated Edition, Instructor's Manual, PowerPoint slides, videos, and a Test Bank -- provides new and experienced instructors all the tools they will need to engage students in this course and increase student retention.
Select your format based upon: 1) how you want to read your book, and 2) compatibility with your reading tool. To learn more about using Bookshare with your device, visit the "Using Bookshare" page in the Help Center.
Here is an overview of the specialized formats that Bookshare offers its members with links that go to the Help Center for more information.
- Bookshare Web Reader - a customized reading tool for Bookshare members offering all the features of DAISY with a single click of the "Read Now" link.
- DAISY (Digital Accessible Information System) - a digital book file format. DAISY books from Bookshare are DAISY 3.0 text files that work with just about every type of access technology that reads text. Books that contain images will have the download option of 'DAISY Text with Images'.
- BRF (Braille Refreshable Format) - digital Braille for use with refreshable Braille devices and Braille embossers.
- MP3 (Mpeg audio layer 3) - Provides audio only with no text. These books are created with a text-to-speech engine and spoken by Kendra, a high quality synthetic voice from Ivona. Any device that supports MP3 playback is compatible.
- DAISY Audio - Similar to the Daisy 3.0 option above; however, this option uses MP3 files created with our text-to-speech engine that utilizes Ivona's Kendra voice. This format will work with Daisy Audio compatible players such as Victor Reader Stream and Read2Go.


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NIAID has long recognized that racial and ethnic differences affect susceptibility to infection and disease. For example, African Americans account for about 13 percent of the U.S. population, yet represent almost half of new AIDS diagnoses. Native Americans experience higher rates of meningitis and invasive bacterial disease from Haemophilus influenzae type B (Hib) than do other groups. Year after year, asthma has a disproportionate affect on inner-city populations, particularly among African American and Hispanic/Latino children.
NIAID is committed to research that helps reduce these and other health disparities. Its efforts have led to the development of better drugs for HIV/AIDS, vaccines that have almost eliminated Hib-related disease, and educational programs and other interventions to improve asthma control among inner-city children.
NIAID also works to attract minorities to careers in biomedical research through programs such as Intramural NIAID Research Opportunities, which provides training in NIAID labs for undergraduate, graduate, and medical students from underrepresented groups, and Research Centers in Minority Institutions, which is partly funded by NIAID and aims to enhance research infrastructure at minority colleges and universities that offer doctorates in health sciences.
Public Health Information in Spanish
Media Availability: Ongoing HIV Replication Replenishes Viral Reservoirs During Therapy—Jan. 27, 2016
Media Availability: Current Malaria Treatment Fails in Cambodia Due to Drug-Resistant Parasites—Jan. 7, 2015
Media Availability: HIV Antibody Infusion Safely Suppresses Virus in Infected People—December 23, 2015
Bulletin: NIH Publishes Criteria for Research on Organ Transplantation Between People with HIV Infection—Nov. 25, 2015
Health disparities are gaps in the quality of health and health care that mirror differences in socioeconomic status, racial and ethnic background, and education level. These disparities may stem from many factors, including accessibility of health care, increased risk of disease from occupational exposure, and increased risk of disease from underlying genetic, ethnic, or familial factors.
The following are examples of health disparities related to infectious diseases and diseases of the immune system:
More information on asthma
More information on autoimmune diseases
More information on viral hepatitis
More information on how HIV/AIDS affects minority populations
More information on transplantation
More information on sexually transmitted diseases
More information on tuberculosis
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Last Updated January 27, 2016


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Email AddressVerified
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- Lourdes Hill College, University of Sydney
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- Mary's Airbnb Symbol
Hey, I'm Mary!
5 things I can't live without ;) - good friends, great coffee, travel, cycling and 'chill time'.
I love the outdoors (cycling/hiking), travel (i.e. meet new people, see new places) and performing arts (especially dance). Photography and interior design ... also favourites for me to do/learn about.
I enjoy travelling where it is not too touristy, and spend some time rather than rush through on a 'mission'. I tend to mix physical adventure travel with 'chill time' to see the sights, and when home as a guest I love to just relax, cook a home meal and recover from whatever I have been up to during the day :) I am a clean and tidy person at home (non-smoker) and enjoy staying in similar, non-cluttered environments.
Life Motto? hmmm...maybe some fav quotes are:
"Life is like riding a (URL HIDDEN) keep your balance you must keep moving." Albert Einstein
"Red wine is to cyclists, like spinach is to Popeye" Stu OGrady


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The order, which was won in an open tender originally released in January, includes delivery of two GEA Process Engineering wet mix plants, two GEA Niro spray dryers, and two GEA Colby powder handling and retail filling plants.
Once up and running the two processing lines will have a capacity to produce 4 ton of infant formula per hour. Production is scheduled to start in August 2012 and will serve the both the domestic market in Vietnam and export markets.


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Buy this Limited Collector's Edition
Soller's Christian started out a blonde in previews but darkened into a brunette closer to the opening. "I had a Kurt Cobain wig, but they decided to tone it down and make the character a little more accessible to the audience. I'm glad they did."
But isn't it a little daunting to play someone who is acknowledged by all as a male beauty and, thus, a suitable vessel for Cyrano's sweet-nothings to Roxane? Do you ever doubt they got the wrong guy? "Every day, man, every day," he confessed with an embarrassed laugh. "I can't believe they cast me as Christian. That's not the side of the character I identify with. I identify with his humanity. He's got such a noble sense of honor, this thing we don't have nowadays in every day life.
"With the ladies, he has this handicap to follow through and succeed, and, historically, I've never been able to see the signs from the ladies. I've never been able to know when the window was open, so I guess maybe I identify with that."
Soller was letting his new status as a Broadway actor settle in. "It's something I always wanted to do — to be on Broadway and to do it with this cast and with Jamie. I worked once before with Jamie in London — in The Faith Machine by Alexi Kaye Campbell at the Royal Court, so I jumped at the chance to work with Jamie again, and, when I knew Doug was attached to this, I said, 'That's it. I gotta do it.' To work with people of this caliber, on Broadway, I can't compute it. I gotta pinch myself."
This is Page's third Cyrano role. "The first time I played Le Bret, then I played Cyrano in two productions, and now I'm de Guiche. One day I hope to play Ragueneau."
|Photo by Monica Simoes
But, for now, de Guiche suits him just fine: "I like the growth of the character. I think he's surprising. It's a really interesting play in its period because villains were very clear-cut, 19th-century melodrama — 'I can't pay the rent'/'You must pay the rent.' And de Guiche has some of that in him but — it was written at the same time as Ibsen and Strindberg and Chekhov are beginning to write. There's a real depth and a melancholy I find to de Guiche that's interesting. The part is spare. You have to really land your moments because you're not given an enormous amount of text to do it in, and I find that to be really challenging, like writing in haiku."
Having played Cyrano twice before, why didn't he go out for understudy this time? "That would have been a lot of work," he pointed out. "This is a new translation. I've done two other translations. You always learn something new from a new translation. When you take a word and translate it, you're interpreting it because a given word can mean so many things. This translation is rougher, more modern, more muscular, sweatier, grittier. That side really comes out in this version."
Almost all of Page's Broadway career has been spent in the same half-block area on 42nd Street. He previously played the American Airlines Theatre as Henry VIII to Frank Langella's Sir Thomas More in A Man for All Seasons. He comes to de Guiche from next door at the Foxwoods Theatre where he was The Green Goblin in Spider Man: Turn Off the Dark. Across the street at the New Amsterdam, he has done The Lion King and Dr. Seuss' How the Grinch Stole Christmas! But not even the imminent Christmas coming of the Grinch could shake him loose from de Guiche, so the role will be played by Jeff McCarthy (a.k.a. Officer Lockstock of Urinetown).
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Our Mission
To make your "dream home" a reality! If you're looking for a new home in the Hampstead, Wilmington, Surf City, Hubert or Jacksonville areas of Eastern North Carolina, then look no further. American Homesmith is not your ordinary home builder — we take the time to learn and understand our future homeowners. By simplifying the new home buying experience, we hope to make the journey as stress free and enjoyable as it should be.
At American Homesmith we value the work we do and respect the buyers that we build for. We strive to deliver spacious floor plans and wonderful features located in highly desirable neighborhoods throughout Hampstead, Wilmington, Surf City, Hubert and Jacksonville, NC.
Our Commitment to Excellence
Our new home builders have over 100 years of combined experience in the home building industry. We have developed methods and procedures to assure a smooth home-buying experience and we feel that value, experience and integrity should be synonymous with American Homesmith in Eastern North Carolina.


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This covered maze holds several thousand stalls of souvenirs and decor items, plus beer gardens, restaurants and events in Bangkok Hall. A cool, convenient,...Thanon Witthayu
Foreigners rub chest-to-shoulder with Thais amid engines, wheels and other machinery in an area also rife with electrical repairers and homewares.Thanon Mahachak
The heart of Little India, Pahurat is awash with fabrics and textiles, from rainbows of saris to Thai and Chinese silks, synthetics and cottons. Winding...Thanon Chakkaphet & Thanon Pahurat


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Play any type of Game at Y8.com. The biggest Game Collection to play free online. Flash, Unity 3D, Html5, Android, Java and Shockwave.
If the game freezes, just click inside it (games can get unresponsive if you click elsewhere on the page).
Sue's in class but she's so hungry she can't focus. Move with the arrows to avoid Sue getting caught by the teacher for eating in class.
This game is part of a series: Sue


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Are you Romano T DeMarco?Claim your profile
Publications (25)89.84 Total impact
Article: Laparoscopic Versus Open Pyeloplasty in Children: Preliminary Report of a Prospective Randomized Trial[Show abstract] [Hide abstract]
ABSTRACT: Pyeloplasty for ureteropelvic junction obstruction in children has traditionally been performed using an open technique. Although laparoscopic pyeloplasty has been shown to be comparable and possibly superior to open pyeloplasty in adult studies, such results in the pediatric population are limited. We evaluated outcomes between transperitoneal laparoscopic and open pyeloplasty in children. All children 1 to 18 years old with ureteropelvic junction obstruction requiring operative repair were offered enrollment in the study. Patients were prospectively randomized to either transperitoneal laparoscopic or open pyeloplasty through a flank incision. We reviewed 20 patients (mean age 7.8 years) who underwent laparoscopy and 19 (7.2 years) who underwent open surgery (p = 0.48). Mean followup was similar between the groups (laparoscopic 8.1 months vs open 11.1 months, p = 0.38). Mean operative time was 151 minutes (range 94 to 213) for laparoscopy and 130 minutes (83 to 225) for open surgery (p = 0.09). Mean hospitalization was 29.3 hours (range 20.5 to 48) for laparoscopy and 36.2 hours (24 to 73) for open surgery (p = 0.06). Analgesic usage was similar between the groups. One failure in the open arm required a revision. Operative, hospital, anesthetic and total charges were similar between the groups. Laparoscopic pyeloplasty appears to be a safe and effective alternative to open pyeloplasty in children. Although the cost is similar, there is a trend toward longer operative times in the laparoscopic group but a shorter overall hospitalization. As more patients are enrolled in the study, these differences may prove significant.
- [Show abstract] [Hide abstract]
ABSTRACT: In the classic view of bladder development the trigone originates from the mesoderm derived wolffian ducts while the remainder of the bladder originates from the endoderm derived urogenital sinus. Recent molecular developmental studies have questioned the veracity of this received wisdom, suggesting an endodermal origin for the trigone. To shed further light on this issue we observed mesenchymal-epithelial interactions between trigone epithelium and fetal urogenital sinus mesenchyma to infer the trigonal germ layer of origin. Mouse trigone epithelium was recombined with fetal rat urogenital sinus mesenchyma in tissue recombinant grafts that were placed beneath the renal capsule of athymic mouse hosts. Grafts were harvested at 4 weeks. Control grafts with bladder dome and ureteral epithelium were also examined. Tissues were evaluated with hematoxylin and eosin, and Hoechst dye 33258 to confirm cell species origin. Immunohistochemistry was done with androgen receptor, broad spectrum uroplakin, dorsolateral prostate secretions and seminal vesicle secretions to differentiate prostatic and seminal vesicle differentiation. Grafts of mouse trigone epithelium with fetal rat urogenital sinus mesenchyma yielded epithelial tissue that stained for dorsolateral prostate secretions but not for seminal vesicle secretions. Control grafts of bladder dome epithelium yielded the expected endodermal prostate differentiation. Control grafts of ureteral epithelium yielded the expected mesodermal seminal vesicle differentiation. The consistent finding of prostatic epithelium in tissue recombinants of trigone epithelium and fetal urogenital sinus mesenchyma reinforces the hypothesis that the trigone is derived from the endoderm and not from the mesoderm, as commonly accepted.
- [Show abstract] [Hide abstract]
ABSTRACT: To gain better understanding of ESWL efficacy in children with renal calculi we report our outcomes using this technique. We reviewed the records of children who underwent ESWL as monotherapy for renal calculi at our institution from 1988 to 2007. Data included clinical characteristics, stone-free rate and its relationship to stone size and location, lithotriptor and complications. The 33 boys and 29 girls with an average age of 10 years underwent a total of 69 treatments. A 53% and 63% stone-free rate was achieved after 1 and 2 ESWL sessions, respectively. A trend toward a higher stone-free rate (61% to 70%) after 1 ESWL session was seen in children with stones less than 50 mm(2), renal pelvic stones and treatment with the Dornier HM3 lithotriptor. Children with stones greater than 100 mm(2), a caliceal location and those treated with the Dornier MFL 5000 lithotriptor had a higher failure rate (25% to 46%). Five patients (8%) required ureteroscopy after ESWL due to retained distal ureteral stone fragments. Five patients (8%) who were not stone-free after therapy required subsequent endoscopic treatment for the stone during followup. Smaller renal stones, renal pelvic calculi and treatment with an older generation lithotriptor were independent variables associated with a higher stone-free rate in children. While ESWL is a simple method in children with renal calculi, those with large or caliceal stones may do best with a primary endoscopic approach.
Article: Long-Term Followup of Dextranomer/Hyaluronic Acid Injection for Vesicoureteral Reflux: Late Failure Warrants Continued Followup[Show abstract] [Hide abstract]
ABSTRACT: Dextranomer/hyaluronic acid injection of ureteral orifices is a popular option in the treatment of vesicoureteral reflux, with success rates ranging from 69% to 89%. We found only 1 study that followed patients beyond the initial postoperative voiding cystourethrogram, which describes a 96% success rate at 2 to 5 years but defines success as "nondilating" reflux. We examined our dextranomer/hyaluronic acid series to evaluate the long-term (1-year) outcome in children who had resolution of reflux on initial postoperative voiding cystourethrography. We retrospectively reviewed our dextranomer/hyaluronic acid experience from February of 2002 to December of 2005. We determined initial success on early (6 to 12-week) postoperative voiding cystourethrogram. We then evaluated long-term success by obtaining a voiding cystourethrogram at 1 year postoperatively in patients who were initially cured of reflux. In addition, success rates between the first and second halves of our experience were evaluated to account for surgeon experience and modification of technique. Our total success rate at initial voiding cystourethrogram was 73% (246 of 337 total ureters). The success rate in the first half of our experience was 65.9% (112 of 170 ureters) and in the second half was 80.2% (134 of 167). A total of 150 ureteral units with initial successful dextranomer/hyaluronic acid treatment were evaluated at 1 year by voiding cystourethrogram. Of these ureters 111 had continued resolution of vesicoureteral reflux, for a long-term success rate of 74%. Including initial postoperative failures, the complete 1-year total success rate was 46.1% (111 of 241 ureters). Although the reflux resolution rates at initial postoperative voiding cystourethrogram approach those of open surgery, there is a significant failure rate at 1 year, which warrants long-term followup.
Article: Community Associated Methicillin Resistant Staphylococcal Infections in a Pediatric Urology Practice[Show abstract] [Hide abstract]
ABSTRACT: Methicillin resistant Staphylococcus aureus is a virulent organism that has seen a rapid increase in prevalence. Community associated methicillin resistant S. aureus is discussed frequently in the infectious disease community. However, there has been little mention of this entity in the urological literature. We reviewed the records of patients presenting with skin/soft tissue infections or documented methicillin resistant S. aureus infection treated at an academic pediatric urology practice between October 2004 and August 2006. A total of 12 patients were included (33% female, 67% male). Mean patient age was 49 months (range 8 to 202). Of the patients 11 (92%) presented with spontaneous infection and 1 (8%) presented with a wound infection. Abscess location was inguinal in 4 patients (33%), scrotal in 3 (25%), perineal in 2 (17%), perinephric in 2 (17%) and labial in 1 (8%). The most common presenting sign at referral was fluctuance (30%). While all patients eventually required surgical drainage, initial treatment by the primary care physician consisted of observation on oral antibiotics in 7 patients (58%). A total of 10 cultures (83%) revealed methicillin resistant S. aureus and 2 cultures (17%) were negative. Mean hospital stay was 5 days (range 0 to 16). Postoperatively, most patients (58%) were discharged home on oral trimethoprim-sulfamethoxazole. Mean followup was 4 months (range 0 to 15). Recurrence was seen in 3 patients at 1 to 15 months postoperatively (mean 6.3). Methicillin resistant S. aureus is increasing in the community and will likely be seen more often in pediatric and adult urological practices. The regional differences among bacterial strains make a standardized approach to these cases difficult. However, increased awareness of this virulent organism is necessary to deliver prompt and successful treatment.
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ABSTRACT: The impact of a fellowship on resident operative experience and education is unclear. We sought to address this issue by comparing resident operative case logs and the pediatric portion of the American Urological Association resident inservice examination at our institution before and after establishing a pediatric urology fellowship in 2002. Pediatric operative case logs of all urological residents from 1998 to 2006 at Vanderbilt University were reviewed. We recorded index and total number of cases as specified by the Accreditation Council for Graduate Medical Education. All residents had completed 6 months of pediatric urology training. Statistical analysis was performed using 2-sample equal variance Student t tests. We compared the 8 index categories and total index cases performed by residents, scores on the pediatric portion of the American Urological Association inservice examination and resident average percentiles for index cases referenced to national data, before and after the implementation of an Accreditation Council for Graduate Medical Education accredited pediatric urology fellowship. Before implementation of the pediatric urology fellowship residents performed significantly more hypospadias procedures, pyeloplasties, renal surgeries, ureteroneocystostomies and urinary/bowel diversions (p <0.05), while the total number of index cases performed was not significantly affected (p = 0.13). In contrast, after the fellowship was started residents performed more hydrocelectomies/hernia repairs (p = 0.01). Compared to national averages for index cases in 2004 to 2005, residents maintained greater than the 50th percentile in all categories except urinary diversion, which was between the 30th and 50th percentiles. Furthermore, residents were in the 70th to 90th percentile in 3 of 9 categories, and greater than the 90th percentile in 3, including total number of index cases. No statistically significant difference in the area of pediatric urology was observed on the resident inservice examination scores before and after the fellowship was established. Residents performed significantly fewer index cases in some areas following initiation of a pediatric urology fellowship at Vanderbilt University, although the total number of index cases performed by residents remained unchanged. Despite the presence of a fellow, residents have remained at or well above the national average in all index case categories except urinary diversion. Moreover, establishment of a fellowship did not negatively impact the educational experience as measured by American Urological Association resident inservice examination scores, specifically in the area of pediatric urology. Choosing the optimal time to institute a fellowship should be made with fellow and resident education as the utmost priority. Periodic review of the data should also be performed to maintain consistent, positive experiences for fellowship and residency training.
Article: First Stage Approximation of the Exstrophic Bladder in Patients With Cloacal Exstrophy-Should This be the Initial Surgical Approach in all Patients?[Show abstract] [Hide abstract]
ABSTRACT: Cloacal exstrophy is rare and it represents a reconstructive challenge. Options for managing the urinary tract include primary closure or approximation of the bladder halves in the midline with later closure. We present our observations and evolving thoughts concerning optimal treatment in these patients. We retrospectively reviewed the records of patients with cloacal exstrophy seen in the last 5 years. Initial management was examined, including complete primary closure vs a staged approach. We noted midline defects, spinal cord abnormalities or other anatomical reasons that precluded primary closure. Seven patients, including 5 females and 2 males, were identified. An omphalocele noted in all 7 patients was closed in 5 at initial operation. All underwent preservation of the hindgut in the fecal stream. Spinal cord tethering was noted in 7 of 7 cases. Complete primary bladder closure was performed in 3 of the 7 patients, while the size of the bladder plates or a large abdominal wall defect precluded closure in the remainder. Continence was not achieved in the 3 cases closed primarily. All patients achieving urinary continence underwent bladder neck closure and augmentation cystoplasty with a continent catheterizable channel. Patients with cloacal exstrophy have anatomical issues that can prevent complete primary bladder closure or preclude the achievement of urinary continence. The high incidence of tethered cord places these patients at risk for upper tract changes and bladder decompensation during followup. Despite successful primary closure in 3 of 7 patients all have a tiny bladder and require secondary procedures to become continent. Extensive dissection during the first operation can contribute to more difficult dissection with potential increased morbidity during subsequent surgeries. Therefore, the best initial approach for the typical patient may be closure of the abdominal wall and approximation of the exstrophied bladder halves in the midline. Secondary closure with continent diversion and reconstruction of the external genitalia can be performed at ages 18 to 24 months.
Article: Urothelial Inhibition of Transforming Growth Factor-β in a Bladder Tissue Recombination Model[Show abstract] [Hide abstract]
ABSTRACT: We examined the role of transforming growth factor-beta in urothelial and bladder development. Transforming growth factor-beta signaling was attenuated in the urothelial compartment and the subsequent effects were examined in a tissue recombination model. Urothelium was cultured from adult rat bladders and transfected with control vector C7Delta or mutant DNIIR (dominant negative transforming growth factor-beta receptor II). Grafts were created by recombining transfected urothelium plus embryonic day 18 bladder mesenchyma and placed beneath the renal capsule of athymic mouse hosts. Grafts were harvested at 21 and 42 days. Final tissues were evaluated with staining and immunohistochemistry using hematoxylin and eosin, Gomori's trichrome strain, broad-spectrum uroplakin, smooth muscle actin-alpha, phosphorylated SMAD2 and Ki67 antigen. Bladder structures were defined as having smooth muscle, suburothelial connective tissue and mature urothelium expressing uroplakin. Urothelial compartment diameters were measured and subcategorized as small--0.10 to 0.40, medium--0.41 to 1.0 and large--greater than 1.1 mm. At 21 days 14 C7Delta control and 15 DNIIR grafts were evaluated. No bladder tissue was seen in the C7Delta grafts vs 49 in DNIIR tissue, including 30 small, 9 medium and 10 large tissues. At 42 days 14 C7Delta and 12 DNIIR grafts were evaluated. Six bladder structures (5 small and 1 medium) were seen in the C7Delta cohort vs 27 (14 small, 7 medium and 6 large) in the DNIIR group. Immunohistochemical detection of phosphorylated-SMAD2 was significantly attenuated in DNIIR tissue. In addition, Ki67 proliferative indexes were 4.0-fold higher in the DNIIR cohort compared to those in C7Delta tissues. We successfully observed that primary urothelium cultures can be genetically manipulated and recombined with undifferentiated mesenchyma to grow bladder tissue. By attenuating transforming growth factor-beta signaling in the urothelium superior bladder tissue growth occurred, suggesting that transforming growth factor-beta is a growth inhibitor in this organ system.
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ABSTRACT: The incidence of testicular ascent of a previously descended but retractile testis is reported to be between 2% and 45%. It has been our bias that only a small percent of retractile testes ascend and ultimately require orchiopexy. We performed a retrospective review of all retractile testes diagnosed by any of 4 pediatric urologists at our institution from 1996 to 2005. A retractile testis was defined as one that could be brought to at least the mid scrotum without tension despite a history of maldescent or a retractile nature. Patients were excluded if followup was less than 6 months or they had a history of ipsilateral inguinal surgery. A followup telephone survey was done in patients not reexamined at resolution. A total of 172 patients met our inclusion criteria and were followed to resolution. A total of 274 retractile testes were initially identified, including 26% unilateral and 74% bilateral testes. A total of 19 testes ascended and ultimately required orchiopexy within a followup of 6 to 101 months. A patent processus vaginalis was identified in 13 cases (68%). Another 235 patients initially seen with a diagnosis of retractile testis who had no followup examination at our institution were contacted via telephone. This set of boys initially had a total of 392 involved testes, of which 2 underwent orchiopexy elsewhere before resolution. The incidence of secondary ascent was 3.2% in the combined set of patients. Retractile testes can ascend and, therefore, they require followup until resolution. In our experience most retractile testes do not require surgery.
Article: Oottamasathien, S. et al. Directed differentiation of embryonic stem cells into bladder tissue. Dev. Biol. 304, 556-566[Show abstract] [Hide abstract]
ABSTRACT: Manipulatable models of bladder development which interrogate specific pathways are badly needed. Such models will allow a systematic investigation of the multitude of pathologies which result from developmental defects of the urinary bladder. In the present communication, we describe a model in which mouse embryonic stem (ES) cells are directed to differentiate to form bladder tissue by specific interactions with fetal bladder mesenchyme. This model allows us to visualize the various stages in the differentiation of urothelium from ES cells, including the commitment to an endodermal cell lineage, with the temporal profile characterized by examining the induction of specific endodermal transcription factors (Foxa1 and Foxa2). In addition, final functional urothelial differentiation was characterized by examining uroplakin expression. It is well established that ES cells will spontaneously develop teratomas when grown within immunocompromised mouse hosts. We determined the specific mesenchymal to ES cell ratios necessary to dictate organ-specific differentiation while completely suppressing teratomatous growth. Embryonic mesenchyme is well established as an inductive tissue which dictates organ-specific programming of epithelial tissues. The present study demonstrates that embryonic bladder mesenchyme can also steer ES cells towards developing specific endodermal derived urothelium. These approaches allow us to capture specific stages of stem cell differentiation and to better define stem cell hierarchies.
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ABSTRACT: To report our experience of testicular and paratesticular tumours in children, as such tumours are rare, and historically yolk sac tumour has been described as the most common lesion in children, but recent reports suggest that benign testicular lesions might be more common. We reviewed retrospectively the records of children treated for testicular tumours from 1998 to 2005. The patients' age, clinical presentation, diagnostic procedures, treatment methods, histopathological findings, and outcome were recorded. Patients aged>144 months and those with non-primary metastatic lesions were excluded. In all, 11 patients met our criteria, with a mean age of 37 months (range 9 days to 144 months). Pathological analysis revealed teratoma in four patients, yolk sac tumour in two, epidermoid cysts in two, extrarenal nephroblastomatosis in one, and paratesticular rhabdomyosarcomas in two. The most common clinical presentation was a painless testicular mass. Depending on the clinical presentation and pathology, scrotal ultrasonography, tumour markers (alpha-fetoprotein and beta-human chorionic gonadotrophin), and/or staging computed tomography (CT) were obtained in eight patients. All patients had a radical orchidectomy. Three patients had elevated tumour markers that normalized after orchidectomy. CT revealed extensive mediastinal adenopathy in one patient with rhabdomyosarcoma. Chemotherapy was administered to both patients with rhabdomyosarcoma. Although there were few patients, most of the lesions were benign tumours, with the most common histological subtype being teratoma. As both malignant and paratesticular lesions occurred at a significant frequency, we would continue to advocate an initial radical inguinal approach at which time testis-sparing could be considered if the preoperative evaluation was favourable, and frozen-section analysis at the time of surgery confirms a benign lesion.
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ABSTRACT: OBJECTIVE: To report our experience of testicular and paratesticular tumours in children, as such tumours are rare, and historically yolk sac tumour has been described as the most common lesion in children, but recent reports suggest that benign testicular lesions might be more common. PATIENTS AND METHODS: We reviewed retrospectively the records of children treated for testicular tumours from 1998 to 2005. The patients' age, clinical presentation, diagnostic procedures, treatment methods, histopathological findings, and outcome were recorded. Patients aged >144 months and those with non-primary metastatic lesions were excluded. RESULTS: In all, 11 patients met our criteria, with a mean age of 37 months (range 9 days to 144 months). Pathological analysis revealed teratoma in four patients, yolk sac tumour in two, epidermoid cysts in two, extrarenal nephroblastomatosis in one, and paratesticular rhabdomyosarcomas in two. The most common clinical presentation was a painless testicular mass. Depending on the clinical presentation and pathology, scrotal ultrasonography, tumour markers (α-fetoprotein and β-human chorionic gonadotrophin), and/or staging computed tomography (CT) were obtained in eight patients. All patients had a radical orchidectomy. Three patients had elevated tumour markers that normalized after orchidectomy. CT revealed extensive mediastinal adenopathy in one patient with rhabdomyosarcoma. Chemotherapy was administered to both patients with rhabdomyosarcoma. CONCLUSION: Although there were few patients, most of the lesions were benign tumours, with the most common histological subtype being teratoma. As both malignant and paratesticular lesions occurred at a significant frequency, we would continue to advocate an initial radical inguinal approach at which time testis-sparing could be considered if the preoperative evaluation was favourable, and frozen-section analysis at the time of surgery confirms a benign lesion.
Article: Subureteral Injection of Dextranomer/Hyaluronic Acid Copolymer for Persistent Vesicoureteral Reflux Following Ureteroneocystostomy[Show abstract] [Hide abstract]
ABSTRACT: We sought to evaluate the use of subureteral dextranomer/hyaluronic acid copolymer injection for persistent vesicoureteral reflux following ureteroneocystostomy. We performed a retrospective review of patients who had undergone dextranomer/hyaluronic acid injection between 2002 and 2005 for persistent vesicoureteral reflux following ureteroneocystostomy. Analysis included evaluation of patient demographics, reflux grades, voiding dysfunction, reflux resolution rates and operative complications. Success was defined as no reflux on voiding cystourethrogram at 1 to 6 months postoperatively. A total of 12 cases with 14 refluxing ureters were reviewed. Of the 12 patients treated 9 (10 ureters) had adequate followup. Mean followup was 10 months. Seven of 10 ureters (70%) demonstrated resolution of reflux after the initial injection. A second dextranomer/hyaluronic acid injection resulted in complete resolution in 2 of the 3 failed ureters (67%). Resolution in the remaining failed ureter could not be assessed due to insufficient patient followup. In children with adequate followup success was ultimately achieved in 9 of 9 ureters (100%) using up to 2 injections. A comparison of clinical factors between patients with success after the initial injection and those requiring 2 injections showed that the presence of persistent voiding dysfunction was the only parameter that was statistically significant. All patients tolerated the procedure without complications. Considering the difficulties inherent in repeat surgery and the high success rate of dextranomer/hyaluronic acid injection in this series, this treatment is an appealing and reasonable option for patients with persistent vesicoureteral reflux following open ureteroneocystostomy.
Article: High Yield of Urodynamics Performed for Refractory Nonneurogenic Dysfunctional Voiding in the Pediatric Population[Show abstract] [Hide abstract]
ABSTRACT: In the pediatric population urodynamic evaluation for nonneurological causes has been previously reported as a low yield endeavor when considering patients with a primary diagnosis of dysfunctional voiding. We evaluated the rate of clinically significant urodynamic findings that would drive therapeutic intervention for a spectrum of urological disorders in pediatric patients without neurological deficit in whom initial conventional management had failed. We retrospectively reviewed the charts of patients who had undergone urodynamics in the last 7 years. Patients with known neurological deficits were excluded. A total of 805 pediatric urodynamic evaluations were performed from December 1997 to July 2004 at our institution, including 89 in patients with no known neurological diagnosis and charts available for review. Of the urodynamic studies 33 (37.1%) were reported as normal and 56 patients (62.9%) had clinically significant discoveries. Storage phase abnormalities were the predominant finding in 37 patients (66.1%), including uninhibited detrusor contractions in 31 (55.4%). Emptying phase abnormalities were less common (19 patients or 33.9%). There was no difference in the percent of patients with positive urodynamics findings depending on sex. In our analysis evaluation of all recent urodynamics performed at a single institution revealed a high rate of pathological findings in patients with various nonneurological diagnoses.
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ABSTRACT: We reviewed our experience with continent catheterizable channels with interest in the timing of conduit related complications. A retrospective review was performed of the outcome of continent catheterizable channels in all patients between 1998 and 2003 who had undergone construction of an antegrade continence enema and/or a Mitrofanoff procedure using appendix, small bowel or continent cutaneous vesicostomy. We performed a total of 117 such stomas in 37 male and 41 female patients 2.5 to 20 years old (mean age 8.9). For the antegrade continence enema we used appendix in 92% of cases, an ileal Yang-Monti tube in 6% and a cecal tube in 2%. For the continent catheterizable channel we used appendix in 43% of cases, a Yang-Monti tube in 38% and continent cutaneous vesicostomy in 19%. Continence was achieved in 98% of patients. Followup was 6 to 71 months (mean 28.4). There were 27 channel related complications (23%). Stomal stenosis occurred in 7 antegrade continence enema procedures (14%) within 1 to 10 months (mean 6.2) and in 9 continent bladder channels (13%), including 5 continent cutaneous vesicostomies, within 1 to 24 months (mean 9.4) after surgery. False passages occurred in 5 antegrade continence enema procedures (10%) within 1 to 13 months (mean 3.6) and in 4 continent catheterizable channels (6%) within 1 to 13 months (mean 6.5) after surgery. Of patients with stomal stenosis 50% were treated with surgical revision, while the remainder was successfully treated with dilation. Most false passages were managed by catheter drainage alone. Reasons for revision were contained perforation, colovesical fistula and inability to catheterize. Patient noncompliance appeared to have a role in stomal stenosis. Continent catheterizable stomas help patients achieve bowel and bladder continence. Stomal incontinence after reconstruction is rare. In our experience most stoma related complications occurred in the first year after reconstruction. Experience with more patients and longer followup will help determine whether such problems continue to accumulate with time or whether continent stomas function well with time, particularly after the initial period of healing.
Article: Prospective, Longitudinal Evaluation of Health Related Quality of Life in the Pediatric Spina Bifida Population Undergoing Reconstructive Urological Surgery[Show abstract] [Hide abstract]
ABSTRACT: Spina bifida, the most frequent permanently debilitating birth defect, results in major urological problems of voluntary bladder control and bowel function, which may impair quality of life. We prospectively assessed quality of life in patients with spina bifida using child and parent reports simultaneously. This study had 3 goals, that is to 1) document baseline health related quality of life in patients with spina bifida preoperatively, 2) study health related quality of life, reporting differences between parents and children, and 3) study changes in health related quality of life prospectively at preoperative and postoperative intervals. Patients with spina bifida who were 2 to 18 years old and required reconstructive urological surgery in 2004 were included in the study. Demographic survey and the validated PedsQL 4.0 health related quality of life questionnaire were used preoperatively and postoperatively. A clinical outcomes data set was completed after the clinician saw the patient. PedsQL 4.0 subscales were scored using the algorithms provided. The response rate was 100%. Mean participant age was 10.3 years. Preoperatively child physical and psychosocial health and school functioning were significantly higher than parent reports (p <0.001). Overall health related quality of life in patients with spina bifida was lower than in healthy children (62.4 vs 85, p <0.001). Six weeks postoperatively significant differences in health related quality of life reporting between parents and children had lowered. Six months postoperatively child emotional and social functioning scores were higher than parent scores (p <0.001). No correlation was found between health related quality of life, and clinical and demographic factors due to insufficient sample size. Children with spina bifida recorded higher health related quality of life scores than parents/guardians. This health related quality of life study addresses concerns that impact daily quality of life in patients with spina bifida. Future health related quality of life studies in patients with spina bifida should use child self-reports.
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ABSTRACT: Tissue recombination is a powerful method to evaluate the paracrine-signaling events that orchestrate the development of organs using the in vivo environment of a host rodent. Studies have reported the successful generation of primary cultures of rodent bladder urothelium, but none have reported their use to recapitulate bladder tissue with tissue recombination. We propose that primary cultured bladder urothelium, when recombined with inductive embryonic bladder mesenchyme, will form bladder tissue in a recombination model. Adult rat bladders were isolated and urothelium obtained. Sheets of bladder urothelium were re-suspended in collagen and maintained in tissue culture. After expansion (>20 passages), the urothelium was recombined with embryonic day-14 mouse bladder mesenchyme, then grafted beneath the renal capsule of immunocompromised mouse hosts. Grafts were harvested after 28 days. Control grafts were performed with bladder mesenchyme alone, cultured bladder urothelium alone, and collagen matrix alone. Final tissues were evaluated with staining and immunohistochemistry (H&E, Gomori's trichrome, broad-spectrum uroplakin, and smooth muscle actin alpha and gamma). Immunocytochemistry on cultured urothelium for broad-spectrum keratin, vimentin, and broad-spectrum uroplakin confirmed pure populations, void of mesenchymal contaminants. Staining of recombinant grafts demonstrated bladder tissue with mature urothelium and stromal differentiation. Control tissues were void of bladder tissue formation. We have successfully demonstrated that a chimeric bladder is formed from primary cultured bladder urothelium recombined with embryonic bladder mesenchyme. This is a powerful new tool for investigating the molecular mechanisms of bladder development and disease. Future applications may include the in vitro genetic manipulation of urothelium and examining those effects on growth and development in an in vivo environment.
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ABSTRACT: Testosterone administered preoperatively in hypospadiac children increases phallic size and improves skin vascularity. We histologically evaluated the role of postoperative testosterone in tissue remodeling in an animal model. Hypospadias was created in 18 rabbits and repaired with a preputial onlay graft. Animals were randomized to receive either one intramuscular (i.m.) dose of testosterone postoperatively (n=6), or 2 weeks of daily 1% topical testosterone (n=6). Control animals underwent the urethral operation, but received no testosterone (n=6). Penises were harvested at 2 and 5 weeks, and blindly assessed for collagen formation, re-epithelialization and fibrosis, and complications. Of the animals sacrificed at 2 weeks, those that received testosterone had a greater incidence of cuboidal epithelium (83%) versus controls (33%). In the 2-week group, animals receiving testosterone had increased fibrosis, periurethral and soft-tissue inflammation compared to controls. By 5 weeks, all differences in fibrosis and inflammation had resolved. No animal developed fistula or diverticulum. Of animals sacrificed at 2 weeks, 67% stained for BrdU, a DNA proliferative marker. At 5 weeks, no non-testosterone rabbit demonstrated positive staining, while 83% of those receiving testosterone were positive. There were no differences between animals that received topical and i.m. testosterone. Administration of testosterone following hypospadias repair in rabbits changes the histologic composition of the urothelium and leads to an exaggerated inflammatory response in the supportive stroma. Such treatment may prove a useful adjunct in patients undergoing complex genital reconstruction.
Chapter: Bladder and Cloacal Exstrophy
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ABSTRACT: Hydrocele is a known complication of varicocelectomy. We evaluated the incidence of hydrocele following laparoscopic varicocelectomy at our institution. A total of 89 boys were treated with laparoscopic ligation of the spermatic vessels for clinically palpable varicoceles between January 2000 and December 2003. Charts were retrospectively reviewed. A total of 10 patients were excluded because they were lost to followup or presented with recurrent varicocele. Followup consisted of office visits with physical examinations at 1 and 12 months postoperatively. Patient charts were reviewed for perioperative variables, operative technique and complications. Only 1 of 79 patients (1.3%) had persistent varicocele with a mean of 20.7 months of followup. A total of 18 patients (22.8%) had development of hydrocele postoperatively, of whom 9 required hydrocelectomy. In addition, 2 of these 9 patients needed repeat hydrocelectomy. Of the 57 patients with greater than 6 months of followup 29.8% had development of hydrocele. A higher rate of hydrocele formation (31.1%) was also noted in patients who underwent ligation and division of the spermatic vessels rather than ligation alone (11.8%, p = 0.04). Our series demonstrates a high rate of hydrocele formation following laparoscopic varicocelectomy, particularly in patients with longer followup. The incidence of hydrocele after laparoscopic varicocelectomy may be underreported. However, there appears to be a statistically significant decrease in hydroceles when the internal spermatic vessels are simply ligated rather than ligated and divided. Despite its ease and low failure rate, the standard technique of laparoscopic varicocelectomy requires reexamination, potentially allowing modifications that may decrease hydrocele formation, such as salvaging lymphatics and avoiding division of the vessels.
Top Journals
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, United States
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Children's Mercy HospitalKansas City, Missouri, United States
Vanderbilt University
Nashville, Michigan, United States
- • Division of Urologic Surgery
- • Department of Pediatrics
- • Division of Pediatric Cardiology
Gateway-Vanderbilt Cancer Treatment CenterClarksville, Tennessee, United States
East Tennessee Children's HospitalKnoxville, Tennessee, United States


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13 weeks and i think i feel the baby
I'm 13 weeks and 5 days with my second child and the past 2 weeks i have been feeling something in my stomach. I was wondering am i feeling the baby. Its been 4 years since my last child so i forget how it is to feel if its the baby moving or not.
Posted: 11/06/2007 by Nermal81
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I am 13 weeks and the doctor was getting frustrated because she was trying to check the baby and the baby kept moving like crazy..The doctor said " I'll wait till the baby wants to settle down," I couldnt believe that at 13 weeks my baby was moving that much. the baby was tossing and turning! This is my first baby and to see that is beautiful!posted 09/03/2010 by CarmenAlexxis
i am 13 weeks and 3 days and i started feeling movement about a week and a half ago and it is more then just flutters they get stronger every day. no person or dr can tell you when you will feel your baby use your mommy instinct, i know i can tell the difference between gas and a kick.posted 07/20/2010 by nat_the#1mom
Im in my 12th or 13th week, but I am also 15 lbs underweight. I have been feeling the baby move for a while now. Being so thin and this being my 4th child, I know what i'm feeling.posted 07/12/2010 by a BabyCenter Member
im 12 weeks im feeling movement is it true and how many week due i need to be to no the sexposted 06/29/2010 by hershymint35
im 11 weeks and 2 days and im sure i felt it too this is number 4 for me hope to feel alot more in the near furture lol congrates to everyone on hereposted 05/28/2010 by a BabyCenter Member
hi.I am 13 weeks and i feel flutering alot in my stomach also. I think it is the baby moving but I wish you the best in your pregnancyposted 05/19/2010 by zachmeece17
i am 13 weeks and 4 days i am pretty sure i felt baby! SO EXCITED!!! this is my first so thank you to all the moms who answered this ? .... :)posted 05/10/2010 by amanda_blackwell1
Wow, I was exactly on the same boat as you are now. I had my first child 4 years ago and I am now 20 weeks pregnant with my second one. I am telling you, I felt this baby move at around 12 weeks...and I'm not talking about bubbles, I'm talking about little pokes. I would feel them about once a week or so. So I believe it! Congrats and enjoy!posted 02/22/2010 by rmrojo02
definitely with you ladies, felt fluttering this past week at 13+ weeks. this is my second child, four years apart, but with the second there is a definite noticeable difference between our own body functions and fluttering. Plus this movements are right under my navel, where no intestines/organs are while pregnant. So i think its great we can feel flutters earlier once we know what it feels like.posted 01/14/2010 by a BabyCenter Member
I am 14 weeks pregnant with my second child and I have felt him moving for the past couple of weeks. I've experienced gas and I know the difference. The baby's tiny movements feel like someone is rubbing the inside of your abdomen while poking it at the same time. It's an awesome feeling. I had an u/s done yesterday and it looked like the baby is a boy :-) That, too, I wasn't expecting. I couldn't beleive I was able to predict the sex of the baby so early in the pregnancy! Anywho, congrats on your pregnancy and go with your gut! When you feel something, you'll know :-)posted 01/13/2010 by rmrojo02
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