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Author Affiliations: Departments of Audiology (Mss Schultz and Pecora Liberman and Dr Goffi-Gomez) and Radiation Oncology (Dr Pellizzon), Hospital do Câncer A. C. Camargo, São Paulo, and Head and Neck Surgery and Otorhinolaryngology Department, Hospital de Cancer de Barretos, Barretos (Dr Carvalho), Brazil.
To investigate occurrences of hearing loss and hearing complaints among patients with head and neck tumors who underwent radiotherapy.
Prospective case-control study.
Tertiary care hospital.
Two hundred eighty-two participants underwent evaluation, including 141 with head and neck tumors and 141 as an age-matched control group. The controls had never undergone oncological treatment that put their hearing at risk.
Main Outcome Measures
Results of audiological evaluation, including the Hearing Handicap Inventory for the Elderly questionnaire and pure-tone, speech, and immittance audiometry, and radiation dose received by the auditory system (based on the percentage of the external auditory canal included in the radiation field).
We observed occurrences of hearing loss in 102 (72.3%) of the participants exposed to radiotherapy and 69 (48.9%) of the control group (P < .001). Hearing losses were mostly sensorineural and of mild degree, but those exposed to radiotherapy more frequently presented with severe and mixed-type hearing losses (P < .001). Of the participants exposed to radiotherapy, 19.1% had a severe handicap (P < .001).
Patients undergoing radiotherapy in the head and neck region have a higher incidence of hearing loss and more severe hearing handicap.
Trial Registration
clinicaltrials.gov Identifier: NCT01102621
Hearing is an important sense for life because it is through hearing that interactions between the environment and society are established. Although there are different degrees of hearing loss, any impediment in conduction of sounds to the auditory nervous system signifies loss of message content, and this may give rise to emotional and social limitations and/or restrictions.
Head and neck cancer is the sixth most prevalent type of cancer worldwide. The treatment methods include surgery, chemotherapy, and radiotherapy, singly or in combination. Among other factors, the choice of treatment depends on the size and location of the tumor, the disease stage, the patient's condition, and, above all, the aim of the treatment (ie, curative or palliative).
Any of these treatment methods may affect the auditory system and cause transitory or permanent hearing losses. In surgical treatment, removal of the tumor and neck dissection may cause hearing losses. Chemotherapy with the use of ototoxic drugs such as cisplatin and carboplatin, when used at high doses, may lead to sensorineural hearing losses.1- 3
Irradiation of head and neck tumors is increasingly used and usually involves the region of the temporal bone in cases of primary tumors and cervical metastases. Sequelae from this treatment and its clinical manifestations may occur during the treatment, just after finishing it,4 or even many years after finishing it.5,6
Depending on the location and size of the tumor, the irradiation dose that reaches the structures of the auditory system may be almost 100%, such as in cases of nasopharyngeal tumors, in which the auditory tube and the mucosa of the middle ear receive practically the same dose as the tumor.7 With intensity-modulated radiotherapy, some authors found that hearing can be protected by administering limited radiation doses to the inner and middle ear.8
However, when the inner ear is included in the irradiation field, permanent sensorineural hearing loss as a consequence of radiotherapy involving the cochlea is much more harmful and of great concern. This may result in cognitive deficit, depression, and even diminished living conditions for the individual.
Sensorineural hearing loss occurs after a latent period ranging from 1½ to 5 years after conventional fractionated radiotherapy.9 Such hearing reduction seems to result from the loss of ciliated cells in the cochlea, especially in the basal turn, and/or damage to the spiral ganglion. The etiology of these losses is thought to relate to insufficient vascularization, thus leading to progressive degeneration and atrophy of the sensory structures of the inner ear, fibrosis and even ossification of the fluids of the inner ear,10 and abnormalities of the cochlear nerve.
The quality of life of patients with cancer has become a matter of growing concern because of higher survival rates. Therefore, we should determine and understand the hearing difficulties that might have a negative impact and may impose changes or restrictions that affect the lives of patients with cancer. Recognizing these patients' problems, limitations, and reactions when faced with communication difficulties will enable better rehabilitation.
In 1982, the Hearing Handicap Inventory for the Elderly (HHIE) was drawn up and standardized with the aim of identifying and grading hearing difficulties and disabilities, as well as the emotional and social aspects of hearing loss. It was translated and adapted to Brazilian Portuguese in 1997 and has been in use since then.
The aims of the present study were to evaluate the frequency of hearing complaints and abnormalities and to characterize such problems among patients with head and neck cancer who have undergone radiotherapy alone or in association with chemotherapy or surgery.
This was a prospective, transversal, case-control study in which the individuals in the exposed (study) and control groups were selected in accordance with the following criteria. The group of exposed individuals consisted of patients with a disease-free survival interval of at least 2 years subsequent to treatment for head and neck cancer that was based on radiotherapy alone or in combination and in which the auditory system was included in the field of irradiation.
The group of nonexposed individuals (control group) was composed of patients with cancer and volunteers who were invited to participate in a study and signed the informed consent without being asked whether they had any previous hearing problems or complaints. The patients with cancer underwent local surgery only, with no chemotherapy or radiotherapy. The volunteers (members of the health care volunteers' team of the Hospital do Câncer A. C. Camargo, a tertiary care hospital) were invited to participate according to their age to complete the age-matched groups (±2 years). The protocol was approved by the internal review board and all of these individuals.
Before each evaluation, the patients answered the question "Do you think you are hearing well?" to detect and characterize the presence of hearing complaints. The HHIE questionnaire11 was also applied. Audiological evaluation was performed between 2 and 29 years after the end of treatment, with a median of 7 years.
For the audiological evaluation, the following procedures were used: otoscopy; pure-tone threshold audiometry through the airways or, if necessary, through bones; and vocal audiometry, using the speech reception threshold and the speech recognition index. Acoustic immittance measurements were made, along with tympanometry and contralateral measurements of the stapedius acoustic reflex thresholds, at the frequencies of 500, 1000, 2000, and 4000 Hz.
All the patients in the exposed group had undergone standardized radiotherapy, that is, once a day with a fraction of the dose of 180 or 200 cGy. This was administered 5 days a week using photons of 4 or 6 MV. The fields of irradiation used (amount, shape, and entry point) and the incident plane depended on the location of the primary lesion and its areas of drainage.
We studied the simulation of radiotherapy planning to localize the external acoustic meatus.12 A 2.5-cm-diameter circle was drawn to include the auditory system. Hence, the percentage of the area of the circle reached by the radiation field was considered for the statistical analysis. When the acoustic meatus was far from the radiation field (ie, contralateral ear), it was given a 3% value of the radiation total dose as a reference by suggestion of the radiotherapist (A.C. de A.P.). Thus, the results from the audiological evaluation were analyzed per ear.
The degree of hearing handicap was divided into the following 3 categories in accordance with the scoring from the HHIE questionnaire, as suggested by the authors: category 0, with scores from 0% to 16%; category 1, with scores from 18% to 42%; and category 2, with scores of more than 42%.
We used commercially available software (SPSS for Windows, version 12.0; SPSS, Inc, Chicago, Illinois) for the statistical analysis. This analysis consisted of calculating means, medians, and standard deviations for the quantitative variables and absolute and relative frequencies for the qualitative variables. To compare hearing losses and their characteristics between the groups, we used the χ2 test. For all statistical test results, P ≤ .05 was considered statistically significant.
In the group exposed to radiotherapy, 141 patients underwent evaluation, including 98 male (69.5%) and 43 female (30.5%) patients. Their ages ranged from 13 to 84 (mean, 61.9) years. In the control group, 141 patients underwent evaluation, including 82 male (58.2%) and 59 female (41.8%) participants. Their ages ranged from 11 to 84 (mean, 61.5) years (Table 1). The most common tumor location was the larynx (23.4%), followed by the nasopharynx (14.8%) and tongue (10.6%). Other sites included the hypopharynx, parotid, soft palate, hard palate, and lower lip (58.2%). Some patients had tumors in multiple locations. After clinical staging, 31.2% of the tumors were designated T1 or T2 and 62.5% were designated T3 or T4. In addition, 2.8% of the tumors were recurrent, and for 3.5% the information was not available. After node staging, 75.2% of the tumors were designated N0 or N1, 3.5% were N2 or N3, and for 21.3% the information was not available. One patient in the sample (0.7%) had M1 stage cancer.
Hearing losses of the sensorineural type predominated, but occurrences of conductive hearing losses (≤0.7%) and mixed-type hearing losses (≤16.3%) were also seen in either ear and in both groups. In the group of individuals exposed to radiotherapy, mild to moderate hearing losses were observed in 57.4% of right ears and 59.6% of left ears. In the control group, hearing abilities were within normal limits in 56.7% of right ears and 55.3% of left ears, and there were mild to moderate hearing losses in 42.6% and 43.3% of right and left ears, respectively; that is, the exposed group presented with hearing losses 20% more frequently (Table 2). In addition, severe or profound hearing losses or anakusis occurred in the exposed group in 6.4% of right ears and 8.5% of left ears compared with only 0.7% and 1.4%, respectively, in the control group (Table 2).
The tympanometric curve was normal in 75.0% of the ears in the group of individuals exposed to radiotherapy and in 95.0% of the ears in the control group. The stapedius reflex was absent in around 65.0% of the ears in the exposed group, and this was inverted in the control group, in which the stapedius reflex was present in 65.0% of the ears.
Although only a small number of patients underwent chemotherapy with carboplatin, most of the patients who took this drug did not present with hearing loss. Most of the patients who underwent chemotherapy with cisplatin presented with hearing loss (Table 3). The total dose of 6500 cGy was statistically significant with regard to hearing losses for both ears (Table 4), but there was no statistically significant association between the percentage of the area of the auditory system that had been included in the field of irradiation and the presence of hearing losses for either ear.
There was a correlation between the degree of hearing loss and score on the HHIE questionnaire. Patients with a higher degree of hearing loss had higher scores on the questionnaire, that is, greater hearing loss was a major hearing handicap independent of group. Among the individuals who presented hearing losses of the most severe grade in both ears, 7 (70%) had a score of 2 on the HHIE questionnaire, demonstrating a major hearing handicap (Table 5).
Furthermore, severe handicap was observed in 2.8% of the participants in the control group vs 19.1% of the patients in the group exposed to radiotherapy. This indicates that, when present, hearing losses were substantially greater and more incapacitating after the radiotherapy.
In the vocal audiometry of the present study, the speech reception threshold that accompanied the degree of loss identified from tone audiometry and its values were mostly within normal limits, that is, greater than 88%, which suggests that the observed sensorineural hearing loss was cochlear.7
The control group was recruited by preferentially selecting individuals of the same sex and age as the exposed individuals. Male patients and individuals who were 50 years or older predominated in the study population. Hearing losses occurred in both sexes and in the 2 age group categories, but we could not conclude that sex and age were independent risk factors for hearing loss. In the control group, however, being 50 years or older was the only independent risk factor for hearing loss (Table 1). Auditory thresholds do not typically undergo significant change until 80 to 89 years of age.14 Hearing becomes severely impaired after the age of 90 years in both sexes,15 and sex has no influence on occurrences of hearing loss after radiotherapy. Such losses occur because of vascular damage in the ear, thereby leading to atrophy of the vascular striae in the basal turn of the cochlear duct and causing greater sensorineural hearing loss of high-pitched sounds. A study of the incidence of ototoxic effects after radiotherapy for head and neck tumors concluded that sex did not influence the development of this complication in univariate or multivariate analysis.16
Some authors have observed clinically significant hearing loss in older patients with green eyes and unfavorable pretreatment hearing after they were treated with intensity-modulated radiotherapy for head and neck tumors.17
Hearing loss associated with aging is a highly prevalent phenomenon among the elderly population, and it may lead to a series of difficulties in communication. In Brazil, presbycusis has been indicated as the most frequent cause of hearing deficiencies among elderly people. Based on the international literature, the National Policy for the Handicapped18,19 mentions a prevalence of hearing loss of about 30% in persons older than 65 years. Unfortunately, there is a large gap in the Brazilian literature regarding epidemiological population-based studies and data on hearing loss according to age and sex among the Brazilian population. Gates and Mills18 determined that, among the general population, the incidence of hearing loss sufficiently severe to impair communication is 10% of all individuals. They also stated that this percentage rose to 40% among individuals older than 65 years. In the present study, individuals in both groups presented with lower hearing thresholds, particularly with regard to high-frequency sounds. However, the individuals exposed to radiotherapy presented with even lower thresholds than those of the control group. This suggests that, despite the ages and the physiological changes inherent to aging, their auditory systems were exposed to aggressive agents that caused the hearing loss to be greater as a consequence of the treatment received. Another study20 described cochlear implantation in 3 patients treated for meduloblastoma who then experienced profound sensorineural hearing loss and chronic ear disease following treatment, suggesting that the hearing loss and auditory damage after oncological treatment can be very extensive.
In the study by Chen et al,21 radiation doses of greater than 6000 cGy in the cochlea were the most significant factor for the presence of sensorineural hearing loss. Doses of 2000 to 3000 cGy in the cochlea led to notable hearing losses in 50% of patients in a study by Hermann et al,15 and ototoxic effects occurred in 41.8% of their patients with head and neck tumors after radiotherapy, of whom 33.2% presented with complications in the outer ear, 28.6% in the middle ear, and 26.8% in the inner ear. In a study by Bhandare et al,16 complications were attributed to the dose of radiotherapy that reached the auditory system, and the authors reported that the incidence of ototoxic effects increased with increasing doses of radiotherapy, particularly with doses ranging from 6000 to 6600 cGy. In the present study, the total dose ranged from 2000 to 9580 cGy, and the percentage of the auditory system that was included in the radiotherapy field ranged from 40% during the first phase of treatment to 16% during the second phase for both ears. A total dose of 6500 cGy was statistically significant for the presence of hearing loss.
In the general population, hearing complaints and the impact of hearing losses vary greatly and depend on individuals' lifestyles, their expectations, and even their general physical health. Among patients with cancer, much has been said about quality of life, but few studies have dealt with hearing loss and the limitations and difficulties encountered because of it.
After analyzing our 2 groups separately, we found that the individuals in the exposed group had more complaints, as shown by their answers on the HHIE questionnaire, than did individuals in the control group. In parallel, the individuals in the exposed group also presented with hearing losses more frequently, including losses of higher grade, thus demonstrating the same relationship as that observed by several other authors22,23 who proved a statistically significant association between higher degrees of hearing loss and higher scores in the HHIE questionnaire. This suggests that the HHIE questionnaire is also capable of measuring hearing handicaps among patients with cancer.
Individuals with untreated hearing losses were more sorrowful, with more feelings of loneliness, depression, worry, anxiety, and paranoia.22,24 They had fewer social activities and were less able to integrate information regarding their environment. Hearing loss affects individuals' psychosocial situation and, if untreated, contributes to social isolation, depression, and low self-esteem. It also seems to be a cofactor related to senile dementia.17 As could be seen from the present study, the group of participants exposed to radiotherapy presented with greater hearing losses of higher grade and with more complaints. This is extremely important because behavioral patterns that are more depressive or that present greater tendencies for social isolation can sometimes be attributed to the cancer or to the functional sequelae of the treatment. Nonetheless, one must remember that hearing loss and hearing handicap may also lead to such behavior.
Hearing loss is still given little recognition and little value, and, for this reason, it is not always treated as a health abnormality. However, it is one of the biggest chronic problems among elderly people, and, as seen from the present study, the population with cancer is even more affected by this. Concern for the quality of life of patients undergoing cancer treatment is necessarily growing, and determination of hearing loss should form part of such investigations to enable better rehabilitation.
Correspondence: Christiane Schultz, MS, Department of Audiology, Hospital do Câncer A. C. Camargo, Rua Professor Antonio Prudente 211, 01509-900 São Paulo, Brazil (email@example.com; email@example.com).
Submitted for Publication: February 24, 2010; final revision received June 1, 2010; accepted July 27, 2010.
Author Contributions: Ms Schultz and Drs Goffi-Gomez, Pellizzon, and Carvalho had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Schultz, Goffi-Gomez, Pellizzon, and Carvalho. Acquisition of data: Schultz and Pecora Liberman. Analysis and interpretation of data: Schultz, Goffi-Gomez, Pellizzon, and Carvalho. Drafting of the manuscript: Schultz and Carvalho. Critical revision of the manuscript for important intellectual content: Schultz, Pecora Liberman, Pellizzon, and Carvalho. Statistical analysis: Carvalho. Administrative, technical, and material support: Schultz and Pellizzon. Study supervision: Schultz, Goffi-Gomez, Pecora Liberman, Pellizzon, and Carvalho.
Financial Disclosure: None reported.
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SANTA CLARA -- Missy Franklin was headed to Santa Cruz to body surf with Cal teammates and coaches two weeks ago when her mother called.
Fellow Colorado Olympian Amy Van Dyken-Rouen had been in a serious accident, D.A. Franklin told her daughter.
Franklin, 19, once wanted to be like Van Dyken-Rouen, Colorado's biggest swim star before "The Missile" took off in recent years.
"That is who I was trying to live up to, that is who inspired me growing up," Franklin said Friday at the Arena Grand Prix Santa Clara.
Now it is Franklin who is inspiring the next generation of young swimmers.
In her first meet of the summer season, the Cal sophomore finished second to incoming Stanford freshman Simone Manuel in the 100-meter freestyle but left the pool smiling because of a good time -- 54.51 seconds. Franklin also swam the 100 butterfly preliminaries in the morning as a training exercise.
Franklin's thoughts, though, are with her former idol who is a six-time Olympic gold medalist.
Van Dyken-Rouen, 41, severed her spinal cord in an ATV accident in Arizona. She flew home to Colorado on Wednesday to begin rehabilitation.
"We don't know what's going to happen," Van Dyken-Rouen told reporters before boarding a plane. "I have no feeling from probably my pubic bone down."
Santa Clara meet organizers dedicated the 100 butterfly Friday night to Van Dyken-Rouen, who was a regular fixture at the Silicon Valley event when she dominated the race.
News of the swimmer's accident broke Franklin's heart but "hearing about also how lighthearted she's been and how she's still herself through the whole process doesn't surprise me at all," Franklin said. "It's so special and inspiring to hear someone who's been through an accident like that still be able to stay true to her self."
Van Dyken-Rouen tweeted Friday that Franklin inspires her after seeing this newspaper's story online.
Felicia Lee, who graduated from Stanford last weekend, won the 100 butterfly in 59.62 seconds, the only woman to break the one-minute barrier.
"Amy is a fighter," Lee said. "She's so strong and has always stayed connected to swimming."
Franklin has inherited that fighting spirit during her remarkable career. With a trademark smile on her face, she won four gold medals and a bronze medal at the 2012 London Games. Then Franklin won an unprecedented six gold medals at last year's world championships before starting college life in Berkeley.
The swimmer plans to compete collegiately one more year before turning professional while training at Cal ahead of the 2016 Rio de Janeiro Games.
Franklin, who recently moved into a Berkeley apartment, credited her first collegiate season with helping set up an important summer. The four-day meet at the George F. Haines International Aquatic Center is one of the final major tuneups before the U.S. championships Aug. 6-10 in Irvine.
The national meet serves as a qualifier for the Pan-Pacific Championships in August in Australia and the 2015 world championships in Russia.
"It's a lot of pressure now, but it's really nice next summer when all we have to focus on is the worlds," Franklin said.
Later, Phelps tied former Cal swimmer Tom Shields in the 100 butterfly in the night's most dramatic race. But the 22-time Olympic medalist wasn't happy with his time of 52.11 seconds. However, Phelps sounded pleased with his freestyle and was equally happy to survive two races in one night. It was his most rigorous racing schedule since coming out of retirement this season.
Contact Elliott Almond at 408-920-5865. Follow him on Twitter at twitter.com/elliottalmond.

subset: commoncrawl


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News Archive
A promising cancer treatment drug can restore function of a heart en route to failure from high blood pressure, researchers at UT Southwestern Medical Center have found.
Tuesday, May 31, 2011 - 11:46
A Californian team say they have managed to convert human skin cells directly into functioning brain cells. The scientists manipulated the process by which DNA is transcribed within foetal skin cells to create cells which behaved like neurons.
Friday, May 27, 2011 - 13:48
Studying the bloodless worm, C. elegans (pictured here), University of Maryland researchers have discovered a protein involved in the process by which humans, and other organisms safely move iron around in the body.
Thursday, May 26, 2011 - 14:11
Animal research is an important part of the research process when developing new treatments and medicines for patients.
Thursday, May 26, 2011 - 12:37
Scientists have found a way to get antibody-based therapies across a key barrier in the brain and deliver a payload of drugs that take aim at an elusive Alzheimer's target.
Thursday, May 26, 2011 - 11:02
After decades of studying the pathological process that wipes out large volumes of memory, scientists at The Feinstein Institute for Medical Research discovered a molecule called c-Abl that has a known role in leukemia also has a hand in Alzheimer's disease. The finding, reported in the June 14th issue of the Journal of Alzheimer's Disease, offers a new target for drug development that could stave off the pathological disease process.
Wednesday, May 25, 2011 - 13:12
A cell treatment to prevent new organs being rejected without the need for lifelong courses of immune drugs is showing promise in mice and may one day make human transplants easier, scientists said.
Friday, May 20, 2011 - 13:51
Scientists at Fred Hutchinson Cancer Research Center have found that a protein called alpha-catenin acts as a tumor suppressor and they also have unlocked the mechanism by which this protein controls cell proliferation.
Friday, May 20, 2011 - 12:20
A human drug that both prevents and cures kidney failure in mice sheds light on disabling human mitochondrial disorders, and may represent a potential treatment in people with such illnesses.
Thursday, May 19, 2011 - 11:40
About half of prostate cancers have a genetic anomaly that appears to make tumor cells responsive to a new class of cancer-fighting drugs, a new study from the University of Michigan Comprehensive Cancer Center finds.
Wednesday, May 18, 2011 - 11:11
Researchers studying the life threatening infectious disease sepsis have discovered how the infection can lead to a fatal inflammatory response through blood vessel cells. The research, which is published in EMBO Molecular Medicine, focuses on blocking crucial Matrix Metalloprotease enzymes (MMP) which activate the response.
Wednesday, May 18, 2011 - 09:57
Using a technique that silences genes promoting infection, researchers have developed a novel, topically-applied molecular microbicide capable of preventing HIV transmission. The microbicide is predicted to have long-lasting effects in mice, opening the door to developing an intravaginal microbicide that could protect women against HIV infection potentially for weeks at a time and bolster public health efforts to halt the spread of HIV/AIDS.
Tuesday, May 17, 2011 - 14:49
Scientists have identified a class of naturally occurring bacteria that can strongly inhibit malaria-causing parasites in Anopheles mosquitoes, a finding that could have implications for efforts to control malaria.
Monday, May 16, 2011 - 13:17
A new discovery in mice by researchers at Wake Forest Baptist Medical Center may one day allow doctors to spare some patients with acute myeloid leukemia (AML) from toxic treatments, while also opening the door for new therapeutic research.
Monday, May 16, 2011 - 12:41
In a study published this month, first author Budd A. Tucker said that he and principle investigator Michael J. Young took skin cells from the tails of rats and used chemical processes to turn them into "induced pluripotent stem cells," then guided them into becoming precursor cells for retinal neurons.
Monday, May 16, 2011 - 11:07
New data offer hints to why Parkinson's disease so selectively harms brain cells that produce the chemical dopamine, say researchers at Washington University School of Medicine in St. Louis.
Friday, May 13, 2011 - 11:02
For the first time, a vaccine has completely protected monkeys against infection with SIV, a virus related to HIV that infects the animals. Out of 24 immunised rhesus macaques, 12 had long-term protection, with no signs of SIV a year after they were deliberately infected with the virus.
Thursday, May 12, 2011 - 10:04
McGill research team found two distinct disease-causing mutations and saved a baby girl.
Wednesday, May 11, 2011 - 14:20
A common, tiny tropical fish plays a key role in a new model for Cushings disease, giving researchers a powerful tool to conduct extensive searches for effective treatments for this serious hormonal disorder, testing up to 300 drugs weekly.
Tuesday, May 10, 2011 - 10:07
Obesity appears to impair normal muscle function in rats, an observation that could have significant implications for humans, according to Penn State researchers. "Our findings demonstrate that obesity involves more than accumulating excess fat and carrying excess weight," said Rudolf J. Schilder, American Physiological Society postdoctoral fellow in physiological genomics, Penn State College of Medicine. "We show that, during the development of obesity, skeletal muscles fail to adjust their molecular composition appropriately to the increasing body weight. Consequently, the muscles of obese mammals are not properly 'tuned' to the higher body weight they carry."
Tuesday, May 10, 2011 - 09:57


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1-Minute Smile Makeover Tricks
9 little changes that can transform your teeth into the pearly whites you've always wanted -- instantly
In addition to that, most people snack on carbohydrate-rich foods. Chips, crackers, and other carb-laden foods are especially bad for our teeth, as "fermentable carbohydrates work with bacteria to begin the decay process and eventually destroy teeth," says Singh. "All carbohydrates eventually break down into simple sugars: glucose, fructose, maltose, and lactose," he says. "And when they do, they are converted by the bacteria in your mouth into plaque -- the primary trigger of gum disease and cavities." The snack food on Dr Singh's don't-eat list that shocked us most? Bananas. Their "chewy, adhesive texture" makes it easier for them to get caught between teeth or under the gum line, where bacteria can accumulate.
SEE NEXT PAGE: Quit your diet soda addiction
Older comments
I never thought that swimming would change the color of teeth! Very enlightening!
by GigiSD Tuesday, April 16, 2013 at 08:53PM Report as inappropriate
Everything in moderation would help with most of these problems. Also I can't imagine brushing with a hard bristle tooth brush. OUCH!!
by krista_dailey Thursday, February 28, 2013 at 10:17AM Report as inappropriate
It's good information. Thank you.
by bksc Wednesday, January 16, 2013 at 12:13AM Report as inappropriate
say cheese
by LittleBunny Monday, January 7, 2013 at 11:34AM Report as inappropriate
by EricaF123 Wednesday, December 26, 2012 at 07:31AM Report as inappropriate
Great article!
by robyne00 Wednesday, September 19, 2012 at 04:41PM Report as inappropriate
by Nicole2814 Saturday, August 11, 2012 at 08:41PM Report as inappropriate
by jaye_tyler Tuesday, July 17, 2012 at 01:35PM Report as inappropriate
There are so many things that I never even considered might be affecting my teeth. I am a diet coke girl and I have no desire to quit drinking it. I hear drinking through a straw is better for your teeth than drinking straight from the can.
by flirtygirl214 Monday, July 2, 2012 at 03:33PM Report as inappropriate
birth control? i had no idea it could affect my teeth!
by liliofthevalley Saturday, May 26, 2012 at 08:45AM Report as inappropriate
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On television, on the radio and on the side of buildings, news about the war is everywhere. Technology has taken us onto the front lines and into the foxholes, and the result is not always healthy.
People with a history of anxiety or depression should watch for post-traumatic stress symptoms. Psychiatrists say insomnia and irritability are just some of the problems that could cause a panic attack. But they say they don't expect the war to stress as many viewers as Sept 11 did.
If 24-hour coverage of the war is stressing you out, some tips to unload the overload include take care of yourself, such as, eating right, exercising and getting enough rest. Do something positive, for example, give blood or take part in community meetings.
Be sociable and spend time with friends and loved ones, take time to do things you enjoy and be sure to talk to others about your concerns, that often relieves stress.
When all else fails turn off the television or radio. Experts say if war anxiety interferes with your daily life, you may need professional help. That can include counseling and sometimes medication. Talk to a doctor if your symptoms do not go away on their own.
wilx.com Extended Web Coverage
Six Myths About Stress
Source: www.nlm.nih.gov (National Library of Medicine, and National Institute of Health Web site) contributed to this report.


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Mercedes-Benz Islanders Tennis Tournament a Great Success
This event is becoming a grand tradition with the Corpus Christi tennis community and the Islanders. I can't begin to thank Mr. Charlie Hicks and Mercedes-Benz for making this great event possible. I would also be remiss if I didn't mention the huge contribution from Gerry Maingot and the Corpus Christi Country Club and their support in this event.
I want to congratulate our winners, Dr. Robert Webster, Carlotta Plantier, Wes Beaullieu, Dale Loveland, Marie Soza and Debbie Ravenburg. Rob Webster teamed with former Islander Dmitry Novikov, and Carlotta Platnier teamed with top Corpus Christi player Jacquelyn Garza to win the prestigious Mercedes-Benz event in the thrilling finals.
We're extremely grateful to all the participates who made this a great event and a great benefit for Islanders Athletics.
Thank you for your continued support of Islanders Tennis!
Steve Moore


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Tesla's Trading Frenzy By the Numbers
Tesla Motors trading spree ranks among one of the most active stocks in the market this month.
Since the electric-car marker reported its first-ever quarterly profit earlier this month, the stock's trading volume has exceeded even short-term trading favorite Apple If Tesla were in the S&P 500, it would rank as the 16th most heavily traded stock in the index, according to WSJ Markets Data Group.
Here's a look by the numbers at the trading frenzy that has engulfed Tesla shares over the past several days.
Trading Volume
Since May 8, the stock has traded an average of 22.6 million shares on a daily basis, far exceeding its normal activity. For most of its history, Tesla has been a relatively sleepy stock. It went public in June 2010 at $17 a share. Between July 1, 2010 and March 28 of this year, trading volume averaged 1.3 million shares a day.
Here's a chart comparing Tesla's trading activity to several S&P 500 stocks over the past several days:
For context J.P. Morgan Chase Wells Fargo Yahoo and Apple have all traded less shares on a daily basis than Tesla during its frenzy over the past several days.
On Friday, the stock already traded more than 10 million shares prior to noon eastern time, exceeding its daily average over the past 30 days, according to FactSet.
Market Capitalization
Tesla's market capitalization has risen by more than $4 billion since May 8, hitting a high of $10.7 billion as of Thursday's close. As a point of comparison, Staples, Tiffany NYSE Euronext and Whirlpool all sport similar stock-market values.
Stock Price
The stock rose 65% from May 8 through Thursday's close. This month alone, the stock is up 72% and for the year it has risen 174%. Shares are up 447% since the company went public in late June 2010 at $17 a share.


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LOS ANGELES -- The Warriors already were struggling, with point guard Stephen Curry wearing a blazer for the second consecutive game because of a mild concussion. Then late in the third quarter, they lost Andre Iguodala to a strained left hamstring.
"Normally, I can just run it off or it would go away," Iguodala said. "But once I heard a pop, I knew it was serious."
Down arguably their two best players, the Warriors were no match for a Lakers squad that smelled blood. Los Angeles styled its way to a 102-95 revenge victory Friday night. The same Lakers squad Golden State blew out by 31 back in Oakland had the Warriors looking like the makeshift team hoping to finish .500.
The Warriors (8-5) shot just 41.5 percent and fueled the Lakers' transition game with 19 turnovers. But it was their defense that let them down.
Burned by lapse after lapse, the Warriors allowed 47.6 percent shooting. Several of the Lakers' 11 3-pointers were wide-open looks because the Golden State defender lost his man. Coach Mark Jackson refused to blame that on the injuries.
"Just disappointing. They outworked us," Jackson said. "We're a no-excuse basketball team. ... We'll be fine. But we cannot walk away with a good taste with how we played and the effort we put forth."
Four of the Warriors' top eight players are now injured. In addition to Curry and Iguodala, the Warriors are also without backup point guard Toney Douglas (stress reaction, left tibia) and backup center Jermaine O'Neal (bruised right knee, mild right groin strain).
Only one of the four -- Curry -- has a chance of playing when the Warriors' play host to the Portland Trail Blazers on Saturday.
Since he sustained the concussion on Monday, Curry's had three noncontact sessions: individual work at Thursday's voluntary practice, Friday's shootaround, and pregame drills before the game. But Curry still hasn't taken the final test.
Before being cleared to play, he needs to participate in full-contact activity and emerge symptom free.
That Curry still hasn't taken that step could be a sign he still has symptoms from the noncontact work he's done. Or, perhaps, the Warriors -- who would have to craft a situation for Curry since everything has been light since Wednesday -- don't want to force it to get Curry back on the court. Either way, he's no guarantee to play when Oakland native Damian Lillard makes his first visit as reigning NBA Rookie of the Year.
The Warriors certainly have their issues without Curry. Golden State was still in position to win.
Guard Klay Thompson, who finished with 19 points on 20 shots, hit a 3-pointer. Then forward Harrison Barnes followed with a steal and a fast-break dunk. The Lakers' lead was down to 61-60 with 6:40 left in the third quarter.
At the 4:23 mark, Iguodala drilled a 3-pointer from the top of the key, tying the game at 63.
But a minute later, after his pass was intercepted, Iguodala came up limping at half-court while playing defense. He immediately grabbed his hamstring and started hopping toward the bench.
After the game, he could hardly walk. He said this injury "worries him a little bit" but that he doesn't expect to be out too long. He said he has an MRI scheduled for Saturday morning.
"My body's been pretty good to me so far," Iguodala said. "I take care of it, so (I'll be back) sooner than everyone thinks."
Iguodala had been the starting point guard with Curry out. He played 48-plus minutes in the overtime loss to the visiting Memphis Grizzlies on Wednesday, all at point guard.
With their top three options on the shelf -- and Kent Bazemore struggling at the position, and rookie Nemanja Nedovic still too inexperienced for the role -- the Warriors found themselves in a tough spot. They entered the fourth quarter down 12 points and had no one to facilitate the offense.
Still, Golden State managed its highest-scoring quarter of the game. The Warriors scored 32 points by consistently attacking the rim. They didn't shoot a high percentage, but they managed nine offensive rebounds, racked up 18 points in the paint and eight at the line.
The problem was defense. They were unfocused and lacked the aggression that kept them close against better teams such as San Antonio and Memphis. The Lakers knocked down four of their 11 3-pointers in the fourth quarter, all of them wide-open because of defensive lapses.
"I don't think we gave our best effort. We didn't play hard enough," Draymond Green said. "That's not how we got to where we are. ... When you let your shots determine how you play defense, that's bad. Let's defend people, and then shots will fall."
Portland (11-2) at Warriors (8-5), 7:30 p.m. CSNBA
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ASPEN - Authorities are expected today to resume their search for a missing Aspen man whose whereabouts were last recorded through a ski-pass scan Thursday at 12:04 p.m. at the Exhibition lift at Aspen Highlands.
Robert Jefferson Walker, a 55-year-old wine salesman who has lived in the area for several years, has not been seen or heard from by those who know him since before that time, his friends confirmed Sunday. He is more commonly known as Jeff Walker.
His girlfriend, Denver resident Liz Sathe, said Mountain Rescue Aspen, the Pitkin County Sheriff's Office and Aspen Skiing Co. personnel spent most of the day Sunday searching Highland Bowl and surrounding areas in an effort to locate him.
"He's missing," Sathe said. "We haven't come up with anything else. They looked all day."
She said Walker apparently changed clothes and left them, along with a wallet and his phone, in a locker in Aspen near Gondola Plaza before heading to Aspen Highlands on Thursday.
"If anyone was hiking up the bowl on Thursday and ran into Jeff Walker, or skied with him anywhere on Thursday, that information would be helpful," Sathe said.
Skico spokesman Jeff Hanle said Walker was known to ski the bowl every day.
Nate Harnish, an Aspen resident and longtime friend, said it also would be helpful if people went to Aspen Highlands on Monday and assisted with the search.
"Tomorrow there should be somebody at the top to let people know where to search," he said. "There's a chance he could be alive. The more people we can get on the mountain, the better."
Harnish said Walker is well-known throughout the Aspen area.
"Honestly, the sheriff's department is probably presuming that he's dead," he said. "The search (on Sunday) lasted from 11 a.m. until about 4 o'clock. We need as much grassroots help as possible because if he's alive, we're really running out of time."
The Sheriff's Office emailed information on Sunday evening stating that it was notified of the missing-person case at 9:30 p.m. Saturday by the Aspen Police Department.
"Search personnel were not able to detect any signs of Walker during their search on Sunday," a statement said.
Teams composed of personnel from Mountain Rescue Aspen and Skico will resume the search Monday. Anyone with information about Walker's whereabouts is asked to call the Sheriff's Office at 970-920-5300.


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text:
via Personal Recipe 1716945:
Such a great night seeing Green Day and don't forget All Time Low... I screamed and sang all night long while standing on a chair, I will always remember that night as the best night of my life. Please check out a video entered into the Green Day short film competition by typing "The Forgotten competition entry" into youtube. xxxxxxxxxxxxxxxxx
Such a good night I will remember for the rest of my life! THANKYOU GREEN DAY!!!!!
It really was fucking awesome. BTW, I like how you're dressing like Dennis the Menace these days :P
I'm happy for you BIllie, seems like you had lot of fun!
I wish I could meet you one day...
My best night ever will be when I meet you one day...
I am sorry because that on Kalemegdan can be about 13,000 people only. :( Better go next time to "Beogradska arena". (Translation "Belgrade's arena") :DD
waw,i love it,you come closer to Belgium at the 4the july,London calling rules;);)
Man..... Look at all those people..... That is truly *awesome*. :D !!!!
(again, no one can jump like him) :D !!!
happy that you enjoyed the show in London... But how about the one in Vienna?? I mean, yeah, we weren`t so many but... it was sooo AWSOME!!!
Yeah, what about Vienna? About 25000 people - including me - were watching your great show!
That´s right! I had the time of my life there
Wonderful setlist in London! How about you performing it again in Rome? PLEASE play Waiting in Rome too!!! That song means so much to me...If you played it, you'd fill my heart with joy. :) I think I'd burst into tears and be grateful to you for the rest of my life. You are great artists and I owe you so much. See you soon! ;) Can't wait to celebrate your return! <3
Billie you give off energy ....! As always! Great! :-*
My only dream was to meet you someday guys. I had never a chance to meet you. you where in Vienna and i have done all but it dit´n work!! So I´m crying cause I´m you´re biggest Fan in Austria and it pisses me off!! What can I do to meet you guys I do anything to make this dream come thrue!!! So Tell me BJ What should i do? Love ya forever !!! I wish i could be there with you!!!!!! Rage and Love


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Book Review
In the yarn panoply, worsted-weight reigns supreme. Knitting up at between 4 and 5 stitches per inch, worsted-weight yarn offers a perfect gauge for projects you want to complete relatively quickly without sacrificing the pleasure of subtlety or detail.
The Cascade 220 Club
Among all the worsted-weight yarns on the market (and many exist), Cascade 220 is one of the most consistently popular. This 100% Peruvian Highland wool yarn comes in generous 220-yard skeins (hence the yarn's name), is available in more than 96 colors, and retails for only $7. It works equally well in colorwork, cables, and simple stockinette. Oh, and did I mention that it felts nicely too?
As I said, Cascade 220 has a substantial following. Chances are you probably have some of it in your stash.
No wonder the editors at Sixth & Spring (in conjunction with Cascade Yarns) decided to compile an entire book of projects expressly for this yarn. Of course "expressly" is a relative term, since Cascade 220 has many imitators. In fact, most of us could probably knit all the projects in this book using other yarns from our stashes.
Quite Quick
The book lives up to the promise of its title, delivering 60 projects total—20 hats, 20 scarves, and 20 mittens—that all classify quite clearly as "quick knits." (Of course some may be quicker than others depending on your skill level.) The small scale of the projects—no coats, afghans, or sweaters here—means that even the more challenging ones will go by quickly.
The pattern difficulty level spans from rank beginner to intermediate knitter, covering everything from stockinette and seed stitch to cables, colorwork, ribbing, bobbles, duplicate stitch, and lace. No felting projects, though.
Nearly all of the patterns require only one or two skeins of yarn. If you stick with Cascade 220, that means you can make a quick, cute project for between $7 and $14. Cheaper than dinner and a movie, and far more memorable.
The Projects
The editors did an admirable job of assembling varied patterns that work well both with Cascade 220 and fall in line with the "quick" premise. The book kicks off strong with Lois Young's Chain-Link Scarf, in which a solid honeycomb stitch dances over a background of semisolid stitches. (The funny thing here is that the scarf is photographed next to a pair of beautiful Lantern Moon single-pointed straight needles that would never accommodate the 264 stitches this scarf requires. But we'll forgive them a little artistic license.)
You'll find a fairly even blend of sophisticated, functional, elegant, and fun projects. Highlights in the latter category include Puppy and Bunny mittens by Sherry Graziano, a Lion Scarf by Amy Bahrt featuring a happy lion's face at the end of a seed-stitch body; and a Monkey Hat by Irina Poludnenko that is exactly what it sounds like, an adorable children's hat with ears and a monkey face above the forehead.
Some of the patterns can be used as extremely simple base templates for your own explorations, such as Julie Gaddy's Embroidered Mittens (which really only require embroidery if you feel so inclined). The silly and simple are followed swiftly by the elegant, such as Debbie O'Neill's angular, flowing Wave Scarf that shows off the variegation of Cascade 220 Paints; Lynn Wilson's Tweed Watch Cap, which pits solid against semisolid in a dance of tiny cables and garter ridges; or Amanda Blair Brown's elegant Zigzag Scarf that mimics a tight herringbone tweed and would make a perfect gift for men.
Happy Hands
Mittens, mitts, and gauntlets are also well represented. Tanis Gray's extremely simple 2x2 Ribbed Wristers serve beginners and last-minute gift-knitters perfectly. Tonia Barry's Smocked Fingerless Mitts are not really smocked but cabled, with buttons for adornment.
And Anne Farnham's Mock Cable Wristers, my favorite, feature a large cabled swirl over the top of each hand. If you really want to be clever with these, you could reverse the cable on the other hand so they mirror one another.
The cable pattern in these mitts and in several other projects is not charted, presumably in an effort to save space and help fit all 60 projects into a tidy 160 pages. But the projects are so small and manageable that avid chart readers should still be able get along just fine.
Guessing on Substitutions
All patterns specify yarn in terms of the number of Cascade 220 skeins you'll need. This is presumably because Cascade was involved in the creation of the book, and yarn companies are, after all, in the business of selling yarn.
Because Cascade 220 has a more generous yardage than many other worsted-weight yarns, you'll have to do a little guesswork if you want to use a different yarn. For example, Tanis's simple Ribbed Wristers most likely only use half the 220-yard skein the pattern requires. Ditto Carol Sulcoski's sassy Ribbed Pillbox.
Best-case scenario, you'll be stuck with leftover yarn; worst-case scenario, you'll embark upon one of these projects using a lower-yardage skein from your stash and run out before you're done. When in doubt, plan for more yarn. And if you run out, just remember that carefully planned contrasting stripes are your friends.
Another thing you won't find here are the basic how-to-knit instructions that other publishers often jam into the first 15 pages of their books. The editors assumed (rightly so) that you already have the basics under your belt and simply want a great collection of quick projects. Likewise, you won't find any stitch or technique explanations in the back.
Ultimately, this is purely a pattern book. And toward that end, it meets—dare I say exceeds—all expectations.


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NC father of dirt collapse victim faces charges
Published: Wednesday, April 17, 2013 at 4:30 a.m.
Last Modified: Tuesday, April 16, 2013 at 9:13 p.m.
STANLEY (AP) — The North Carolina father who was working in a two-story-deep hole that collapsed killing his daughter and her cousin faces drug and firearms charges.
The Lincoln County sheriff's department said Jordan Arwood, 31, of Stanley, is charged with possession of a gun by a felon, and making a controlled substance. He was being held Tuesday in the county jail on $20,000 bond.
Arwood was operating a backhoe in a pit last week when the walls caved in on the children. The bodies of 6-year-old Chloe Jade Arwood and 7-year-old James Levi Caldwell were dug out the next day.
While investigating the accident, sheriff's deputies removed six firearms including an AR-15 rifle and a marijuana plant from Arwood's home.
The sheriff's office said it was still investigating the case. When investigators finish, they plan to present their findings to the district attorney's office to determine if charges will be filed.
Officials described the pit as 20 feet by 20 feet with a sloped entrance leading down to the 24-foot bottom. The children were at the bottom of the construction site retrieving a child-sized pickaxe when the walls fell in on them. No permits had been issued for Arwood to dig on the site.
In an interview with The Associated Press, Arwood said he worked frantically to save the children from the wall of falling dirt that killed them but they were just outside his reach. He says he dug faster and faster trying to save the children until he couldn't breathe.
Investigators say they still don't know why Arwood was digging the hole. But he said he was building a rammed earth home, an ancient building method where dirt is used to shape the foundation.
Arwood said he had been digging the hole for three months.
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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Gentlemen's Hardware Manicure Set
- Overview
For the man on the go, this Gentlemen's Hardware Manicure Set has everything you need to stay dapper and sophisticated. Sized for traveling, each grooming kit includes two sizes of nail clippers, scissors, nail file, tweezers and a cuticle pusher.
- 3.5"w x 4.3"d x 1.4"h.
- Polyester case in Gray; polyurethane trim in Brown.
- Contains 6 stainless steel tools.
- Imported.
- Details + Dimensions
- Overall product dimensions: 3.5"w x 4.3"d x 1.4"h.
- Includes two sizes of nail clippers, scissors, nail file, tweezers and a cuticle pusher.
Spot clean.
- Shipping + Return Info
Most purchases are shipped from our Distribution Center by UPS, to arrive in your home within 5-7 business days of order receipt.
Shipping Rates
The shipping rate varies depending on your order total and shipping options. View Shipping Rates and Options
Next Day Delivery
For an extra charge of $17.50 per address, we can arrange for rush delivery to most destinations.
Return Policy
We take great pride in the quality of our merchandise. If for any reason you are not happy with your purchase, you may return the item(s) within 30 days of receiving the order for a full refund of the merchandise cost. After 30 days, we will replace or refund your purchase against manufacturer's defects ONLY. Please note that we cannot accept returns on mattresses, monogrammed/personalized items, special order upholstery items and special order rugs, one-of-a-kind rugs, or on items damaged through normal wear and tear. We also cannot accept returns of final-sale items, which are identified by a price ending in .99 or .97.
For further assistance please call our customer service department at 1.888.922.4119 or send an email to firstname.lastname@example.com


text:
iArchiver is the archive tool that Apple forgot: create, extract and convert archives with beautiful and enjoyable drag and drop.
Some features designed to make your life easier:
- Simple and fast redefined. Extracting archives was never simpler and faster: with iArchiver's quick extract all you need to do is drag your file onto the iArchiver icon in the dock and your files will extract in-place.
- Watch and see. With iArchiver's progress reports when creating, extracting and converting archives you always know what's happening.
- When ignore becomes bliss. iArchiver now gives you the option to ignore Mac-specific files such as .DS_Store and resource forks to make your files more accessible to Windows and Linux users.
- At the pulse of time. iArchiver is Leopard-ready so you can enjoy all its features on the newest version of your favorite OS.
iArchiver supports the following formats:
- creates Zip, DMG, 7-zip, Tar, Gzip, Bzip2 and CPIO archives
- extracts Zip, Rar, StuffIt (.sit), DMG, 7-zip (.7z), HQX, LhA, Tar, Gzip, Bzip2, RPM, JAR and CPIO archives
- converts between the above formats
iArchiver handles your archiving needs -- effortlessly and elegantly.
Required OS: not specified
Tags: archive , compression , utility , rar , 7zip , zip
5 Opinions
Going to be replaced by Rucksack. I have links to the dev.
for me it worked great, but it misses a lot of cool features that free apps of that kind of stuff don't miss.
For example it does not provide an option to move the archive to trash after the extraction process completes successfully (this is one of the best features that I like in unarchiver)
Also I would like to have it menu bar (like stuffit do which is commercial too)
but the thing that makes it special is that it provides an option for non including any of the auto-generated files/folders of OSX till now I used to use terminal with zip command and running "export COPYFILE_DISABLE=true" command to not include in the archive the __MACOSX folder but iArchiver solves tis issue :)
This app is buggy when the archive contain non-western character file names.
This thing looks lovely, the only tool I've seen so far that meets all my needs... with one exception. It seems very flaky when it comes to opening multiple files to be extracted via file association or open with from the finder. It doesn't show a nice queue of items to be extracted the way The Unarchiver does, and when I attempted to extract one dmg while another was still extracting, it extracted the files from the second one into the folder it had created for the first, and didn't extract the first at all. Not sure if this behavior is only with dmg files, will see.
Simply the simplest archiving tool on the mac. feels like it belongs.


text:
Wildlife Crossings Are Saving Animals
Bridges and underpasses allow for safer passage, habitat connectivity in Arizona
Bridges and underpasses allow for safer passage, habitat connectivity in Arizona
More than half of all new residents to Tucson area live in northwest side towns.
ADOT's proposal draws excitement, but some worried about price tag in billions.
University students visit the city to learn about global conditions
Developer expected to submit finalized plan to city in 30 days.
Tucson playing catchup on street repair, after years of state budget cuts, city priorities elsewhere.
2014 saw cash-buyers increase, institutional investor buys decrease
Joesler's only shopping center in Tucson thought to be the oldest in the state
Opponents worry construction project is too dense; proponents say it's an environmentally-friendly way of developing land.
Figures down from 36.5% to 30.8% in past year, RealtyTrac numbers show.
Demand for rental properties is shaping city's real estate; what may be causing residents to think about renting before buying.
Project proposes work on interchanges along I-10, Ina, Ruthrauff and Houghton Roads, I-19 and Ajo Way; more roadways near Raytheon.
City is below national average or 10 percent; some local businesses argue more positions in field are needed.
New U.S. Census data shows the number of houses built in area grew by 17 percent from 2012 to 2013.
Arizona Dept. of Transportation wants public comment on possible routes; agency says still has a ways to go to make it a reality.
Site includes existing plans for more than 1 million-square-feet of retail development; land addition covers southeast side of town.
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- Apr 23:
- Boston bombing suspect's wife is 'nice,' 'sweet' American convert to Islam
- Boston bombing victim Martin Richard, 8, laid to rest privately
- Older Boston bombing suspect frequently visited jihadist websites, U.S. officials say
- Apr 21:
- Top cop says Boston bomb suspects likely planning more attacks
- Governor: Video shows Boston bomb suspect placing backpack
- Police: Boston bomber may have been killed by his own brother
- Apr 20:
- Doctor: Boston suspect had so many wounds he couldn't tell which was fatal
- Authorities arrest two in town where Boston bombing suspect may have lived
- Boston bombing suspect hospitalized following arrest
- Apr 19:
- Boston bombing suspect Tamerlan Tsarnaev's mother-in-law sickened by attack
- Boston Red Sox, Bruins postpone games during manhunt
- Boston bombings: Television can only 'hurry up and wait'
- Boston bombing suspect's U-Mass Dartmouth classmates: He was 'calm,' 'cool,' 'laid back'
- Boston bombing suspects' sister says she doesn't know what got into them
- Boston bombing suspects' uncle, 'ashamed,' asks nephew to turn himself in
- Boston bombing suspects spent night in Honda before carjacking a Mercedes
- Boston manhunt: MIT police chief says slain officer Sean Collier was dedicated, well-liked
- Boston manhunt: Chronology of chaotic search for suspects in marathon bombing
- Boston bombing suspect Dzhokhar Tsarnaev captured alive, police say
- Boston bombing suspects: Who are the two brothers?
- Boston bombing suspect Dzhokhar Tsarnaev captured alive, police say
- Police: Suspect who killed MIT cop is dead; second suspect tied to Boston bombing
- Apr 18:
- Boston bombing suspect on video sought; Obama at memorial: 'You will run again'
- Apr 17:
- Source: Authorities recover Boston bombing pressure cooker lid
BOSTON -- Police and reporters converged on the federal courthouse in Boston on Wednesday amid conflicting reports of whether a suspect was in custody in the marathon bombings that killed three people and wounded more than 170.
Several media outlets reported earlier in the day that a suspect had been identified from surveillance video taken at a Lord & Taylor store between the sites of the two bomb blasts.
A law enforcement official briefed on the investigation told The Associated Press that a suspect was in custody. The official, who was not authorized to divulge details of the investigation, said the suspect was expected in federal court.
But FBI and the U.S. attorney's office in Boston said no arrests had been made.
"Contrary to widespread reporting, there have been no arrests made in connection with the Boston Marathon attack," the FBI said in a statement. "Over the past day and a half, there have been a number of press reports based on information from unofficial sources that has been inaccurate. Since these stories often have unintended consequences, we ask the media, particularly at this early stage of the investigation, to exercise caution and attempt to verify information through appropriate official channels before reporting."
The official who spoke to the AP did so on condition of anonymity and stood by the information even after it was disputed. A news briefing was scheduled later Wednesday.
Law enforcement agencies had earlier pleaded for the public to come forward with photos, videos or any information that might help them solve the twin bombings. Police also gathered surveillance video from businesses around the finish line.
The bombs were made from ordinary kitchen pressure cookers packed with explosives, nails and ball bearings to inflict maximum carnage, investigators and others close to the case said. But the FBI said nobody had claimed responsibility.
Investigators in white jumpsuits had fanned out across the streets, rooftops and awnings around the blast site in search of clues on Wednesday. They combed through debris amid the toppled orange sports drink dispensers, trash cans and sleeves of plastic cups strewn across the street at the marathon's finish line.
President Barack Obama branded the attack an act of terrorism. Obama plans to attend an interfaith service Thursday in the victims' honor in Boston.
Scores of victims of the Boston bombing remained in hospitals, many with grievous injuries. Doctors who treated the wounded corroborated reports that the bombs were packed with shrapnel intended to cause mayhem. In addition to the 5-year-old child, a 9-year-old girl and 10-year-old boy were among 17 victims listed in critical condition.
View Boston blasts in a larger map
The trauma surgery chief at Boston Medical Center says most of the injuries his hospital treated after the marathon bombings were to the legs.
"We have a lot of lower extremity injuries, so I think the damage was low to the ground and wasn't up," Dr. Peter Burke said. "The patients who do have head injuries were blown into things or were hit by fragments that went up."
Dozens of patients have been released from hospitals around the Boston area.
At Massachusetts General Hospital, all four amputations performed there were above the knee, with no hope of saving more of the legs, said Dr. George Velmahos, chief of trauma surgery.
"It wasn't a hard decision to make," he said Tuesday. "We just completed the ugly job that the bomb did."
The bombs exploded 10 or more seconds apart, tearing off victims' limbs and spattering streets with blood. The blasts near the finish line instantly turned the festive race into a hellish scene of confusion, horror and heroics.
The blasts killed 8-year-old Martin Richard, of Boston, and 29-year-old Krystle Campbell, of Medford. The Shenyang Evening News, a state-run Chinese newspaper, identified the third victim as Lu Lingzi. She was a graduate student at Boston University.
Associated Press writers Jay Lindsay, Pat Eaton-Robb, Steve LeBlanc, Bridget Murphy, Rodrique Ngowi and Meghan Barr in Boston; Eileen Sullivan, Julie Pace and Lara Jakes in Washington; Paisley Dodds in London; Lee Keath in Cairo; and Marilynn Marchione in Milwaukee contributed to this report along with investigative researcher Randy Herschaft in New York.


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The Lutheran Church - Missouri Synod
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In 2009, Microsoft appointed Journey Education Marketing DBA Academic Superstore as a Large Account Reseller (LAR). Journey Education is the only academic focused LAR in the USA. Being a Microsoft Large Account Reseller provides Journey/Academic Superstore with the ability to offer the Microsoft Academic Select Program as well as specially priced Microsoft products to students and teachers through our network of 31,000 stores.
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At Pampered Puppy we have amassed a large selection of informative dog articles. We have dozens of articles on designs, fashion, dog books, and much more.
Everything you need to know about air travel with your pet by Maria Coder
Flying the "friendly" skies is getting more complicated, especially if you're flying with a pampered pup. But knowing the rules could spare you a major headache. In fact, you may even be able to score some miles, without any pain and suffering.
Realistically, wherever you go, you pet is going to face some travel requirements. The farther away from home you travel, the heftier those requirements will be. While most airlines share many requirements they all have different policies. One airline may allow three pets per trip in the passenger cabin, while another will only allow two pets and may make exceptions for a guide dog. Other airlines will only allow pets in cargo while some airlines won't take any pets in cargo at all. Then of course, you have to keep up with the changes in policies. Just because pets were allowed in the cabin last year, doesn't mean the same is true this year.
Take Air Canada, for instance. About a month ago, the Montreal-based airline raised its fees for transporting pets as a way to lower its annual fuel costs and make a yearly profit for the first time since 1999. On its overseas flights, the same pet that fit under the seat last year must now travel in cargo. The airline will no longer allow pets in the cabin for international flights. A ticket in cargo will cost you $245.
First decide where you and Fido are going. From there you can check out the policies of the airlines that'll get you both to your destinations. The easiest and fastest way to get your hands on all the information you need is to visit the individual airline's Web site. Once you narrow down your choices based on your own criteria, call and double-check the rules you've read online are up-to-date. While most airlines keep their Web sites fresh with the most current information, it never hurts to ask. Plus, you'll have to let the airline you choose know that you're traveling with your pet. If you're traveling an airline like JetBlue, you're likely to call right away. The New York-based company gives you double rewards points when you travel with your pet.
JetBlue accepts a total of three small dogs and cats in the passenger cabin of each flight. The travel fee is $50 per pet each way. The airline only allows one pet per customer unless you're traveling with a certified service animal or a documented emotional support animal. Your pet and his or her carrier count as one personal item. Guide dogs are not charged a travel fee and are not included in the pet count.
For safety and timing, if you're traveling with your pooch you won't be assigned to sit in an exit row or bulkhead seats. You'll also be placed in window or aisle seats. JetBlue does not transport animals in cargo because of the lack of oxygen and pressurized air.
"We understand pets are very important parts of our customers' lives and we want to be able to make sure they're well taken care of and that our customers make it to their destinations on time," says Bryan Baldwin, Coordinator of Corporate Communications with JetBlue.
In the cabin, pets must fit in a carrier that is smaller than 18" in length, 12.5" in width and 8" in height. Hard carriers slightly smaller than that may be purchased with cash, check or credit card at any JetBlue ticket counter for a nonrefundable fee of $20. In the coming weeks, soft-sided sherpa pet carriers will also be available for a nonrefundable fee of $40. Only one pet is allowed per carrier and the pet must stay inside the carrier for the whole flight. Because of this restriction, the pet must be able to move inside the carrier with ease. The combined weight of the pet and the carrier must not weigh more than 20 pounds. It must also be leak-proof. For more information on pet travel on JetBlue call 1-800-JET-BLUE or visit www.JetBlue.com.
Much like JetBlue, American Airlines also restricts the number of pets per flight. "We recognize if we're carrying in the airplane cabin or as cargo that they're living beings and we treat them as we would human passengers," says Tim Wagner, spokesperson for American Airlines.
AA allows seven carry-on kennels per flight: two in first class and five in coach and/or business class. Guide dogs and search dogs are not included in that count. American Eagle and AmericanConnection only allow two kennels at most, depending on the aircraft. Keep in mind, connecting flights will have their own rules, even if you're flying on American Airlines' connecting flights or flights that are in or outside American Airlines' partnerships with the United States, Alaska, Puerto Rico, St. Thomas, and St. Croix. The airline does not permit carry on pets to/from Hawaii, Trasnatlantic/Transpacific, or Central and South America.
The largest cabin size dog carriers must not exceed 23" in length by 13" in width, by 9" in height. A pet carrier and pet counts as one of the passenger's carry-on bag. The carrier may hold two dogs or two cats as long as they are the same species, the same ages (between 8-weeks and 6-months), and weight less than 20 pounds. Pets must be at least 8 weeks old. The animals must be able to stand up, turn around, and lay down comfortably. The carriers must be leak-proof too.
The cost of traveling with your pooch is $100 for cargo and $80 for the passenger cabin payable at the airport, American Airlines Travel Centers, or travel agencies. Payments are accepted by check, cash, credit card, or voucher. Kennels may also be purchased at an additional cost, where available. Last year, American Airlines began to phase out the availability of kennels. Charges also apply for each connecting flight when the voluntary stopover is four hours or more. Only one charge applies if a two-segment connection is less than four hours. Guide dogs and service assistant animals travel free of charge.
Pets traveling in cargo have more rules to adhere to. The maximum combined weight of a pet and kennel cannot weigh more than 100 pounds. If you dog and kennel combined weigh more than 100 pounds AA will send him or her via cargo. AA also ships unescorted pets that way.
The largest size for checked kennels is 40" long by 27" wide by 30" high. However, the maximum size kennel (series 500) is not accepted on Boeing MD-80 (S80) aircraft. Series 700 kennels are not allowed on any AA airplanes. Kennels that fold down flat, a.k.a. collapsible kennels, are also not allowed for safety reasons. AA used to sell regular kennels at its ticket counters but the sales continue to dwindle as the airline began phasing out the option last year. The kennel you provide must be made of wood, metal, plastic, or similar material. It must be leak-proof, escape-proof, and must lock securely. The kennel must have ventilation on two sides, in addition to the door. Your pup must be able to stand, turn, sit, and lie down comfortably. It is your responsibility to secure rigid plastic kennels with releasable cable ties to all four corners. AA will provide the ties to you at no additional cost. It is also your responsibility to provide written certification that your dog has been offered food and water within four hours (with the specific time noted) before delivery to the kennel. This certification must be signed, dated, time stamped, and securely attached to the outside of the kennel. You must also provide feeding and watering instructions for a 24-hour period. A "no food or water" request is not acceptable unless directed by the attending physician. When you check in you are asked to hand over a container for water and one with dog food, just in case.
Like most airlines, AA does not require a health certificate for pets to travel in the cabin or as checked baggage within the 50 United States. That said, individual states may have their own requirements. Check with your vet or state authorities for more information. Keep in mind, all states require proof of current rabies vaccination for dogs over 12 weeks old. For more information on pet travel on American Airlines call 1-800-433-7300 or visit www.aa.com. For additional AA Cargo information call 1-800-CARGOAA or visit www.AACargo.com.
Another example of varying pet travel regulations is U.S. Airways. As of October 1st the airline will no longer accepts pets as checked baggage or cargo because of security reasons. If; however, you bought a ticket for yourself and Fido before August 17, 2005, those arrangements will be honored through November 5, 2005. The policy change will not affect service animals. Customers on domestic flights will be able to travel with their pup, as long as they meet the pet carrier requirements. Only two animals may travel in Coach and only one animal may travel in First Class. The good news: the pet travel fee has been reduced from $100 per pet to $80 each way. Like most other airlines, only one pet per customer again, It's important to note that pets will not be accepted as checked baggage if your itinerary includes a code-share flight operated by United Airlines.
Additionally, a limited number of kennels is permitted on each aircraft. Some kennels may not be accepted on certain US Airways Express aircrafts.
In-flight carriers must follow the same requirements as JetBlue and American Airlines. The maximum size for a US Airways cabin carrier; however, is 21" x 16" x 8" for a hard-sided carrier and 21" x 16" x 10" for a soft-sided carrier. For more information on pet travel on U.S. Airways call 1-800-428-4322 or visit www.usairways.com.
Most airlines that transport people and pets to Hawaii require pets to travel as checked baggage. This rule obviously excludes airlines that won't transport your pooch as checked baggage no matter what.
Hawaii requires a 120-day quarantine for dogs. The quarantine period may be reduced to 5-days or less if specific qualifications are met. All pet arrivals and connections in Hawaii must go via Honolulu since there are no transit or quarantine facilities in any other Hawaiian locations. No pets are accepted on non-stop flights to Maui or Kauai. Pregnant pups past 45 days gestation are not permitted.
For more quarantine information visit http://www.hawaiiag.org/hdoa/ai_aqs_info.htm or call the Animal Quarantine office in Honolulu at 808-483-7171.
Dogs entering the Dominican Republic must have a health certificate issued within 15 days prior to the arrival date by a vet in the country of origin. It must state that Fido in good health and traveling from an area that during the last three months has been free from serious diseases. You must have your pup's proof of vaccinations from more than 30 days but less than one year prior to the date of arrival in the Dominican Republic. A dog will need an anti-rabies vaccine, triple vaccine (distemper, lectopirosis, hepatitis), and parvo-virus vaccine certificates.
To leave the country, pet parents must obtain a health certificate for their pet at the Office of Animal Health. This certificate is valid for 72 hours and will be needed to enter the next port of call. The Direccion General de Ganadaria (Office of Animal Health) can be reached at 1-809-542-0132.
Pups from Canada, the United States and countries not known or suspected to have rabies are admitted but must meet some conditions. Fido must be over six months old, must have a Veterinary Health Certificate issued within 24 hours of embarkation, and must have had a rabies vaccination administered for the duration of one or three years no less than one month prior to arrival.
An import permit is required from the Ministry of Agriculture, Trade and Industry for all animals being brought into the Bahamas. The permit is valid for one year from the date of issue. Applications for these permits, must be made in writing, and cost $10. The fee is waived for service animals. This permit must be obtained prior to arrival in the Bahamas and requires a minimum of 48 hours for processing.
Dogs from countries known or suspected to have rabies (including mainland Europe and most of South and Central America) are not allowed. For more information call the Department of Agriculture at 1-242-325-7502.
Japan requires pet parents to contact Animal Quarantine Service at least 40 days prior to arrival and has very strict entry requirements for pets.
Carry-on pets are not allowed on Transatlantic, Transpacific or Central/South American flights. Pups traveling as checked baggage may be allowed.
A new regulation requires all pups traveling into the European Union to have a tattoo or implanted microchip that matches the identification number on their vaccination card. Pets without a tattoo or microchip will not be allowed to enter the European Union. Domestic pups must also have a veterinary certificate and are required to fill out paperwork for the European Community for Non-Commercial Movement (Regulation (EC) No. 998/2003). . If your travel originates in Aruba, Bermuda, Canada, Japan, Cayman Islands or the USA, parts 1 through 4 must be completed for movement into the European Union and requires 30 days of preparation for your pet. If your travel originates in any other country, parts 1 through 5 must be completed. These regulations require a minimum of four months preparation for your pet.
For more information on these regulations contact the APHIS-VS Area Office in the state from which your pet will be starting the trip.
Most airlines have put temperature restrictions in place to make sure your pet isn't exposed to extreme cold or heat in animal holding areas, terminal facilities, when moving between terminal and aircraft, or while awaiting departure.
The general rule of thumb is that pets won't be accepted when the current of forecasted temperature is higher than 85 degrees Fahrenheit, for most pups. Snub-nosed dogs, like Pugs, won't be accepted if the current or forecasted temperature is higher than 70 degrees. Some airlines will allow a Pug to fly until the temperature hits 75 degrees.
Similarly, pets cannot be accepted when the ground temperature is below 45 degrees Fahrenheit at any location on the itinerary unless the pet has a vet's statement of low temperature acclimation. When temperatures fall below 20 degrees Fahrenheit, pets may not usually be checked, with or without an acclimation statement.
A typical acclimation statement must include the name and address of the passenger, the name of the animal, the name and signature of a licensed vet, the vet's accreditation date and number, and the temperature to which the animal is acclimated.
Pets are usually not accepted to/from Anchorage Alaska when temperatures are forecast below 20 degrees Fahrenheit.
Airports are a tricky place for humans and they cause even more confusion to our four-legged counterparts. It's important pet parents do their homework and find out what Fido needs beforehand. Aside from calling the airline to make sure they know you pup is coming with you, arriving early is the next best thing. Most airlines advise you arrive three hours early if you're traveling with a pup as checked baggage. If your pup is your carry-on, you can get away with waiting around an hour less. A frequent mishap is arriving too early. Most airlines won't check in your pet more than four hours beforehand.
Being a responsible pet parent also means you'll have to do a little digging. You and your pup want to enjoy your flight and arrive safely at your destination. Before you book, take a look at the airline's animal safety record. Not so long ago a federal law was passed requiring airlines to disclose how many pets were injured, killed, or lost on flights each month. Now the Department of Transportation posts the reports on its Web site at: http://airconsumer.ost.dot.gov/reports/index.htm You'll have to scan the reports month-by-month because the government does not record cumulative totals. Nonetheless, it'll give you a good idea of what can happen to an animal traveling in the cargo area of an airplane on a particular airline, in a certain time period. From there you may decide to fly at a different time and so forth.
In an interview with Cox News Service, Diana Cronan, spokeswoman for the Air Transport Association, a trade group that represents nearly 20 major airlines, said not surprisingly, the numbers are low. "The airlines take the transportation of your pet very seriously."


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Activision Explains Petraeus's Role in Call of Duty: Black Ops 2
After his extramarital affair with biographer Paula Broadwell came to light, David Petraeus stepped down from his role as director of the Central Intelligence Agency–only to find himself drafted as a virtual character in the just-released video game Call of Duty: Black Ops 2. Now Activision, the company behind Call of Duty: Black Ops 2, is explaining what Petraeus is doing in the game.
In the video game, actor Jim Meskimen is credited with voicing Petraeus.
Here's Activision's complete statement:
General Petraeus was not paid, was not involved in the creation of the game, and has not been asked to endorse the game. Call of Duty: Black Ops II and its fictional storylines are aimed at providing fun and enjoyment. It is clear to game players that his character and others that are based on real-life figures are fantasy.
Including Gen. Petraeus and other real-life figures was strictly a creative decision made many months ago when the storyline was drafted. We are not commenting further on the latest news or Gen. Petraeus. His service to his country and career accomplishments are a matter of public record.
Related Videos: Call of Duty: Black Ops 2


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Meg Swansen's Knitting
by Meg Swansen
Buy it Now at Amazon.com
In the world of knitting royalty, Meg Swansen is Crown Princess to the late Queen Elizabeth Zimmermann, her mother.
The Story
Swansen's mother, Elizabeth Zimmermann, designed the very first set of Aran instructions to be published in the United States in the February/March 1957 Vogue Pattern Book.
Reference Material
The Tools, Techniques & Terms section at the beginning of the book isn't just the usual cursory two-page glossary.
Patterns include Faroese, Fair Isle, elaborate Turkish patterns in subtle color gradations, intriguing Celtic color swirls, and a pair of easy Norwegian drop shoulder-style cardigans that would make excellent shape and color lessons for beginners. There is just one stitch-intensive pattern. The rest involve lots of colorwork.
Going Beyond the Patterns
The more you understand the fundamentals of any pattern, the more fun you can have expanding on it. Meg Swansen has always encouraged creativity in knitting.
Meg's patterns call for very specific yarns you most likely won't find at your local shop. The only easy way to obtain them is directly from Meg's company, Schoolhouse Press.
Easy to Use
The book includes clear, easy-to-read charts. It also shows photos detailing specific challenging areas of the garment, something most pattern books skip. In this way it's as much a textbook on knitting techniques as a collection of patterns.
Discuss this book in our forums
Buy it Now at Amazon.com
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The Magic of Reading with Curtis Hed
Friday, June 21, 2013
11:00am @ Sugar Creek Branch
Magician Curtis Hed will once again be presenting his Magic of Reading Show in conjunction with the Kansas City Public Libraries summer reading program.
Curtis's show includes Magic, Comedy, some Juggle, and Duo the Dove. As for the show itself, it's one of those rare presentations that is as enjoyable for the adults as it is for the kids. Like one of those good kid movies where the kids enjoy the show on one level and the adults on another, only unlike kid's movie it's live and it doesn't have chase scene, a bad guy, or a talking donkey.