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Please check Bill updates under the Government tab/State Bill Update for the latest information.
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Please check Bill updates under the Government tab/State Bill Update for the latest information.
This past June, I was invited to testify before the Senate Oversight Committee and to address two issues; the first being the transition to FFS and the second, the State's Transition Plan. The following reflects the testimony that was provided.
Let me first start by saying that NJACP has been afforded an opportunity to work with DDD leadership throughout the rate setting process. They have solicited feedback and our input. I share this with you as this is not always the case with state regulatory agencies and for that we are truly appreciative. I'm hopeful that we will continue to have this cooperative working relationship. Having said that, you have asked that we address New Jersey's Division of Developmental Disabilities' transition from a contract-based reimbursement system to Fee-for-Service as well as New Jersey's State Transition Plan and I am happy to speak to both of these issues. I would preface what I say by simply stating that my intention or that of my association is not to disparage DDD but rather to share with you what concerns the providers I represent have in regard to the significant changes they are facing.
There are many advantages in becoming a member of the New Jersey Association of Community Providers.
NJACP member Bancroft celebrated the grand opening of new Corporate Headquarters in Cherry Hill on July 28th. Toni Pergolin, CEO/Chief Executive, spoke to attendees from the community, policymakers, and Bancroft staff about consolidating several locations in a new building, with enhanced programs, including, an office for BOSS (Bancroft Office Support Services). BOSS is a training center that provides job opportunities and vocational training to people with intellectual and developmental disabilities. Those in attendance and speaking at the event included Acting Governor Kim Guadagno, Cherry Hill Mayor Chuck Cahn and several Camden County Freeholders. To commemorate the opening, members of Maggie's Farm Adult Employment Program assisted with a tree planting ceremony. Cherry Trees were planted to represent Bancroft's commitment to the region. NJACP congratulates Bancroft.


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Hamilton Beach 60 Cup Coffee Urn
Item #: 61986 | Model #: D50065 |
- $ 74 97 74.97
Non-members pay 10% surchargeJoin now!
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Shipping to Alaska or Hawaii adds a location surcharge to the regular rate. We offer an expanded assortment, however some restrictions may apply. Delivery estimates, taxes, and fees are based on ZIP Code. Club Pickup orders are based on your club's current price and item availability on the day of payment.
About this item
Built with the long-lasting beauty and performance of stainless steel, this classic urn is a polished addition to any gathering. To make life easy, guests serve themselves, and when the party's over, the urn cleans up fast in the dishwasher.
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subset: commoncrawl


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This robe looked like fun in the photo, with a lot of bright colors, and it was a terrycloth robe, which is what I was looking for. The actual item looks like a clown suit. The terry is VERY thin. Since clowns scare me, I sent it back.
Nice bright colors but too bulky
So, I'm 57 and I wear a brightly striped robe. My partner loves it -- and loves that it keeps me warm. That it does. Can't think of anything I'd rather get into after a bath, or, at the end of a long day. Love this thing.
A high-quality, comfortable, and colorful robe at a very reasonable price. The sizing and cut of the robe fits my wife very well. It wicks moisture away quickly and provides nice warmth without being too heavy.
- How did the color on site compare with the actual product? Exact
- Please tell us about the quality of the product. Soft, full-weight fabric; brilliant colors
- How accurate was the sizing? Very accurate
I LOVE this robe. It feels warm and comfy, the colors are vibrant and true to the ad and I am really enjoying my purchase. In a couple of the previous review, I noted that the reviewers felt it ran small so I ordered an L/X rather than an S/M. It's probably a bit big...the shoulders drop and I have to roll the sleeves up, but I would rather have it a little too big than too small. I'm totally pleased...wish that all my online purchases turned out as well.
- How did the color on site compare with the actual product? Very well
- Please tell us about the quality of the product. I LOVE this robe. It's great to look at and feels very soft and comfortable.
- How accurate was the sizing? I'm about a size 6/7...I ordered an L/X to be sure it was big enough
I bought one of each color for my teen age neices. They both fit them very well. The girls said they are warm and fluffy.
- How did the color on site compare with the actual product? the colorful one was exactly like the picture. The lighter one is a strip that is hard to see from the picture.
- Please tell us about the quality of the product. high quality
- How accurate was the sizing? The Medium's fit average to small sized teen girls.
nice colors fits well but does not dry very well....the material its soft and warm but i was expecting something that dries much better....
- How did the color on site compare with the actual product? good
- Please tell us about the quality of the product. vetry nice and warm but does not dry very well....
- How accurate was the sizing? ok
This is a nice high quality and warm robe. It just runs smaller than I expected. I ordered the L/XL and it is nowhere near wide enough to wrap oneself up. Not for the intended party. That said it is very nice. I ordered it in the pink stripe and the colors are vivid and the material soft. Just be certain if you like roomy robes to order up and know that it is in no way large enough for an XL.
- How did the color on site compare with the actual product? same
- Please tell us about the quality of the product. great quality fleece fabric
- How accurate was the sizing? inaccurate runs small
I ordered two robes and loved them so much, I've returned to get more. Sadly, my size is already sold out, but I'm buying a smaller one for my granddaughter, who fell in love with mine when we opened and tried them on. The hood is a wonderful addition, for keeping your head warm after getting out of the shower and before drying your hair. The length -- longer than any robe I've had before -- makes it great for cozy cuddling up on chilly nights! I'd give it six stars, if possible. I hope Overstocks gets more in, in size 3X!
- How did the color on site compare with the actual product? The color is even better in person - deep, vibrant, clear colors!
- Please tell us about the quality of the product. Has a wonderful "hand," silky soft, dense, and plush.
- How accurate was the sizing? Generous sizing, extremely comfortable, long, cozy robe.
For the price the robe surpasses by far any I have ever bought . It is plush soft and rich in color just like wrapping myself in a cloud :) The fit is great even for large people. Am trult satisfied with this purchase from Overstock.
Thick, soft, warm. I purchased the white/yellow one and the pic's don't really do it justice. It is fairly colorful. Wife likes it a wears it often.
I LOVE my new robe...I seriously look forward to bath/shower time SO much more now because It means I'll get to wrap myself in marshmallowy softness. YAY! GREAT Deal. Awesome purchase.
Bought this for my teen age daughter for Christmas. She absolutely loves it. The fabric is thick and lush and washes up beautiful. Very warm, good quality. I only wish they made it in other colors.
I got this robe for my mom as a Christmas gift after an ordered robe from Victoria's Secret turned out to be a very expensive, very thin cover-up. This robe is fantastic! My mom wears it all the time and loves it. I'm thinking of getting one for myself! My only complaint is that the robe arrived with a slightly torn pocket, but 2 minutes with a needle and thread fixed that. I don't think that could be blamed on the manufacutor.
this was a gift for a woman that lives in a nursing home. Her clothes often go "missing" so I wanted somthing one-of-a-kind that would stand out and that is what I got. The colors were brilliant and beautiful. She LOVED it.
This robe was really nice, however the colors were much brighter than in the picture. I returned it only for that reason. if you like bright colors, it would be a great robe for you. I just want something more soothing!
This robe is very soft and comfortable. I was a bit concerned about ordering a s/m so I got a l/xl and the only issue is the arms are pretty long (I normally wear a medium), no big deal just rolled them up. When I washed the robe, there were not fuzzies all over, that shows a pretty good quality. The only reason I gave 4 stars is I had wanted something a bit more light weight, will be great in the winter.
very soft and comfortable and best of all a bit water resistent - great for getting out of the hot tub!!
This is a very colorful, very soft robe that is exactly what my wife wanted. Great buy!


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Support Those Candidates Challenging the Tax RaisersTaxes come into question as the Nevada primaries are coming up within the next few weeks and Heidi Harris urges the public to educate themselves.
Voter Registration Deadline Is TuesdayRegistration can only be done in person at a County Election Department office or online through the Nevada Secretary of State's Office's website.
NV Bernie Delegate Erin Bilbray on the Disruptive DemocratsThe Democratic Convention in Nevada on Saturday brought more disruption and chaos than was expected and the hosting casino had to cancel the event.
Guest: NV State Controller Ron Knecht on the Commerce TaxSmall businesses in Nevada might be at risk as the state has to determine which taxes to remove, keep, and add.
Heller Voting Against Clinton, Not Necessarily for TrumpSen. Dean Heller says he's committed to voting against Hillary Clinton, but isn't committing to vote for Donald Trump.
Vote Now – People's Choice Awards Voting Is Officially OpenThe People's Choice Awards announced that nominee voting is now open.
Early Voting Begins Saturday
City Council Candidate Left Off Ballot AgainThe wrong ballots were mailed out for the Peoria City Council race again.
Who Wants To Vote?To vote in the next election, you have to be registered.
Biden Decries Voting Restrictions In NAACP AddressVice President Joe Biden Wednesday called on members of the NAACP to spread the word about what he called "a hailstorm" of measures to restrict citizens' ability to vote, trying to rally the Democratic Party's base before the midterm elections.
More Residents Registering To VoteThe Nevada secretary of state's office says over 15,000 residents have registered since the close of the primary election registration period in May.
Nevada Primary Day 2014Turnout is light on Nevada primary day


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Police planning DUI checkpointsMay 15,2014Police planning
DUI checkpoints
Vermont State Police, assisted by local law enforcement agencies, will conduct DUI sobriety checkpoints May 19-30 in the Rutland County area.
Vermonters are urged to use a designated driver whenever necessary and to wear seatbelts.MORE IN This Just InBENNINGTON A Sandgate man with a previous conviction for a sex crime against a child in New... Full StoryThousands of Vermonters will have the chance to get their drivers licenses back starting Thursday. Full StoryA Castleton man, who police said has had several incidents at Fowler Services, denied striking... Full Story
- Most Popular
- Most Emailed


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Magnetic dry-erase Whiteboard Maps & Magnetic Map Kits.
MagnaMaps® with their unique Map-Magnets™ let you flexibly display, instantly update and share your map activity.
MagnaMaps® flexibly display your map related activities with the instantly movable Map-Magnets™ and cartographic charting materials in each kit and are designed to stay like new for a lifetime of daily use.
Select and order here online, factory-direct, maps in many sizes, styles and display options. Order them customized as specific and detailed as you want, any size, any style, from full wall to portable, with options to fit any of your needs. If you have special map requirements, please contact us or call 800 624 4154 and tell our cartographers what you have in mind. We can custom print your steel map and ship it to you in 3 business days or less.
FEEDBACK: "The MagnaMap is amazing! It has been very helpful and easy for everyone to use. As a fire duty officer it has made plotting and tracking fires and resources much easier ....TERRIFIC PRODUCT!!!!" AFMO,W. Ranger District, Bitterroot Forest, MT


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Focus Stocks
Trading Idea: Key levels for State Street
Published on Thursday, 11 October 2012 07:44 Written by TradersHuddle Wire
New York, October 11th (TradersHuddle.com) - Shares of State Street Corporation (NYSE:STT) are trading very close to calculated support at $41.42 with price action closing at just $41.46 and placing the stock near levels where traders will start paying attention.
State Street's stock range is defined by its calculated support defined at $41.42 and by the resistance level at $44.61, which should be used by traders planning their trades. These support and resistance levels are based on a peaks and troughs algorithm of the stock's price action.
Traders wanting to establish a position should pay close attention to State Street's price action, and establish it as close to support as possible, but only after buying materializes. Traders should understand that the resistance point at $44.61 might limit their upside, however, if the stock breaks resistance, it could be a good point to add to the position.
State Street Corporation (NYSE:STT), through its subsidiaries, provides various products and services for the institutional investors worldwide. The company provides securities administration and investment management services. The company serves mutual funds, collective investment funds, corporate and public retirement plans, insurance companies, foundations, endowments, and investment managers.
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A Meridian chiropractor hosted an open house Thursday at his new location on Great River Drive, just off North Hills Street.
A ribbon was cut for McArthur Chiropractic.
Dr. Russel McArthur says he has developed a new treatment technique that is producing results for his patients.
"The type of treatment we use is absolutely painless," said McArthur. "It's not even like the old time pop and snatch kind of maneuvers that people are so scared of. It's a very effective technique, very low force. And most often, the comment when people get off the table is, is that all you're going to do? And it has been very effective."
McArthur says his website, mcarthurmethod.com, has 150 testimonials about the treatment, which he has been sharing internationally.


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Psychology Achievements
Julie Neiworth receives NIH grant for primate researchJuly 13, 2012
Julie Neiworth, Professor of Psychology and Director of Neuroscience, was awarded an NIH AREA (Academic Research Enhancement Award) grant for $344,204.00 for the period July 15, 2012 through July 14, 2015. The title is "revisiting challenged findings to determine social and cognitive abilities in tamarins", and it was funded by the NICHD, under Award # R15HD072751.
Ken Abrams, Assistant Professor of Psychology, presented a poster co-authored by Emily Snyder '11 and Kelley Stevens '11, at the Anxiety Disorders Association of America (ADAA) annual convention titled "Does Nicotine Withdrawal Promote Panic? Findings From a Carbon Dioxide Rebreathing Challenge."
Neil Lutsky, William R. Kenan, Jr. Professor of Psychology, presented the Society for the Teaching of Psychology Invited Address at the Midwestern Psychological Association meeting in Chicago on May 4. His talk was titled "Psychological Literacy and its Dis-Contents." Lutsky also recently served as an external reviewer for the Department of Psychology at Creighton University.
Larry Wichlinski, Associate Professor of Psychology, was recently named to The Princeton Review's list of "The Best 300 Professors." The list covers all departments and fields represented at four-year institutions of higher education in the United States.
Kathleen Galotti, Professor of Cognitive Science, served as an invited external reviewer of the multidisciplinary Cognitive Science Program at Vassar College in April. Vassar College was the first undergraduate institution to offer this interdisciplinary program.
Abrams publishes paper in College TeachingApril 16, 2012
Ken Abrams, Assistant Professor of Psychology, published a paper in the journal College Teaching titled "Student-designed public service announcement (PSA) videos to enhance motivation and engagement."
Ken Abrams, Assistant Professor of Psychology, gave a presentation at the annual meeting of the Association of American Colleges and Universities (AAC&U) in Washington, D.C. titled "Toward Internationalizing the Undergraduate Psychology Curriculum: A Sustainable Model of Inter-Institutional Collaboration." The presentation was part of an Associated Colleges of the Midwest (ACM) sponsored symposium titled "Sustaining and Sustainable Collaboration: Making an Impact."
Neil Lutsky William R. Kenan, Jr. Professor of Psychology, gave an invited address to the annual Southeastern Teachers of Psychology conference held in Atlanta, February 23 through 25. His presentation was titled "Though This Be Madness, Yet There Is Method: Promoting Quantitative Reasoning in the Teaching of Psychology." In January he also presented a paper, "What's Luck Got to Do with It? Social Comparison May Account for Superstition's Effect on Performance," at the San Diego meeting of the Society for Personality and Social Psychology.
Neiworth interviewed on NPR about self-awareness in primatesFebruary 13, 2012
Julie Neiworth, professor of psychology and director of neuroscience, was interviewed on the radio as part of a show about awareness in primates. Click here to tune in to the recorded broadcast.
Galotti serves on panel at Oberlin CollegeJanuary 30, 2012
Kathleen Galotti, Professor of Cognitive Science, recently served on a panel reviewing the Psychology Department at Oberlin College. Galotti also served as a panelist for the 2012 National Science Foundation Graduate Fellowship program.
Ken Abrams, Assistant Professor of Psychology, and Kelley Stevens '11 published a paper titled "The relation between premenstrual dysphoric disorder, panic attacks, and panic disorder" in Advances in Psychology Research, Volume 81. The paper represents an extension of the comps work completed by Kelley, who is first author
Abrams publishes article in Nicotine & Tobacco ResearchNovember 21, 2011
Ken Abrams, Assistant Professor of Psychology, Kate Leger '10, Laura Schlosser '10, Anne Merrill '10, Molly Bresslour '10, and Avantika Jalan '10 published an article in Nicotine and Tobacco Research titled "Nicotine Withdrawal Exacerbates Fear Reactivity to CO2-Induced Bodily Sensations Among Smokers."


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See Serge Seidlitz's portfolio and read all about their work at Debut Art â the artist and illustrator agency in London.
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Dillon Thomas's curator insight, October 21, 2013 11:51 AM
I am in the process of creating my own infographic, these are infograph's that inspire me..
Daryl Nazareth's curator insight, March 28, 2014 7:48 AM
An excellent graphical statical analyses for how much usage the world with use in 2015.
Senior, Personnes Agées & Silver Economie's curator insight, August 7, 2014 12:15 PM
Senior & Digital : l'empire contre attaque !
Marc Vaucelle's curator insight, August 26, 2014 9:30 AM
l'usage d'un réseau social détermine l'âge ...!


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shoppers recently viewed this!
Doris Panos
Pearl Mock Lariat
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Description: 18K yellow gold mock lariat necklace with a circle diamond pendant and three 12-13mm South Sea white pearl drops. Total carat weight is 1. Chain measures 15½ inches and diamond circle has a diameter of about 0.6 inches. Pearls drop about 4¼ inches. Lobster clasp closure.
Brand: Doris Panos


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pcb Companies serving Egypt
Current filtering criteriaYou can remove a filter by clicking on the x
Codel International Ltd
based in Bakewell, UNITED KINGDOM
CODEL are world leaders in the design and manufacture of systems for continuous emissions gas monitoring (cems) and combustion control analysers, such as in-situ and extractive flue gas emissions analysers (analyzers), pollution sensors, dust monitor/particulate monitors, opacity/smoke monitors, flue gas analysers (analyzers), road tunnel atmosphere sensors and velocity ...
Environmental Source Samplers, Inc.
based in Wilmington, NORTH CAROLINA (USA)
Environmental Source Samplers, Inc. (ESS) has a long and proven track record. We have been providing air quality related services since 1979. Headquartered in Wilmington, North Carolina, ESS has provided stack testing services in most of the fifty states and internationally. ESS serves clients in many industries including: Aluminum, Asphalt, Automobile, Carbon, ...
BlueStream Environmental Technologies (Pty) Ltd.
based in Johannesburg, SOUTH AFRICA
BlueStream Environmental Technology has over a decade of experience in developing microbial solutions that are both economically sound and environmentally effective. BlueStream products provide a safe, easy and effective solution for challenging hydrocarbon waste problems with numerous successful applications. BlueStream has earned its reputation for excellence with ...
AMCON Inc.
based in Yokohama, JAPAN
AMCON Inc., team of professionals of dewatering, provides rich variety dewatering equipment from low priced micro compact dewatering equipment to high-capacity king-size dewatering equipment to meet your request.
Kurz Instruments, Inc.
based in Monterey, CALIFORNIA (USA)
Kurz Instruments has maintained a reputation for designing and manufacturing Thermal Mass Flow Transmitters for industrial gas flow measurement. Our engineers, product development specialists and management have developed flow metering products capable of operating in the harshest of environments. For more than 35 years our team has successfully provided solutions to our ...
Euro-Gas Management Services Ltd
based in Devon, UNITED KINGDOM
We`ve been providing solutions to the problems of industrial safety and environmental pollution for 25 years. Our team have over 50 years of experience in gas detection. We take safety very seriously. With our technical expertise and knowledge of worldwide industrial markets, Euro-Gas meets the essential needs relating to the safety of personnel and pollution control. We ...
Munson Machinery Co., Inc.
based in Utica, NEW YORK (USA)
Established in 1823, Munson Machinery is a world-leading manufacturer of dry bulk mixing, blending and size reduction equipment. Munson offers 17 high-performance equipment lines, each with numerous models to meet specialized requirements in the chemical, pharmaceutical, nutritional, and food/dairy industries.Munson engineers each machine to suit individual batch or ...
Modern Water - Monitoring Division
based in Cambridge, UNITED KINGDOM
Modern Water's Monitoring division has developed some of the world's most advanced systems for monitoring water quality. We provide market-leading toxicity monitoring systems, trace metal and environmental monitoring systems. The range includes systems for portable, online, and laboratory use. Our toxicity monitoring products, Microtox and Microtox CTM, detect toxins in ...
Maxxam Analytics
based in Mississauga, ONTARIO (CANADA)
Maxxam is the Canadian market leader in analytical services and solutions to the energy, environmental, food and DNA industries and a member of the Bureau Veritas Group of companies – a world leader in testing, inspection and certification services. We support critical decisions made by our customers through the application of rigorous science and the knowledge and ...
Genesis Water Technologies, Inc
based in Maitland, FLORIDA (USA)
Genesis Water Technologies, Inc. is a USA based manufacturer of advanced, innovative and sustainable treatment solutions for applications in process water, drinking water, water reuse and waste water to our valued clients and collaboration partners worldwide.
based in Alpharetta, GEORGIA (US) (USA)
NoOdor.com, a premier global supplier of EcoSmart, EnergySmart & HealthSmart indoor air pollution & bad odor removal products. They have a proven track record for over 20 years with thousands of satisfied customers because they really work. They also provide many unique advantages that benefit people, pets and the planet while providing superior performance. Our popular ...
Camlab Limited
based in Over, UNITED KINGDOM
Camlab has more than 5 decades of experience in the supply of laboratory products, instrumentation and consumables for scientific applications in all environments. Specialist activities include water analysis and process instruments, life science instrumentation, consumables and accessories, and an extensive range of laboratory equipment for pharmaceutical and industrial ...


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The fabric of your life---
Tennessee owned a three point lead with 9:35 left at Intrust Bank Arena on Saturday-- only to see Tekele Cotton hit two free throws, make a great block to save a bucket on the other end and then score an old fashioned three point play. Cotton had 14 of his team high 19 points down that nine and a half minute stretch and was a big reason the Shockers were able to start 10-0 for the first time in its storied history.
Cotton added five rebounds, four assists; two steals and a block in the 70-61 win which avenges a loss last year in Knoxville that would have seen WSU go to 10-0. What you love about Tekele Cotton is his willingness to do whatever it takes to win, without a single care about who gets the credit. He is the quintessential team player on team full of them, that he's improved his shot so much makes him so much more than the defensive specialist many thought him to be. He was inspiring against the Vols.
Speaking of tough---
"For him to play 32 minutes is unimaginable".
Gregg Marshall was shaking his head when he said this about Ron Baker, who played despite sustaining an ankle sprain not even 24 hours before. No, Baker didn't have his best game, but he had his most courageous and don't think that teammates don't take their cues off things like that. It killed Baker to miss the amount of time he did last season, it's not surprising to me that he showed up ready to go, it did surprise me that he went so hard for so long. Baller.
Seeing double---
Darius Carter seemed more comfortable with the bigger, longer athletes of the Vols and he played large with 11 points and 14 rebounds off the bench. Just as importantly, he was part of the three Shocker bigs who helped neutralize Jarnell Stokes who'd come into the game off four straight double-doubles during which he averaged 18 points and 12 rebounds, holding him to 8 and 4 was a big key for the Shockers.
C'mon Cle---
Cleanthony Early wouldn't be talked about as an NBA talent if he didn't have that kind of ability, even though he's putting up decent numbers he continues to look like he's forcing things. It's interesting that a guy gets the professional attention for playing one way, then, once he gets it, changes the way he plays.
It's just one man's opinion, but there were far too many forced or bad shots taken against Tennessee, too few rebounds, too many bad decisions and what's worse some that looked selfish down the stretch. For Wichita State to have the type of season it wants Cle has got to be a better decision maker, he's got the game he just has to have the head as well. I can only imagine how exciting it is to get the type of attention he has, but you have to be able to handle it lest you're hindered by it.
On to Dixie---
Alabama is off to halting start, but they'll be more than capable at home on Tuesday night. Like Tennessee, they'll have SEC athletes and, in Kansas City's Trevor Releford, an experienced point guard whose 1-1 against the Shockers. It's interesting, that for teams like Tennessee and Alabama, who play in a league with Kentucky and Florida, that Wichita State is a big game-- but the Shockers wouldn't want it any other way and to their credit they seem more than comfortable that their reputation now precedes them.


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|Back to home > Search Home
Career Resource Center Library
The collection allows faculty and students to research a wide range of career development resources.
Search Tips
The Departmental Collections Catalog provides access to campus collections apart from those of the main Wesleyan University Library. To add your collection contact Sally Grucan, Cataloging Librarian, Olin Library, x3845.


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You are a fan of hand tranquility ? Come to discover the best forums hand tranquility on the internet and share your experience with a community fan of hand tranquility . You can also build a forum hand tranquility and create your online discussion.
North Wales Sea Fishing Forum. Sunnyrhyl.com Sea Fishing Forum
fishing, north, wales, shark, bass, tope, rhyl, llandudno, colwyn, mackerel, prestatyn, pensarn, sunny, sunset, sunrise, peace, #tranquility
Hand Reading Forum: palm reading & palmistry forum: psychodiagnostic chirology, life purpose hand analysis, vedic palmistry & multi-perspective palm reading!
#hand, reading, palm, palmistry, analysis, hands, chirology, psychodiagnostic, elemental, vedic, reflexology
A message board dedicated to constructive discourse and the archiving of useful information in all aspects of practical self-defense with an emphasis on unarmed personal combat.
self, defense, defence, protection, personal, safety, lito, angeles, reality, based, self-defense, rbsd, street, fighting, combatives, unarmed, combat, #hand


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Software Applications and Programming
Software development is an area of IT that helps many businesses be productive. Computer programmers design and write code to customize existing software applications and custom products, among other things.
The Information Technology - Software Applications and Programming program in the School of Information Technology at ITT Technical Institute teaches students how to perform tasks associated with developing and modifying software applications. Additional curriculum topics, investigated through classroom theory and laboratory applications, include programming languages and algorithms, database development and applications, and other related technical subjects.
As a software programmer, you can be part of a team that provides customized software solutions for businesses and consumers. If you enjoy solving puzzles, are comfortable with logical thinking and solution development, and enjoy working in a team setting, software applications and programming is an area of IT you might like to pursue.
Potential Employment Includes:
- C++ Developer
- C++ Programmer
- Java Developer
- Java Programmer
- System Application Developer
- Software Developer
- Software Programmer
- Visual Basic Developer
- Visual Basic Programmer


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Tuberculosis (TB) is a serious global infection with an estimated prevalence of 13.7 million cases worldwide.1 Transplant recipients have a 36- to 74-fold higher risk of developing TB versus the general population.2 TB in liver transplant recipients presents unique challenges, including a delayed diagnosis secondary to insensitive testing and treatment complications due to antituberculous drug toxicities and interactions with immunosuppressive agents. This review focuses on the epidemiology, clinical features, diagnosis, clinical evaluation, and treatment of liver transplant patients infected with TB.
Mycobacterium tuberculosis infection in liver transplantation
Mycobacterium tuberculosis can cause significant infections in liver transplant candidates and recipients. Its nonspecific clinical features and prolonged growth time in culture make the diagnosis difficult, and treating tuberculosis (TB) remains challenging because of significant toxicities and drug-drug interactions. The diagnosis of a latent TB infection may be accomplished with tuberculin skin testing and with the newer interferon-γ release assays, although this infection may be underrecognized because of host factors. Latent TB should be treated, but the degree of liver failure and the likelihood of progression to active TB will dictate whether this should occur before or after transplantation. Patients who have a history of TB, have used muromonab-CD3 or anti-T lymphocyte antibodies, or have experienced allograft rejection or coinfection with cytomegalovirus, Pneumocystisjiroveci, or Nocardia are at the greatest risk of developing active TB. Active TB in transplant patients is difficult to treat because of drug-induced hepatotoxicity and the significant interaction between rifampin and calcineurin inhibitors. In this article, we review the epidemiology, clinical features, and evaluation of transplant candidates and recipients. In addition, we offer recommendations on the appropriate diagnostic and treatment regimens for patients with latent and active TB infections. Liver Transpl 16:1129–1135, 2010. © 2010 AASLD.
Rates of 0.47% to 2.3% for active TB in adult liver transplant recipients has been reported.2–5 Because of the difficulty of accurately diagnosing symptomatic TB, these figures most likely underestimate the burden of the disease. In addition, the frequency of the disease varies geographically, with particular regions (Asia and Africa) having a higher prevalence than other areas of the world.6 Several factors place transplant patients at greater risk of developing active TB.
A previous TB infection increases the likelihood of TB developing after transplantation.5 The RESITRA (Spanish Network of Infection in Transplantation) cohort documented a relative risk of 4.3 for the development of symptomatic TB when the purified protein derivative (PPD) test was positive instead of negative.4 In a systematic review of 139 cases of active TB infection after liver transplantation, 37% had a positive tuberculin skin test (TST), 23% had abnormal pretransplant chest imaging, and 13% had a history of untreated/improperly treated TB.7 The number of pretransplant patients with a positive TST underestimates the number of patients infected with TB because end-stage liver disease may result in cutaneous anergy, which decreases the sensitivity of the TST. Chest radiography findings consistent with TB (ie, a military pattern, cavitary lesions, and upper lobe focal infiltrates) appear to be the single most important risk factor associated with the development of early-onset TB.3
The intensity of the immunosuppression (specifically the use of muromonab-CD3 and anti–T lymphocyte antibodies) plays an important role in the development of active TB.5, 6 Other risk factors include preexisting conditions that may affect immune function, such as chronic liver disease, diabetes mellitus, coinfections (cytomegalovirus, Pneumocystisjiroveci, and Nocardia), and allograft rejection.3–5 In Spain, older age appears to increase the risk of posttransplant TB. This association may be relevant to countries such as Spain that are experiencing a decrease in TB cases in the general population; this suggests that older individuals may be more likely to harbor latent TB than younger persons.4, 6 Although posttransplant acquisition (donor-derived or nosocomially transmitted) is infrequent, it has been reported in the literature.2, 8
Most active TB cases are diagnosed within the first 12 months after transplantation.2–4 In a large Spanish cohort, 95% of all TB cases occurred during the first year, with a median time of onset of 183 days after transplantation (range = 28-499 days).4 Similarly to the general transplant population, 83% of all TB cases among liver transplant recipients occur within the first year with a median time to onset of 4 months, the majority of cases primarily being a result of disease reactivation.2
Extrapulmonary TB occurs more frequently in transplant recipients versus normal hosts. An older review of solid organ transplant recipients with Mycobacterium tuberculosis infection noted that 51% had pulmonary TB, 16% had extrapulmonary TB, and 33% had disseminated TB.2 A more recent series documented only disseminated disease in 9.5% of patients.4 Disseminated disease may occur more frequently when liver transplant patients have received muromonab-CD3.2
Extrapulmonary and disseminated TB can involve obscure locations with varied clinical presentations. The involvement of nearly every organ, including the liver, gastrointestinal tract, skeletal system, muscles, skin, orbit, central nervous system, renal and genitourinary tract, lymph nodes, pericardium, larynx, and adrenal glands, has been described.2, 3 Because the presentation may be distinct from that seen in normal hosts, high clinical suspicion and a thorough evaluation are necessary for the diagnosis of most cases of extrapulmonary and disseminated TB. Tissue biopsy may be critical for the establishment of the diagnosis.
Fever, night sweats, and weight loss are commonly observed symptoms.2, 9, 10 In patients with pulmonary TB, chest radiographs vary and may include focal infiltrates (40%), a military pattern (22%), nodules (15%), pleural effusions (13%), diffuse interstitial infiltrates (5%), and cavitary lesions (4%). Nodular patterns are more common in non–renal transplant recipients.2
Latent TB
TST using PPD and interferon-γ release assays [QuantiFERON-TB Gold (QFT) from Cellestis and T-SPOT.TB from Oxford Immunotec, Ltd.] are the 2 types of tests available for the diagnosis of a latent tuberculosis infection (LTBI; Table 1). In the general population, these 2 tests have good concordance for detecting latent TB.11 One study compared QFT to PPD testing in 153 chronic liver disease patients awaiting liver transplantation. Concordance between the 2 tests was 85.1% (k = 0.60), and this suggests that QFT was comparable to PPD for the diagnosis of latent TB in this population.12 Another study comparing QFT to PPD testing in patients with chronic liver disease revealed fewer positive results with PPD testing.13 Currently, there is no reported advantage for one test versus the other; but in normal hosts, interferon-γ release assays have the advantage of differentiating people whose positive skin test reflects prior vaccination against Bacille Calmette-Guérin (BCG) infection. Although this ability to differentiate TST positivity related to BCG immunization has not been studied specifically in liver transplant candidates, the assays are likely to have similar performance characteristics and therefore may be advantageous in patients with a history of prior BCG immunization. Patients with a remote history of BCG immunization who are TST-positive are more likely to be positive because of prior infection with TB rather than vaccination; consequently, the majority of TST-positive adults are likely to have latent TB. Moreover, it is notable that patients with chronic liver disease are less likely than those in the general population to be identified by either modality because of diminished cellular responses associated with cirrhosis.14–16 Because both QFT and TST measure the cellular immune response to M. tuberculosis, testing with QFT is unlikely to be helpful in patients with a negative TST related to defective cellular immune responses.11, 12 The full evaluation of a patient with cirrhosis before liver transplantation should be thorough and include a detailed medical and exposure history and a review of chest radiography (see the section on the evaluation of transplant candidates and donors). In posttransplant recipients, the diagnosis of LTBI similarly involves the use of TST or interferon-γ release assay testing. Test sensitivity is diminished because of the use of immunosuppressants after transplantation; as a result, historical and radiographic evaluations may be especially critical.
|Pretransplant candidates and donors
|History: TB risk factors, exposures, and prior infection. Testing: TST or interferon-γ release assays (assay sensitivities may be reduced in patients with cirrhosis) and chest radiograph for the evaluation of evidence of past infection (eg, granulomas and apical scarring). Key points: The 2-step method may detect TB in patients with remote exposure via the booster effect. For deceased donors, obtaining a history from family members may be useful. Chest radiography may help to identify patients with a history of TB.
|Drugs: Isoniazid daily for 9 months or rifampin daily for 4 months (before transplantation only). Key points: Patients with compensated cirrhosis should be considered for treatment. Patients with uncompensated cirrhosis should defer therapy to the period after transplantation. Patients with recent exposure to TB, radiographic evidence of previously healed TB, and low body weight are at increased risk of progressing to TB disease, so higher priority for early intervention should be considered.
|History: Varied symptoms depending on the presence of pulmonary or extrapulmonary disease. Testing: Chest radiograph. Invasive diagnostic techniques may be required, especially for patients with extrapulmonary disease. Key points: A definitive diagnosis requires the isolation of M. tuberculosis in a culture and/or pathological confirmation. All positive cultures should undergo antimycobacterial drug susceptibility testing.
|Candidates: Patients with active TB should not undergo transplantation; exceptions might be considered for patients with well-controlled infections. If patients undergo transplantation during therapy, one should consider altering the regimen to exclude rifamycin. Donors: Active TB is a contraindication for transplantation.
|Posttransplant recipients
|History: TB risk factors, exposures, prior infection, and donor TB status. Testing: TST or interferon-γ release assays. Key points: The sensitivity of testing is significantly reduced; negative tests do not exclude a diagnosis. The 2-step method may detect TB in patients with remote exposure via the booster effect. Chest radiography may help to identify patients with past infections.
|Drugs: Isoniazid daily for 9 months. Key points: Recipients of donors with latent TB should receive a 9-month course of preventive therapy with isoniazid.
|History: Varied symptoms depending on which organ or organs are involved. Extrapulmonary disease may be seen. Testing: Chest radiograph. Invasive diagnostic techniques may be required. Key points: A definitive diagnosis requires the isolation of M. tuberculosis in a culture and/or pathological confirmation. All positive cultures should undergo antimycobacterial drug susceptibility testing.
|Localized, nonsevere disease: The initial therapy should not include rifamycins, and maintenance agents should include isoniazid and ethambutol. The addition of pyrazinamide or levofloxacin may shorten the treatment length. Severe disease, disseminated TB, or resistant disease: Rifamycin treatment should be considered during the initial and maintenance phases. Key points: Rifampin can significantly decrease serum levels of calcineurin inhibitors, and rifabutin may be preferable, although calcineurin inhibitor levels will still be reduced. Close monitoring of calcineurin inhibitor levels is imperative with early dose increases recommended.
Active TB
TB may be present as a latent infection (quiescent or asymptomatic) or an active infection. The diagnosis of active TB requires the isolation of M. tuberculosis and/or pathological confirmation with consistent changes in tissue sampling, including granulomas and/or the presence of acid-fast bacilli (Table 1). TST and interferon-γ release assays should not be used because they have reduced sensitivity in this population and do not differentiate between latent and active disease. Transplant patients infected with TB have a high frequency of coinfections (cytomegalovirus, community-acquired pneumonia, urinary tract infection, Nocardia, and aspergillosis), with rates as high as 23%, and these may lead to the delayed diagnosis of TB in transplant recipients.3
The clinical features of active TB in transplant patients differ from those in the general population, and the manifestations will depend on the site or sites of infection. Pulmonary TB is most common and should be considered in patients with unexplained respiratory illnesses who have abnormal radiographs. In comparison with normal hosts, the typical findings of upper lobe involvement and cavitation may be less commonly noted, and patients may present with pulmonary nodules, bronchiectasis, or even lymphadenopathy.2, 6 The manifestations of extrapulmonary disease are diverse; consequently, TB should be considered in any patient with unexplained fever, especially if the recipient or the transplant donor has previously been noted to have a documented or suspected untreated latent infection. In many cases, because of the increased incidence of extrapulmonary disease and the difficulty of isolating the organism in expectorated sputum, invasive diagnostic techniques may be required. Bronchoscopy, laparoscopy, tissue biopsy, and bone marrow evaluation may be required to make a diagnosis.3, 10 A definitive diagnosis requires the isolation of M. tuberculosis from a culture. With standard microbiological methods, M. tuberculosis may take up to 6 weeks to grow; as a result, the use of specialized media that enhance growth and molecular and genetic amplification techniques may be useful in patients for whom there is a high clinical suspicion of TB.3, 17 Once TB is identified, it is important for clinical isolates to be tested for susceptibility to available antimycobacterial medications. In some cases of active TB, cultures will be negative. Consequently, consistent pathological findings, including the presence of acid-fast bacilli or caseating granulomas, may be indications for the initiation of antituberculous therapy.
Evaluation of Transplant Candidates
A thorough history documenting TB risk factors, exposures, and infections should be obtained from all transplant candidates.5, 6 This includes previous travel to endemic areas, institutional exposure, and contact with individuals with active TB (ie, household or workplace contacts).5, 6 Previous infections with TB, latent or active, should be recorded along with details about the treatment (or lack of treatment), medications, and length of therapy5, 6 (Table 1).
All transplant candidates should be evaluated for latent TB by either TST or interferon-γ release assays; this includes patients with a history of BCG vaccination.5, 6 Despite this recommendation, only 40.5% to 47% of transplant recipients are tested prior to transplantation.2, 4, 5 There are limited data comparing TST and interferon-γ release assays in transplant candidates, and no gold standard exists to support the use of one test over the other. Because of the immunosuppressed state of most transplant candidates due to cirrhosis, a TST with ≥5 mm of induration at 48 to 72 hours is considered positive and reflective of past infection.5, 6 Patients with negative results should have a second TST in 1 to 3 weeks.5, 6, 18 This 2-step method may identify patients with remote exposure to TB via the booster effect, by which the first TST stimulates the immune system and allows it to react to the second test.18 Despite the use of the 2-step method, the potential to underdiagnose LTBI in this immunosuppressed population, which is at risk for cutaneous anergy, remains high. Anergy testing, aimed at identifying patients who can mount a delayed-type hypersensitivity response, is controversial, unpredictable, and generally not recommended.18 In anergic patients, serial TSTs will not result in a positive skin reaction. The proportion of patients falling into this category is unknown, and this has important treatment implications. It is unknown which patients with negative testing will be most likely to benefit from treatment for latent TB. Patients with radiographic findings or a clinical history highly suggestive of prior untreated TB should be assessed on a case-by-case basis for the treatment of latent TB, and consideration should be given to the risk of the treatment versus its benefit. Patients who are not treated should be closely followed for potential reactivation. Further research and improved diagnostic assessments are needed in this area.
An individual should not undergo TST or interferon-γ release assay testing only if he has a well-documented history of previous TB infection or a positive TST in the past.5, 6 A patient with a positive test should undergo chest radiography and a symptom review to rule out active TB.5, 6 Active TB is a contraindication for transplantation,5 although exceptions might be considered for patients on treatment with a well-controlled infection, especially if they have progressive liver failure related to antituberculous medication.
Evaluation of Transplant Donors
M. tuberculosis infections have been transmitted through liver transplant grafts.5, 19 Because of this risk, all living donors should undergo an evaluation similar to that used for transplant candidates; it should include a careful history and TST or interferon-γ release assay testing, particularly in areas with a high prevalence of TB, such as Asia and Africa5, 6, 20 (Table 1). Centers for Disease Control and Prevention guidelines should be used in interpreting TST results, whereas QFT and T-SPOT.TB should be read according to the manufacturers' instructions.6 The challenge is accurately diagnosing TB infections in deceased donors, who provide organs for more than 95% of all liver transplants and for whom only limited relevant historical information, including previous tuberculin testing, is often available.21 Obtaining a TB history from family members and relatives may be useful.6 Living donors with LTBI should be considered for treatment.6 Treatment should be expedited for patients with recent TST conversion and/or TB exposure because these patients are at greater risk for developing active TB.6 Treatment regimens are similar to those recommended for the general population (see the section on latent TB treatment). The length of therapy prior to liver donation has not been well studied, and further investigation is required to determine if a subset of patients can be treated with a shorter course prior to donation under the assumption that the recipients will be treated after transplantation. In the case of transplantation using organs from deceased donors, it is more difficult to assess the presence of latent TB. All donors should undergo screening with detailed histories and chest radiographs. Because historical information for donors is often incomplete, the risk of donor-derived TB may be underestimated. Donors from areas in which TB is more prevalent and those with probable TB exposure (defined as known close contact or a high-risk living environment such as prison) should be carefully scrutinized for evidence of both active and latent TB. In these cases, whenever it is possible, respiratory and urine cultures should be collected.5 In addition, any enlarged lymph nodes in the surgical field should be biopsied and cultured for M. tuberculosis.5 Because this is not part of the usual donor acquisition evaluation; the recipient institution should make a specific request. Additionally, the finding in a recipient of unexpected TB thought to be possibly of donor origin should prompt notification of the local organ procurement organization and subsequent communication with transplant centers caring for other recipients of organs from the same donor to facilitate the evaluation for potential donor-derived TB.
Organs from donors with active TB or with a high suspicion of active TB should not be used.6 Recipients of organs from donors with latent TB should receive a 9-month course of preventive therapy with isoniazid (see the section on latent TB treatment).
Latent TB
Transplant recipients with LTBI are at increased risk of developing active TB. Reactivated TB may be difficult to diagnose in transplant patients, pose a potential public health safety risk, and increase the potential for serious morbidity and mortality.6 For these reasons, the treatment of LTBI is generally recommended. Liver transplant candidates and recipients present a unique challenge because of the potential risk of hepatotoxicity associated with therapy.
The standard therapy for treating LTBI in the general population is isoniazid daily for 9 months.22 Alternative regimens include isoniazid twice weekly via directly observed therapy for 9 months, isoniazid daily for 6 months, and rifampin daily for 4 months.22 Concerns about hepatotoxicity secondary to the use of these agents have prompted some experts to recommend delaying treatment for LTBI until the period after liver transplantation. This differs from the recommendations for other solid organ transplant candidates, such as kidney and lung transplant candidates, for whom the treatment of latent TB is recommended before transplantation whenever this is possible.5, 6 If treatment is delayed until the period after transplantation, rifampin should be avoided because of interactions with calcineurin inhibitors. The initiation of posttransplant preventive treatment should begin as soon as a patient's liver function has stabilized to prevent the development of reactivated diseases.
Recent studies have shown that LTBI treatment can be safely used in select liver transplant candidates.6, 23, 24 One study compared 18 liver transplant candidates (mean Child-Pugh score = 8) who received 12 months of isoniazid treatment for LTBI to matched controls; no difference in hepatic function tests was noted between the 2 groups, and none of the 18 cases had to discontinue therapy.23 Another study reported similar findings and noted the safe use of either 9 months of daily isoniazid or 4 months of daily rifampin in 14 liver transplant candidates (mean Child-Pugh score = 6).24 Given these findings, we recommend that transplant candidates with compensated cirrhosis be considered for the treatment of LTBI with close monitoring for treatment-related toxicity, whereas patients with decompensated disease should defer therapy until the period after transplantation when their liver function is more stable (Table 1).
There are no studies evaluating the safety of transplantation for individuals who are in the midst of treatment for LTBI, and it is unknown if these individuals are at risk for worse outcomes because of activation of TB or drug toxicity in the new liver. Because of the relative effectiveness of LTBI treatment, the tolerability of isoniazid in the transplanted liver, the limited availability of acceptable donor organs, and the high rate of death for patients on the waiting list, it is reasonable to consider transplantation for patients receiving LTBI treatment. The standard duration of treatment should be completed.
It should be recognized that patients with recent exposure to TB (new TST conversion), radiographic evidence of previously healed TB, and low body weight are at increased risk of progression from LTBI to TB disease.18 These individuals deserve special consideration and should receive treatment as soon as it is medically possible.
Once therapy is started, liver enzymes should be monitored frequently; experts suggest checking liver function tests every 2 weeks for 6 weeks and then monthly.6 In the general population, guidelines recommend stopping therapy if the enzymes are elevated 3-fold and the patient is symptomatic or if there is a 5-fold elevation without symptoms.18 No guidelines for discontinuing therapy have been established in the liver transplant population. An elevation in liver enzymes does not necessarily reflect drug toxicity because a number of conditions may manifest in a similar manner. Liver biopsy may be needed to clarify the underlying ideology. In patients with significant hepatotoxicity, some experts recommend that levofloxacin and ethambutol for at least 6 months be considered, although there are no controlled trials of this treatment.2, 3, 5
Active TB
The American Thoracic Society, the Centers for Disease Control and Prevention, and the Infectious Diseases Society of America recommend 4 regimens for the treatment of pulmonary TB.22 These regimens include a 2-month intensive phase followed by a continuation phase of 4 to 7 months.22 In the liver transplant population, recommendations for treating active TB differ because of the known risk of drug-drug interactions between antituberculous medications and immunosuppressive agents and the potential for hepatotoxicity associated with first-line TB therapy.5, 6 These differences also have an impact on the suggested length of treatment.5, 6
Isoniazid, rifampin, and pyrazinamide can all cause hepatotoxicity.17, 22 The deleterious effect on the liver is increased when these agents are used in combination rather than alone.5, 6 In a large Spanish series, 12 of 24 liver transplant recipients with TB (50%) developed hepatotoxicity during treatment.25 Another major challenge in treating TB in transplant patients is the use of rifampin, which can significantly decrease serum levels of calcineurin inhibitors and mammalian target of rapamycin inhibitors and alter corticosteroid metabolism.3, 5, 6, 17 For this reason, rifamycins must be used with extreme caution in transplant recipients. Cyclosporine and tacrolimus doses should be increased 3- to 5-fold at the outset of therapy, and levels should be monitored closely.5, 26 However, even with this adjustment and careful monitoring, combining rifampin and calcineurin inhibitors can lead to increased graft rejection, graft loss, and TB-related mortality.5 Rifabutin appears to be as effective as rifampin, but it is a weaker inducer of cytochrome P3A4 and therefore results in less intense drug interactions.6, 22, 27 Little data exist on its use in the transplant population, but it appears to be just as efficacious as rifampin in human immunodeficiency virus–infected patients and may be considered an alternative in situations in which the use of a rifamycin is mandatory.5 If rifabutin is used, cyclosporine and tacrolimus doses should be increased upon the initiation of therapy, and calcineurin inhibitor levels should be monitored closely. Because of the risks of administering rifamycins in transplant recipients, many clinicians opt to avoid these medications in transplant recipients for whom alternative regimens are feasible.
Fluoroquinolones and aminoglycosides are other agents used in the treatment of TB; they are primarily used in cases of multidrug resistance or intolerance of first-line medications. Patients on aminoglycosides, such as streptomycin, amikacin, and kanamycin, should be monitored closely for nephrotoxicity (especially with calcineurin inhibitors) and ototoxicity.22 Fluoroquinolones, notably levofloxacin and moxifloxacin, are frequently used in the treatment of drug-resistant TB.22 The prolonged use of these agents may result in arthralgias, which typically resolve once the drug has been discontinued.3 Because of a more favorable side-effect profile versus rifampin and aminoglycosides, fluoroquinolones have been increasingly considered in transplant recipients.3, 22
The treatment of active TB in transplant recipients is based on expert opinion, and no randomized clinical trial data are available3, 5 (Table 1). In cases of localized, nonsevere disease, attempts should be made to avoid rifamycins in initial therapy, and maintenance agents should include isoniazid and ethambutol for 18 months. The addition of pyrazinamide or levofloxacin may shorten the treatment length, but patients should be closely monitored. Some experts prefer to use a rifamycin; in that case, 9 months of therapy is sufficient. Patients with severe disease, disseminated TB, or suspicion or evidence of resistance to isoniazid should be considered for rifamycin treatment during the initial and maintenance phases. Multidrug-resistant TB may require the use of 4 to 6 agents for a prolonged period of time and should be managed only in consultation with an infectious diseases specialist.22
The ideal length of therapy remains controversial, and it is affected by the extent of the disease, choice of regimen, response to therapy, and resistance profile of the organism. Some experts suggest that bone and joint involvement, central nervous system disease, and disseminated TB require longer treatment.6 In addition, patients with cavitary pulmonary TB who remain culture-positive after 2 months of therapy require longer treatment. In general, many providers recommend 12 to 18 months of anti-TB treatment.3, 5, 17, 20
In conclusion, TB is a serious infection in the transplant population. In particular, liver transplant patients have a poor prognosis. The mortality rate has been as high as 30% to 100% in various series.3, 17 In addition, allograft rejection is a serious result of either a planned or drug-induced reduction of immunosuppressive therapy.17 Experience with antituberculous therapy in the liver transplant population is necessary to prevent mortality and organ rejection. Future research should focus on developing rapid, sensitive, and specific diagnostic tests, new therapeutic drugs with fewer side effects, and shorter treatment strategies for transplant patients.


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Industry News
Military Writers Society Of America Author Of The Year Headlines Lexicon Writer's Conference
Jack Woodville London, Historical Fiction Author, Attorney and Veteran speaks to Authors on doing historical research titled, "Maps, Mistresses and Machiavelli"
July 12, 2012 - PRLog -- Denton, TX – On Saturday, July 21, Jack Woodville London will headline the list of presenters at the Lexicon Writers Conference in Denton, Texas - 30 minutes north of D/FW International Airport and Dallas, Texas. The Lexicon Writers Conference seeks to assist, promote, and educate writers in all genres, fiction and non-fiction, and is available for published and unpublished writers. London will speak on "Maps, Mistresses and Machiavelli"
Saturday, July 21 1:00 p.m. Highlighted Speaker
Mitch A. Haynes, president of the conference says, "In a world filled with people who think they are writers, only a handful will truly succeed. What separates them from the rest of the crowd…They take advantage of all the available opportunities and resources to promote their work and themselves."
The first of its kind in Denton, events like this are for writers and authors who want to pitch their work to agents of publishers around the country, but also to rub elbows locally – to find readers who enjoy the same genre, editors who can assist with manuscripts, and to meet people who may just offer encouragement in the field. This conference caters to those who want to meet other writers, agents and editors, hear speakers and access vendors that are ready to impart knowledge and connections, all without the $500+ price tag of attendance.
Mr. London is author of the French Letters series, Virginia's War and Engaged in War. London's French Letters series is historical fiction based on life during World War II and its effect on the people at home and on those serving on the front lines of the war in Britain and France. London bases his series on a number of letters between Virginia and Will, weaving an intriguing story around this framework. London's work is said to be "the greatest literary work since Hemingway."
About Jack London
Jack Woodville London is a well-known trial attorney, acclaimed author and World War II historian. London is a graduate of West Texas A&M, the University of Texas and the Academy of St. Céré, France. Recent awards include the prestigious Author of the Year title from Military Writers Society of America and Honorable Mention for Fiction in the esteemed London Book Festival. Jack also has a series of articles about writing titled "A Novel Approach." His books are available at bookstores and at Amazon.com in both print and Kindle formats.
For information about Jack and his work or to schedule an interview, visit www.jwlbooks.com or contact his publicist, Sandy Lawrence, at 281.989.8892.
For information on Lexicon Writers Conference, visit http://lexi-
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It's kind of a drag
Two things stuck out this year. One was the size of the crowd in the grandstand on Friday. Nice. Ten, maybe 15 thousand. The other was the lack of a crowd . . . among big Chicago media. Yes Chicago is a stick-and-ball town. And I do realize that WGN radio paid attention on its morning show. I'm not suggesting that more newspapers and TV stations won't be on the grounds for eliminations on Sunday, and I'm also not suggesting that the Indy Racing League weekend at the Milwaukee Mile was any less deserving of coverage. It's just one of those things that makes you go "huh?" Having seen my pal from the Tribune at the Mile for a couple of days last weekend, it seemed odd to not see someone on Friday. Drag racing apparently is a big step down. They don't know what they're missing.
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- Report: #378196
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Complaint Review: NATURAL CURES - Kevin Trudeau - ITVdirect.com
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A few months later, I noticed a charge for $9.95 on my American Express card, for Nat Cures. I did not know what that was for, so I looked at my other statements and found I was charged this same amount for June, July, and August. I called the phone number and talked to "Jason". He told me I had a 30 day trial to a newletter via their website, and since I didn't cancel it, I was being charged $9.95 a month for it. I told him I didn't know about the website and wanted it cancelled and credit for the charges.
He told me he could not credit all the months, but would issue one credit, if I did not dispute the charges with American Express. I told him that would not work, and to cancel my subscription. I contacted American Express, and they issued me credits for each of the charges without any problem.
I received my statement from Am. Express for September, and sure enough, there was the charge again for Nat Cures. They are issuing me another credit again, but can not stop the charges from coming. I have to call them every month to have the charge credited until Natural Cures stop billing my card.
I sent a cancel my subscription email to firstname.lastname@example.com, firstname.lastname@example.com, firstname.lastname@example.com, and email@example.com. Hopefully they will cancel this "subscription". I will post any responses I receive from them on my report here.
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Publications International
Disney Classics "Me Reader" & ABC Write & Erase Set
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Description: Disney Classics Story Reader Me Reader & 8-Book Library
The Disney Classics Story Reader Me Reader and 8-Book Library is a new electronic reading system from the makers of Story Reader 2.0. The Me Reader is an electronic pad that reads out loud each one of eight Disney Classics storybooks. The reading pad is compatible only with the storybooks included in the set. The Me Reader system is recommended for children ages 3 years and older. The device is simple to use. To begin, children select one of the eight storybook buttons on the Me Reader, which is made of sturdy hard plastic. Next, they find the storybook they have selected, open to the first page of the story, and press the Read Story button on the pad to activate the narrator s voice. Each time they turn a page, children again press the Read Story button to continue hearing the story. Kids know which Read Story button to press by matching those on the pad with those in the storybook. The set includes these eight 20-page hardcover Disney Classics storybooks: Finding Nemo, Lion King, Aladdin, Winnie the Pooh, Dumbo, Jungle Book, 101 Dalmatians, and Peter Pan. The Disney Classics Story Reader Me Reader and 8-Book Library is packaged in a sturdy cardboard storage box with a plastic carrying handle. Three AAA batteries that power the reading pad are included.
Mickey Mouse Clubhouse: ABC Fun Write & Erase
This spiral-bound shaped board book has 8 sturdy spreads, 3 erasable markers, and a wipe-off cloth. Mickey and his pals are having all sorts of adventures inside and out of the Clubhouse - learning the alphabet along the way, as well as other fun things! This book has 16 activity pages, 3 nontoxic markers, 1 soft cotton wipe-off cloth, and a reusable plastic case. Use the wipe-off pages over and over for many hours of learning fun.
- Author:* Editors of Publications International
- Format: Hardcover, Board Book
- Age Range: 2 years and up
Material: Hardcover, Board Book
Brand: Publications International
Origin: Imported


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Video: The Concert Corner - Summerfest, Harley-Davidson's 110th, Garbage and more
Lot to run through in the Concert Corner chat this week. A whopping 96 bands were announced last week to play Summerfest and the Harley-Davidson 110th Anniversary. And then there was Garbage's return to Milwaukee for the first time since 2005. Plus there's a lot to look forward to this week: the Joy Formidable, the Last Bison, the WAMI Awards.
So I tried to condense all this in my chat with CineStars' Brittany Umar, but of course couldn't get terribly deep. You can follow the links for more information on Summerfest 2013 headliners, the Harley-Davidson 110th anniversary lineup, the Garbage Eagles Ballroom show, Joy Formidable at Turner Hall Ballroom and the WAMI Awards. »Read Full Blog Post
Comedian Ron White coming to Riverside
"Blue Collar Comedy" star Ron White is returning to the Riverside Theater April 12.
Last time White was in town was February 2012, when he performed stand-up at a sold-out Riverside. That's a typical accomplishment for White: he's sold more than 10 million CDs and DVDs and has been one of the top three grossing touring comedians in the U.S. over the past five years. »Read Full Article
On Tap for Today: Storytime for kids, laughs for adults and music after the movie
Hello, new week. What's going on?
Keep reading for the answer. »Read Full Blog Post
Milwaukee Film Festival picks: Day Twelve
While many of its films are local-centric, the Milwaukee Film Festival spans the globe looking for films from other countries that audiences here might enjoy. Today is a great day to sample foreign-language romantic comedies in which opposites attract.
"Finding Mr. Right" (4:30 p.m., Downer Theatre) is a Chinese "Sleepless in Seattle"-type tale about a spoiled and shallow woman who, when she becomes pregnant, is sent to America, where she clashes - and falls in love - with a sensitive single dad who is her opposite. »Read Full Blog Post


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- Report: #63643
Report - Rebuttal - Arbitrate
Complaint Review: NADN
NADN4330 South Valley View, Suite 134 Las Vegas, Nevada U.S.A.
NADN National Audit Defense Network fraudulent ripoff refund claims Las Vegas Nevada
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In March, 2002, my husband was pestered into signing up for the services provided by the National Audit Defense Network at a cost of over $800.00. Within one hour after this telephone conversation, after discussing the situation with me, I telephoned the company in order to request a cancellation. I was told by a customer representative that he would "go upstairs", find our application, and tell the processor to cancel the order. About a week later we received a package from the NADN which we immediately returned unopened.
Some weeks later, when we discovered that our credit card had been charged $810.95 by the NADN, I contacted them again. This time, I was informed that we had not followed proper procedure and therefore were not entitled to a refund. Proper procedure, which was described in a letter included in the package we returned unopened, involved obtaining a "return authorization" number from the company and requesting a refund in writing within 7 days from receipt of their informational package. This letter was to be forwarded to them "in a manner which has verifiable proof of receipt (Certified or Registered Mail, facsimile transmission, Express Delivery)".
After speaking to a number of company representatives, I was finally told that if we didn't use their services for one full year, we would be eligible for a complete refund.
One year later, after speaking to another company representative, I was informed that we are not entitled to a refund. In fact, the NADN's official policy states that "If after following our tax savings advice you do not accrue an additional $3,000.00 in tax deductions during the next twelve months, you will be entitled to a full refund of your first year's NADN membership fees at the end of your first year." That's right, we would have been eligible for a refund if we had used their services, but the fact that we didn't makes us ineligible.
Beware!!! If you're contacted by the National Audit Defense Network, tell them you know the truth about their fradulent business practices. And tell them you heard it from...
Pittsburgh, Pennsylvania
This report was posted on Ripoff Report on 07/14/2003 07:43 PM and is a permanent record located here: http://www.ripoffreport.com/r/NADN/Las-Vegas-Nevada-89103/NADN-National-Audit-Defense-Network-fraudulent-ripoff-refund-claims-Las-Vegas-Nevada-63643. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
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LISTEN Movie Reviews: "22 Jump Street", "How to Train Your Dragon 2"
Posted June 13th, 2014 @ 1:07pm
It's "sequel weekend" at movie theaters. Hap Erstein with PalmBeachArtsPaper.com gives us his reviews of the latest films.
"How to Train Your Dragon 2"
"Words and Pictures"
Art House Pick of the Week


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The OpenFlow networking standard is feeling the embrace of the world's largest network operators. And perhaps none moreso than Google, which sees great potential for the open networking standard to solve sticky problems in its sophisticated data center infrastructure. Read More
Google Turns to Tape to Rescue Lost Gmail
When a bug wiped out multiple storied copies of Gmail boxes during a software update, Google turned to its backup tapes to restore the data. The incident affected 0.02 percent of Gmail users, the company said. Read More
Google Spending Soars on Real Estate Deal
Google's capital spending soared to $2.5 billion in the fourth quarter, more than three times more than the company has spent in any previous quarter. The increase was caused by Google's purchase of 111 8th Avenue, its New York headquarters building. Read More
Google: We Bought 111 8th Ave. for Office Space
Google executives say they purchased 111 8th Avenue in New York because they needed more office space, not for its value as one of Manhattan's leading Internet hubs. Read More
Google Confirms Purchase of 111 8th Avenue
Google today confirmed the reports that it has purchased 111 8th Avenue, one of Manhattan's largest buildings and a key hub for Internet traffic. Read More
Video: Google's Finland Data Center Project
A video provides a look inside Google's data center project in Finland, which is converting a former paper mill into a state-of-the-art data center that will be cooled using water from the Baltic Sea. Read More
WSJ: Google is Buying 111 8th Avenue
Google has signed a contract to buy 111 8th Avenue, one of the most important telecom and Internet connectivity hubs in Manhattan, the Wall Street Journal reports. Read More
Google Building Two More Data Centers
Google is expanding its data center capacity with new construction in the Carolinas, the company said this week. Citing the need for additional server capacity, Google is completing work on a second data center at its campus in Goose Creek, South Carolina. Read More
Weekend Roundup: Google Data Center in India?
Reports of a huge Google data center in India, Linux now supports Tilera architecture, Cirrascale announces support for OpenStack, Petascale Computing facility receives construction award. Read More
Google Drives 6 Percent of Internet Traffic
Google now represents an average 6.4 percent of all global Internet traffic, up 1 percent from last year, according to the latest analysis from Arbor Networks. Read More
Additional Google Articles
- Google Resumes Work on Oklahoma Data Center
- Google's Data Center Spending Soars
- Google: Our Fiber Gets Shot Down
- Google Using Sea Water to Cool Finland Project
- Google Adds Capacity for Instant Launch
- Daniel Costello Moves from Microsoft to Google
- Google & Facebook: A Tale of Two Data Centers
- Google Energy Buys Up Iowa Wind Power
- Google Boosts Data Center Spending
- Google Patents Liquid-Cooled 'Server Sandwich'
- Google: How We're Making the Web Faster
- Google Patents 'Tower of Containers'
- Videos: Google's Data Center Technology
- Google Eyes 'Optical Express' for its Network
- Roundup: VISI, The Planet, Google TV, Cray


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Take extra advantage of Robur GAHPs in the netherlands!
Subsidies scheme available for Robur GAHP of 5000 euros extended to 2020. Energy savings, cost savings and sustainability together with Gas Absorption Heat Pumps (GAHP).READ MORE
Mostra Convegno Expocomfort 2016
From the 15th to the 18th of March, 2016 at Fiera Milano. Robur will exhibit at Pavillion 5, stand C19-D20.READ MORE