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To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus-infected children living in Peru.
Cross-sectional observational study.
Two public hospitals and 1 nonprofit center in Lima, Peru, between August 2009 and April 2010.
A total of 139 HIV-infected children, ages 4 to 19 years.
Hearing impairment and otologic health were assessed with pure tone audiometry, tympanometry, and otoscopy. The primary outcome was hearing loss, defined as average threshold >25dB for 0.5, 1, 2, and 4 kHz, in one or both ears. Historical and socioeconomic information was obtained through parental survey and medical chart review. Statistical analysis included univariate analysis and multivariate logistic regression.
Fifty-four (38.8%) of 139 children had hearing impairment. On multivariate analysis, risk factors included: tympanic membrane perforation (odds ratio [OR] 7.08; 95% confidence interval [CI], 1.65-30.5; P = .01), abnormal tympanometry (OR 2.71; 95% CI, 1.09-6.75; P = .03), cerebral infection (OR 11.6; 95% CI, 1.06-126; P = .05), seizures (OR 5.20; 95% CI, 1.21-22.4; P = .03), and CD4 cell count <500 cells/mm3 (OR 3.53; 95% CI, 1.18-10.5; P = .02).
The prevalence of hearing impairment in HIV-infected children in Lima, Peru was 38.8%. Middle ear disease, prior cerebral infection, and low CD4 cell count were significantly associated with hearing impairment. The high prevalence of hearing impairment emphasizes the need for periodic hearing assessment in the routine clinical care of HIV-infected children.
The use of highly active antiretroviral therapy (HAART) has prolonged the life expectancy of human immunodeficiency virus (HIV)-infected children and expanded the spectrum of acute and chronic conditions that may develop during their life span. An increased incidence of chronic conditions such as hearing impairment (HI), as a direct result either of HIV infection or of HIV treatment, may produce life-long behavioral, educational, and socioeconomic consequences.
HIV infection has been associated with HI in both adults and children.1,2 Although potentially associated infections, especially otitis media,3-5 are more prevalent in HIV-infected children, no association with HI has been reported. In adults, studies examining the association between the use of HAART and HI have been inconclusive.6-8 Other studies have suggested a correlation between disease progression (declining CD4 cell counts) and HI identified by pure tone audiometry.1 Similar correlations have not been reported in pediatric populations.
The prevalence of HIV infection in Peru is estimated to be less than 1% in adults and children, with the majority of cases clustered around urban centers such as Lima. Domestic and international efforts have aimed to keep HIV prevalence low, with Peru being the number one recipient of funds in South America from the Global Fund for AIDS, Tuberculosis and Malaria.9 As the majority of children contract the virus perinatally,10 mother-to-child transmission has been a primary focus of preventive measures.
In Peru, there is no universal hearing screening of adults or children, and HI is infrequently identified in children. A previous study by our group detected HI in 6.9% of HIV-uninfected schoolchildren in Lima11. The objective of this study was to determine the prevalence and associated risk factors of HI in HIV-infected Peruvian children. Early identification of such conditions could permit appropriate intervention and minimize developmental delay or impairment.
This cross-sectional observational study included HIV-infected children between the ages of 4 and 19 years recruited at 3 sites in Lima, Peru. The sites were the pediatric HIV services of 2 public hospitals, Instituto Nacional de Salud del Niño (INSN) and Hospital Nacional Arzobispo Loayza (Loayza), and the Hogar San Camilo, a nonprofit center providing social services for HIV-infected children. Both hospitals are large referral hospitals in Lima: the INSN is a tertiary pediatric hospital, and Loayza primarily serves an adult population with a small pediatric service. Parents or guardians were invited to enroll their children when they presented for outpatient care at one of the hospitals or during activities at San Camilo. The only exclusion criterion was the child's inability or refusal to cooperate with 1 or more components of the study. Informed consent was obtained from each guardian or subject older than 17 years; assent was obtained from each child 17 years old or younger. Human subjects approval was obtained from the institutional review boards of the University of Washington School of Medicine, Stanford University School of Medicine, Instituto Nacional de Salud del Niño, Hospital Nacional Arzobispo Loayza, and Hogar San Camilo.
All studies were conducted in a closed room at each site to minimize ambient noise. Hearing was assessed through pure tone audiometry using the Interacoustics AT220 audiometer at .5, 1, 2, and 4 kHz. Patients with an average of >25dB threshold on air conduction audiometry also underwent bone conduction testing.
HI was defined according to the World Health Organization (WHO) parameters as an average threshold pure tone average (PTA) >25dB on audiometry. In cases where bone conduction testing was performed, the air-bone gap was calculated as the air conduction PTA minus the bone conduction PTA. Conductive HI was defined as air conduction PTA >25dB with normal bone conduction and an air-bone gap of 10dB or more. Sensorineural hearing impairment was identified as air conduction PTA >25dB, bone conduction PTA >25dB, and an air-bone gap less than 10dB. If impairment in both air and bone conduction was found and the air-bone gap was >10dB, the patient was given the diagnosis of mixed HI. Patients with HI in one or both ears were considered hearing impaired.
Tympanometry was used to assess for middle ear disease, with abnormal classified as B- and C-type curves. Peak pressures, compliance, and canal volume were recorded. Otoscopy with a Welch Allyn 3.5V Macroview otoscope (Welch Allyn Inc, Skaneateles Falls, New York) identified clinical conditions such as otitis media, cerumen impaction, and tympanic membrane (TM) perforation. Cerumen impaction was defined as an obstructed view on otoscopy in addition to a B-type curve on tympanometry. In patients with cerumen impaction, the affected ear(s) were irrigated for disimpaction prior to audiometry.
Medical, family, and social histories were abstracted from medical charts; and a questionnaire regarding medical history and symptoms of HI or ear disease was administered to the participant's guardian. Malnutrition was identified through documentation in the medical records or through biometrics, using WHO criteria for moderate malnutrition (weight for age or weight for height, less than 2 standard deviations below average). Data regarding age at seroconversion, CD4 cell count, HIV viral load, use of HAART, and history of infections was also abstracted. Univariate and Backward Wald multivariate statistical analyses were performed using SPSS Version 17.0 (SPSS, an IBM Company, Chicago, Illinois).
Patients with abnormalities identified on otologic examination (eg, chronic TM perforations, previously undiagnosed moderate or severe HI) were referred for further evaluation and treatment at the otolaryngology service at the hospital where they were receiving HIV care.
One hundred thirty-nine children were enrolled: 112 from INSN, 16 from Loayza, and 11 from San Camilo. One patient declined enrollment. Results of audiometry, tympanometry, and otoscopic examination are presented in Table 1. Demographic information is presented in Table 2. The average age was 9.9 years; 72 (52%) were female. For some children, the medical and social histories were incomplete because of hospital transfers, incomplete documentation, and change of guardianship. Opportunistic infection status was recorded when present in the chart. Medical background from hospital records and questionnaires is presented in Table 3.
Fifty-four (38.8%) children had HI detected, the majority of which was conductive loss (48, 34.5%). One child had sensorineural hearing loss and 5 had mixed hearing loss (Table 1). Sixty-seven (48.2%) children had an abnormal tympanogram. Fifty-three (38.1%) had type B tympanograms indicating middle ear pathology and 18 (12.9%) had type C tympanograms suggesting eustachian tube dysfunction. On otoscopy, 19 (13.7%) children had a TM perforation, 24 (17.3%) had cerumen impaction, and 23 (16.5%) had TM inflammation. One-half of patients with cerumen impaction (12) had hearing impairment. Of these, six also had pathology (TM perforation or otitis media with effusion) seen in the opposite ear. All children with TM perforations had conductive hearing impairment on audiometry, and 33.3% of children with conductive hearing impairment had a TM perforation—compared with only 3.3% of patients without conductive hearing impairment (P < .001). Otitis media with effusion was detected in 7 children (5%).
HIV history is presented in Tables 4 and and5.5. The age at HIV seroconversion was recorded or calculated when available. Fifty-three (98%) of 54 children with HI were receiving HAART therapy (average duration 4.7 years) compared with 71 (84%) of 85 children without hearing impairment (average duration 4.2 years). Initial HAART treatment for children in this study typically included lamivudine, zidovudine, and nelfinavir. Children with CD4 cell counts declining to <250 underwent HIV genotyping and were typically switched to secondary treatment regimens. CD4 cell count levels were checked monthly and viral loads every 3 months. In children with hearing impairment, 16 (31%) had a most recent CD4 cell count of <500 cells/mm3 and 17 (33%) children had a detectable viral load (>400 copies/mL) at the time of hearing assessment.
Clinical findings correlated with HI are displayed in Table 6. Otologic and neurologic risk factors correlated with HI included a history of TM perforation, abnormal tympanometry, seizures, and history of cerebral infections; these factors remained significant after adjustment for other variables. Specific HIV-related risk factors were also evaluated. Hearing impairment was correlated with use of HAART (P = .01), specifically protease inhibitors (P = .03), although this relationship was not significant in multivariate analysis. A CD4 cell count of <500 cells/mm3 and undetectable viral load remained significant risk factors even after adjustment for other variables. Duration of HIV infection and duration of HAART use were inversely correlated with viral load (P = .02 and P = .03, respectively). When children were divided by CD4 cell count greater or less than 500 cells/mm3, undetectable viral load remained a significant risk factor only for those children with CD4 cell count less than 500 cells/mm3.
This is the largest study to date of HI and ear disease in HIV-infected children. The prevalence of HI in HIV-infected Peruvian children (38.8%) was more than 5 times greater than the prevalence of hearing impairment (6.9%) in HIV-uninfected Peruvian children previously reported by our group11; this is also markedly higher than the 1% to 3% study in Angola detected hearing impairment in 26% of HIV-infected children by brainstem auditory evoked potentials or pure tone audiometry.15 Ninety-two percent of these children had an otorhinolaryngological abnormality identified, including 27% with chronic otitis media; however, correlation between the presence of otologic pathologies and hearing impairment was not reported.
The majority (88.9%) of HI identified in our population was due to conductive loss. This finding was consistent with the results of the otoscopic examinations, which detected TM perforations in 13.7% and cerumen impaction in 17.3% of children. The strong association of TM perforation and abnormal tympanometry with hearing loss suggests middle ear pathology was a significant contributor to hearing impairment in HIV-infected children. The low prevalence of sensorineural and mixed hearing impairment suggests that hearing impairment was not predominantly because of ototoxicity associated with HAART usage.12 The lack of correlation between HAART and hearing impairment is consistent with most recent studies of adults, which revealed no relationship between nucleoside reverse transcriptase inhibitors and hearing impairment.10
Compared with HIV-uninfected Peruvian children in our prior study,11 HIV-infected children in this study had a higher prevalence of frequent ear infections (18.8% vs 11.3%). Frequent ear infections were a risk factor for hearing loss in univariate but not multivariate analysis. The association of HI in HIV-infected children with acquired ear disease, as opposed to congenital ear disease, is supported by a study from Nigeria, where universal newborn hearing screening of infants born to HIV-infected mothers did not detect an increased risk for sensorineural hearing loss.16
Middle ear pathology in HIV-infected children may produce HI through several mechanisms. Otitis media, especially when accompanied by effusion or damage to the TM, can produce conductive hearing loss.17 HIV infection has been associated with recurrent otitis media, which may lead to more frequent TM perforations and impaired healing between infections. The association between hearing impairment and low CD4 cell count may be because of the accumulative damage to the TM and middle ear caused by recurrent episodes of otitis media. An undetectable viral load was unexpectedly a risk factor for hearing loss. One potential explanation is that lower viral load was a surrogate marker for longer duration of HIV infection. Univariate analysis detected a significant correlation between undetectable viral load and longer time since HIV seroconversion (odds ratio [OR] 2.67; 95% confidence interval [CI], 1.21-5.87; P = .02), suggesting that children with longer duration of HIV infection received effective antiretroviral therapy. Longer periods of HIV infection would thus lengthen time at risk for recurrent middle ear infections leading to hearing loss. Low viral load was also associated with longer time since initiation of HAART (OR 5.31; 95% CI, 1.147-24.586; P = .03). Although HAART itself was not a risk factor for hearing loss in multivariate analysis, longer duration of antiretroviral therapy suggests a longer exposure period to recurrent middle ear infections or a more aggressive process, including more severe or frequent middle ear infections.
The correlation between TM perforation and hearing loss supports the theory of middle ear disease as an important cause of hearing impairment in HIV-infected children. The prevalence of TM perforation in our HIV-infected children (13.7%) was much higher than in our historical control group of HIV-uninfected Peruvian children (<4.5%).11 In addition to the increased susceptibility of HIV-infected children to middle ear infections, low CD4 cell count may directly lead to chronic TM perforations. A study of immune cell response in a mouse model of artificially created TM perforations detected a strong lymphocyte-mediated response within the first week after perforation that was greater than the response observed during acute otitis media.18 T-cell presence peaked at day 3 and B-cell presence at day 6—with B cells producing the most vigorous immune response. The authors hypothesized that CD4 helper T cells were first recruited to help activate B cells, which then carried out the majority of the healing response. Incomplete healing due to immunocompromise in our HIV-infected children may have led to chronic TM perforations with impaired healing and resultant conductive hearing impairment.
HIV infection may put children at higher risk for developing hearing impairment, likely due to a combination of recurrent ear infections and impaired healing between infections. The identification of middle ear disease as a risk factor for hearing impairment in HIV-infected children can help address long-term effects on linguistic, social, educational, and vocational development. Given the high prevalence of HI detected in this study, and the lack of universal hearing screening for HIV-infected Peruvian children, expanding the scope of evaluation and care of chronic HIV infection should include evaluation for HI and prompt treatment of recurrent otitis media.
Hearing impairment was identified in 38.8% of HIV-infected children in Lima, Peru. Risk factors included abnormal tympanometry, TM perforation, and low CD4 cell count, suggesting middle ear disease is a significant factor causing hearing impairment. The link between hearing loss and low HIV viral load may indicate that longer periods of immunocompromise contribute to increased susceptibility to middle ear disease or longer history of recurrent episodes of otitis media. Other risk factors include cerebral disease such as seizures and cerebral infection. The proper identification, prevention, and treatment of these conditions should be taken into account during the management of HIV-infected children in Peru and other countries.
The authors thank the staff at the Department of Tropical Medicine at Universidad Nacional Mayor de San Marcos, the nurses at Instituto Nacional de Salud del Niño, and the volunteers and staff members at Hogar San Camilo. In particular, we thank Alitza Flores Atachagua for her help with data collection. From the University of Washington, we acknowledge Thanh G. Ton for her counsel with statistical analysis. We express our gratitude to the staff at the Fogarty International Center at the National Institutes of Health for their help in bringing together the people and resources for this project.
Funding sources: This work was supported by the following National Institutes of Health: Office of the Director; Fogarty International Center; Office of AIDS Research; National Cancer Institute; National Eye Institute; National Heart, Blood, and Lung Institute; National Institute of Dental and Craniofacial Research; National Institute on Drug Abuse; National Institutes of Mental Health; National Institute of Allergy and Infectious Diseases; and the Office of Research on Women's Health—through the International Clinical Research Fellows Program at Vanderbilt University (R24 TW007988).
Author Contributions
Christina K. Chao, protocol design, data collection and analysis, manuscript preparation; Josephine A. Czechowicz, protocol conception and design, manuscript review; Anna H. Messner, protocol conception and design, data analysis, manuscript preparation; Jorge Alarcón, protocol design; Lenka Kolevic Roca, data collection; Marsi M. Larragán Rodriguez, data collection; César Gutiérrez Villafuerte, data analysis; Silvia M. Montano, protocol design; Joseph R. Zunt, protocol conception and design, data analysis, manuscript preparation.
Competing interests: Anna H. Messner received royalties as an author for UpToDate.
Sponsorships: None.
Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599811429271 http://otojournal.org
The opinions and assertions made by the authors do not reflect the official position or opinion of the government of the Republic of Peru, the Ministry of Health of Peru, or the US Department of the Navy or Army.
This work was presented at the XVIII International AIDS Conference in Vienna, Austria, July 2010.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Marisol Thomas and Rob Thomas - 'The Normal Heart' at Ziegfeld Theater on May 12, 2014 in New York City. - New York, New York, United States - Tuesday 13th May 2014 (2 Pictures)
Marisol Thomas and Rob Thomas
Photo credit: Andres Otero
Marisol Thomas and Rob Thomas
Photo credit: Andres Otero
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"Know that Tiamat seeks ever to rise to the stars, and when the Upper is united to the Lower, then a New Age will come of Earth, and the Serpent shall be made whole, and the Waters will be as One"
And a man may cry out, what have I don't, and my generation that such evil shall befall me? And it mean nothing, save that a man, being born, is of sadness, for he is of the Blood of the Ancient Ones, but has the Spirit of the Elder Gods breathed into him. And his body goes to the Ancient Ones, but his mind is turned towards the Elder Gods, and this is the War which shall be always fought, unto the last generation of man;
for the World is unnatural.
When the Great KUTULU rises up and greets the Stars, then the War will be over, and the World be One.
We are the product of that dynamic balance, thus we have our(limited) free will that
don't really have .
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Filled with grief after the unexpected death of his older brother, Dexter, last spring, BYU senior quarterback Taysom Hill decided to wear his number and dedicate his season to Dexter.
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Skip to comments.Mike Shula is Out at Alabama
Posted on 11/26/2006 11:25:54 PM PST by catholicfreeper
Tuscaloosa - A tumultuous week for Mike Shula is over. ABC 33/40 sports has learned Shula will not be retained as the Alabama head football coach.
We first reported the story just after midnight. The Alabama coaches out on the road recruiting have been summoned back to Tuscaloosa.
After a 10-win season last year, this season was full of disappointments. There were second half letdowns against Arkansas, Florida, Tennessee and Auburn, and a brutal loss at home to Mississippi State. His inability to win games against his Western Division rivals was especially disappointing.
Looking at his overall record in the last 4 years, Shula was 26-and-23, 13-and-19 in the SEC, 1-and-3 against Tennessee and Arkansas, 0-and-4 against LSU and most disturbing, 0-and-4 against Auburn.
Where Alabama goes from here isn't clear. There's been a lot of talk about Steve Spurrier and Nick Saban. There is however no reason to believe either guy will come to Tuscaloosa.
Other names mentioned: Rich Rodriguez, Jim Grobe and Paul Johnson.
Jeff Speegle will be in Tuscaloosa later this morning, and we will continue to follow this story throughout the day.
ping MikefromOhio;ABG(anybody but Gore); aft_lizard;
UAL sinks a bit further. Maybe this time they can hire just one coach this off season.
Cecil Hurt of the the Tuscaloosa News alluded to the fact he was just too darn stubborn to change his staff. He's an upstanding guy, no doubt about it. I feel bad in one sense, but hey he's 4 million richer, just hope his father doesn't trash the University of Alabama for a tough choice they had to make.
If Saban goes to Alabama and you hear of him getting shot in the scrotiods, I repudiate my culpubiliality as I am insanitary.
Tigs looked good last Fri., oh yeah.
"There were second half letdowns against Arkansas, Florida, Tennessee and Auburn, and a brutal loss at home to Mississippi State. His inability to win games against his Western Division rivals was especially disappointing."
And it took OT to beat a 4&8 \ 2&6 Ole Miss team.
The Dolphins coach?
Oh please take him away from the fins. Please.
When Bama was going through the "revolving coach" period I was very much in favor of Shula becoming their coach. I was willing to give the team a chance to get in shape. However, I want Bama to become the powerhouse they once were in college football (its been too damn long since they were one) and if it means Shula being replaced in order to accomplish this then I'm all for it.
God, I hope they don't hire Spurrier. Anybody but Spurrier.
Word I am getting through friends at Bama is that THey gave Mike an "OR ELSE" deal -- fire his assisstants or else they fire him. He stayed Loyal to his staff, so the school let him go.
"...his play calling was too conservative."
I nominate Mike Leach from Texas Tech. I'd like to see the spread offense tried at a school that gets top quality recruits.
I think Nick Saban has managed to salvage his job in Miami. This move is kind of stunning because I figured Bama would give Shula one more year to turn things around. Everybody, except for Tide fans, alums, and the administration, knew this was a rebuilding year. Likewise, I don't see Darth Visor plunging into that cesspool. Maybe they can talk Gene Stallings or Pat Dye out of retirement...
Yes it has, but Steve Spurrier has already said he's not interested in another job, he's happy being a Gamecock. Besides, after yesterday's win over Clemson, I'm sure he's a bit more convinced Carolina will be able to compete for the SEC Championship sooner than later.
From LindysSports.com one week ago:
He is 0-19 when trailing going into the fourth quarter, which means two things: 1) he has not been able to rally his team to any come-from-behind victories, and 2) his teams have trailed going into the fourth quarter 19 times in that span. In four years, good teams don't trail 19 times going into the fourth quarter.
"0-and-4 against Auburn"
Nuff said!
And this is not in "Chat" because . . . . ?
I believe it's now 0 and 5 against Auburn. Fear the thumb.
Urban Meyer has been experimenting with it at Florida. He gets roundly castigated for it by Florida fans who insist that SEC defenses are too fast and athletic for "gimmicky" spread offense plays to work.
What a small world. LindySports originated (as Lindy's SEC) in the offices I've occupied for 18 years.
Finebaum gets another scalp. Well, that's probably giving him too much credit but his show, while a guilty pleasure, is less about football and more about football-related politics.
Not to preach, but what Alabama fans can't seem to grasp is that they have the history, the name recognition, the fan base, etc. but since Gene Stallings gave them a final shot of oxygen they have been average at best. I'm not a Buckeye/Buckeye fan but Ohio State has finally put Woody Hayes where he belongs (i.e., in their hearts) and let Tressel run the program the way he sees fit - it's produced one national title and a second to come this year in all likelihood. Alabama should consider doing the same with Bear Bryant, as much as people respect and admire him (including me).
There is a destructive game of "you're not good enough for us" that seems to pervade the fan base (at least the vocal fanbase). Patience isn't an easy thing to learn but after a full decade of false dawns and letdowns one would hope that the fans might be willing to throttle back for at least a year or two.
I ask the same question I always ask of rabid college football fans (of which I am one): if every team is to go 10-2 every year, exactly which teams will provide the opposition for the 10 wins? There are only so many teams willing to be a weekly doormat.
Which is exactly what the AD and the trustees wanted - Shula out, fans placated and complete deniability since they can claim Shula fell on his sword.
The game of musical coaching chairs continues. Everyone wants a Messiah for a coach, but almost all just end up with a flawed human being.
Coaches aren't the problem. The college game itself is broken. The NCAA doesn't have the backbone to clean up the game, and make the athletes REAL students.
What a sorry and embarrassing spectacle to watch "grown-ups" act like children over the fortunes of their schools on the gridiron, especially under the guise of "intercollegiate" football.
It's a farm system for the NFL.......nothing more, nothing less.
I know all that. If Shula was fired for failing to discipline Simpson at the beginning of this season, I guess I can see that. I am a UF fan so turmoil at UAL is not a big deal to me. But I am very very much interested in Meyer having success at UF because we have had a bit of turnover from Spurrier to Zook to Meyer. UAL needs to stabilize its coaching situation, but I somewhat glad they are failing to do so according to this report.
Shula might be the best that Shalala and Co. can do down in Miami.
Time for Jackie Sherrill?
I Nick Saban related to the Buffalo Bills' former coach Lou Saban?
Spurrier left UF precisely because it got to the point where the fans expectations every year got to be too high. It would be no different at Bama. At Carolina, the fans are happy just to be where they are, and they will only get better.
I agree, this isn't the WAC, and I hope Meyer has learned that by now. Leak has done pretty good, but this isn't the kind of offense he excels in. Tebow should be more productive with Urban's offensive style.
What Urban needs to do, is to upgrade our offensive line, with FSU and Miami slipping, UF should clean up in recruiting. And oh, getting a kicker would also be nice.
Hmmm...Bama went with Shula over Sylvester Croom years ago. I wonder if they'll reconsider Croom. His record's not that good, 9 and 25 over 3 years, but heck it's Mississippi State.
Can you say Dennis "I'm not leaving" Franchione. Don't give me this crap, about all-in-the-family, they put that to bed in 2001 when they hired man teets francphony, and also Mike "I'm Rollin' Baby" Price IN 2003. Other programs deserve excellence, but so does Alabama, you and others should quit selling the program short. Bill Cury was Ga Tech grad btw, Gene Stallings a Texas A&M grad. So please move onto a subject like who is going to win OSU or USC.
You have put it better than I could ever hope to: Bama fans think they are better than everyone else and their coaching carousel proves it.
The hatred for Franchione is as pathetic as it is overlong. Sure he lied but at the end of the day he jilted UA for another school - it doesn't matter who - and the egos in and around Tuscaloosa can't accept being second choice.
The flurry of coaches taking their names OUT of consideration today is quite amusing. Media types keep couching it in euphemisms but the bottom line is that a coach might want to deal with the university and the players, but really doesn't want to deal with the fans.
Ohio State had a similar problem and got lucky with Jim Tressel. Still, there are some coaching jobs that have way too much baggage due to the hypercritical fans.
Give me a break. The guy franchione, would have walked naked back to college station, he left the team in the middle of the night for goodness sakes.
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Ana Silvera
Ana Silvera is a British alternative singer-songwriter and composer, known for the poeticism of her lyrics, her classical piano style and her work with choirs.
Ana Silvera is from Syrian/Irish descent. She grew up in North London, the daughter of a writer and a psychologist. She is operatically trained, and has performed solo roles with the English National Opera including Königskinder by Engelbert Humperdinck, (broadcast live on BBC Radio 3) as well as appearing at the Royal Opera House when she was a teenager.
She studied voice and piano at the Guildhall School of Music and Drama and English Literature at University College London.
Recent Years[edit]
In 2012, Ana Silvera performed a seven-part song cycle entitled "Oracles" plus a second choral work that drew on Estonian folklore, "Tule Maale, Armas Veli!" (Step Onto The Ground, Dear Brother!), at the Roundhouse main space alongside the Estonian Television Girls Choir [1] in February 2012. She shared the bill with Imogen Heap for this concert, as well as a following performance at Sage Gateshead. The performance was positively reviewed, and with the works described by Artsdesk as 'two stunning folkloric sagas...captivating, mysterious and complex'.[2] "Oracles" was then nominated for a British Composer Award 2012. A short film, directed by Kate Church documenting the creation of "Oracles" was premiered on PORT Magazine website.[3]
Her debut album, "The Aviary",[4] was released with KMC Records in March 2012, to positive acclaim, described by The Guardian as 'a stunning album...that mixes operatic and folk elements with magical story-telling'.
Ana Silvera has performed and/or been played on radio stations including BBC Radio 3 (The Verb,[5] Late Junction), BBC Radio 6, BBC Wales, XFM and Resonance FM. Ana Silvera has collaborated with New York-based producer Brad Albetta (Martha Wainwright, Teddy Thompson), renowned London-based producer Ray Singer, violinist/arranger Maxim Moston (Antony & the Johnsons, Rufus Wainwright),[6] and Jeff Langston (Antony and the Johnsons). Ana Silvera has performed at major venues in London including the Purcell Room, Union Chapel and The Roundhouse.
She has also played keyboard and sang backing vocals with alt-folk singer, Yo Zushi.
Royal Ballet Collaboration[edit]
Ana Silvera was commissioned in 2013 by the Royal Opera House to create, compose and perform in a new work for Royal Ballet alongside choreographer Ludovic Ondiviela and film maker Kate Church, entitled 'Cassandra'.[7] It premiered on the 30 October 2014 at the Linbury Theatre, Royal Opera House and starred soloist Olivia Cowley as the main character, replacing principal ballerina Lauren Cuthbertson who was injured shortly before the show.
Musical style[edit]
Ana Silvera's writing often relates to fairy and folklore, and/or writes through personas, sometimes historical or fictional, such as Biblical figure Salome, Heloise (of Heloise and Abelard fame) or Nadezhda Mandelstam, wife of Osip Mandelstam. Her recent song cycle, "Oracles", was based on the 'traditional arc of a fairytale'. Accordingly, her lyrics are quite literary in style, and she is therefore included in the new clutch of singers who cite literary sources and classical styles of playing as their primary reference points. She also plays piano and guitar.
In performance, she has played covers of Jacques Brel's "Ne Me Quitte Pas" and Britney Spears's "Womanizer". She has also written a song inspired by the life of Coco Chanel called 'Notes from an Opera'.
Ana Silvera has cited chanson singers such as Barbara and Jacques Brel as major influences.
- 2010 Hometown as limited edition 7" vinyl and on iTunes
- 2010 Hometown official video directed by Ryan Foregger
- 2010 Letter from New York available on iTunes
Solo albums
- 2012 "The Aviary" (Karamel Music Collective)
- 2006 Live at West Road Concert Hall (OT Records)
- 2007 Notes for Holy Larceny Yo Zushi (Pointy Records)
- ^ "Estonian Television Girls Choir Official Site". Retrieved 2011-07-20.
- ^ "Artsdesk Review". Retrieved 2014-07-12.
- ^ ""Oracles" Film by Kate Church". Retrieved 2014-07-12.
- ^ "The Aviary on Bandcamp". Retrieved 2011-07-20.
- ^ "Live Performance on The Verb". Retrieved 2011-07-20.
- ^ "Maxim Moston website". Retrieved 2014-07-12.
- ^ "Cassandra at the Royal Opera House". Retrieved 2014-08-20.
External links[edit]
- Official website
- Ana Silvera Facebook page
- Ana Silvera blog
- Line of Best Fit interview
- Wears the Trousers Iiterview
- Link to BBC3 Verb Live Broadcast


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Villa Nicoletta - Caret Bay review We spent the week of 8/10-8/17 at Villa Nicoletta in Caret Bay St Thomas and here is our impression. The Good: 1. Amazing Views!! 3 out of 4 bedrooms had balconies with incredible views of the ocean and parts of the island. The villa faces east so sunrise views are spectacular. 2. The Tiki... More
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As stated on the official Champions of Norrath website, SOE director of marketing, Michael Lustenberger, notes, "Voice chat is the final piece of the puzzle with Champions. It's the one feature that has been most requested in the game and we are pleased to announce its inclusion. With the addition of voice chat, we believe Champions is now far and away the leader in its genre."
Champions of Norrath, exclusively for the Playstation 2 console, is slated for a February release in the US and Canada.
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n.— «Casting aspersions on all the "nurdle" explanations that have gone before, E.R. McSwine explains, with an air of authority, that the word came from "nodule," which was part of the original phrase, "Styrofoam packing nodules."» —"Compliments to One and All" by Leah Garchik San Francisco Chronicle (California) Oct. 9, 1997. (source: Double-Tongued Dictionary)
- Sweet Dreams 06/17/2016: In deafening workplaces, like sawmills and factories, workers develop their own elaborate sign language to discuss everything from how their weekend went to when the... [more]
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Articles tagged sin nombre
26 Oct 2011 // 10:00 PM
Illegal immigration is a hotly contested topic in American society and politics. Sin Nombre opens up important questions about migration that documentaries often ignore: there is no such monolithic category as "the immigrant", and migration is not solely an economic decision.READ more
//Mixed media
Blesst Chest "Blesst Chest Theme Song" (audio) (premiere) // Music
The Chairman Dances "Dorothy Day and Peter Maurin" (audio) (premiere) // Music
National Park Radio 'The Great Divide' (album stream) (premiere) // Music
Kendra Erika "The Truth Never Lies" (video) (premiere) // Music
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Culture Belongs to the Alien in 'Spirits of Xanadu'
// Moving Pixels
"The symbols that the artifact in Spirits of Xanadu uses are esoteric -- at least for the average Western gamer. It is Chinese culture reflected back at us through the lens of alien understanding.READ the article


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Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
D. J. Fitzgerald singled, doubled, tripled, stole a base, scored one run, and knocked-in two more, and LHP Austin Kirk threw four shutout innings, as the Peoria Chiefs rallied to tie the Cedar Rapids Kernels (Los Angeles Angels Class "A" affiliate) 3-3 on Field #2, while next-door on Field #3 Michael Burgess clubbed a grand slam HR over the RF fence and Evan Crawford doubled, tripled, walked, stole a base, drove-in two runs, and scored another, as the Daytona Cubs rallied from an early 5-0 hole to tie the Inland Empire 66ers (Angels Advanced "A" affiliate) 7-7, in Cactus League Minor League Spring Training action at Fitch Park in Mesa, AZ, this morning.
This was the "getaway day" game for both Daytona and Peoria, but since the Iowa Cubs will be remaining in Mesa for another day (they open the season Thursday at Round Rock, TX), I-Cubs catcher Welington Castillo stayed at Fitch Park and served as a DH for Daytona while his teammates traveled to Diablo Park in Tempe to face the Angels Salt Lake Bees AAA affiliate.
After a short intrasquad game on Field #1, several players from the Boise/Mesa (Extended Spring Training) squad (C Yaniel Cabezas, SS Wes Darvill, 3B Dustin Harrington, C Brian Inoa, and LF Blair Springfield) saw some late game action with Daytona in the game on Field #3. (Players from the Boise/Mesa Extended Spring Training group are often used as late inning replacements in Minor League Spring Training games).
Peoria OF Matt Szczur (who has been sidelined more than a week with a leg injury) was able to run the bases in a PFP & baserunning work-out with some of the pitchers from the Boise/Mesa squad on Field #4 prior to the intrasquad game on Field #1. It is unknown if Szczur will be cleared for game action by Opening Day next Thursday, or if he will begin the season on the Peoria 7-day DL and remain at Fitch Park for a few more days.
And OF Smaily Borges has been moved down to Peoria from Tennessee, probably to serve as a "Crash Davis"-type minor league mentor to RHP Juan Yasser Serrano and OF Rubi Silva (all three are Cuban defectors, but the 27-year old Borges is older than the others, and was brought to the U. S. by the Cubs a year earlier). It's possible that Borges will eventually serve as a player-coach at Peoria (like 1B John Urick is at Daytona), although he is probably needed on the Chiefs active roster right now, at least until Szczur returns to game action.
In addition, RHP Alessandro Maestri and LHP Chris Siegfried have been released (both were with the Tennessee squad). Siegfried was the Cubs 11th round draft pick in 2007 out of the U. of Portland (where he was a teammate of current Iowa RHP Austin Bibens-Dirkx), and Maestri was the first player signed by the Cubs out of the MLB European Academy (in January 2006). Despite getting released by the Cubs, the 25-year old Maestri could be the #1 starting pitcher for Team Italy in next year's World Baseball Classic (he pitched for Team Italy in both the 2006 and 2009 WBC), presuming there is one.
The DAYTONA CUBS OPENING DAY ROSTER has been established;
* bats or throws left
# bats both
PITCHERS (13): * Jeffrey Beliveau, * Brent Ebinger, Ty'Relle Harris, Aaron Kurcz, Jordan Latham, * Jeff Lorick, Dae-Eun Rhee, Kevin Roderick, * Zac Rosscup, Ryan Searle, Nick Struck, Brett Wallach, and Rob Whitenack
CATCHERS (2): Michael Brenly and Chad Noble
INFIELDERS (6): * Justin Bour, * Matt Cerda, Junior Lake, # David Macias, * Jake Opitz, and * Logan Watkins,
OUTFIELDERS (4): * Michael Burgess, Evan Crawford, Jae-Hoon Ha, and * Nelson Perez
PLAYER-COACH (1): * John Urick (1B signed to a player contract, but is inactive unless needed and normally serves as 1st base coach)
Here are today's abridged box scores from Fitch Park (Cubs players only):
FIELD #2 (CLASS "A" – Peoria Chiefs vs Cedar Rapids Kernels)
1. Arismendy Alcantara, SS: 1-4 (P-5, 6-3, 6-3, 1B, R)
2. Rubi Silva, CF: 1-4 (5-3, K, 1-3, 1B)
3. D. J. Fitzgerald, LF: 3-4 (E-5, 3B, 1B, 2B, R, 2 RBI, SB, PO)
4. Richard Jones, 1B: 1-4 (1B, F-7, F-8, K, RBI)
5a. Ryan Cuneo, DH: 0-1 (F-7)
5b. Smaily Borges, PH-DH: 0-3 (F-9, 6-4 FC, K)
6. Anthony Giansanti, 3B: 2-4 (1B+E6, F-8, K, 1B)
7. Xavier Batista, RF: 1-4 (K, L-5, E-5, 1B)
8. Sergio Burruel, C: 0-4 (5-3, K, 6-4-3 DP, 6-4-3 DP)
9. Elliot Soto, 2B: 1-3 (K, K, 1B, R)
1. Austin Kirk: 4.0 IP, 5 H, 0 R, 0 BB, 3 K, 1 GIDP, 56 pitches (38 strikes), 5/4 GO/FO
2. Eric Jokisch: 1.2 IP, 3 H, 3 R (3 ER), 1 BB, 2 K, 1 HR, 34 pitches (21 strikes), 2/1 GO/FO
3. Bryce Shafer: 1.0 IP, 1 H, 0 R, 2 BB, 0 K, 1 WP, 26 pitches (10 strikes), 1/1 GO/FO
4. Juan Yasser Serrano: 1.1 IP, 1 H, 0 R, 0 BB, 1 K, 17 pitches (12 strikes), 2/1 GO/FO
5. Marcus Hatley: 1.0 IP, 1 H, 0 R, 0 BB, 3 K, 24 pitches (15 strikes)
1. CF Rubi Silva E-8 – dropped pop fly in CF allowing batter to reach base safely
2. C Sergio Burruel E-2 - dropped pop up in foul territory prolonging AB
Sergio Burruel: 1-1 CS, 1 E (see above)
FIELD #3 (CLASS "ADVANCED-A" – Daytona Cubs vs Inland Empire 66ers)
1a. Logan Watkins, 2B: 0-1 (K, BB, BB, R)
1b. David Macias, 2B: 1-2 (P-6, 1B, RBI)
2a. Matt Cerda, 3B: 0-3 (F-7, P-6, 4-6-3 DP)
2b. Dustin Harrington, 3B: 1-2 (1B, K)
3. Jae-Hoon Ha, DH #1: 0-4 (K, BB, F-9, 6-4-3 DP, 3-U, R)
4a. Justin Bour, 1B: 0-1 (K, BB, R)
4b. Jake Opitz, 1B: 0-2 (E-3, K, CS)
5. Welington Castillo, DH #2: 0-3 (BB, K, K, F-8)
6a. Michael Burgess, LF: 1-2 (K, HR, R, 4 RBI)
6b. Blair Springfield, LF: 0-2 (3-1, F-9)
7a. Michael Brenly, C: 0-1 (K, BB)
7b. Yaniel Cabezas, C: 1-1 (1B)
7c. Brian Inoa, C: 0-1 (F-7)
8. Nelson Perez, RF: 0-4 (K, K, K,, K+WP, R)
9a. Junior Lake, SS: 0-2 (6-3, 3-U)
9b. Wes Darvill, SS: 0-2 (K, E-6, R)
10. Evan Crawford, CF: 2-3 (6-3, BB, 2B, 3B, R, 2 RBI, SB)
1. Aaron Kurcz: 4.0 IP, 7 H, 5 R (5 ER), 1 BB, 5 K, 67 pitches (45 strikes), 2/5 GO/FO
2. Dae-Eun Rhee: 3.0 IP, 3 H, 2 R (0 ER), 0 BB, 5 K, 48 pitches (34 strikes), 3/1 GO/FO
3. Jeff Lorick: 1.0 IP, 0 H, 0 R, 1 BB, 0 K, 10 pitches (4 strikes), 2/1 GO/FO
4. Jordan Latham: 1.0 IP, 2 H, 0 R, 0 BB, 1 K, 14 pitches (9 strikes), 2/0 GO/FO
5. Kevin Rhoderick: 1.0 IP, 1 H, 0 R, 0 BB, 1 K, 19 pitches (10 strikes), 2/0 GO/FO
1. P Aaron Kurcz E-1 – errant pick-off attempt at 2nd base allowed runner at 2nd and runner at 1st to advance a base
2. SS Junior Lake E-6 – fielding error allowed batter to reach base safely – eventually scored unearned run
3. LF Blair Springfield E-7 – errant throw back into infield after single allowed runner who had stopped at 3rd to score and batter-runner to move-up to 2nd base
Brian Inoa: 1 PB
WEATHER: Sunny & breezy with temperatures in the 80's
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
Thanks as always Phil. Does this mean that past 3rd round pick Dylan Johnston has finally bit the dust?
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
He was a 4th round pick and no, it means their experiment with trying to convert him to a pitcher failed; he's on the DL again with a shoulder injury-> Elbow, shoulder, shoulder.
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
Nice to see Dae-Eun Rhee have a nice outing. He was in a few Cubs top ten prospects lists before TJ. I was just interested in how he's looked this spring? It would be awesome if he could regain his 2009 form. Thanks.
this seems to happen a lot to a certain ballplayer
A groundout in the fourth gave the A's a 2-1 lead. Kurt Suzuki helped set up the run, reaching on a one-out double when Mariners left fielder Milton Bradley lost a fly ball in the sun.
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
Is it just me, or do you follow non-Cubs teams more than you follow the Cubs?
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
Not that I want to defend Bradley's defense or his concentration... you made it sound like MB did something boneheaded but in reality it was a tough sun field and Ryan Langerhans also lost one in the sun later in the game that was even more costly (in the 7th that lead to 4 runs, Bradleys lead only to one run).
Milton Bradley lost a ball in the bright sky in the fourth inning to give Kurt Suzuki a double that led to one run and Ryan Langerhans did the same on a two-base hit by Coco Crisp in the seventh that ignited a four-run outburst against rookie reliever Josh Lueke that broke the game open.
and here's a link that works...
or as Harry Caray said: "Aw, how could he (Jorge Orta) lose the ball in the sun, he's from Mexico."
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
That was Rey Sanchez Harry said that about. Playing SS the year Dunston left.
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
HC might have used a variation on that line more than once but it's all over the internets that he said it regarding Orta while broadcasting for the WSux.
Rey Sanchez is from Puerto Rico, although I think the HC reference may have just said "how can a Latin ballplayer lose a ball in the sun? Dunno, can't fine a soundbite on it. Here's a link that says the Rey Sanchez quote is a bit different:
I remember Sanchez more for getting a high infield pop fly hit to him and Harry Caray saying, "He's never missed one of these in his life," only for Sanchez to drop the ball and Steve Stone saying, "He just did!"
and the Jorge Orta links...
and a Northside Lounge thread that discusses both the Orta and Sanchez references as being different.
Re: Chiefs & D-Cubs Rally to Tie a Wrap on Minor League Camp
What happen to Luis Flores?? Released???
Recent comments
Stockpiling young talent isn't only for trading for someone like Chapman though. Even with an elite closer winning the World Series is basically a crap shoot so the key is to get to the playoffs as much as possible and not just mortgage everything on one year. Once you get there an elite bullpen certainly helps but the playoffs can be won by one hitter or starting pitcher getting hot (Murphy, Molina, Baumgardner) and a closer might not be able to stop that.
I'm also not crazy about press convictions. As the police report noted, there were no marks on the lady in question. There's a TMZ link (of course) to her police pictures, as well.
I think the only way this trade goes real bad is if Cubbery intervenes and Chapman is suddenly bad for some reason.
I am right there with you closing in on 60.
I don't care that much about "mortgaging" one player who is not only blocked by two guys, but is not ready to hit the majors for at least a couple years.
There is no reason why this team, this year, can't have a real shot at something NONE of us have experienced.
Further, I don't feel that even if they fall short that they have ruined their farm system.
I have made my opinion clear here, with others, Warren was shit on the Cubs save one spot start.
Trading for Warren, Warren sucking, getting Warren back for Chapman plus 3 prospects, sounds like Revenge of The Yankees on the former Boston executive. Old rivalries never die.
I pray to the heavens above Chapman doesn't suck for some reason, or he'll be booed out of town faster than a Todd Hundley revival meeting.
I'm kind of nostalgic for the Schwarber-for-Miller rumors.
This offseason, after some ridiculous playoff run and Chapman saving every game from here until the end of the postseason striking out 27/9innings, I welcome anyone to quote this thread and call me a dummy: I hate this trade, and my hate is 2 parts Chapman makes this team less likeable and 1 part that's a ridiculous overpay for 30 regular season innings and, at tops, 10 postseason innings. Already hoping they don't extend him.
btw...Thanks AZ Phil. I'm really enjoying your take on this trade.
I'm a bit disappointed on the Warren experience. Essentially they gave Castro away for crickets (OK, well they signed Zobrist with the Castro salary dump). Otherwise one might look at it as Chapman for Castro and our #1 minors prospect (Torres) + McKinney/Crawford. Seems pricey for a 2 month rental. We will see if this price tag is that steep in a relative way based on the remaining deadline deals for relievers.
Yep. One of the great things about this team (in addition to being really good at baseball) was the "likable" factor. Feels a bit different now. Who knows...maybe Chapman will be the king of the dance parties.
Here are some possible corresponding minor league moves we might see in the aftermath of the Chapman trade:
SOUTH BEND to MYRTLE BEACH: OF Donnie Dewees and INF Bryant Flete
EUGENE to SOUTH BEND: OF Robert Garcia and INF Vimael Machin
There is really no reason to replace Billy McKinney at Tennessee because both Chris Coghlan and Jorge Soler are doing their rehab at Tennessee.
And there are plenty of pitchers at Iowa. No need to replace Warren at AAA. .
I am 70 years old. The Cubs last played in the World Series in 1945. I was born in 1946. I hate to lose a prospect like Torres, but when the opportunity is there to get that World Series ring, you go for it. This was the idea in stock piling all this young talent. I would like to see Reddick added now and the Cubbies should be done.
I would expect Richard to accept an optional assignment because based on how he's played this season, there is a decent chance that he won't find work elsewhere. Rather stay and potentially get a ring. Same goes for Coghlan since he's struggled mightily this year.
Edwards should not go down. He's pitched very well and Maddon is very impressed with him. I would expect Grimm to go down for Cahill so he can get back on track (he's pitched better in July, but he's not getting enough appearances).
chitownmvp01: Indeed Clayton Richard would seem to be odd man out once Chapman reports, but Richard might accept a minor league assignment if he is promised a return to Chicago on 9/1 when MLB Active List rosters expand (Richard has minor league ioptions left).
The only player in the deal that would cause me a second thought is Gleyber Torres.
McKinney and Crawford are decent prospects but both are redundant/replaceable in the system and Warren was really only a middle-reliever or #6 starter, so to me it's really just Torres for Chapman.
There is no Comp pick for players traded mid-season. 2+ months of Chapman is it.
to get one of the best you have to give up one/some of your best...but it's a bit painful to watch the system's best prospect walk for any 2-3 month rental, especially one that's not an everyday player.


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|November 20, 2012 09:42 AM EST
Datadog, an innovator in the IT monitoring space, today announced a $6.2M A-round of funding, co-led by Index Ventures and RTP Ventures, an affiliate of ru-Net Holdings, with participation from existing investors IA Ventures, Amplify Partners, Contour Ventures and NYCSeed. With the new funding, Datadog intends to expand its development, sales and marketing operations to serve its rapidly growing enterprise customer base.
Unlike traditional monitoring products, Datadog focuses on presenting an integrated view of the tools and services used by IT teams across development and operations, and delivering the right insights to the relevant team members. In addition to its out-of-the-box capabilities, Datadog is built to aggregate data from other applications, cloud providers and specialized management tools, covering the full lifecycle from code change to deployment to monitoring alert with a consistent data model and experience from end-to-end.
"IT teams are deluged with data from an ever larger number of tools, creating as many data silos that prevent them from understanding and resolving issues," said Olivier Pomel, CEO of Datadog. "We founded Datadog to make it easy and affordable for enterprises to tame this complexity, embrace faster release cycles, and marry legacy and next-generation architectures while avoiding split brains between Development and Operations."
"Datadog gives us visibility into our performance metrics, alerts and incidents, no matter the origin. As a result Dev and Ops teams have an easier time being on the same page, and at the end of the day, we see fewer issues and solve them faster," said Sabry Tozin, SVP Engineering at IGN, a Datadog enterprise customer.
"Our success is based on the simple premise that we built a tool practitioners want to use. It takes 5 minutes to set up, servers, clouds and apps appear automatically, and the product is as friendly as the best consumer sites," added Alexis Le-Quoc, CTO, Datadog.
"Olivier, Alexis and the Datadog team have identified a significant opportunity within increasingly complex IT environments and built an elegant and easy to deploy product for Devops. We're excited to welcome them to the Index family," said Shardul Shah, Index Ventures.
"We see Datadog setting the standard for infrastructure monitoring in the cloud age: they aggregate tens of billions of records a day from dozens of sources for their largest customers, yet present it in a simple interactive package," said Murat Bicer, Managing Director at RTP Ventures. "We are thrilled to be partnering with them."
About Index Ventures
Index Ventures is a leading global venture capital firm active in technology and biotechnology investing since 1996. From our offices in Geneva, London and San Francisco we love to discover and support the most entrepreneurial teams wherever they are looking to build market defining global businesses. For more information on our investments, from seed through to growth stage, please visit http://www.indexventures.com
About RTP Ventures
Ru-net Technology Partners (RTP), an affiliate of ru-Net Holdings, is an early stage venture capital firm. Investing globally out of offices in New York, Boston and Moscow, we support entrepreneurs building innovative technologies with a focus on cloud computing, software as a service, and enterprise infrastructure. For more information, please visit our website at http://www.rtp.vc.
About Datadog
Datadog is a service for IT, operations and development teams who write and run applications at scale, and want to turn the massive amounts of data produced by their apps, tools and services into actionable insight. Datadog is a privately-held, venture-funded company based in New York City. To tame the complexity of your systems, maximize velocity, availability and performance, and avoid split-brains between dev and ops, try it at http://datadoghq.com You'll be up and running in 5 minutes.
There will be new vendors providing applications, middleware, and connected devices to support the thriving IoT ecosystem. This essentially means that electronic device manufacturers will also be in the software business. Many will be new to building embedded software or robust software. This creates an increased importance on software quality, particularly within the Industrial Internet of Things where business-critical applications are becoming dependent on products controlled by software. Qua...
Jul. 24, 2016 05:30 AM EDT Reads: 1,285
"There's a growing demand from users for things to be faster. When you think about all the transactions or interactions users will have with your product and everything that is between those transactions and interactions - what drives us at Catchpoint Systems is the idea to measure that and to analyze it," explained Leo Vasiliou, Director of Web Performance Engineering at Catchpoint Systems, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York Ci...
Jul. 24, 2016 04:45 AM EDT Reads: 1,864
SYS-CON Events has announced today that Roger Strukhoff has been named conference chair of Cloud Expo and @ThingsExpo 2016 Silicon Valley. The 19th Cloud Expo and 6th @ThingsExpo will take place on November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. "The Internet of Things brings trillions of dollars of opportunity to developers and enterprise IT, no matter how you measure it," stated Roger Strukhoff. "More importantly, it leverages the power of devices and the Interne...
Jul. 24, 2016 04:45 AM EDT Reads: 1,968
The Internet of Things will challenge the status quo of how IT and development organizations operate. Or will it? Certainly the fog layer of IoT requires special insights about data ontology, security and transactional integrity. But the developmental challenges are the same: People, Process and Platform. In his session at @ThingsExpo, Craig Sproule, CEO of Metavine, demonstrated how to move beyond today's coding paradigm and shared the must-have mindsets for removing complexity from the develo...
Jul. 24, 2016 01:30 AM EDT Reads: 1,128
SYS-CON Events announced today that MangoApps will exhibit at the 19th International Cloud Expo, which will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA. MangoApps provides modern company intranets and team collaboration software, allowing workers to stay connected and productive from anywhere in the world and from any device.
Jul. 24, 2016 01:15 AM EDT Reads: 1,218
The IETF draft standard for M2M certificates is a security solution specifically designed for the demanding needs of IoT/M2M applications. In his session at @ThingsExpo, Brian Romansky, VP of Strategic Technology at TrustPoint Innovation, explained how M2M certificates can efficiently enable confidentiality, integrity, and authenticity on highly constrained devices.
Jul. 24, 2016 01:15 AM EDT Reads: 878
"We've discovered that after shows 80% if leads that people get, 80% of the conversations end up on the show floor, meaning people forget about it, people forget who they talk to, people forget that there are actual business opportunities to be had here so we try to help out and keep the conversations going," explained Jeff Mesnik, Founder and President of ContentMX, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 23, 2016 11:45 PM EDT Reads: 1,219
Internet of @ThingsExpo has announced today that Chris Matthieu has been named tech chair of Internet of @ThingsExpo 2016 Silicon Valley. The 6thInternet of @ThingsExpo will take place on November 1–3, 2016, at the Santa Clara Convention Center in Santa Clara, CA.
Jul. 23, 2016 11:15 PM EDT Reads: 1,860
When people aren't talking about VMs and containers, they're talking about serverless architecture. Serverless is about no maintenance. It means you are not worried about low-level infrastructural and operational details. An event-driven serverless platform is a great use case for IoT. In his session at @ThingsExpo, Animesh Singh, an STSM and Lead for IBM Cloud Platform and Infrastructure, will detail how to build a distributed serverless, polyglot, microservices framework using open source tec...
Jul. 23, 2016 11:00 PM EDT Reads: 2,234
The 19th International Cloud Expo has announced that its Call for Papers is open. Cloud Expo, to be held November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, brings together Cloud Computing, Big Data, Internet of Things, DevOps, Digital Transformation, Microservices and WebRTC to one location. With cloud computing driving a higher percentage of enterprise IT budgets every year, it becomes increasingly important to plant your flag in this fast-expanding business opportuni...
Jul. 23, 2016 10:15 PM EDT Reads: 2,443
From wearable activity trackers to fantasy e-sports, data and technology are transforming the way athletes train for the game and fans engage with their teams. In his session at @ThingsExpo, will present key data findings from leading sports organizations San Francisco 49ers, Orlando Magic NBA team. By utilizing data analytics these sports orgs have recognized new revenue streams, doubled its fan base and streamlined costs at its stadiums. John Paul is the CEO and Founder of VenueNext. Prior ...
Jul. 23, 2016 09:30 PM EDT Reads: 1,951
A critical component of any IoT project is what to do with all the data being generated. This data needs to be captured, processed, structured, and stored in a way to facilitate different kinds of queries. Traditional data warehouse and analytical systems are mature technologies that can be used to handle certain kinds of queries, but they are not always well suited to many problems, particularly when there is a need for real-time insights.
Jul. 23, 2016 08:45 PM EDT Reads: 1,665
CenturyLink has announced that application server solutions from GENBAND are now available as part of CenturyLink's Networx contracts. The General Services Administration (GSA)'s Networx program includes the largest telecommunications contract vehicles ever awarded by the federal government. CenturyLink recently secured an extension through spring 2020 of its offerings available to federal government agencies via GSA's Networx Universal and Enterprise contracts. GENBAND's EXPERiUS™ Application...
Jul. 23, 2016 08:30 PM EDT Reads: 1,779
"My role is working with customers, helping them go through this digital transformation. I spend a lot of time talking to banks, big industries, manufacturers working through how they are integrating and transforming their IT platforms and moving them forward," explained William Morrish, General Manager Product Sales at Interoute, in this SYS-CON.tv interview at 18th Cloud Expo, held June 7-9, 2016, at the Javits Center in New York City, NY.
Jul. 23, 2016 08:30 PM EDT Reads: 2,033
Big Data engines are powering a lot of service businesses right now. Data is collected from users from wearable technologies, web behaviors, purchase behavior as well as several arbitrary data points we'd never think of. The demand for faster and bigger engines to crunch and serve up the data to services is growing exponentially. You see a LOT of correlation between "Cloud" and "Big Data" but on Big Data and "Hybrid," where hybrid hosting is the sanest approach to the Big Data Infrastructure pro...
Jul. 23, 2016 08:00 PM EDT Reads: 1,804
Internet of @ThingsExpo, taking place November 1-3, 2016, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with the 19th International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world and ThingsExpo Silicon Valley Call for Papers is now open.
Jul. 23, 2016 08:00 PM EDT Reads: 2,423
The IoT is changing the way enterprises conduct business. In his session at @ThingsExpo, Eric Hoffman, Vice President at EastBanc Technologies, discussed how businesses can gain an edge over competitors by empowering consumers to take control through IoT. He cited examples such as a Washington, D.C.-based sports club that leveraged IoT and the cloud to develop a comprehensive booking system. He also highlighted how IoT can revitalize and restore outdated business models, making them profitable ...
Jul. 23, 2016 07:15 PM EDT Reads: 1,878
We all know the latest numbers: Gartner, Inc. forecasts that 6.4 billion connected things will be in use worldwide in 2016, up 30 percent from last year, and will reach 20.8 billion by 2020. We're rapidly approaching a data production of 40 zettabytes a day – more than we can every physically store, and exabytes and yottabytes are just around the corner. For many that's a good sign, as data has been proven to equal money – IF it's ingested, integrated, and analyzed fast enough. Without real-ti...
Jul. 23, 2016 07:00 PM EDT Reads: 892
I wanted to gather all of my Internet of Things (IOT) blogs into a single blog (that I could later use with my University of San Francisco (USF) Big Data "MBA" course). However as I started to pull these blogs together, I realized that my IOT discussion lacked a vision; it lacked an end point towards which an organization could drive their IOT envisioning, proof of value, app dev, data engineering and data science efforts. And I think that the IOT end point is really quite simple…
Jul. 23, 2016 06:15 PM EDT Reads: 829
With 15% of enterprises adopting a hybrid IT strategy, you need to set a plan to integrate hybrid cloud throughout your infrastructure. In his session at 18th Cloud Expo, Steven Dreher, Director of Solutions Architecture at Green House Data, discussed how to plan for shifting resource requirements, overcome challenges, and implement hybrid IT alongside your existing data center assets. Highlights included anticipating workload, cost and resource calculations, integrating services on both sides...
Jul. 23, 2016 06:00 PM EDT Reads: 1,902


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Dental prosthetics are intraoral prosthesis applied to reconstruct or restore intraoral defects such as missing parts of teeth, missing teeth, and missing hard or soft structures of the jaw and palate. The market for dental prosthetics is segmented as bridges, crowns, veneers, dentures, and others that include inlays, onlays, etc. The dental prosthetics market is expanding at a promising growth rate globally owing to the rising geriatric population, advancement in dental prosthetics, rising edentulous population and rising incidences of dental caries and other periodontal conditions. According to the American Association of Oral and Maxillofacial Surgeons, around 69% of adults aged 35 years to 44 years have lost at least one permanent tooth due to tooth decay, an accident, gum disease or a failed root canal. The rising number of tooth loss cases would subsequently fuel the market for dental prosthetics during the forecast period. Moreover, rising prevalence of lifestyle habits such as smoking, tobacco intake, and dietary irregularities are responsible for the growth in number of oral cancer patients in the world. Hence, high prevalence of oral cancer would increase demand for dental reconstruction, which in turn would propel the growth of dental prosthetics market. However, poor dental coverage and low reimbursement could hamper the growth of market during the forecast period.
The global dental prosthetics market has been estimated on the basis of types of dental prosthesis such as bridges, crowns, veneers, dentures and other products that include inlays and onlays. The crown segment accounted for the largest market share of the overall dental prosthetics market in 2014 and continues to be the leader during the forecast period. According to American Academy of Implant Dentistry, around 15 million people in the U.S. undergo crowns and bridge replacements for missing teeth every year.
Geographically, the dental prosthetics market has been categorized into five regions: North America, Europe, Asia-Pacific, Latin America and Middle East and Africa. Europe accounted for the largest market share of the dental prosthetics market followed by North America in 2014. Rising geriatric population, presence of major players and well-structured distribution channel are driving the growth of these regions. Furthermore, the European Commission (Eurostat) has estimated that the geriatric population in Europe would reach 525 million by 2035. The aging population plays an important role in the growth of the market as tooth decay, periodontal disease, and caries become more severe and prevalent with age. Thus, rise in geriatric population would boost the demand for dental prosthetics. Asia Pacific was the third largest market for dental prosthetics, the region is expected to register the fastest CAGR during the forecast period. Large untapped opportunities, improving health care infrastructure, increasing prevalence of oral cancer and other periodontal diseases, expansion of market players, and rising geriatric population in the region would contribute to the market growth.
Institut Straumann AG, Dentsply International, Inc., Nobel Biocare Holdings AG, Zimmer Biomet Holdings, Inc., Avinent Implant Systems, Ivoclar Vivadent Inc.and Biohorizons, Inc. are the major players operating in the global dental prosthetics market. Most of these players are constantly striving to retain or enhance their market share by developing technologically advanced products.
1. Preface
1.1. Report Description
1.2. Market Segmentation
1.3. Research Methodology
2. Executive Summary
2.1. Global Dental Prosthetics Market Share, by Geography, 2014(%)
2.2. Global Dental Prosthetics Market, by Type, 2014 (US$ Mn)
2.3. Dental Prosthetics: Market Snapshot
3. Global Dental Prosthetics Monitors Market – Industry Analysis
3.1. Introduction
3.2. Drivers
3.2.1. Rise in geriatric population
3.2.2. Increase in incidence of oral diseases and rise in the number of dental procedures
3.2.3. Growing medical tourism in developing nations
3.3. Restraints
3.3.1. Competitive pricing and equipment costs
3.4. Opportunities
3.4.1. New products, services, and device development
3.4.2. Emerging economies to offer sustained growth opportunities
3.5. Porter's Five Forces Analysis
3.6. Market Attractiveness Analysis – Dental Prosthetics Market
3.7. Market Share – Dental Prosthetics Market (2014) (%)
4. Market Segmentation – By Type
4.1. Introduction
4.2. Global Dental Bridges Market Revenue, 2013–2023, (US$ Mn)
4.3. Global Dental Crowns Market Revenue, 2013–2023, (US$ Mn)
4.4. Global Dental Veneers Market Revenue, 2013–2023, (US$ Mn)
4.5. Global Dentures Market Revenue, 2013–2023, (US$ Mn)
4.6. Global others (inlays, onlays, etc.) Market Revenue, 2013–2023, (US$ Mn)
5. Dental Prosthetics Market - Regional Analysis
5.1. Global Dental Prosthetics Market: Regional Overview
5.2. North America Dental Prosthetics Market Overview
5.3. Europe Dental Prosthetics Market Overview
5.4. Asia Pacific Dental Prosthetics Market Overview
5.5. Latin America Dental Prosthetics Market Overview
5.6. Middle East and Africa Dental Prosthetics Market Overview
6. Recommendations
7. Company Profiles
7.1. 3M Health Care
7.2. AVINENT Implant System, S.L
7.3. BioHorizons, Inc.
7.4. DENTSPLY International, Inc.
7.5. Ivoclar Vivadent AG
7.6. Institut Straumann AG
7.7. Nobel Biocare Holdings AG
7.8. Zimmer Biomet Holdings, Inc
This report on the dental prosthetics market studies the current and future prospects of the global market. Dental prosthetics are intraoral prosthesis applied to reconstruct or restore intraoral defects such as missing parts of teeth, missing teeth, and missing hard or soft structures of the jaw and palate. Growing prevalence of dental diseases, increasing geriatric population, and increasing awareness about advanced dental prosthetics is expected to accentuate the growth of dental prosthetics market globally.
The dental prosthetics market report comprises an elaborate executive summary, which includes a market snapshot that provides information about various segments and sub-segments of the market. It also provides information and data analysis of the global dental prosthetics market with respect to market segments based on the type dental prosthetics and their geographic analysis.
Based on type, the dental prosthetics market has been segmented into five major categories: bridges, crowns, veneers, dentures and other segment that include inlays and onlays. The market segments have been extensively analyzed based on usefulness, efficacy, revenue, and geographical coverage. The market size and forecast in terms of USD million for each segment has been provided for the period from 2013 to 2023. The report also provides the compound annual growth rate (CAGR %) for each market segment for the forecast period from 2015 to 2023, considering 2014 as the base year.
Geographically, the global dental prosthetics market has been categorized into five major regions: North America, Europe, Asia Pacific, Latin America and Middle East and Africa. The market size and forecast for each of these regions has been provided for the period from 2013 to 2023, along with their respective CAGRs for the forecast period from 2015 to 2023, considering 2014 as the base year. The research study also covers the competitive scenario in these regions. A detailed qualitative analysis of factors responsible for driving and restraining the growth of the market and future opportunities has been provided in the market overview section. This section of the report also provides market attractiveness analysis, Porter's Five Forces analysis, and market share analysis by key players, thus presenting a thorough analysis of the overall competitive scenario in the global dental prosthetics market.
A list of recommendations has been provided for new entrants as well as existing market players to assist them in taking strategic initiatives to establish a strong presence in the market. The report also profiles major players in the intracranial pressure monitors market based on various attributes such as company overview, financial overview, product portfolio, business strategies, and recent developments. Major players profiled in this report include 3M Health Care, AVINENT Implant System, S.L., Biohorizons, Inc., Institut Straumann AG, Nobel Biocare Holdings AG, DENTSPLY International, Inc., Ivoclar Vivadent AG and Zimmer Biomet Holdings, Inc.,
The global dental prosthetics market is segmented as follows:
Global Dental Prosthetics Market, by Type
- Bridges
- Crowns
- Veneers
- Dentures
- Others (Inlays, Onlays, etc.)
Global Dental Prosthetics Market, by Geography
- North America
- Canada
- Europe
- Germany
- Rest of Europe
- Asia Pacific
- China
- India
- Rest of Asia Pacific
- Latin America (LATAM)
- Brazil
- Rest of LATAM
- Middle East and Africa (MEA)
- South Africa
- Rest of MEA


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THE SATURDAY PROFILE; On War Criminals' Trail, an Unflagging Hunter
Published: February 9, 2002
(Page 2 of 2)
THE murder of her mentor in 1992 by Sicilian gangs shook her. Briefly she wanted to give up her work. But every year in May, the anniversary of his death, she said, she joins other magistrates in visiting Mr. Falcone's grave in Palermo. It is a sign, this pilgrimage, of the pledge she made to perpetuate his efforts.
What she finds most difficult in her work, she said, is the lack of time. Travel, cajoling governments to arrest suspects, staffing problems, coping with the United Nations bureaucracy -- all this consumes her.
''I'd like to be in court more to argue cases, but I have very full days,'' she said.' And personally? ''My private life, I'd say, is very limited, almost nonexistent. But it's not a big sacrifice, because I love my work. I'll catch up later.''
She married twice, both times to lawyers, and both marriages ended in divorce years ago. ''It couldn't be helped,'' she said with a hint of regret. ''They were Latin men who still had notions that a woman's place is in the home.''
She lit yet another cigarette. She has been trying to quit. But, she lamented, quitting demands too much energy.
In her office at the tribunal, a few days later, she was in a prankish mood. She picked up a small digital camera, a gift from her only son, the cinematographer. ''Now it's my turn to ask questions,'' she said, training the camera on her interviewer. ''I'm collecting evidence. I'm using the same weapons.''
Her Arusha office is paneled with tropical wood and bare except for a blue United Nations flag. But on her office wall in The Hague, there are pictures of the three most-wanted men in the Balkans. The portrait of Slobodan Milosevic now has a large blue cross through it. ''Of course I'm satisfied to have him in court,'' she said of the Balkan strongman. Her fist hammered on the table, making her bracelets rattle: ''He has killed, he has committed thousands of crimes.''
There is another clue to Ms. Del Ponte's normally well-hidden emotions. In Bosnia and in Rwanda, she has visited the sites of massacres and sought out war victims, listening for hours to the stories of widows, bereft parents, people who have lost entire families.
''The prosecutor represents the victims,'' she said. ''I need the contact with them. It motivates me, it makes me understand what I'm doing. It's the human side of the law.''
So how does she feel now, facing Mr. Milosevic in court during recent hearings?
''At first I thought, well, finally I will meet the great Milosevic,'' she said. ''But he has been behaving like a sulking child.'' After one session, she said, ''I went up to him and told him: 'I'm ready to listen to you.'
''But he wouldn't talk to me. He kept staring at the floor. Finally, I gave myself a small satisfaction. I told the guards, 'Please, just take him away.' ''
Photo: CARLA DEL PONTE (Roger Dohmen/HH, for The New York Times)