text:
Are you Stephen Livingston?Claim your profile
Publications (23)135.96 Total impact
Article: Autoimmune hepatitis in the Alaska Native population: Autoantibody profile and HLA associations[Show abstract] [Hide abstract]
ABSTRACT: Background & AimsThe Alaska Native population is one of few populations in the world with a high prevalence of autoimmune hepatitis. The objective of this study was to determine the frequency and HLA and clinical associations of autoantibodies in Alaska Native people with autoimmune hepatitis. Methods Alaska Native individuals with autoimmune hepatitis were recruited in clinics conducted statewide. Sera were tested for the presence of autoantibodies described in either autoimmune hepatitis or rheumatic disease. Associations between autoantibodies and HLA alleles and clinical features were assessed. ResultsSeventy-one patients were included. At the study visit, 34 patients (47.9%) had antibodies to double-stranded DNA by immunofluorescence; 27 (38.0%) had anti-neutrophil cytoplasmic antibodies; and 11 (15.5%) had anti-Ro antibodies. Only one person had antibodies against soluble liver antigen, and in that person, anti-Ro was absent. Associations were found between autoantibodies and HLA alleles, including positive associations between HLA DR3 and anti-double-stranded DNA antibodies and between HLA DR14 and antineutrophil cytoplasmic antibodies. There was no association between autoantibodies and clinical outcomes. Conclusions As in other populations, the prevalence of anti-double-stranded DNA antibodies and antineutrophil cytoplasmic antibodies is high in Alaska Native people with autoimmune hepatitis. In contrast to data from other populations, there is a lower prevalence of anti-soluble liver antigen and a lack of association between anti-Ro and anti-soluble liver antigen. In addition, the HLA profile and associations with autoantibodies are unique. No clear prognostic implications of autoantibodies have emerged in this population.
Article: Relationship Between Level of HBV DNA and Liver Disease - a Population-Based Study of Hepatitits B e Antigen-Negative Persons with Hepatitis B.[Show abstract] [Hide abstract]
ABSTRACT: There is little information on the proportion of persons with chronic hepatitis B virus (HBV) infection with active hepatitis. We aimed to determine the proportion of persons with hepatitis B e antigen-negative chronic HBV infection who develop immune active HBV infection over time, and the relationship between demographic and viral factors on severity of disease on liver biopsy. We performed a longitudinal population-based cohort study of 754 Alaska Native patients with chronic HBV infection. Levels of alanine aminotransferase (ALT) were measured every 6 months and levels of HBV DNA were measured at study entry and whenever ALT levels exceeded the upper limit of normal (ULN). Immune-active chronic HBV infection was defined as levels of ALT ≥30 U/L in men and >20 U/L in women and levels of HBV DNA>2,000 IU/ml at 1 or more time point, from 2001 through 2008. Liver biopsies were scored using the modified histology activity index score of Knodell and the Ishak fibrosis score. Of the study participants, 186 (25%) met the criteria for immune active HBV: 56% of these initially and 44% later, during follow up. Of the 38 patients with liver biopsy results, only 1/16 with ALT levels consistently below twice the ULN and 1/19 with HBV DNA between 2000 and 20,000 IU/ml, vs. 12/22 (55%) with ALT > twice ULN (P=.002) and 11/18 (61%) with 1 or more measurements of HBV DNA > 20,000 IU/ml (P<.001), had moderate or severe hepatitis or fibrosis. In a cohort of Alaska Natives with chronic HBV infection, 25% met criteria for immune active HBV. There is a low probability of advanced fibrosis if levels of HBV DNA never exceed 20,000 IU/ml.
Article: Clinical management of chronic hepatitis B infection in Alaska Native People: outcome and effectiveness of surveillance for early detection of hepatocellular carcinoma and antiviral therapy to prevent cirrhosis
Article: Treatment eligibility in Alaska Native and American Indian persons with hepatitis C virus infection[Show abstract] [Hide abstract]
ABSTRACT: Treatment with pegylated interferon and ribavirin may prevent progression of liver disease among patients with chronic hepatitis C virus infection (HCV). Treatment initiation is based on published clinical eligibility criteria, patients' willingness to undergo treatment and likelihood of success. We examined treatment eligibility in a cohort of Alaska Native and American Indian persons with chronic HCV infection. Retrospective cohort study. Medical records of all treatment naïve HCV RNA positive patients given an appointment by hepatology specialty clinic staff in 2003 and 2007 were evaluated by a hepatology provider to investigate documented reasons for treatment deferral. Treatment was initiated in 4 of 94 patients (4%) in 2003 and 14 of 146 patients (10%) in 2007. Major reasons for treatment deferral in 2003 versus 2007 included inconsistent appointment attendance (36% of deferrals vs. 18%), active substance abuse (17% vs. 22%), patient decision (17% vs. 27%), liver biopsy without fibrosis or normal ALT (8% vs. 3%), uncontrolled psychiatric condition (7% vs. 7%) and concurrent medical condition (6% vs. 9%). There was significant improvement in proportion of appointments attended in 2007 versus 2003 (76% vs. 67%, p = 0.04) and the percentage of patients attending at least 1 appointment (84% vs. 66%, p = 0.002). Multiple reasons for treatment deferral were documented. Despite a significant improvement in hepatology clinic attendance and an increase in the number of patients started on treatment in 2007 compared to 2003, the overall percentage of those treated remained low.
Article: Genetic and functional heterogeneity of the hepatitis C virus p7 ion channel during natural chronic infection[Show abstract] [Hide abstract]
ABSTRACT: The present study describes natural genetic heterogeneity of hepatitis C virus (HCV) p7 protein, the ion channel that plays a critical role in assembly and release of HCV, within 299 variants isolated from serum specimens of 27 chronically infected patients, 12 of whom with human immunodeficiency virus (HIV) co-infection. Liver fibrosis stage was inversely correlated with p7 synonymous substitutions (dS) (p=0.033), and indices of p7 genetic diversity were significantly higher in HIV-negative subjects compared to HIV-positive subjects (dS, p=0.005; non-synonymous substitutions (dN), p=0.002; dN/dS ratio, p=0.024; amino acid distances, p=0.007). Six p7 genes with naturally occurring unique amino acid variations were selected for in vitro study. The variants demonstrated diversified functional heterogeneity in vitro, with one variant from a subject with severe liver disease displaying hyperactive ion channel function, as well as other variants presenting altered pH-activated channel gating activities.
Article: Update on Diagnosis and Treatment within the Four Clinical Phases of Chronic Hepatitis B Infection[Show abstract] [Hide abstract]
ABSTRACT: Four phases of chronic hepatitis B virus [1] infection have been identified: immune tolerant, immune active, inactive, and hepatitis B surface antigen (HBsAg) clearance. These phases are defined by using a combination of hepatitis B "e" antigen (HBeAg) status, alanine aminotransferase (ALT) level, and HBV DNA level. To determine the extent of liver inflammation and fibrosis needed to decide whether antiviral therapy is necessary often requires a liver biopsy. Recent studies have found that levels of HBsAg can also be used to determine the phase of HBV and can even predict persons who may remain in the inactive phase over time. Non invasive markers including transient elastography can detect a proportion of those with a high probability of severe fibrosis and mild disease but are not yet helpful to determine the status of most chronically infected persons.
Article: Genetic Diversity of Near Genome-Wide Hepatitis C Virus Sequences during Chronic Infection: Evidence for Protein Structural Conservation Over Time[Show abstract] [Hide abstract]
ABSTRACT: Infection with hepatitis C virus (HCV) is one of the leading causes of chronic hepatitis, liver cirrhosis and end-stage liver disease worldwide. The genetics of HCV infection in humans and the disease course of chronic hepatitis C are both remarkably variable. Although the response to interferon treatment is largely dependent on HCV genotypes, whether or not a relationship exists between HCV genome variability and clinical course of hepatitis C disease still remains unknown. To more thoroughly understand HCV genome evolution over time in association with disease course, near genome-wide HCV genomes present in 9 chronically infected participants over 83 total study years were sequenced. Overall, within HCV genomes, the number of synonymous substitutions per synonymous site (d(S)) significantly exceeded the number of non-synonymous substitutions per site (d(N)). Although both d(S) and d(N) significantly increased with duration of chronic infection, there was a highly significant decrease in d(N)/d(S) ratio in HCV genomes over time. These results indicate that purifying selection acted to conserve viral protein structure despite persistence of high level of nucleotide mutagenesis inherent to HCV replication. Based on liver biopsy fibrosis scores, HCV genomes from participants with advanced fibrosis had significantly greater d(S) values and lower d(N)/d(S) ratios compared to participants with mild liver disease. Over time, viral genomes from participants with mild disease had significantly greater annual changes in d(N), along with higher d(N)/d(S) ratios, compared to participants with advanced fibrosis. Yearly amino acid variations in the HCV p7, NS2, NS3 and NS5B genes were all significantly lower in participants with severe versus mild disease, suggesting possible pathogenic importance of protein structural conservation for these viral gene products.
Article: Azathioprine metabolite measurements are not useful in following treatment of autoimmune hepatitis in Alaska Native and other non-Caucasian people.[Show abstract] [Hide abstract]
ABSTRACT: In autoimmune hepatitis (AIH) patients treated with azathioprine, the utility of measuring thiopurine methyltransferase (TPMT) and azathioprine metabolites has been limited. To evaluate the association between TPMT genotype and enzyme activity, and the impact of TPMT enzyme activity on levels of azathioprine metabolites and leukopenia to assess the clinical utility of monitoring azathioprine metabolites in Alaska Native and other non-Caucasian AIH patients. Individuals with AIH were recruited at the Alaska Native Medical Center (Alaska, USA) and the University of Texas Southwestern Medical Center (Texas, USA). Identification of TPMT genotype and measurement of enzyme activity were performed. The metabolites 6-thioguanine nucleotides (6-TGN) and 6-methylmercaptopurine (6-MMP) were measured in participants who were on azathioprine, and the associations with disease remission and leukopenia were assessed. Seventy-one patients with AIH were included. The distribution of TPMT genotypes was similar to that reported in other populationbased studies. TPMT genotype and phenotype were strongly associated (P<0.0001). Levels of 6-TGN and 6-MMP correlated with azathioprine dose only in individuals with normal TPMT enzyme activity. Patients with leukopenia due to azathioprine were no more likely to have abnormal TPMT enzyme levels than those without leukopenia (P=1.0). No specific level of 6-TGN metabolites was associated with remission or leukopenia. Results of the present study were consistent with previous studies in Caucasian populations. TPMT genotype and phenotype correlated well, and levels of 6-TGN and 6-MMP metabolites were not associated with remission of AIH or toxicity of azathioprine. The present study confirmed the limited utility of monitoring levels of azathioprine metabolites in AIH patients.
Article: Factors associated with the progression of fibrosis on liver biopsy in Alaska Native and American Indian persons with chronic hepatitis C[Show abstract] [Hide abstract]
ABSTRACT: Various factors influence the development and rate of fibrosis progression in chronic hepatitis C virus (HCV) infection. To examine factors associated with fibrosis in a longterm outcomes study of Alaska Native/American Indian persons who underwent liver biopsy, and to examine the rate of fibrosis progression in persons with subsequent biopsies. A cross-sectional analysis of the demographic, inflammatory and viral characteristics of persons undergoing liver biopsy compared individuals with early (Ishak fibrosis score of lower than 3) with those with advanced (Ishak score of 3 or greater) fibrosis. Persons who underwent two or more biopsies were analyzed for factors associated with fibrosis progression. Of 253 HCV RNA-positive persons who underwent at least one liver biopsy, 76 (30%) had advanced fibrosis. On multivariate analysis, a Knodell histological activity index score of 10 to 14 and an alpha-fetoprotein level of 8 ng/mL or higher were found to be independent predictors of advanced liver fibrosis (P<0.0001 for each). When surrogate markers of liver inflammation (alanine aminotransferase, aspartate aminotransferase/alanine aminotransferase ratio and alpha-fetoprotein) were removed from the model, type 2 diabetes mellitus (P=0.001), steatosis (P=0.03) and duration of HCV infection by 10-year intervals (P=0.02) were associated with advanced fibrosis. Among 52 persons who underwent two or more biopsies a mean of 6.2 years apart, the mean Ishak fibrosis score increased between biopsies (P=0.002), with progression associated with older age at initial biopsy and HCV risk factors. The presence of type 2 diabetes mellitus, steatosis and duration of HCV infection were independent predictors of advanced fibrosis in the present cohort, with significant fibrosis progression demonstrated in persons who underwent serial biopsies.
Article: Clearance of Hepatitis B Surface Antigen and Risk of Hepatocellular Carcinoma in a Cohort Chronically Infected with Hepatitis B Virus[Show abstract] [Hide abstract]
ABSTRACT: Some individuals who are chronically infected with hepatitis B virus (HBV) eventually lose hepatitis B surface antigen (HBsAg). Hepatocellular carcinoma (HCC) has been demonstrated to occur in a few patients after loss of HBsAg. Neither factors associated with loss of HBsAg nor the incidence of HCC thereafter have been clearly elucidated. We performed a prospective population-based cohort study in 1,271 Alaska Native persons with chronic HBV infection followed for an average of 19.6 years to determine factors associated with loss of HBsAg and risk of developing HCC thereafter. HBsAg loss occurred in 158 persons for a rate of HBsAg clearance of 0.7%/year. Older age, but not sex, was associated with clearance of HBsAg, and loss of HBsAg was not associated with any particular HBV genotypes (A, B, C, D, and F) found in this population. Participants were followed for an average of 108.9 months after HBsAg loss. Six patients, two with cirrhosis and four without, developed HCC a mean of 7.3 years after HBsAg clearance (range, 2.0-15.5 years). The incidence of HCC after clearance of HBsAg was 36.8 per 100,000 per year (95% CI 13.5-80.0) which was significantly lower than the rate in those who remained HBsAg-positive (195.7 cases per 100,000 person-years of follow-up [95% CI 141.1-264.5; P < 0.001]). After loss of HBsAg, HBV DNA was detected in the sera of 28 (18%) of those who cleared a median of 3.6 years after clearance. CONCLUSION: HCC can occur in persons with chronic hepatitis B who have lost HBsAg, even in the absence of cirrhosis. These persons should still be followed with periodic liver ultrasound to detect HCC early.
Article: Adverse Outcomes in Alaska Natives Who Recovered From or Have Chronic Hepatitis C Infection[Show abstract] [Hide abstract]
ABSTRACT: The factors associated with adverse outcome from hepatitis C virus (HCV) infection are incompletely understood. To determine the incidence and risk factors associated with the development of end-stage liver disease (ESLD) and liver-related death (LRD), we conducted a retrospective/prospective population-based study in a cohort of Alaska Native persons chronically infected with HCV from 1994 to 2005. We followed 960 persons prospectively for an average of 7.2 years and retrospectively for 12.1 years with data from medical records and serum samples. We compared data from subjects that were chronically infected with those who recovered from HCV infection, stratified by alcohol use. Survival models were used to examine factors associated with ESLD and LRD in chronically infected patients. During prospective follow-up, 80 (8.8%) and 47 (5.2%) patients developed ESLD and LRD, respectively. In examining incidence per 100 person-years, no difference was found among heavy alcohol users in the incidence of LRD (2.28 versus 3.50; P = .34) or ESLD (3.21 versus 5.69; P = .13) in persons with chronic HCV compared with those recovered from HCV infection. In subjects that consumed <50 g alcohol/d, the incidences of LRD were 0.77 and 0.09 (P = .01) and of ESLD were 1.58 versus 0.36 (P = .002), respectively, in subjects with chronic infection versus those that recovered. Multivariate analysis showed that older age, heavy alcohol use, and HCV genotype 3 were associated with ESLD. A history of heavy alcohol use is associated with the highest incidence of LRD and ESLD, regardless of whether patients are chronically infected or recover from HCV infection.
Article: Negative Immune Regulator Tim-3 Is Overexpressed on T Cells in Hepatitis C Virus Infection and Its Blockade Rescues Dysfunctional CD4+ and CD8+ T Cells[Show abstract] [Hide abstract]
ABSTRACT: A number of emerging molecules and pathways have been implicated in mediating the T-cell exhaustion characteristic of chronic viral infection. Not all dysfunctional T cells express PD-1, nor are they all rescued by blockade of the PD-1/PD-1 ligand pathway. In this study, we characterize the expression of T-cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) in chronic hepatitis C infection. For the first time, we found that Tim-3 expression is increased on CD4+ and CD8+ T cells in chronic hepatitis C virus (HCV) infection. The proportion of dually PD-1/Tim-3-expressing cells is greatest in liver-resident T cells, significantly more so in HCV-specific than in cytomegalovirus-specific cytotoxic T lymphocytes. Tim-3 expression correlates with a dysfunctional and senescent phenotype (CD127low CD57high), a central rather than effector memory profile (CD45RAnegative CCR7high), and reduced Th1/Tc1 cytokine production. We also demonstrate the ability to enhance T-cell proliferation and gamma interferon production in response to HCV-specific antigens by blocking the Tim-3-Tim-3 ligand interaction. These findings have implications for the development of novel immunotherapeutic approaches to this common viral infection.
- [Show abstract] [Hide abstract]
ABSTRACT: A higher proportion of deaths among American-Indian/Alaska-Native (AI/AN) people has been attributed to chronic liver disease (CLD) compared with other racial/ethnic groups in the United States. The objectives of this study were to determine CLD prevalence and to define its etiologies and complications among AN and AI people, who received health care from an urban hospital center. We conducted a retrospective, cross-sectional study of AN and AI people > or =18 years old who had at least one patient encounter at the Alaska Native Medical Center during January 2003-December 2004. A total of 1,886 (7.2%) of 26,166 AI/AN people met criteria for having CLD. The most commonly identified etiologies were alcohol-related liver disease (42%), nonalcoholic fatty liver disease (31%), chronic hepatitis C virus infection (26%), and chronic hepatitis B virus infection (8%). Compared with women, men had a higher overall prevalence of CLD (81.9 vs. 64.7 per 1,000), but were less likely to die from a CLD-related cause (1.5 vs. 2.7 per 1,000). These differences in the CLD deaths were mostly attributed to alcohol-related liver disease. This is the first known population-based study to examine the burden and etiology of CLD among AN people. Causes of CLD were similar among AI/AN people as those reported among other racial/ethnic groups in the United States. Identifying specific etiologies of CLD among populations can help target appropriate prevention and treatment strategies as they are specific to the causes of CLD.
Article: T1021 Liver Biopsy Results and Risk Factors for Advanced Liver Disease in a Large Population-Based Cohort of HCV Carriers Undergoing Liver Biopsy
Article: Clinical significance of elevated alpha-fetoprotein in Alaska Native patients with chronic hepatitis C[Show abstract] [Hide abstract]
ABSTRACT: The clinical significance of elevated serum alpha-fetoprotein (AFP) in patients with chronic hepatitis C virus (HCV) infection is not well defined. We analysed data from a population-based cohort of patients with HCV infection to assess the prevalence of elevated serum AFP, to determine its association with clinical and virologic parameters and with clinical outcomes. We defined a slightly elevated serum AFP level as 8 to <15 and a high-AFP level as > or =15 microg/L. Among 541 HCV-RNA-positive persons, 61 (11%) had a slightly elevated or high AFP at the time of consent. AFP > or =8 microg/L was associated with the older age, aspartate aminotransferase/alanine aminotransferase ratio >1, and higher alkaline phosphatase levels, but not with heavy alcohol use, IV drug use, genotype, viral load or duration of HCV infection. Among 192 persons with an AFP at liver biopsy, 17% had an AFP > or =8 microg/L. The sensitivity/specificity of an AFP level > or =8 in detecting Ishak 3-6 fibrosis was 39%/95%. Among 372 persons with a minimum of four AFP measurements over 6 years, 5% had persistently elevated AFP >8 microg/L, 19% had both elevated and normal AFP measurements, and 76% had persistently normal AFP. Elevated AFP at consent was associated with hepatocellular carcinoma (HCC) and end-stage liver disease. Over 6 years of follow-up, persistently elevated AFP was associated with the development of HCC; no person with AFP persistently <8 microg/mL developed HCC. Serial AFP measurements appear to be useful in identifying persons with advanced fibrosis and help to determine who needs periodic screening with liver ultrasound to detect HCC.
Article: Clearance of Hepatitis B e Antigen in Patients With Chronic Hepatitis B and Genotypes A, B, C, D, and F[Show abstract] [Hide abstract]
ABSTRACT: Persistence of hepatitis B e antigen (HBeAg) in chronic hepatitis B has been associated with increased risk for development of cirrhosis and hepatocellular carcinoma. Five hepatitis B virus genotypes were identified in Alaska Native persons; we analyzed clearance of HBeAg by age and genotype. In this prospective cohort study, 1158 Alaska Native persons throughout Alaska were tested serially for HBeAg for a median of 20.5 years and were genotyped. Initial and final HBeAg-positive specimens, time to clearance, age at clearance, and subsequent HBeAg results were analyzed for persons initially HBeAg-positive. Subsequent HBeAg results were analyzed for persons initially negative. Genotypes A, B, C, D, and F were identified. Genotype C persons initially HBeAg-positive were more likely than those with other genotypes to be positive on initial and final specimens (P < .001 for each) and time to HBeAg clearance was longer (P < .001). Age at which 50% of persons cleared HBeAg was <20 years for those infected with genotypes A, B, D, and F and 47.8 years in genotype C (P < .001). After losing HBeAg, those with genotypes C and F were more likely to revert to the HBeAg-positive state (P < .001). Genotype may have a strong effect on mode of transmission and outcome. Genotype C may have been responsible for most perinatal transmission, given that seroconversion from HBeAg occurs decades later than in other genotypes.
Article: Hepatitis B-associated vasculitis in Alaska Natives: Viral genotype, clinical and serologic outcome[Show abstract] [Hide abstract]
ABSTRACT: The highest incidence of hepatitis B virus (HBV)-associated vasculitis in the world has been reported in Alaska Natives. We examined the incidence of HBV-associated vasculitis before and after mass HBV vaccine immunization and the association between HBV genotype and vasculitis in a population-based cohort study in Alaska natives chronically infected with HBV. Genotyping was performed in vasculitis cases and 644 hepatitis B-positive controls without vasculitis using polymerase chain reaction and sequencing of the S gene. Occurrence of HBV vasculitis from 1974 to 2004 was calculated. HBV vasculitis patients and controls were also tested for basal core promoter and precore mutations. Fifteen cases of HBV-associated vasculitis were identified: 13 (86%) had genotype D and one each genotype A and F. Genotype D was more commonly found in patients with vasculitis than controls [odd ratio (OR)=5.9, confidence interval (95% CI) 1.2, 21.8; P<0.015). HBV-associated vasculitis was associated with genotype D.
Article: Hepatitis B Virus Genotypes in Alaska Native People with Hepatocellular Carcinoma: Preponderance of Genotype F[Show abstract] [Hide abstract]
ABSTRACT: The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection has been associated with specific HBV genotypes and the presence of specific mutations. From a cohort of Alaska Native people with chronic HBV infection, we genotyped 47 patients with HCC and 1129 patients without HCC, and we tested patients with HCC and control patients for mutations in the basal core promoter and precore regions. Genotype F was found in 68% of patients with HCC, versus 18% of those without HCC (P<.001). For patients with genotype F, the median age at diagnosis of HCC was lower than that for patients with other genotypes (22.5 vs. 60 years, respectively; P=.002). Overall, there were no significant differences in the number of basal core promoter and precore region mutations between patients with HCC and control patients. We found a significant association between genotype F and the development of HCC among Alaska Native people with chronic HBV infection but no significant association between HCC and basal core promoter or precore mutations in genotype F.
Article: Diagnostic accuracy of a fibrosis serum panel (FIBROSpect II) compared with Knodell and Ishak liver biopsy scores in chronic hepatitis C patients[Show abstract] [Hide abstract]
ABSTRACT: Liver biopsy is the primary method of assessing liver injury in hepatitis C patients. FIBROSpect II (FS), a diagnostic panel of three extracellular matrix remodelling markers, may be useful as a noninvasive alternative to this procedure. The purpose of this study was to correlate FS results with liver fibrosis scores to determine if this test is sufficiently accurate to be a viable alternative to liver biopsy. A total of 142 serum specimens were evaluated for fibrosis with FS and were compared with Knodell and Ishak fibrosis scores. FS reports an index score ranging from 0.1 to 1.0, which corresponds to the probability of progressive liver fibrosis. Using a FS index cut-off of 0.42, 50 of 54 patients with Ishak 3-6 were classified as having advanced fibrosis (METAVIR F2-F4) and 58 of 88 patients with Ishak 0-2 as having no/mild fibrosis (METAVIR F0-F1), resulting in a sensitivity of 93%, specificity of 66%, and an overall test accuracy of 76%. With a 38% prevalence of advanced fibrosis, the negative predictive value was 94% and positive predictive value was 63%. A biopsy length of > or = 2 cm was associated with higher concordance between FS results and liver fibrosis scores (P = 0.01). FS was clinically useful in ruling out advanced fibrosis in hepatitis C by identifying patients with mild disease in whom treatment could be deferred. The limitation of this test is its decreased sensitivity and specificity in the middle of the test's reporting range between scores of 0.42 and 0.80.
Top Journals
Alaska Native Tribal Health ConsortiumAnchorage, Alaska, United States
University of Washington SeattleSeattle, Washington, United States
Alaska Native Medical CenterAnchorage, Alaska, United States


text:
Home Theatre Tickets Comedy Ed Byrne
Ed Byrne Tickets
Find the Ed Byrne tickets you're looking for on NME ticket exchange, the world's largest ticket marketplace. Select an event to view the range of tickets available or view the Ed Byrne tour on a map to find an event near you. You can also sell your spare Ed Byrne tickets on NME ticket exchange, and listing tickets is free. All Ed Byrne tickets are covered by the NME ticket exchange Ticket guarantee!
More Results
0 remaining
Can't find the event you're looking for? Tell us about it!

subset: commoncrawl


text: Casey Talks About 'New Girl' By A Couple Of N3rds I decided to set aside some time to talk about a show I really do not like.... more »I decided to set aside some time to talk about a show I really do not like. Admittedly, I was pretty hungover when I did this, so it's not very good. We basically threw a bunch of sound effects in it to try to pretend it's interesting. Sorry everybody! « less Published April 19, 2012 64 views More Info » Full Credits A Couple Of N3rds Uploader Stats & Data 2 Funny Votes 2 Die Votes 64 Views Published: April 19, 2012 Categories: Clean Comedy Rants Keywords: New Girl TV Series Casey Grim Casey Grim Adam McLaughlin Adam McLaughlin ACoupleOfN3rds Zooey Deschanel Comedy Stand Up Sketch Funny Cute Awkward Nerd Humour hipster Up Next: Cosmo Talk - Episode 1 AUTOPLAY Up Next In: 10 Cosmo Talk - Episode 1 A Nerd Romance: Casey and Adam's Anniversary Adam McLaughlin's Anti Puppet Spray Couples Talk - Farting Follow Facebook Twitter Tumblr Instagram Browse Related Comments 20+ more View All ▶ A Couple Of N3rds Vaguely Related Videos Vaguely Related Pics & Words Advertisement Advertisement


text:
- PRECIOU5 is a: Woman looking for a Woman
- STATS Height: 5'04"
- Weight: 120 lbs
- Age: 32 years old.
- Birthday: December 8
- LOCATION All of Virginia USA
- Last time online More than 3 months
Other places to find me:
PRECIOU5 has no current links.
My Passions Network Sites:
No gifts yet
Information Listing
Lets have hot & steamy safe fun;)
About Me (My Interests / Hobbies / Descriptions)
- Hobbies & Interests
- naturism, reading, computers, travel, nudism, shopping, dancing, video games, photography, sports, movies, wine tasting, target practice, music, writing, pole dancing, television
- Body Type
- slim, skinny, supermodel, slender
- Movies
- comedy, sci-fi, horror, romance, action, romantic comedy
- Orientation
- bisexual, lesbian
- Eye Color
- brown
- Hair Color
- black
- Ethnicity
- African American
- Have Kids
- no - maybe with the right person
- Education Level
- high school grad
- Income level
- that's private
- Do you smoke?
- cigarettes
- Do you drink?
- socially, wine
- I currently live
- with roommate(s)
- Socially, I am
- social butterfly, shy at first, but warm up quickly
- Political Views
- conservative
- Food Related
- Vegetarian, Fine Dining, Lactose Intolerant (am I sharing too much?), Soul Food, Sushi
- Personality
- conservative, dominatrix, lover
- Individuality
- tattoos
- Religious Views
- Christian, Not Religious, but Spiritual
- Drugs
- never
- I'm looking for
- travel companion, friends - with benefits, miss right now, something REALLY hot
- My Sign
- sagittarius : nov. 22-dec. 21
- Pets
- Dog
- Gender
- Female
- Music
- Hard Rock, Jazz, Techno, Hardcore, Motown, Alternative Rock, Heavy Metal, Opera, Bluegrass, Hip Hop, R and B, Classical, Rock
- Hair Style
- straight, straightened, long hair
- Fitness & Sports
- wrestling, aerobics, volleyball, jogging, walking, martial arts, working out, pole dancing, tennis
- Health Related
- chiropractic
- Groups:
- none
About My Match (What I'm looking for)
No preferences defined yet!
Favorite videos
PRECIOU5's Profile Link:
Current Favorite Websites for PRECIOU5*
No Favorite Websites added yet.
Favorites / Friends for PRECIOU5
No Favorites / Friends Added Yet
Last forum posts of PRECIOU5 on Writers Passions
No forum posts yet
Current Favorite Books for PRECIOU5
No Favorite Books added yet.
Visit the Writers Passions Book Library
Current Favorite Video Games for PRECIOU5
No Favorite video games added yet.
Visit the Writers Passions video game Library
Writers Passions: Report This Profile
Help us keep Writers Passions free of spam and fake profiles.
If you see spam, fake information, nonsense information, offensive information or an empty profile, please click the button below and enter your reason for reporting this profile. It will be reviewed promptly.
Note: Reporting Tool Only Visible To Logged In Members
If you see spam, fake information, nonsense information, offensive information or an empty profile, please click the button below and enter your reason for reporting this profile. It will be reviewed promptly.
Note: Reporting Tool Only Visible To Logged In Members
Recommended Writing Sites
Make Money Writing Online
Writing Information
Publish Online
Online Dating Sites
Webcam Sites
Personals / Chat Sites
FIND Other Singles In
Meet In The Real World


text:
• DEADSPIN tries to muscle in on Lleyton Hewitt's hardbody sister.
Just don't try that posing at the Gold's Gym in Provo.
• AZ SPORTS HUB gets the good word from Anquan Boldin, who's nice enough to record a personal voice mail.
• 100% INJURY RATE needs to cool down, as they get funky with this fat Flyers fan.
• In honor of Martin Luther King Jr., THE WORLD OF ISAAC offers up these memorable sports speeches.
• DAWG SPORTS barks up what the pigskin coaches had to say at the latest NCAA convention.
• BRUINS NATION thanks Vince Young for getting Norm Chow to Westwood.
• INSIDE USC hears that Petros Papadakis was booed right out of the Trojans' new arena after insulting a fan.
• PITTSBURGH SPORTS & MINI PONIES compares the Patriots' on-field dominance with Peyton Manning's gift of advertising prowess.
• Speaking of Eli's brother, we bet he hoped this commercial wouldn't be airing for another few weeks.
• Speaking of Eli himself, GUEST OF A GUEST wonders why does the Giant QB look like he's always out of it?
• GIRLS GONE SPORTS may have the answer.
• I'M WRITING SPORTS can't wait until April, as they break down the Red Sox vs. Tigers for AL supremacy.


text:
Are you Noriko Izumi?Claim your profile
Publications (5)11.06 Total impact
Article: Features of Japanese patients with myelodysplastic syndrome in an aging population of Sado Island[Show abstract] [Hide abstract]
ABSTRACT: Myelodysplastic syndrome (MDS) is relatively common in the elderly, and aging of populations is progressing in developed nations, notably so in Japan. The major age group in Japan and Sado Island are distributed between 30 and 60 and between 50 and 80, respectively. The aim of this study was to analyze the features of MDS in the population of Sado Island to anticipate the characteristics of the disease in the near future. One-hundred and fifty-three patients (71 male, 82 female, 19-94 years old, median 73 years old) with de novo MDS between 1985 and 2005 were retrospectively evaluated. All patients were reclassified according to WHO-2001 criteria. The predictive power of the international prognostic scoring system and the WHO classification-based prognostic scoring system were evaluated. The major causes of death were leukemic transformation (38%) in refractory anemia with an excess of blasts and infection (48%) for total MDS. Age was another independent prognostic factor. Elderly patients exhibited a significantly poorer prognosis mainly due to infections such as pneumonia. Although novel remedies for MDS and hyperferremia have recently been developed, prevention of infection remains important in MDS, particularly for older patients.
Article: Risk factors for acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: Retrospective analysis of 73 patients who received cyclosporin A[Show abstract] [Hide abstract]
ABSTRACT: Cyclosporin A (CsA) has been used most widely as an immunosuppressive agent for preventing graft-versus-host disease (GVHD). To explore the risk factors including CsA blood levels for grades II-IV acute GVHD, we retrospectively analyzed the data of patients who underwent allogeneic hematopoietic stem cell transplantation in our hospital between March 1989 and July 2001. Seventy-three patients (47 males and 26 females) received CsA and short-term methotrexate for GVHD prophylaxis. CsA 1.5 mg/kg was administered as a 3-h infusion twice daily from day 1 until the patient recovered from the toxic gastrointestinal complication. Methotrexate was given at a dose of 15 mg/m(2) on day 1 and 10 mg/m(2) on days 3, 6 and 11. Grades II-IV acute GVHD occurred in 18 patients (24.7%). Multivariate Cox regression analysis revealed that higher C(5) (the whole-blood CsA concentration at 5 h after the start of infusion) before the onset of acute GVHD reduced the onset of grades II-IV acute GVHD with a hazard ratio of 0.994 (95% confidence interval 0.989-0.999) for every increase of 1 ng/ml. Our data indicate that inadequate exposures of CsA can be a vital risk for developing acute GVHD. From our results, we consider that precise monitoring of CsA concentrations and adjustment of CsA dose using the concentration may be effective to prevent the onset of severe acute GVHD. To confirm this finding, further prospective study will be needed.
Article: [A short duration treatment with intensive consolidation therapy for patients with acute myelogenous leukemia--13 year experience in a single institute].[Show abstract] [Hide abstract]
ABSTRACT: Fifty-seven patients with acute myelogenous leukemia (AML) received the following treatment in our hospital between May 1992 and April 2005. Group A: combination of enocitabine, daunorubicin, 6-mercaptopurine riboside and prednisolone (BHAC-DMP) for remission induction, BHAC-DMP or idarubicin (IDR)+cytarabine (Ara-C) for first consolidation, combination of prednisolone, Ara-C, mitoxantrone and etoposide (PAME) for second consolidation, and PAME for late intensification; Group B: IDR+Ara-C for remission induction, PAME for first consolidation, and high-dose Ara-C+mitoxantrone for second consolidation; Group C (acute promyelocytic leukemia, APL) : all-trans retinoic acid (ATRA) for remission induction, BHAC-DMP or IDR+Ara-C for first consolidation, and PAME for second consolidation. The complete remission (CR) rate was 77% in Group A, 76% in Group B, and 71% in Group C. Five-year relapse-free survival rate of the CR patients was 35% in Group A, 49% in Group B, and 70% in Group C. All of the patients had severe neutropenia, but the number of infectious death was small. A short duration treatment with intensive consolidation therapy was effective for patients with AML and improved their quality of life (QOL).
Article: Masked MLL gene rearrangement was disclosed in the clinical course and sequential development of chromosome abnormality in a patient with therapy related acute myelogenous leukemia.[Show abstract] [Hide abstract]
ABSTRACT: Therapy related acute myelogenous leukemia in a 55-year-old Japanese woman is described. She had been treated for a diagnosis of non-Hodgkin's lymphoma 2 years before the onset of the secondary leukemia. She was diagnosed as AML (FAB: M2) with monosomy 7, and successfully treated by an intensive combination chemotherapy followed by an autologous peripheral blood stem cell transplantation. The disease relapsed shortly after the treatment, and the karyotype analysis revealed a complex abnormality accompanied with t(9;11)(p22;q23), however, monosomy 7 was absent. Southern blotting analysis was performed, and MLL rearrangement was evident in both the bone marrow samples obtained at that time and the cryopreserved marrow cells obtained at the onset of the disease. The bone marrow sample stored in a Carnoy solution at the onset was further analyzed, and three karyotype panels showing 45,XX, -7, t(9;11)(p22;q23) were found. Like this situation, a masked MLL rearrangement may have existed in some cases with hematopoietic malignancies, and appear to be disclosed in the clinical course.
Article: Long‐term production of pre‐existing alloantibodies to E and c after allogenic BMT in a patient with aplastic anemia resulting in delayed hemolytic anemia[Show abstract] [Hide abstract]
ABSTRACT: Delayed hemolysis mediated by long-term production of pre-existing recipient-derived antibodies directed against donor RBC antigens after allogenic BMT is an unusual complication of hematopoietic transplantation. A 26-year-old man with aplastic anemia had pre-existing alloantibodies to E and c. He received BMT from a donor, whose Rh phenotype was E+, c+. From about 1 month after the transplant, he showed mild hemolysis due to the antibodies. The patient was typed as group B, CCDee and had anti-E and c alloantibodies before BMT. The donor was typed as group O, ccDEE. Although MNCs from the donor marrow were infused into the patient, DAT became positive on Day 21, and the patient-origin antibodies remained detectable by both DAT and IAT even 20 months after BMT. However, immunomagnetically isolated peripheral circulating B cells were 100 percent donor origin. The patient received prednisolone from Day 221, and thereafter, the signs of hemolysis disappeared. It is likely that the long-term production of alloantibodies is due to the existence of long-lived recipient plasma cells, which survive the conditioning regimen. This case suggests that patients with pre- existing alloantibodies that do not belong to the ABO system should be carefully followed up after BMT.
Top Journals
Niigata Rinko HospitalNiahi-niigata, Niigata, Japan


text:
This job posting is no longer available on Indeed.
Find similar jobs:Graphic Design Intern jobs
Graphic Design InternPart Time
United Way of Calgary and Area is the largest non-government source of funding for human care and community support programs in the Calgary region. United Way works with its community partners to build sustainable solutions for the future, while providing services today to improve lives of people when they need it most.
United Way of Calgary and Area is looking for a part time Graphic Design Intern to join the Marketing and Communications team, from October to the end of December 2013. Reporting to the Manager of Marketing, the intern will work closely with the Digital Design Specialist to support the creation, production and project management of a variety of print and digital collateral.
The Core Competency characteristics every member of United Way is expected to possess are Client/Customer Value Creation, Planning & Organizing, Change Management, Innovative Outlook, Communication & Influence and Leadership Capability.
Role & Responsibilities
Experience and Skills
For consideration, please apply by email (in Adobe or Word.doc format) by 12pm Tuesday, November 5th, 2013
Subject line: Graphic Design Intern
UNITED WAY OFFERS A COMPETITIVE SALARY AND BENEFITS PACKAGE. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Visit our website at www.calgaryunitedway.org
We thank all applicants for their interest and effort in applying for this position, however, only those being considered will be contacted.


text:
Article Summary
BMW's Concept 4 Series Coupe has made its world premiere at the North American International Auto Show (NAIAS) in Detroit. The fourth generation of the company's mid-range coupe line presents a slightly larger and more sporty version of the earlier Series 3 that manages to show a good deal of originality while retaining the BMW identity.
Read the full article: BMW Concept 4 Series Coupe makes world premiere
Related Articles


text:
|This document may not represent best practices for current development, links to downloads and other resources may no longer be valid. Current recommended version can be found here. ArchiveDisclaimer
Compiler Warning (level 4) C4220
Visual Studio 2005
Error Messagevarargs matches remaining parameters
Under the default Microsoft extensions (/Ze), a pointer to a function matches a pointer to a function with similar, but variable, arguments.


text:
the Karst hills of Guangxi by foureyesWatch
©2008-2016 foureyes
.....I see things things with an intense joy, and while I observe, there is no observer, only a beauty almost like love.
For an instant, I'm absent, myself and my problems, my anxieties, my troubles:....nothing but this wonder exists
Guangxi Province, China
.....I see things things with an intense joy, and while I observe, there is no observer, only a beauty almost like love.
For an instant, I'm absent, myself and my problems, my anxieties, my troubles:....nothing but this wonder exists
Guangxi Province, China
Often times when it feels work is about to consume me I look up at the sky and this is how I feel. Of course it helps to have an interesting sky and you've found it here. Have you ever been somewhere when the clouds have caused (usually in thunderstorm season) the sun to appear in such a way that it seems the time of day has been reversed? In afternoon it looks like morning and in morning afternoon? That's almost what it seems like I'm looking at here. It's such a great and strange feeling. Great capture. It's been awhile since I browsed your gallery.
beautiful! But what a shame, the position of that logo, right smack though the houses, which is what I wanted to see. Any chance to move it, and put it up high in the sky or so?
I wish I could feel as you stated above, just once.... Nice capture.
Extremely beautiful!
very very nice.
Frickin' AWESOME!
that's beautiful, the red really stands out.
What a beautiful shot in an exotic and wonderful location. Its like a Chinese version of the Elysian fields!
i love this picture i love it how the sun hits the water.
You have an amazing gift...your gallery is beautiful.
Man, this is so serene. Beautifully shot.
What a beautiful place. It's a pity modern day China seems to have abandoned its traditional techniques of building in harmony with the location and embraced Western stick-anything-anywhere values instead.
nice color,nice capture
i'm seeing it but i can't even imagine it.
it's like it is frozen in time! i want to be there... *swoons*
Oooooo Great Photo!
ooo! Amazing, I love reflection, I always trying to include waster, preferably still water into my pictures!
You described perfectly what I felt when I see this picture.
great shot but the sky looks tacky
really beautiful shot <3!
i want to be in there...now!!
i wish i wish!
its really coooool.
i wish i wish!
its really coooool.
you get so many comments, i hate to bother you with more, but krishna's quote is so perfect for this photo, and for how i believe you see the world in general
I really like the bright of the orange, and I love the one lone man. Lots.
i can't believe a scene like this actually exists/existed - this seems like it would need to be manufactured in order to exist - it is so beautiful, and your capture of it - as with all your work - is ingenious, and light-conscious.
I just love this! I really like the light and the red details. it's awesome!!
So serene....it's gorgeous...
I feel that you appear as an American, but inside you just a pure Chinese.
Wow, I love the way the tower reflects in the pond... Absolute
Amazing work!
That. Is. Freaking. Amazing.
I'm totally speechless.
I'm totally speechless.
looks soo peaceful. beautiful photo.
brilliant reflecctions and nice touch with the person in red striding by the water!
amazing capture and shot.
I rarely add a favorite and many times it comes from you, so I wanted to thank you for your pictures, this one is a very peaceful and drama one, just giving to take a flight to China and discover such a country.
cool you know of karst hills.
i love this area of china
great picture
i love this area of china
great picture
.. Peaceful..
.. Peaceful..
this one is incredible... the reflection in the water, what a well timed and composed shot!
beautiful place!!!
This is beyond magnificent, this is too beautiful.
Increadibly beautiful, the colors, the scenery, the entire photo is magnificent!


text:
Best Cheap Lunch (2007)
Ba Le Sandwich
Banh mi -- Vietnamese sandwiches with a distinctively French twist -- are the plats du jour here, every jour of the week. There are a dozen or so varieties available at the counter, from classic pork pt with pork and more pork to spicy pork and barbecued pork and even all-vegetable offerings, all mounted on dwarf baguettes that have the distinctive delicacy of masterful baking. No matter what's on your sandwich, it costs just $2.50, which should leave plenty of change for an iced Vietnamese coffee or lychee soda.
More Awards from This Winner
Location Details
More Food & Drink Awards
Best Dinner for $10 (for two)Tacos D.F.
Best Sometime ItalianTonti's
Best International BreakfastBritish Bulldog
Best CoffeehouseCity, O' City


text:
All Clear for SwedishAmerican Hospital
Posted: 07/19/2008 - Hospital went into lock down mode at about 7:30pm Saturday
Posted: 07/19/2008 - Hospital went into lock down mode at about 7:30pm Saturday
Updated: 07/19/2008 - A Sycamore parent gets a scare no mother would ever want to get. Her daughter kidnapped and taken into the bedroom of a stranger.
Updated: 07/20/2008 - 20 people were arrested last night at a roadside safety check point.
Posted: 07/19/2008 - Drugs and other criminal activity taking place in rental properties have caused a major problem for local landlords.
Posted: 07/19/2008 - Three Rockford teens are in jail tonight. After robbing two people at gunpoint.
Posted: 07/19/2008 - Crews make progress against California wildfires
Posted: 07/19/2008 - Tropical Storm Cristobal forms off Southeast coast
Posted: 07/19/2008 - Tornado reported in Minnesota, watch issued
Posted: 07/19/2008 - Storms bring Minnesota tornado reports, warnings
Posted: 07/19/2008 - Rising prices has more farmers changing crops
Posted: 07/19/2008 - Obama makes first stop on tour of war zones
Posted: 07/19/2008 - Dalai Lama in town for six days
Posted: 07/18/2008 - Two Year Old Toddler Missing In Florida.
Updated: 07/18/2008 - A Pecatonica couple gives thanks to those giving blood, knowing full well what that donation can do.
Posted: 07/18/2008 - 23 News Team Serve Up Brats In Rockford.
Updated: 07/18/2008 - As proposals to raise more state revenue stall in Springfield like gambling expansion and privatizing the lottery, one remaining option is raising Illinois' income tax.
Updated: 07/18/2008 - Animal rights activists are furious over an army plan to use live pigs as shooting targets in Hawaii but they say they're still doing it.
Updated: 07/18/2008 - Who knew a great belly flop could win us some cash.
Updated: 07/18/2008 - Clothes for kids campaign kicked off at CherryVale Mall today.
Posted: 07/18/2008 - Winnebago County Deputy Joseph Boomer may learn fate next week
Posted: 07/18/2008 - A 78-year-old wife hits her 78-year-old husband...
Posted: 07/18/2008 - A fatal accident in DeKalb County...
Posted: 07/17/2008 - Consumer Confidence In America
Updated: 07/17/2008 - Miles of pipeline are being laid down right now in Boone County as work begins on a major crude oil transportation project.
Updated: 07/17/2008 - A local hospital simulates an emergency situation to see how they can improve their response.


text:
Sponsored By
Real Estate Roundup From Nov. 25, 2015On the market to find a house, or just like looking at local real estate? Check out our picks for Real Estate Roundup from Nov. 25, 2015.
Good Question: What's The Cost Of Raising A U.S. Child?The Department of Agriculture releases a report every year estimating what it costs to raise one child from the ages of zero to 17. In 2014, the estimate came out to $245,340. So, where does that money go?
Minnesota Housing Chief Tapped For New Federal Reserve PanelA Minnesota agency commissioner will have a voice on a new advisory council of the powerful Federal Reserve Board. Minnesota Housing Finance Agency Commissioner Mary Tingerthal was appointed Tuesday to a 15-member panel that will offer input on how federal monetary policy affects the needs of low- and middle-income consumers.
Study: Americans Waiting Longer Than Ever To Buy First HomesYounger Americans are waiting longer than ever to buy a home for the first time. The real estate firm Zillow crunched the numbers and found the typical first-timer rents for about 6 years before buying a home. That's up from 2.6 years in the early 1970s.
Housing Vouchers Could Help Reduce Homelessness In US, Study FindsA new government study suggests housing vouchers could help reduce homelessness in the U.S. The United States Department for Housing and Urban Development examined homeless families at emergency shelters in 12 cities.
Real Estate Wednesday: Short & Sweet Version Of 'Artisan Home Tour'On this real estate Wednesday, WCCO This Morning's Ali Lucia showcases a shorter version of the Artisan Home Tour, which is in its second year.
Housing Unit Growth In North Dakota Unsurpassed In NationThe recent energy boom in western North Dakota has fueled a growth in housing units unsurpassed in the nation. A new Census Bureau report shows that North Dakota had the fastest rate of growth in housing units in the country between 2010 and 2014, and also between 2013 and 2014.
Survey: MN 2nd Least Affordable Midwestern State For RentA new report says minimum wage workers do not make enough money to find affordable rent in Minnesota. According to the "Out of Reach 2015" report, Minnesota is the second least-affordable state in the Midwest.
Edina Approves Controversial Youth Housing ProjectThe city of Edina was expected to decide Wednesday night if it will fund a controversial multi-million dollar housing project.
Zillow: Rental Prices Fall In Twin CitiesThe Twin Cities rental market continues to buck a national trend. Zillow just released a new report for March. The website, which tracks real estate information, said nationwide home rental prices shot up 3.7 percent last month from a year ago.
Minnesota May Boost Cash Grants For Low-Income FamiliesMinnesota's cash grant for low-income families could increase for the first time in nearly 30 years. A family of three receives about $532 per month. Democratic Gov. Mark Dayton and some lawmakers in both parties want to increase the grants by $100 to help the nearly 33,000 families in the program deal with rising housing and transportation costs.
Twin Cities Rents Drop Amid Nationwide SpikeRent prices around the country are spiking, but renters in the Twin Cities saw a slight drop last month, according to a new report by the real estate website Zillow.


text:
19 Reviews
An excellent, if calorie dense, peach cobbler recipe. I doubled the recipe as suggested for a 9 x 13" pan and was very glad that I made the last minute decision to put a jelly roll pan underneath it in the oven. Overflowed very badly! The doubled recipe calls for 8 large peaches and I had a bunch of small to medium so I guesstimated the volume. Looks like I was a bit off. The cobbler crust is very cake-like and pairs well with the not-so-sweet peach filling. Certainly a winner but will be an occasional offering as it is a very high calorie treat!
Good cobbler. I doubled the recipe and used frozen peaches. It did need a little more juice in it. I will add a little water with the peaches next time or use canned peaches.
The texture of this is a bit more like a cake than cobbler, but it has a nice flavor. Was I supposed to have any sugar mixture leftover somehow? This would be a bit easier to follow if the ingredients were broken out under a Fruit Filling heading and a Cobbler heading with the sugar split up the same way the cinnamon is. Step four and five should be joined in to a single sentence. Thanks for posting.
Good, basic and versatile cobbler done by my DD today we did one end tinned peach and one end tinned plum with yummy result !
This was just perfect! :) Doubled the recipe but used a few extra peaches just because I had them. Thanks for a super cobbler recipe!
Awesome cobbler. Everyone loved it! I doubled and put into a 9x13 pan but only used about 3/4 cup butter. I also added some frozen blueberries to the fresh peaches. A big hit with vanilla ice cream!
This was easy to prepare and tasted wonderful. Thanks for a great recipe.
Easy to make and delicious. We really liked the topping. Thanks for sharing.
This was a great cobbler. Your method is definitely my favorite for making a crust on a cobbler. I made it as listed, but with whole wheat flour. One of the best cobblers I've had.
My neighbor's peach tree has several branches hanging over my fence with globe size peaches hanging off of it. I couldn't resist and picked a couple when I saw this recipe. I used oven proof bowls and little oven-proof dishes to make this into individual servings. We really enjoyed this with whipped cream and I bet that tree will look pretty empty in no time! Thank you Wildflour.


text:
AdBlock blows! Please disable the add-on to ensure you get the most out of Tube8's features and functionality. Read about why you shouldn't use AdBlock. Close
Add to Favorite List:
Create a new folder:
Next »
alessandro blow job
Recognize a pornstar in this video?
Help make pornstars easier to find on Tube8 by telling us who is in this video.
Thanks! The pornstar names will be added to this video when enough users submit the same names.
You must enter a pornstar name that already exists in our database.
- Category: Amateur
- Views: 1,778
- Added: 4 years ago
- Description: alessandro succhia cazzi
- Tags: alessandro
- Pornstars: Add Pornstar
- Favorite by: 0
- Report This Video


text:
Welcome to the CODE project
This website features academic resources issued from the project Comparing Online Democracy and Elections (CODE). This is an Economic and Social Research Council (ESRC) funded project examining the internet's impact on elcetions, campaigns and citizen participation perspective.
CODE is hosted at the Cathie Marsh Institute for Social Research (CMIST), The University of Manchester.
The Principal Investigator is Prof Rachel Gibson.
Marta Cantijoch is the Research Associate and Cheryl Anderson the PhD student.
The website will be periodically updated to provide the following information:
- Output: our papers and publications
- Data: survey, questionnaires, interview questionnaires, web archive collection, websites analyses
- Resources: links of interest to other research on the internet and politics
- Events: information on workshops, conferences and other activities
- People: our biographies
- Code 2.0: follow our recommended twitter feeds and blogs on the internet and politics


text:
SooVAC's latest show features art in crawl spaces, closets, and on walls
Work by Sean Connaughty
This Saturday, the Soo Visual Arts Center opens its "9th Annual Juried Exhibition." The show features an eclectic mix of photography, collage, video, drawings, and installation curated by University of Minnesota assistant professor Chris Larson. The work in "Untitled 9" can be seen in some curious spaces -- a broom closet, the crawl space behind walls, in the office -- and all of the pieces have a sense of camouflage and transformation.
Related articles:
Serena Cole's 'Through a Glass, Darkly' features unsettling transformations, portraits
SooVAC pays tribute to founder Suzy Greenberg
"Through a quiet sense of natural wonder," writes Larson on SooVAC's website, "13 artists noiselessly manipulate, cut, dissect, blur, and disintegrate architecture, bodies, and the landscape. Murmuring." Indeed, while the art varies in genre and style, Larson has put together a collection of work that is shifting and hidden.
The most notable example is an installation by Leslie Kelman, on display in the crawl space between two walls. You can only see it if you peek your head in through the broom closet, or look in through a window on the side of the building. It's meant to be uncomfortable, says SooVAC executive director Carolyn Payne, and explores both an unusable domestic space and an unusable industrial space.
There's also an installation by Sean Connaughty, built in a space that used to be a closet. A wall has been built over it, with a window that allows you to look into an aquarium. Inside the aquarium are concrete floats with plants inside of them. It's rather space agey, and like much of Connaughty's work, uses natural and living materials to create a world that is both alive and strange.
Then there's Rachel Breen's interesting piece of copper. It's covered up with black paper which has been torn and has holes poked all over it, creating a pattern. The copper shimmers through, glowing, a hidden source of light.
There are a couple of video pieces in the show, including a work by Timothy Barnes that includes footage of a window drape set to Kenny G music, and Sara Wichterman's video about humans and fire.
A number of pieces in the show deal with architectural forms. Matthew Yaeger's wall construction looks like a fort made of wood, paper, plastic, and other miscellaneous items. It's a kind of skyscraper made of random materials that look as if they could have been accidentally assembled that way. Matthew Winkler also has an architectural type of piece made of paper folded and cut in an intricate pattern that creates wonderful shadows on the wall. Noel Worden's photograph, and Jesse Drexler's M.C. Escher-like collage also deal with architecture and the idea of a thing not being exactly what it seems.
Other artists featured in the exhibit include mixed-media work by Mary Bergs, photography by Monica Howell and Joseph Kaercher, and Haley Prochnow's very interesting collage work.
"Untitled 9: SooVAC's 9th Annual Juried Exhibition"
November 10 through December 30
There will be an opening reception from 6-9 p.m. Saturday, November 10
Soo Visual Arts Center
2638 Lyndale Ave. S., Minneapolis
November 10 through December 30
There will be an opening reception from 6-9 p.m. Saturday, November 10
Soo Visual Arts Center
2638 Lyndale Ave. S., Minneapolis
Use Current Location
Related Location
Soo Visual Arts Center
2909 Bryant Ave. S.
Minneapolis, MN 55408
Get the Arts & Culture Newsletter
Find out about arts and culture events in Minneapolis & St. Paul and offers you won't hear about anywhere else.
Sponsor Content


text:
Are Goku and Vegeta really brothers?
MJluver 2009/08/23 15:18:46
dragon ball z club
dragon ball z club
I dont think so Goku has a elder brother, Raditz.And Vegeta has a younger brother.And King Vegeta is Vegeta's father and Bardock is Goku's father so i really dont know
You must be a member of the group dragon ball z club to vote on this poll.
Sort By
- apris 2010/03/25 02:41:13Nothen Goku would be a prince
- the rea... apris 2012/04/04 01:05:49i think they are but if there not can we be friends
- Fallen The Dark Angel 2009/09/01 01:38:52
- SuperSaiyan2TeenGohan 2009/08/24 20:47:40NoNo they're not because the father of Goku is Bardock and the father of Vegeta is King Vegeta.If Goku was the brother of Vegeta then he'd probably have been an elite instead of a low class Saiyan
- SuperSa... MJluver 2009/08/25 08:08:34Yup.
- SuperSa... MJluver 2009/08/25 20:16:23Cause of my favorite character in this show called Zatch Bell.
The girl with the cat is Shion.
Just go to youtue and put Zatch Bell episode 32 part 2.
That's one of the best parts.
- SuperSa... MJluver 2009/08/27 20:38:10Yup.Actually, I just finished watching Bio-Broly.
- SuperSa... MJluver 2009/08/28 20:38:39Yeah.
- SuperSa... MJluver 2009/08/31 05:32:14
- SuperSa... MJluver 2009/08/31 20:01:35
- SuperSa... MJluver 2009/09/01 20:39:46Yeah.Of course wouldn't miss it!
- SuperSa... MJluver 2009/09/03 00:19:09Yeah I know!
- SuperSa... MJluver 2009/09/04 04:30:28I'd have to say Gogeta, and you?
- the rea... SuperSa... 2012/04/04 01:10:09fuck you fuck you you dum ass bitch
- Dummy (The guy in my avata... 2009/08/23 15:25:23
See Votes by State
2016/02/07 09:39:19
Hot Questions on SodaHead
More Hot Questions


text:
Ragnabreak - Adriana by chesterocampoWatch
©2013-2016 chesterocampo
Card illustration for fantasy card game Ragnabreak. International title: Deity Wars. Check out the game here.
© CROOZ, Inc.
Tsk, galing! Inspiration ka po sakin!
So realistic and detailed! Wonderful art! Keep up the brilliant work..
Brilliant piece, because of... well everything. Poses, angles, details, anatomy, bright colours... amazing.
Amazing detail, your work is awesome
Amazing work!
love it!!
Gorgeous artwork.
Card game artists are incredible. *___*
Absolutely awesome!
this is "artwork"!!
insanely awesome
holy hell thats amazing
Beautiful. All the details looks amazing.
Beautiful work. Very well done.
I like color and light
GREAT! The colors, shading details yes everything
Wow, it's beautiful ! Her posture is great ^^
I really like the light too
The lighting and colors on this piece are just so attractive!
this is simply outstanding!!!!what an incredible piece of fantasy work....breath taking stuff!!!!instant favourite!!!!!!!!!!!!!!!!!!!!
beautiful ><
ohh nice pose and lighting
In this one, colors ended really clean i love it, it must took you tons and tons of hours.