text:
Author Affiliations: Department of Community Medicine (Ms Frisbee and Drs Shankar, Knox, and Ducatman) and Center for Cardiovascular and Respiratory Sciences (Ms Frisbee and Dr Shankar), West Virginia University School of Medicine, Morgantown; Department of Environmental and Occupational Health, Emory University Rollins School of Public Health, Atlanta, Georgia (Dr Steenland); Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York (Dr Savitz); and Public Health and Environmental Research Unit, London School of Hygiene and Tropical Medicine, London, England (Dr Fletcher).
Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) are man-made compounds with widespread presence in human sera. In previous occupational and adult studies, PFOA and PFOS were positively associated with serum lipid levels.
To interrogate associations between PFOA and PFOS and serum lipids in children and adolescents.
Cross-sectional community-based study.
Mid–Ohio River Valley.
A total of 12 476 children and adolescents included in the C8 Health Project, which resulted from the pretrial settlement of a class action lawsuit pursuant to PFOA contamination of the drinking water supply.
Main Outcome Measures
Serum lipids (total, high-density lipoprotein [HDL-C], and low-density lipoprotein [LDL-C] cholesterol and fasting triglycerides).
Mean (SD) serum PFOA and PFOS concentrations were 69.2 (111.9) ng/mL and 22.7 (12.6) ng/mL, respectively. In linear regression after adjustment for covariables, PFOA was significantly associated with increased total cholesterol and LDL-C, and PFOS was significantly associated with increased total cholesterol, HDL-C, and LDL-C. Using general linear model analysis of covariance, between the first and fifth quintiles of PFOA there was a 4.6-mg/dL and a 3.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C levels, respectively, and an 8.5-mg/dL and a 5.8-mg/dL increase in the adjusted mean levels of total cholesterol and LDL-C, respectively, between the first and fifth quintiles of PFOS. Increases were 10 mg/dL for some age- and sex-group strata. Observed effects were nonlinear, with larger increases in total cholesterol and LDL-C levels occurring at the lowest range, particularly of PFOA.
Although the epidemiologic and cross-sectional natures of this study limit causal inferences, the consistently observed associations between increasing PFOA and PFOS and elevated total cholesterol and LDL-C levels warrant further study.
Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) are perfluoroalkyl acids: man-made compounds used as emulsifiers during the manufacture of fluoropolymers, which are chemicals that give nonstick heat resistance to cookware or breathable yet waterproof properties to fabrics and upholstery. Perfluoroalkyl acids may also result from the metabolism or breakdown of fluorinated telomers, which are compounds used as coatings for commercial food packaging, factory treatments for fabrics and carpets, and manufacturer pretreatment for "stain-resistant" clothing.
Recent reviews of the scientific literature1- 3 regarding PFOA and PFOS emphasize their environmental persistence and presence in a variety of marine and freshwater species. Human serum samples across myriad age groups and geographic areas are known to contain perfluoroalkyl acids generally and PFOA and PFOS specifically. Recent results from the National Health and Nutrition Examination Survey4,5 reported detection of perfluoroalkyl acids in almost all samples, with a US population median for PFOA of 5.2 ng/mL and 3.9 ng/mL (1999-2000 and 2003-2004), respectively. Identified sources of human exposure to PFOA and PFOS include drinking water, dust, food packaging, breast milk, cord blood, microwave popcorn, ambient air, and occupational exposure,1,6- 8 although the relative contribution of each is unknown.
Animal studies have identified the liver as a primary target organ for perfluoroalkyl acid physiologic activity. Reported toxicological effects of exposure to PFOA and/or PFOS include hepatomegaly, reduction in serum triglycerides and cholesterol in some animal species, and alterations in coenzyme A activity. These alterations in hepatic metabolism and function have been attributed to perfluoroalkyl acid action as a peroxisome proliferator-activated receptor–α (PPAR-α) agonist with subsequent peroxisome proliferation.1- 3
Compared with effects seen in animals, human studies have reported different associations between PFOA and lipid levels. In occupationally exposed employees, PFOA associations have included increased PFOA concentrations and increased total cholesterol (total-C) but not triglycerides or other lipids9; increased total-C and low-density lipoprotein cholesterol (LDL-C) but not high-density lipoprotein cholesterol (HDL-C)10; increased total-C but not triglycerides or HDL-C11; and increased triglycerides but no association with total-C or LDL-C.12 A study of a community cohort with known environmental PFOA contamination reported no association between PFOA and total-C.13 A recent, much larger study of adults from the same and adjacent environmentally exposed communities reported a robust, positive association between PFOA and total-C and LDL-C and a less clear association between PFOA and triglycerides.14
To our knowledge, no study has investigated potential associations between perfluoroalkyl acids and lipids in children and adolescents. The importance of such studies is 3-fold. First, if such associations are etiologic, exposure prevention would become important to reduce the long-term health consequences of elevations in known cardiovascular disease risk factors. Second, studying potential health consequences of an environmental exposure in children and adolescents may provide greater insight because these groups likely have fewer factors confounding underlying associations (eg, prevalent chronic or acute disease or medication use) compared with adults. Third, given possible differences in physiologic processes owing to developmental changes in children and adolescents, toxic effects may be different compared with those observed in adults. Thus, the purpose of this study is to interrogate associations between serum PFOA and PFOS and lipids in a large, community-based sample of children and adolescents.
The participants in this study were 12 476 children and adolescents aged 1.0 to 17.9 years at their enrollment in the C8 Health Project (hereafter referred to as the Project). The Project has been more completely described elsewhere.15 Briefly, it resulted from a pretrial settlement of the class action lawsuit Leach v E.I. du Pont de Nemours & Co,16 filed in 2002 after PFOA from the DuPont Washington Works facility near Parkersburg, West Virginia, was found to have infiltrated several local drinking water supplies along the mid–Ohio River Valley. Project eligibility criteria included the ability to document consumption of contaminated drinking water (from 1 of 2 public water districts in West Virginia or 4 in Ohio, or from private water sources within the public water districts that contained ≥0.05 PFOA parts per billion) for at least 1 year between 1950 and December 3, 2004, at a primary residence, place of employment, or school. Participants were enrolled during a 13-month period between August 1, 2005, and August 31, 2006. Participation and enrollment included documentation of identity and eligibility; a self-reported survey of demographics, personal health history, and lifestyle habits; self-reported height and weight; and voluntary submission of a blood sample. As we have previously reported, approximately 60% of participants were residents in an eligible water district at the time of their enrollment in the Project, and an estimated 80% of people who resided in the eligible water districts at the time of the Project enrolled as participants.15 With 69 030 total participants (12 476 children and adolescents), to our knowledge the Project represents the largest community-based study to date investigating potential associations between PFOA exposure and human health effects.
Children and adolescents voluntarily submitted blood samples at a maximum of 26 mL. Samples were centrifuged, divided into aliquots, and refrigerated at community-based data collection sites until being shipped to laboratories for analysis.
Clinical laboratory tests were performed at an accredited clinical diagnostic laboratory (LabCorp Inc, Burlington, North Carolina). The lipid panel included total-C, HDL-C, LDL-C, and triglycerides. The LDL-C was calculated using the Friedewald formula for participants with triglycerides lower than 400 mg/dL (to convert to millimoles per liter, multiply by 0.0113). Although fasting was not a requirement for phlebotomy, the time of the last meal was reported.
The primary laboratory performing perfluorocarbon analysis (Exygen Research Inc, State College, Pennsylvania) was also used for an independent study of a smaller group of residents in 1 water district included in the Project.17 Full perfluoroalkyl acid analytic techniques and quality assurance protocols for the Project have been published elsewhere.15 Briefly, the analytic protocol was a modification of a previously described protocol that used a protein precipitation extraction together with reverse-phase high-performance liquid chromatography/tandem mass spectrometry.18 Spectrometric detection was performed using a triple quadrupole mass spectrometer in selected reaction monitoring mode, monitoring for the individual m/z (mass-to-charge) transitions for the perfluoroalkyl acid and 13C-PFOA surrogate.
Project data collection administered by Brookmar Inc, Parkersburg, West Virginia, was conducted with the authority and supervision of the Wood County, West Virginia, Circuit Court. Brookmar Inc used a consenting procedure approved by parties to the Settlement that included language specific to the Project's purpose and data collection procedures and the mandatory documentation requirements to demonstrate Class eligibility. All participants submitting a voluntary blood sample completed the standard consent and release forms of the clinical laboratory contracted for phlebotomy. The Project group at West Virginia University and the C8 Science Panel obtained institutional review board approval from their own academic institutions permitting access to anonymous Project data.
The outcome variables were total-C, LDL-C, HDL-C, and triglycerides. For simplicity, the same covariables were considered for all analytic models: age, sex (except for models stratified by sex), body mass index (BMI) z score, duration of fast (in minutes), and whether the participant engaged in a regular exercise program. Age was included as a continuous variable and as 2 strata (aged 1.0-11.9 years and 12.0-17.9 years) to assess possible age and developmental confounding. For all analyses using quantiles, grouping was established within age group and sex, and so quantiles are age-group and sex specific. Engagement in a regular exercise program was self-reported as part of the survey ("Do you engage in an exercise program?" with a "Yes/No" response option), as were fasting status, height, and weight. Analyses including triglycerides were conducted for only those reporting a fast of 6 hours or more. The BMI z score was calculated using Epi Info software, 2000 reference data set (Centers for Disease Control and Prevention, Atlanta, Georgia).
Multiple linear regression was performed to assess for the presence of an overall linear association between PFOA or PFOS and lipids. Both PFOA or PFOS and the dependent variable were natural log transformed.
General linear model analysis of covariance was performed to estimate predicted lipids (estimated marginal mean [EMM]) after adjustment for covariables based on increasing PFOA or PFOS quintiles. The serum lipid was defined as the dependent variable, PFOA or PFOS quintile as a fixed factor, and the other independent variables (age, sex, BMI z score, exercise, and fasting status) as covariates. The covariable-adjusted EMM for each quintile is presented graphically for the overall population (all age groups and both sexes combined). The difference in the covariable-adjusted EMM between the fifth and first quintile was established for each age and sex strata. To interpret the statistical significance of the trend in the quintile-based change in the covariable-adjusted EMM, linear regression analysis was used to estimate the β coefficient (and corresponding P value) for the PFOA or PFOS quintile, which is reported as a β for trend.
To assess the linearity or nonlinearity of any association between PFOA or PFOS and serum lipid levels, 20-group quantiles were determined and the population median for each group was calculated. General linear model analysis of covariance was again used to determine the covariable-adjusted EMM for each quantile, which was plotted against its PFOA or PFOS median.
Binary logistic regression analysis was performed to assess the odds of abnormal lipids with increasing PFOA or PFOS quintile. For total-C, LDL-C, and triglycerides, categorization as abnormal was based on American Heart Association–endorsed cutoff values for "borderline" or "high" in children (total-C≥170 mg/dL, LDL-C≥110 mg/dL [to convert to millimoles per liter, multiply by 0.0259], and triglycerides ≥150 mg/dL.19 For HDL-C, values lower than 40 mg/dL (to convert to millimoles per liter, multiply by 0.0259) were classified as abnormal. Logistic regression analysis was performed using PFOA or PFOS quintile dummy variables, in which the first quintile was considered the reference group.
Interaction between PFOA and PFOS was dually assessed. Logistic regression analysis, with models otherwise constructed as described previously, was performed with the PFOA quintile, the PFOS quintile, and the product of quintiles (interaction term) included in the analytic model. The statistical significance of the interaction term (P for interaction) is reported. Logistic regression analysis was also used to assess for the presence of multiplicative interaction using models as described previously. Four groups were created based on the PFOA and PFOS quintiles: group 1 (PFOA first to fourth quintile and PFOS first to fourth quintile), group 2 (PFOA fifth quintile and PFOS first to fourth quintile), group 3 (PFOA first to fourth quintile and PFOS fifth quintile), and group 4 (PFOA fifth quintile and PFOS fifth quintile). Logistic regression was then completed using 3 dummy variables, in which group 1 was considered the reference group.
Sensitivity analyses were conducted for the effects of fasting and socioeconomic status. Using models otherwise constructed as described previously, multiple linear regression was performed for models with and without household income (dichotomized at ≤$30 000/y or >$30 000/y) and models adjusted for fasting status or with only participants having completed a fast of 6 hours or longer. The magnitude and statistical significance of β coefficients for the different models were then compared. Both PFOA or PFOS and the dependent variable were natural log transformed. All analyses were performed using SPSS statistical software (SPSS Inc, Chicago, Illinois).
General characteristics of participants are reported in Table 1. The mean (SD) age was 11.1 (4.5) years, and participation was similar across both sexes (48.9% girls and 51.0% boys; data missing for 6 participants [0.1%]). Of the 12 476 children and adolescents included in this study, more than 10 000 (>80.0%) had perfluoroalkyl acid quantification and serum lipids available for analysis. Consistent with US Census Bureau estimates for the area, 11 894 (96.1%) reported their ethnicity as white, 4406 (39.7%) were classified as overweight or obese (≥85th BMI percentile), and 4576 (36.7%) reported having a regular exercise program. According to participant-reported residence at the time of enrollment, a slightly higher proportion of participants were from Ohio compared with West Virginia (6796 [54.5%] vs 5520 [44.2%], respectively).
Mean (SD) total-C was 160.7 (29.3) mg/dL, with 65.8% of values classified as acceptable (<170 mg/dL). Mean (SD) calculated LDL-C was 87.3 (25.2) mg/dL, with 83.7% of values classified as acceptable (<110 mg/dL). Mean (SD) HDL-C was 49.3 (11.3) mg/dL, with 92.2% of values classified as ideal (≥35 mg/dL) and 19.7% lower than 40 mg/dL. Finally, mean (SD) fasting triglycerides were 99.1 (56.0) mg/dL, with 85.6% of values classified as acceptable (≤150 mg/dL).
Mean (SD) serum PFOA and PFOS concentrations were 69.2 (111.9) ng/mL and 22.7 (12.6) ng/mL, respectively, with serum concentrations statistically significantly higher in boys and younger children for PFOA and PFOS, particularly the former. Consistent with the environmental (drinking water) contamination and as previously reported,15 serum PFOA concentration for 12- to 19-year-olds in the Project population was substantially higher than the reported concentration for 12- to 19-year-olds in the 2003-2004 National Health and Nutrition Examination Survey,5 whereas PFOS concentrations were similar (29.3 ng/mL vs 3.9 ng/mL and 19.1 ng/mL vs 19.3 ng/mL, respectively).
Results from regression analysis (not shown) demonstrated that after adjustment for covariables, total-C and LDL-C were linearly and positively associated with PFOA and PFOS (P < .001 for all models). Triglycerides were also linearly and positively associated with PFOA (P = .02) but not with PFOS. The HDL-C was not linearly associated with PFOA but was positively associated with PFOS. For linear regression models and other analyses reported in this article, virtually all covariables were statistically significantly associated with the dependent variable (not shown).
Associations between increasing PFOA and PFOS quintiles and the covariable-adjusted EMM of serum lipid levels are depicted in Figure 1. Total-C and LDL-C demonstrated a consistent increase for each increase in PFOA or PFOS quintile: a 4.6-mg/dL and 3.8-mg/dL increase in the covariable-adjusted EMM of total-C and LDL-C between the first and fifth quintiles of PFOA and an 8.5-mg/dL and 5.8-mg/dL increase in the covariable-adjusted EMM of total-C and LDL-C, respectively, between the first and fifth quintiles of PFOS. Overall associations between PFOA and PFOS and HDL-C and triglycerides were less clear, with no apparent association between PFOA quintile and covariable-adjusted EMM for HDL-C or between PFOS quintile and covariable-adjusted EMM for triglycerides. There was a small increase in the covariable-adjusted EMM of HDL-C and the first to third quintiles of PFOS, but not for the third to fifth quintiles of PFOS.
Changes in covariable-adjusted estimated marginal means (general linear model analysis) across perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) quintiles. A, Total cholesterol (total-C). B, High-density lipoprotein cholesterol (HDL-C). C, Low-density lipoprotein cholesterol (LDL-C). D, Fasting triglycerides. Lipid values are presented as mean (SE). To convert total-C, HDL-C, and LDL-C to millimoles per liter, multiply by 0.0259; fasting triglycerides to millimoles per liter, multiply by 0.0113.
These associations are more fully characterized in Table 2, which reports differences between the fifth and first quintiles and β for trend for each of these age/sex groups. For PFOA and total-C and LDL-C, there was a trend toward a larger increase in the covariable-adjusted EMM in the younger compared with the older age group (5.8 mg/dL vs 4.2 mg/dL, respectively, for total-C and 4.9 mg/dL vs 3.2 mg/dL, respectively, for LDL-C) and in boys compared with girls (within each age group). The β for trend for each of these age groups was statistically significant (P < .05). For PFOS, there was a trend toward a larger increase in the covariable-adjusted EMM in older compared with younger age groups (9.5 mg/dL vs 5.5 mg/dL, respectively, for total-C and 7.5 mg/dL vs 3.4 mg/dL, respectively, for LDL-C) and a trend toward larger increases for boys compared with girls (within each age group). The β for trend for each of these age groups was also statistically significant (P < .05).
In contrast, each β for trend for age group and sex strata for the associations between PFOA and HDL-C and triglycerides was not statistically significant (except in 1 group), making differences in the covariable-adjusted EMM difficult to interpret. For associations between PFOS and HDL-C, each β for trend was statistically significant for boys and both sexes combined (but not girls) for both age groups, although marginal increases in the covariable-adjusted EMM were small (1.1-2.6 mg/dL). Similarly, each β for trend for age group and sex strata for the associations between PFOS and triglycerides was not statistically significant (except in 1 group), making differences in the covariable-adjusted EMM difficult to interpret.
In Figure 2 and Figure 3, the covariable-adjusted EMM for serum lipids for the 20-group quantiles of PFOA or PFOS are plotted against the median of PFOA or PFOS for the quantile. For PFOA and PFOS, the results demonstrated a nonlinear association between increasing PFOA or PFOS concentration and total-C and LDL-C. For PFOA, the largest increases in the covariable-adjusted EMM of total-C and LDL-C were seen at the lowest range of PFOA concentrations; the slope attenuated at higher serum concentrations. Although population exposure and corresponding serum concentrations of PFOS were lower, the relationship between increasing PFOS quantiles and the covariable-adjusted EMM of total-C and LDL-C was similar across the spectrum of serum PFOS concentrations. The HDL-C level also demonstrated a small, nonlinear association with increasing PFOS quantile.
Nonlinear changes in covariable-adjusted estimated marginal means (general linear model analysis) across perfluorooctanoic acid (PFOA) 20-group quantiles. Models were adjusted for age, estimated time of fasting, body mass index z score, sex, and regular exercise. Lipid values are presented as mean (SE). Values for PFOA are presented as the median value for the quantile group in question (axis truncated because of very large range in median values ≠ PFOA serum concentration). A, Total cholesterol (total-C). B, High-density lipoprotein cholesterol (HDL-C). C, Low-density lipoprotein cholesterol (LDL-C). D, Fasting triglycerides. To convert total-C, HDL-C, and LDL-C to millimoles per liter, multiply by 0.0259; fasting triglycerides to millimoles per liter, multiply by 0.0113.
Nonlinear changes in covariable-adjusted estimated marginal means (general linear model analysis) across perfluorooctanesulfonate (PFOS) 20-group quantiles. Models were adjusted for age, estimated time of fasting, body mass index z score, sex, and regular exercise. Lipid values are presented as mean (SE). Values for PFOS are presented as the median valve for the quantile group in question. A, Total cholesterol (total-C). B, High-density lipoprotein cholesterol (HDL-C). C, Low-density lipoprotein cholesterol (LDL-C). D, Fasting triglycerides. To convert total-C, HDL-C, and LDL-C to millimoles per liter, multiply by 0.0259; fasting triglycerides to millimoles per liter, multiply by 0.0113.
Logistic regression results are given in Table 3. Increasing PFOA and PFOS quintiles were positively associated with an increased risk of abnormal total-C (adjusted odds ratio, 1.2 [95% confidence interval, 1.1-1.4] and 1.6 [1.4-1.9], respectively) and LDL-C (1.4 [1.2-1.7] and 1.6 [1.3-1.9], respectively). Increasing PFOS quintiles were also associated with decreased risk of low HDL-C (adjusted odds ratio, 0.7 [95% confidence interval, 0.6-0.9]). Neither PFOA nor PFOS was associated with an increased risk of abnormal triglycerides.
Results of analyses assessing interaction appear in Table 4. For total-C, LDL-C, and triglycerides, results do not support an interaction between PFOA and PFOS in the prediction of these lipids. There is some evidence of multiplicative interaction between PFOA and PFOS in the reduction of risk of low HDL-C (the odds ratio for group 4 exceeds the product of the odds ratios for groups 2 and 3).
Sensitivity analyses were conducted to assess the stability of the association between PFOA or PFOS and lipid levels after the inclusion of household income and for fasting-only participants. Results (not shown) suggested that after adjustment for the same covariables, models were stable and associations were unaltered. The positive, statistically significant association between both PFOA and PFOS and total-C and LDL-C was not altered after the inclusion of household income (a proxy for socioeconomic status) or when analysis was performed only on the subset of participants who had completed a fast of 6 hours or more. Likewise, the positive, statistically significant association between PFOA and fasting triglycerides was not altered after the inclusion of household income. Perfluorooctanesulfonate was not associated with fasting triglycerides, with or without the inclusion of household income. The association between PFOA and HDL-C was not statistically significant, with or without the inclusion of household income or for the fasting or nonfasting participants. The positive, linear association between PFOS and HDL-C was statistically significant, with and without the inclusion of household income and for the fasting and nonfasting participants.
To our knowledge, this study reports the first assessment of associations between PFOA and PFOS and serum lipids in children and adolescents from the largest community-based study of the effects of PFOA exposure to date. Across several types of analyses, results consistently provided evidence for a positive association between PFOA and PFOS and serum lipids, specifically an increase in total-C and LDL-C with increasing PFOA and PFOS serum concentrations. Dose-response relationships were nonlinear, with larger increases in lipids at the lower range of PFOA concentration in particular. Additionally, results suggested that the magnitude of association between PFOS and total-C and LDL-C was higher than that between PFOA and total-C and LDL-C. Finally, there was a statistically significantly increased risk of abnormal total-C and LDL-C with increasing PFOA and PFOS serum concentrations.
Results reported in this article are consistent with those of previous studies in adults, which have generally shown a trend toward a positive association between PFOA and cholesterol. Our observations are also consistent with a study of adults (≥18 years) from the same Project population, in which authors reported an 11- to 12-mg/dL increase in total-C from the lowest to highest decile of serum PFOA (vs our finding of a 4.6-mg/dL increase from the lowest to highest quintile) and a corresponding 8- to 9-mg/dL increase in LDL-C (vs 3.8 mg/dL reported in this article), and a 10- to 12-mg/dL increase in total-C from the lowest to highest decile of serum PFOS (vs our finding of an 8.5-mg/dL increase from the lowest to highest quintile) and a corresponding 11- to 12-mg/dL increase in LDL-C (vs 5.8 mg/dL reported in this article).14
Evidence from animal studies has suggested that activation of PPAR-α is an important mechanism through which PFOA and PFOS exert biological effects, although it is unclear whether this animal-based evidence can be extrapolated to humans. The elimination time for PFOA and PFOS in humans is substantially longer than in rodents, resulting in a longer duration to reach a steady-state dose.20 In addition, PPAR-α is expressed in human liver tissue at approximately 10% of rodent levels, and humans and other primates are refractory or less responsive to PPAR-α agonists compared with rodents.21 Thus, associations reported in this article are etiologically plausible if a non-PPAR-α mechanistic pathway operates in humans in addition to or instead of a PPAR-α pathway; some studies of humans and other primates have reported lipidemic effects through non-PPAR-α–dependent mechanisms.22
The nonlinear nature of the observed associations, particularly for PFOA, suggests a possible saturation point in an underlying physiologic mechanism. Furthermore, whereas serum PFOA levels in this study population exceeded levels from a nationally representative sample, PFOS levels were similar (as explained previously). Regardless, the magnitude of the observed associations between PFOS and total-C and LDL-C were similar and in some instances larger compared with those observed with PFOA. Thus, PFOA and PFOS specifically, and possibly perfluoroalkyl acids as a general class, appear to be associated with serum lipids, and the association seems to exist at levels of PFOA and PFOS exposure that are in the range characterized by nationally representative studies.
The strengths of this study include the large sample size and participation rate (and consequent ability to examine associations in different age groups and in both sexes) and the replication in children and adolescents of observations made in adult populations. The replication of observations in a sample free from some factors that can confound associations in adult samples contributes additional strength to our observations. Confounding on the basis of sex or developmental effects was controlled through stratification, but the prevalent design of the Project did not permit assessment of the effects of cumulative exposure nor of the residual or persistent effects of prenatal exposure. The long-term health consequences of elevated serum lipid levels in the ranges observed in this study (3.0-10.0 mg/dL) are unclear.
The cross-sectional nature of this study is an acknowledged weakness; thus, causal inference is limited. Additional potential limitations include self-reported survey data, limited availability of covariables known to be associated with lipids, and uncertainty of fasting status for the analysis of triglycerides.
Studying the susceptibility of children and adolescents to these chemicals has been identified as a particular data need and research priority.23 We have previously reported a U-shaped pattern in serum concentrations of PFOA in boys and girls and of PFOS in girls in this population (ie, serum concentrations were higher in younger age groups, decreased into early to middle adulthood, and increased again through adulthood).15 Furthermore, the effects of perfluoroalkyl acids on developing physiologic systems or of sustained, long-term exposure are unknown. The large sample size in this study and findings consistent with results from adult occupational and larger community studies support a strong need to prioritize research regarding the effects of perfluoroalkyl acids in children and adolescents to assess whether the clear associations reported in this article are etiologic.
In conclusion, although the epidemiologic and cross-sectional nature of this study inherently limits causal inference, the consistently observed associations between increasing PFOA and PFOS serum concentrations and elevated total-C and LDL-C warrant further study. Should the association prove to be etiologic, the cumulative effects of such an elevation in cholesterol on long-term cardiovascular health are unclear given the early age at which these associations were observed.
Correspondence: Stephanie J. Frisbee, MSc, MA, Department of Community Medicine, West Virginia University School of Medicine, Robert C. Byrd Health Sciences Center, 1 Medical Center Dr, PO Box 9105, Morgantown, WV 26506-9105 (firstname.lastname@example.com).
Accepted for Publication: February 9, 2010.
Author Contributions: Ms Frisbee and Drs Shankar, Knox, Steenland, Savitz, Fletcher, and Ducatman 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: Frisbee, Knox, and Ducatman. Acquisition of data: Frisbee and Ducatman. Analysis and interpretation of data: Frisbee, Shankar, Knox, Steenland, Savitz, Fletcher, and Ducatman. Drafting of the manuscript: Frisbee and Ducatman. Critical revision of the manuscript for important intellectual content: Frisbee, Shankar, Knox, Steenland, Savitz, Fletcher, and Ducatman. Statistical analysis: Frisbee, Shankar, Knox, Steenland, Savitz, and Fletcher. Obtained funding: Ducatman. Administrative, technical, and material support: Frisbee and Ducatman.
Financial Disclosure: Ms Frisbee and Drs Shankar, Knox, and Ducatman were engaged in the Project pursuant to a contractual relationship between Brookmar Inc and West Virginia University. This study was funded in part by that contract. Drs Steenland, Savitz, and Fletcher are members of the separate C8 Science Panel, whose Wood County Circuit Court–appointed obligation is to determine "probable links" between PFOA exposure and health outcomes. Panel membership was jointly agreed to by the Plaintiffs and DuPont and then approved by the Court. As such, these authors are in receipt of funding from the C8 Class Action Settlement Agreement.
Funding/Support: The C8 Health Project was funded by the Settlement Agreement in the case of Leach v E.I. du Pontde Nemours & Co., Civil Action No. 01-C-608 (W. Va. Circuit Court of Wood County, 2004), which resulted from drinking water contamination by the chemical perfluorooctanoic acid (PFOA, or C8). The Court authorized the creation of Brookmar Inc, an independent company created solely to design, publicize, and implement the C8 Health Project, including all enrollment and data collection. Brookmar Inc received funding exclusively from the Settlement, administered through a Court-approved financial professional (the Health Project Administrator). Brookmar Inc made data from the C8 Health Project available to the C8 Science Panel, also created pursuant to the Settlement Agreement, and to a group at West Virginia University, pursuant to a contractual relationship with Brookmar Inc. The design of the Project was developed in consultation with, although not subject to, the wishes of the settling parties. All authors declare that their ability to design, conduct, interpret, and publish this research study was unimpeded and fully independent of the Court and settling parties, who had no role in preparing, reviewing, or approving the manuscript.
Additional Contributions: We gratefully acknowledge the contributions of Cathy Lally, MPH, and Jessica MacNeil, MPH, from the Emory University Rollins School of Public Health for their expertise and assistance in data cleaning and the personnel at Exygen Research Corporation and Axys Analytics for ensuring accurate descriptions of laboratory methods. Finally, because of the scale of the C8 Health Project, many individuals provided valuable assistance during its development and implementation. We gratefully acknowledge these contributions and thank all individuals who supported the execution of the project.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Pediatrics editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers' bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
© The Financial Times Ltd 2016 FT and 'Financial Times' are trademarks of The Financial Times Ltd.
The search tool on FT.com allows you to make detailed and specific searches for FT.com content. You are also able to search the newspaper. The FAQs below explain how to use the search tool. Below are answers to common questions to search queries.
For our general list of all our contact information click here.

subset: commoncrawl


text:
Top Definition
A person who is temporarily possessed by a demonic spirit which causes them to draw penises, in various states of erectness, on whatever canvas may be available at the time; ie. dusty cars, computer screens, windows, etc.
Dammit! Look at the giant penis on my car window. The dick devil is at it again.
af Webster37 2. oktober 2012
Trending Now
Can you define these popular missing words?
yet another creative name for the vagina.
af lolz at stuff 18. august 2011


text:
Billie Joe Armstrong and company reinforce their scrappy punk status at the Verizon Wireless Amphitheater, inviting fans to come on stage and sing along.
Heads up, Jerry Brown and Meg Whitman: You may be in for some unexpected company come November.
"I'm running for governor of California!" Billie Joe Armstrong revealed Tuesday night at Irvine's Verizon Wireless Amphitheater, where Green Day played one of the final dates of its U.S. tour in support of last year's "21st Century Breakdown."
That this announcement came not long after the frontman declared (in slightly saltier language) that he's a rock star and can therefore do whatever the heck he wants was no cause for worry: Armstrong is a benevolent despot who encourages fans to join him onstage and launches free merchandise into the cheap seats with an air-powered T-shirt gun.
The singer's introduction into state politics would present another problem, though: the early retirement of what might be America's best live band.
Green Day is riding as high as it ever has this year, thanks in large part to the success of "American Idiot," the Broadway adaptation of its 2004 album of the same name. And in Irvine the Oakland-based outfit — filled out to a six-piece with auxiliary players on guitars, keyboards and other instruments — seemed determined to prove that its theatrical streak runs deep.
Towering columns of fire erupted behind drummer Tré Cool during "Give Me Novacaine." A video-screen backdrop depicted the ruins of a city skyline in "Boulevard of Broken Dreams." And confetti sprayed skyward as the band concluded its main set with an accordion-enriched version of its 2000 hit "Minority."
Yet Tuesday's three-hour show also emphasized the vitality of Green Day's connection to its scrappy punk-scene roots. In older songs such as "Burnout" and "When I Come Around," both from the group's 1994 breakout, "Dookie," Armstrong and his bandmates did what they were doing long before they graduated to arenas and stadiums, bashing out their hard-pop tunes with fat-free efficiency. Only the energy had been upped to suit the needs of a capacity crowd of more than 15,000.
In another nod to those cozy dive-bar days, Armstrong repeatedly invited audience members to take over his vocal duties, most memorably in "Longview," Green Day's first big single. The frontman's initial pick flamed out after one verse, but her successor sang the rest of the song with an awestruck enthusiasm that collectivized the band's superstardom while reinforcing it at the same time.
When the young man finished, he held out the microphone toward Armstrong, but Armstrong declined to take it back, obviously enjoying the sight of an ordinary kid temporarily granted extraordinary power. Following his idol's earlier example, the fan mounted Cool's drum riser and then leaped off it as Armstrong looked on approvingly.
Talk about noblesse oblige.


text:
So on a bit of a whim this morning, wanting to spare her the trauma of a salon, I stood her on the toilet, my sharpest sewing scissors in hand, and proceeded to snip snip away.
Soon I knew that I made a big mistake. I realised - much too late - that I am no hair professional, especially when it comes to a wriggling toddler. My sweet little girl now sports a rather mis-shaped choppy hairdo, near bald patch on one side, looking a little like she had a run-in with some sort of weed eater.
Horrified, I packaged her up and ran her over to the closest hair salon. But they had no time for our emergency, and we returned straight home, me trudging along full of melancholy, Adelaide skipping away, happily oblivious.
Yet, I have discovered upon our return home, that pigtails are still (if barely) possible!


text:
(based on 3 reviews)
Ratings Distribution
5 Stars
4 Stars
3 Stars
2 Stars
1 Stars
of respondents would recommend this to a friend.
Reviewed by 3 customers
Displaying reviews 1-3
Back to top
Love the Project Planner!
By ljackson428
from Cleveland, Ohio
Comments about Levenger 100 Circa Project Planner Refills, Letter:
Great purchase! Just got a new job and this is a great way to keep all my projects together in my Circa notebook!
Bottom Line Yes, I would recommend this to a friend
Was this review helpful? Yes / No
- You may also flag this review
By Karl
from Neenah, WI
I would agree with the earlier post - 1 page (front/back) should be used for 1 project
Merchant response: Thank you for your feedback. I understand how this will assist you with planning your projects. Your suggestion has been submitted to our Product Development and Design Team for further review.We will contact you with options to help make it right.
(1 of 1 customers found this review helpful)
Like the Revisions but not the Color
By TNTPackrat
from Undisclosed
Possibly "Warm White" is easier on the eyes but to me it just looks like old paper that's been around a while. The subtle changes to the layout are very nice EXCEPT... am I the only one who wishes there was lined notes or additional task list on the back side so that 1 sheet = 1 project????
Bottom Line No, I would not recommend this to a friend
Merchant response: Thank you for your observations of the Project Planner Refills. We appreciate and welcome all suggestions that allow improvement. Please call us at 1-800-542-0242 and we will assist you in returning them for a refund, if you wish. We can also discuss other options to make it right. Your satisfaction is our #1 priority, and we'll do whatever it takes to make it right.
© Copyright Levenger Company
2016. All Rights Reserved.


text:
An Evans man is being held on a $500,000 bond, accused of videotaping a sexual encounter with a child.
According to an arrest affidavit, Evans police arrested Manuel Meza-Barrera, 24, after a witness told them she had seen the video of him assaulting the child. An officer viewed the video in which a child is performing a sexual act on a man, the report states, and a witness identified the man as Meza-Barrera.
Meza-Barrera was still being held in the Weld County Jail on Wednesday evening, and he faces one count of sexual assault on a child by one in a position of trust.
His next court appearance is scheduled for Nov. 20.


text:
Systemwide Events Calendar
CyberSafety Education & Awareness WorkshopOctober 12, 9:00am - 11:00am
Windward Campus, Hale Kuhina 114
This workshop will explain in lay terms the safety and security issues in computer technology and what the Internet poses to the user. Topics include online banking, social networking, and privacy. Ideal for seniors, teachers, and parents. NOTE: Children & teenagers MUST be accompanied by their parent(s). This is NOT a class to learn basic computer skills. Attendees should already be familiar with basic computer skills (creating folders, copy & paste, etc), including Web surfing and e-mailing.
Instructor: Chris Duque
Course Code: P10CS344
Course Fee: FREE
Date: Saturday, October 12
Time: 9:00 a.m. - 11:00 a.m.
Meetings: 1
Event Sponsor
Career and Community Education, Windward Campus
More Information
Career and Community Education, 808-235-7433, email@example.com
|Saturday, October 12
|The Wellness Center - Fitness Class Schedule
Maui Campus, Pilina Bldg., Wellness Center
|Recreational Thrill Craft Operators Safety Educational Course
Windward Campus, Hale Alaka'i 101
|Ocean Safety Educational Course
Windward Campus, Hale Alaka'i 101
|KavaFest 2013
Manoa Campus, McCarthy Mall between Art and Snyder
|CyberSafety Education & Awareness Workshop
Windward Campus, Hale Kuhina 114
|Fashion Society Car Wash
Honolulu Campus, Dillingham Boulevard Administration parking lot (across Costco)
|Taking Better Photos With Your Digital Camera
Windward Campus, Hale Alaka'i 102
|Children's Drawing and Printmaking Class
Manoa Campus, Lyon Arboretum, 3860 Manoa Rd.
|Pay Per View Showing of UH Football vs. UNLV
Manoa Campus, Campus Center, 2nd Floor
- Highlighted dates have scheduled events.
- Select the date to view all events for that day.
Ongoing Events
- The Wonder of Learning: the Hundred Languages of Children Exhibit
- Waikiki Parc Features Nicole Naone
- Course Reserves Deadlines and Information
- Red Hat System Administration I
- EWC Arts Exhibition: Bollywood & Beyond: Costume in Indian Film
- Kalaupapa -- A Source of Light, Constant and Never-Fading
- Trip Around the Island
- Convergence: Glitch_Click_Thunk, Featuring Mark Amerika
- Trip Around the Island exhibit
- Conflict Resolution Day Book Displays


text:
on December 28, 2012 - 4:10 PM
, updated December 28, 2012 at 10:12 PM
A 23-year-old woman has pleaded guilty to attempted bribing of a witness, the Erie County District Attorney's Office announced.
Nikole L. Ward admitted offering $1,000 to a witness in a Black Rock home invasion case if the witness did not testify against burglary defendants Lonnie A. Spears, 28, and Andrew Spears, 25.
Ward faces up to four years in prison when sentenced by Erie County Judge Kenneth F. Case on April 1.
The witness alerted the District Attorney's Office and testified at the trial.
Andrew Spears was eventually convicted of first-degree robbery, and Lonnie Spears was convicted of second-degree criminal possession of a weapon. Both crimes are violent felonies.
"Crimes like witness bribery and witness intimidation are an attack upon the integrity of the criminal justice system and must be dealt with in a firm and resolute manner," District Attorney Frank A. Sedita III said. "I trust that our local judiciary agrees with this sentiment and sentences such felons accordingly."
Lonnie Spears was sentenced to 12 years in prison as a second-time violent felony offender, according to the District Attorney's Office.
Andrew Spears has yet to be sentenced, because he is challenging his status as a second-time violent felony offender.


text:
December 19, 2011
Sweet Pea Totes ~ Classy Curvy Handbag
This is my first time using a pattern from Sweet Pea Totes. The designer Mary is a bag-maker extraordinaire and has MANY beautiful finished bags in addition to her patterns in her shop. The unique thing about this pattern, is that it is one of four designs that you can purchase as an E-book or through Simplicity as a printed pattern. The E-book is great for beginners or someone that likes more detailed instructions - it is 32 pages long and full of photographs and easy to follow step-by-step instructions. The Simplicity pattern is your typical paper pattern and all the instructions fit on one side of the fold-out sheet; a second bag pattern is included in the same envelope.
The fabric I used is from Anthology's Rendezvous line and the button was picked up from Jo-Ann's. The bag came together quite easily and I love how many details are included in the design. The finished bag is quite roomy, making it great for carrying a few extra things or a lunch. This is definitely a pattern I would make again.
Linking up to Manic Monday, Take-A-Look Tuesday and Fabric Tuesday.
16 comments:
- Rachel said... #
What a beautiful bag. I love the red and grey! Gorgeous!
- December 19, 2011 at 8:12 PM
- Quiltstory said... #
Super cute bag and pattern! Love it! Love the fabrics you chose! :) Thanks for linking up!
- December 19, 2011 at 8:15 PM
- Lisaleh said... #
This is really lovely. I particularly like the button! PS - found you via Quilt Story.
- December 19, 2011 at 8:40 PM
- Svetlana said... #
What a wonderful bag. You did such a great job. Very pretty.
- December 19, 2011 at 8:41 PM
- Catherine said... #
wow, gorgeous bag!
- December 20, 2011 at 12:24 AM
- Katy Cameron said... #
Very cute, love the fabric and the button
- December 20, 2011 at 4:40 AM
- Laura said... #
It's Great
- December 20, 2011 at 7:25 AM
- Lynette @ My Craft Discovery said... #
super cute bag! Love how it turned out.
- December 20, 2011 at 7:25 AM
- Pieces to Love said... #
Cute bag, I love it!
- December 20, 2011 at 10:03 AM
- Anita said... #
You did a great job. I've made a few bags from this pattern myself and hope to make one more before Christmas! I love your fabrics. It's a great pattern and it comes together super easy and super fast. =) Thanks for sharing.
- December 20, 2011 at 3:43 PM
- Sweet Pea Totes said... #
I Love how it turned out Rebecca! You did a great job! Thank you so much for the review. So glad you liked the pattern.
- December 20, 2011 at 8:15 PM
- **nicke... said... #
what a cute bag and you did such a great job! i love it!
- December 20, 2011 at 10:35 PM
- Jenniffier said... #
What a wonderful bag. It looks so lovely.
- December 21, 2011 at 8:21 AM
- pillowsalamode said... #
- December 21, 2011 at 12:37 PM
- Sue said... #
LOVE it! The fabric is fabulous too :)
- December 21, 2011 at 3:01 PM
- Robin said... #
Super cute bag! Such great details and the fabrics you chose are lovely.
- December 21, 2011 at 5:03 PM


text:
After several years of decline in Weld County's infant mortality rate, numbers on the rise again have prompted Weld officials to seek ways to keep infants safe and healthy.
The Local Infant Life Initiative, as the new county program is called, is one month in to rounding up health care providers and other experts who will analyze infant deaths in the region to keep the rate from rising any further, said Mark Wallace, executive director of Weld County's Department of Public Health and Environment.
Since 2009, Weld's infant mortality rate has increased from about five deaths per 1,000 live births to nearly eight, according to data provided by public health officials.
Over the years, the county has often had erratic changes in its infant mortality rate, sometimes higher and sometimes lower than the state and national averages.
In Colorado, infant mortality has slowly declined from nearly nine deaths per 1,000 live births in 1990 to about six last year.
Many things can contribute to the death of an infant, from financial strains that subsequently affect a baby's health to a mother's access to prenatal care, Wallace said. The committee aims to first look through medical records of babies who died and then to interview the mother about her life during the pregnancy, so that members can offer solutions relevant to the issues that they might have faced. All of the analyses will be done with the consent of the baby's family, Wallace said.
He said the committee won't focus on child abuse or medical malpractice, which are separate issues.
Weld County is facilitating the infant life initiative with a $25,000 state grant, which will help pay for the cost of printing materials and identifying a committee, Wallace said. Aside from that, he said the county will have little involvement, other than providing the data and tools.
"It's really a process taken on as a community," he said.
Once the official committee is formed, Wallace said they will likely begin approaching families in January.
There are other indicators that help communities monitor the health of babies and their mothers — such as low birth weight and early entry into prenatal care — but infant mortality can be one of the most evasive because of so many possible causes, he said.
He said a good example could be the ultrasound.
"Maybe (the committee will find) it would have been helped if the mother had a high-level ultrasound, and moms say it's too expensive. We might as a community say, 'Is there anything we can do?' "


text:
Now more than ever, we need your support! Become a Supporting Subscriber today.
Children in Need - The End of Time, Part One Preview Clip
This is the preview clip of Doctor Who: The End of Time, Part One, this year's Christmas special starring David Tennant as the 10th Doctor. This preview clip was shown during the BBC Children in Need fundraising special tonight.


text:
"Look what Lammy got us!" Kardashian wrote on Instagram, sharing a sweet snapshot of their pooch. "Our baby boxer."
Just last week, the reality star, 28, blogged about hitting up a pet store with stepdad Bruce Jenner. "I couldn't resist saying hi to the puppies," she wrote. "They were SO cute!" (Kardashian didn't specify where her adorable gift came from.)
The latest Kardashian to keep up with joins a family of canines, including a shelter puppy sisters Kendall and Kylie Jenner rescued with Khloé last August.
And it looks like the furball may already have a name. Kendall introduces her canine cousin in a video, referring to him as Bernard Hopkins, a nod to the famous boxer (but Bee for short, she adds).
"Look at how cute he is!" she says.
In another video, Bee gets to know the rest of the family, including Kourtney Kardashian's 3-year-old son Mason.
Even sis Kim Kardashian, who's expecting a new addition of her own, couldn't contain her excitement over the pint-sized pup.
WHAT?!!!??? THEY GOT A BOXER??? AWWWW RT @kendalljenner- @khloekardashian and Lamar's new baby! weeeehttp://instagr.am/p/WxylwADo6l/— Kim Kardashian (@KimKardashian) March 13, 2013


text:
The 49th annual Skills-USA national Leadership and Skills Conference is set to begin today with 16 students from Vanguard-Sentinel ready to participate in the national contest.
Competition for the chapter display is to begin Tuesday at the conference site in Kansas City, Mo. This year's display, titled "Prepared with the Skills American Needs," was designed to represent students becoming prepared with all the skills, Eric Radford said.
Radford, a 2013 graduate from Upper Sandusky and Sentinel's building trades program, is one of three students on the presentation team. The others are senior Alex Martinez, a precision machining student, and Brett Cassidy, an electrical trades student. Both are from Hopewell-Loudon High School.
The display, made of steel, plywood, sheet metal, and plastic, shows a motorized tulip opening up to the Skills-USA emblem. The flower is raised above 11 pillars bracing a cut out of Ohio. It rises several levels representing the 11 programs at Sentinel and several local and national levels, Radford had said.
The display cost about $3,800 and more than 600 hours to complete.
For the competition, Radford has to present a six-minute speech that is to be judged. He said he competed at the national level last year and learned the competition is a good way to work well with one another.
Fact Box
Other students competing
- Automotive refinishing - Caleb Peacock, Collision Repair, 2013 graduate from Columbian High School
CPS-information technology - Isaiah Galvan, 2013 graduate from Old Fort High School; Aaron Reasor, 2013 graduate from Lakota High School; Aaron Triplett, 2013 graduate from Gibsonburg High School.
- Collision repair technology - Aaron Maki, 2013 graduate from Columbian High School.
- Computer programming - Kelsey Johnston, 2013 graduate from Fremont Ross High School.
- Nurse assisting - Veronica Province, 2013 graduate from Columbian High School.
- Telecommunications cabling - Logan Robinson, 2013 graduate from Bettsville High School.
Voting delegate - Ciara Long, senior from Mohawk High School.
"We want to win," Cassidy said. "But it is a good experience to meet different people that you would not normally meet."
During the state competition, Martinez said, "This display is a good example of what a technical school is. It has been (an) honor to do and a tribute to all the programs."
The teamworks team also has been preparing for national competition. The team includes four recent graduates: Salvador Cantero III of Fostoria, Austin Kelbley of Mohawk, Jacob Serviss of Seneca East and Jacob Welly of New Riegel.
The team spends roughly five hours a day preparing for the competition whether in their specific fields or together at Sentinel, Serviss said.
The competition is a two-day building competition followed by a presentation of a building plan given by the team. The competition for the team is to take place Tuesday through Thursday.
"It has been a good time," Cantero III said.
The team said collectively that they would like to win, but they are learning skills they can take with them, such as leadership, skills they have learned in class and working more efficiently together.
The awards ceremony is to take place at 6 p.m. June 28.
Following the national Skills-USA competition is to be the World-Skills competition July 2-7.
Anthony Costantini, of Greensprings, and Jarrod Nichols of Clyde, are to compete in the two-member Skills-USA World Team in the mechatronics competition.
Costantini has received an associate's of applied science in mechanical engineering technology from Terra State Community College. Nichols is studying engineering at University of Toledo. Both are former students of the Vanguard Technology Center in Fremont, participating in the engineering technology and robotics program.
Costantini and Nichols earned the right to represent the United States by winning the silver medal in the mechatronics competition during the National Skills-USA Championships in 2010.
"This is to be a once-in-a-lifetime experience," Nichols said. "I have been working with Costantini since 2009, now that we are older it is easier to work together, we've grown up a lot."


text:
Rustic Kitchen Island
- Overview
The stainless-steel surface of the Rustic Kitchen Island pays homage to zinc-topped counters from Parisian bistros, while sturdy legs in acacia wood warm things up. Prep ingredients up top and store bowls, bakeware and kitchen gadgets below. It's the perfect kitchen companion.
- 46"w x 30"d x 38"h.
- Solid acacia wood frame; stainless steel top.
- Single fixed shelf for added storage and display.
- Imported.
- Details + Dimensions
- Overall product dimensions: 46"w x 30"d x 38"h.
- Shelf dimensions: 38.5"w x 15"d x 2"h.
- Clearance: 8".
- Number of boxes: 2.
- Shipping package (1): 50.4"w x 34.25"d x 5.5"h; 59.5 lbs.
- Shipping package (2): 40.2"w x 31.9"d x 16.6"h; 162.8 lbs.
Assembly required.
Wash with soap, detergent, or solvent such as alcohol or acetone. Rinse well with cold water and wipe dry. Rust prevention: Soak parts in 9:1 warm water to nitric acid solution for up to 1 hour or wash thoroughly with water. Wet the surface with oxalic acid solution and leave it for approximately 20 minutes. Rinse well with cold water and wipe dry.
- 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:
Allison Ables Property Management Services
|Available Rentals
|Tenant Login
|Owner Login
As a property owner, you need a professional real estate management company on your team. We are available to respond to inquiries and show prospective tenants your Gainesville FL rental home 7 days per week. Our marketing, technology, and customer service are unrivaled.
No other company in Gainesville rents properties faster than us! We rent properties in an average of 45 days. Our competitors average 90 days. You could lose thousands of dollars in rent by listing with our competitors!
Owner Cost Schedule:
Exclusive Allison Ables Benefits:
Our Property Management Services Include:
- Inspection of property to determine fair market rental value
- Evaluation and recommendation of upgrading and/or repair work to increase rental rates
- Advertise your rental with photos via AllisonAbles.com (the #1 local real estate website in Gainesville), Gainesville MLS, Gainesville SUN News, Rentals.com and at least 20 other websites including Zillow, Trulia and Realtor.com
- Show available properties to prospective tenants
- Negotiate the best rental price and terms
- Establish criteria for the acceptance or rejection of resident applicants
- Process applications, including employment/income verification and credit and civil and criminal background checks to find a qualified tenant
- Prepare and coordinate lease agreement
- Collect rents, deposits and fees
- Distribute and collect keys and community access cards to and from tenants
- Disburse balances to owners within 3 business days of receipt of rent from tenants
- Regularly inspect the property while rented to insure proper maintenance / tenant compliance
- Account for security deposits, escrows for repairs and rents collected
- Generate Statements for property income and expenses
- Provide 1099 forms and financial reports at year-end
- Coordinate and Supervise Regular Maintenance and Renovations
- Arrange for emergency repairs
- Complete Move-in and move-out condition forms with photos
- Manage tenant relations and renewals
- Serve notices for evictions and violations
Compare our simple cost schedule to your current contract and you'll see that we offer the best value. We do not believe in nickel and diming our customers. Nor do we inflate maintenance and repairs - our owners are billed at actual cost. The only BS you'll find at our office is from the University of Florida.
Contact us for a free no-obligation analysis of your rental property and a sample management agreement.


text:
Systemwide Events Calendar
Valentine's DayFebruary 14, 9:00am - 12:00pm
Honolulu Campus, HCC Building 2 Student Lounge
"Make Something for Someone You Love" A fun-filled event full of crafts, food, and socialization. An opportunity for your creative side to come out and make something wonderful for someone you care for. Everyone is invited, single or taken!!!
Event Sponsor
Student Life and Development, Honolulu Campus
More Information
Misty Chiechi, 845-9498, email@example.com
|Thursday, February 14
|The Wellness Center - Fitness Class Schedule
Maui Campus, Pilina Bldg., Wellness Center
|Timpuyog's Valentine Bake Sale
Manoa Campus, McCarthy Mall, in between Webster Hall and the Art Building
|Valentine's Day
Honolulu Campus, HCC Building 2 Student Lounge
|Hakuoh Handbell Choir
Leeward Campus, Theatre
|Hakuoh University Handbell Choir Free Concert
Leeward Campus, Leeward Community College Theatre
|Condom Fair 2013
Manoa Campus, Campus Center
|Study Strategies for College Success
Hawaii Campus, Manono Campus, Bldg. 379 Rm. 1
|The Making of The Glades Project
Manoa Campus, 325 Henke Hall
|Special Microbiology / Biology Seminar
Manoa Campus, Biz Ad A101
|One Billion Rising at UH Maui College
Maui Campus, Great Lawn
|Pacific Connections Seminar Series
Manoa Campus, 3121/3125 John Burns Hall (East-West Center)
|One Billion Rising at UHM
Manoa Campus, Campus Center, 2500 Campus Road
|Political Science Final Oral
Manoa Campus, Saunders 624
|Stephen Wilcox, baritone
Manoa Campus, Orvis Auditorium
|Oceanography Seminar
Manoa Campus, MSB 100
|Chess Club at UH Manoa Meeting
Manoa Campus, Campus Center Room 310
- Highlighted dates have scheduled events.
- Select the date to view all events for that day.
Ongoing Events
- Scholarships Available!
- Lineage : A Family Tree of Printmakers
- The White Rose : nonviolent resistance against the Nazi regime
- Arts Exhibition: Ainu Treasures: A Living Tradition in Northern Japan
- Biggest Loser Challenge
- SAPFB Fall 2013 Funding Applications Available
- Picturing the Ryukyus: Images of Okinawa in Japanese Artworks from the UH Sakama
- Civil War 150 Traveling Exhibit
- East-West Center 12th International Graduate Student Conference


text:
|Parallel and Antiparallel Interfacial Coupling in AF-FM Bilayers
Cooling an antiferromagnetic–ferromagnetic bilayer in a magnetic field typically results in a remanent (zero-field) magnetization in the ferromagnet (FM) that is always in the direction of the field during cooling (positive Mrem). Strikingly, when FeF2 is the antiferromagnet (AF), cooling in a field can lead to a remanent magnetization opposite to the field (negative Mrem). A collaboration led by researchers from the Stanford Synchrotron Radiation Laboratory working at ALS elliptically polarizing undulator Beamline 4.0.2 has verified a proposed explanation involving a small magnetic moment at the AF interface, but in the process also found both positive and negative moments and a way to distinguish them.
To understand the occurrence of either preferred direction, one has to assume that the AF layer exhibits a small magnetic moment at the interface that can be aligned by the cooling field. After cooling, this moment will not change its direction, even upon reversal of the external field, since it is now strongly anchored (pinned) in the magnetic system of the AF. This very small moment at the interface then aligns the FM via an internal magnetic field called magnetic exchange coupling. This exchange-bias phenomenon is useful in modern magnetic devices.
Two years ago, the Stanford group was able to provide the first direct experimental evidence for the existence of this small interfacial moment in the AF by using Beamline 4.0.2. To explain the anomalous behavior with FeF2, it has been postulated that the coupling between the pinned moment in FeF2 and a FM layer is not parallel but antiparallel and thus reverses the favored direction of the FM. In the new experiment, the researchers verified this proposition in a high-quality 2.5-nm FeF2–Co bilayer grown at West Virginia University. They used x-ray magnetic circular dichroism (XMCD) spectroscopy, a technique that can selectively detect the magnetic properties of sites close to the interface and distinguish between the magnetic properties of cobalt and iron atoms.
Hysteresis loops (magnetization vs. applied magnetic field) of the interfacial iron spins and the FM cobalt layer taken at 300 K (well above the ordering temperature, TN =78 K) for FeF2 show that both loops are symmetric and the entire moment at the FeF2 interface follows the Co moment. Since one would expect the orientations of all iron moments within the FeF2 lattice to be in constant motion above TN, it is clear that the magnetic moment of the cobalt layer can be used to induce magnetic order in the topmost layer of the FeF2.
At 15 K, the investigators observed a partial shift in the cobalt hysteresis loop indicating a positive remanent magnetization. Most of the spins at the interface simply seem to follow the FM Co layer as they do above TN, and the overall shape of the interfacial hysteresis loop closely resembles that of the cobalt layer. However, it appears that the interfacial iron loop shifts down towards negative magnetization. This shows that a small fraction of the spins at the interface generate a magnetic moment that always point opposite to the favored magnetization of the FM.
In sum, the group found that a small fraction of interfacial magnetic moments tend to align the FM layer opposite to their moment, which can lead to a reversal of the preferred magnetization direction of the FM with respect to the cooling field. These moments appear only below the antiferromagnetic ordering temperature. On the other hand, the FM is able to align some of the moments at the AF surface so that they point in the same direction as the FM even above TN. All in all, the magnetic properties at AF–FM interfaces are the result of complicated and competing processes. The present results provide clear evidence to distinguish between these two types of coupling mechanisms.
Research conducted by H. Ohldag and J. Stöhr (Stanford Synchrotron Radiation Laboratory); H. Shi and D. Lederman (West Virginia University); and E. Arenholz (ALS).
Research funding: National Science Foundation and U.S. Department of Energy, Office of Basic Energy Sciences (BES). Operation of the ALS is supported by BES.
Publication about this research: H. Ohldag, H. Shi, E. Arenholz, J. Stöhr, and D. Lederman, "Parallel versus antiparallel interfacial coupling in exchange-biased Co/FeF2 bilayers," Phys. Rev. Lett. 96, 027203 (2006).


text:
EAST LIVERPOOL After repeated attempts to stop illegal dumping at the Second Street recycling center, it has been closed by the Carroll-Columbiana-Harrison Solid Waste District (SWD).
The seven bins located near the entrance to state Route 39 were removed this week, leaving behind evidence of why the decision was made, with several large pieces of furniture and other trash lying near a sign indicating it was a recycling site only.
In an Aug. 19 letter to City Council, SWD Director of Operations Eric Matthews said the decision to close the site was made by the SWD board of directors due to "repeated unsuccessful attempts to maintain the site from all parties involved."
Matthews went on to say those attempts include law enforcement grants, security cameras, unsuccessful attempts to prosecute illegal dumpers, and constantly cleaning the site that resulted in "huge expenses" in personnel and disposal fees.
He said that, despite repeated attempts to rectify the situation, it had worsened to the point of becoming a health and safety concern as well as resulting in damaged equipment due to illegal items being placed in and around the recycling bins.
Not only has the situation created these issues, but has resulted in an "undesirable image" of the Kimble Company, which collects the recyclables, the SWD and the city, Matthews said.
Officials of the SWD had met with city officials in the spring to discuss the issue and said then
that, although illegal dumping is a problem at some of the other 60-65 sites it sponsors in the three-county district, at none of them is it as bad as in East Liverpool.
The Second Street recycling center was the most-used collection center in the tri-county area, according to officials.
At one meeting, SWD officials said the Salem recycling site was "spotless," located as it is next to the city fire department, and thought was given to relocating the Second Street center to the now-closed Pleasant Heights fire station or near Central Station.
The city's environmental committee had met on the issue a few times, seeking alternatives to the Second Street site and in May recommended it be relocated to a spot near Westgate School which members believed would lend itself less to illegal dumping since it would be near the sewage treatment plant which is manned 24 hours per day and would be less accessible from the highway.
However, Mayor Jim Swoger said Friday the SWD had decided that site was unacceptable then followed up with the decision to close the Second Street site, leaving in operation only a much smaller recycling center at Oakland and Pennsylvania avenues.
Visibly displeased with the decision, Swoger said, "I thought we did a great thing with this. I didn't realize there were that many ignorant people to ruin it for everybody. It was a great asset for not only the city but West Virginia and even Calcutta."
SWD representatives said previously their observation shows the illegal dumping taking place was not by city residents but from "across the river," with an average of half a truckload of debris illegally dumped at the site weekly.
There are also recycling sites operated by the SWD in Liverpool Township near the township hall and St. Clair Township at the former township hall on East Liverpool Road.
Swoger said the items dumped at the now-closed site will be cleaned up Tuesday and a barricade erected to try and prevent further illegal dumping on the property, which is actually owned by the state of Ohio.
Having made numerous attempts to catch people in the act of dumping at the site, Swoger said, "It always has been my pet peeve. I guess I've lost."
The city does also offer curbside recycling to its residents, who can dispose of unwanted cardboard, glass, paper and plastic in furnished bins. Swoger said plans call for offering aluminum can recycling in the near future, as well as some additional changes in the recycling program.


text:
One of the Top 10 best business web directories alive!
Browse the categories below and submit your website(s) to the most relevant category or subcategory.
Browse the categories below and submit your website(s) to the most relevant category or subcategory.
There are certain types of businesses, offers, products that are targeted only to a specific location, like a town, a state or a country. We are talking about small businesses, offices, hospitals, etc..
For example, if you have a florist shop in London, UK, and if you are delivering flowers locally only, you may want to submit your website to Regional / Europe / United Kingdon / London / Florist Shops.Regional Directory
These are our most popular categories based on the number of hits they receive on a three month period basis.
Suggesting a website is easy: just select the most relevant category which describes your resource, and click the top menu "Submit" hyperlink.
After you complete the submission process, one of our editors will review your webpage.
The effectiveness of submitting websites to business web directories has been always a very hot debate. Read an extensive review about this topic, here.
Another feature we've developed is the possibility to allow a resource owner to have his listing "nofollow"-ed.
All categories and subcategories contain detailed, relevant descriptions and appealing images.
You can submit an extra 5 deep links if you opt for Express listing.
Our web directory instantly collects thumbnails of your website to visually enhance your listing.
Once a website gets in, it will stay there forever.
Having a business listing in an established web directory delivers targeted customers.
Business description, address, phone number, social media fan pages? You can list them too if you want.
Identify the most relevant category for your website and use the "Submit" menu link. Please note that a refundable (if rejected) review fee applies.
You have to see the whole picture, and you'll realize that the success of a business or website comes from many sources, including web directories.
Some of these common sources include proper legal work, SEO, getting listed in quality business directories, social media, internet marketing, offline advertising, no BBB negative review and so on. It's like putting together the pieces of a puzzle!
As many marketing specialists said, having your website sent to a gazillion of "free web directories" is close to worthless.
It is way better to be listed in 20 authoritative business directories than in 2k obscure ones. There are so many options out there... but hey - the most important thing to remember is that even on the Internet, just like in real life, quality is way better than quantity.


text:
Guided tours in Ferrara. Voyages and tours of the Po Delta tours and excursions all included in the Emilia-Romagna, Italy
Destination Italy Travel Agency
Tourist services
Travel arrangements for groups
Advice to businesses
Training for tourism
Where we are
Contact details
Subscribe to the newsletter
Excursions and Tours
Events and exibitions in Italy
Cycling in Italy : Excursions & Tours
Excursions & Tours in Emilia Romagna
Sightseeing and Tours in Emilia Romagna Delta Po Park
Excursions & Tours in Veneto
Excursions & Tours in Trentino Alto Adige
Excursions & Tours in Friuli Venezia Giulia
Excursions & Tours in Piemonte and Valle d'Aosta
Excursions & Tours in Ligury
Excursions & Tours in Lombardy
Excursions & Tours in Marche
Excursions & Tours in Tuscany
Excursions & Tours in Umbria
Excursions & Tours in Rome and Latium
Excursions & Tours in Campania
Excursions &Tours in Apulia and Basilicata
Excursions & Tours in Sicily
Excursions & Tours in Sardinia
Malta l'isola felice
Italy Gran Tours All Inclusive - the Best Selected Programs -
Excursions and Tours for Schools in Italy
Made in Italy tecnology and creativity of Present Times: Thematic Tours
Italian Historical Gardens: the nature meets art: Unic Theamatic Tours
Incoming and Hospitality:Raggio Verde all Tourist Services for Leisure & Business
Gold Selection of Hotels and Villas: the history meets the best welcome
Spa & Wellness: best italian destinations
Golf Destination in Italy
Destination Overseas
Excursions & Tours in Trentino Alto Adige
Special offers for this category:
Alto Adige Cities and Abbeys Tour 4 days 3 nights
Dolomiti's Gran Tour 6 days 5 nights
Raggio Verde Incoming Italy - Tour organizer for travel agencies, associations, sports groups, corporate cral Italy. Programming languages for foreign tour operators and travel agencies. All inclusive tour packages for holidays. Programming tour schools in Italy and all 'foreign. Continuing education for tour operators and input.
Via Sgarbata n. 298 - 44100 Ferrara - Italy - Tel. +39 0532 / 769833 | Fax +39 0532 / 798014 | E-mail:
Partita IVA 01428530388 - C.F NGLLRI66L56D548L - Numero REA - Camera di Commercio Ferrara 166627/1998
Sede legale e amministrativa Via Sgarbata 298 Ferrara
Licenza agenzia di viaggio: autorizzazione Provincia di Ferrara n. 102131 del 02 Dicembre 2008
| Credit by
Site map www.raggioverde.net
Cookie's Policy


text:
U.S. Cattle Producers Lead the Way!
Contact: , 303-867-6302;
America's Cattle Producers truly lead the way! A couple of key examples: 1) The U.S. supplies 25 percent of the world's beef with 10 percent of the world's cattle, and 2) half of America's cattlemen and women contribute $500 or more a year to local and national charities, and 32% contribute more than $1,000 a year.
The Beef Checkoff Program was established as part of the 1985 Farm Bill. The checkoff assesses $1 per head on the sale of live domestic and imported cattle, in addition to a comparable assessment on imported beef and beef products. States retain up to 50 cents on the dollar and forward the other 50 cents per head to the Cattlemen's Beef Promotion and Research Board, which administers the national checkoff program, subject to USDA approval.


text:
Inside Windows 8: Martyn Lovell and Elliot H Omiya - The Windows Runtime
- Posted: Nov 12, 2012 at 12:54PM
- 9 comments
Loading user information from Channel 9
Something went wrong getting user information from Channel 9
Loading user information from MSDN
Something went wrong getting user information from MSDN
Loading Visual Studio Achievements
Something went wrong getting the Visual Studio Achievements
Right click "Save as…"
Windows 8 introduces an application programming model for building new kinds of user mode apps called Windows Store Apps. The name reflects the new way users discover, download, purchase, rate, and install applications on Windows 8: The Windows Store.
What is WinRT, exactly? Why is it designed the way it is? What's the history of WinRT? What are the primary goals of this new technology? How did the Windows engineering team arrive at the design and implementation of this new Windows user mode development platform? These are the key questions addressed in this conversation with Windows Runtime engineering leaders Martyn Lovell and Elliot H Omiya (we call him EHO). Elliot and Martyn are two of the original WinRT architects. Watch as they tell us how it was conceived, how it works, and why COM is such a big part of the equation (it's not your grandmother's COM, mind you. WinRT is a very different COM than classic COM).
Huge thanks to Martyn and EHO for this excellent conversation.
Tune in.
Oops, something didn't work.
It really does work the way they describe it, extraordinary!
Ah, good stuff. I'd really like to see a good deal more drill downs into WinRT.
@dot_tom: You will The next in this series is a very deep conversation with whiteboarding covering the new app model. It's the next Going Deep episode.
This one was a historical and architectural overview, introductory in nature. It also included some information that's most likely new to you.
I requested this series in 2011, apparently
@felix9: Such is timing.
"For better or for worse, desktop apps are desktop apps." -- this quote makes me sad. It says to me that no investment has been made to improve the desktop developer's life. As a scientific data visualization tool, our app has MANY windows (and needs all of them). We would LOVE to do XAML UI in C++ with our desktop app. A Windows Store app makes no sense at all for our app. What do we desktop devs have to look forward to? We use WPF now (from C++/CLI) but it's just too darn slow and uses .NET but only so that we can use WPF + XAML.
I would be disappointed if Windows 9 did not do something for the desktop now that the tablet UI is a done deal. But it's understandable that they couldn't overhaul the desktop as well in the same timeframe.
Great video. Enjoyed it a lot. WRT is a really great story for developers.
3 days ago, schroedl wrote
"For better or for worse, desktop apps are desktop apps." -- this quote makes me sad.
I feel similarly. We have legacy dependencies which won't pass the restricted WinRT API. Here's hoping that we'll get language projections and native XAML for desktop use (or side-loaded enterprise apps which can be compiled with fewer restrictions).
From what I'm seeing from Build, it seems they are catering to the HTML/js devs while abandoning the c# devs
Comments have been closed since this content was published more than 30 days ago, but if you'd like to continue the conversation, please create a new thread in our Forums, or Contact Us and let us know.


text:
If there was one disappointment about Nike's awesome Back to the Future II Air Mag, it's that the shoes didn't have Marty's power laces (and that they only made 1,500 and neither you nor I own a pair). But Nike designer Tinker Hatfield says that's about to change--power laces are coming in 2015. The future is here!
|Scooped by R Murali Ramasamy


text:
Under the direction of James D. Luketich, MD, the UPMC Division of Thoracic and Foregut Surgery adheres to its overall mission of offering a multidisciplinary approach to patient care in an innovative environment.
Our experienced surgeons are committed to developing new minimally invasive surgical techniques that they share with other surgeons worldwide via specialized training conferences.
Recognized as one of the most active thoracic and foregut surgical divisions in the United States, our surgeons specialize in treating diseases affecting the:
Areas of expertise cover all aspects of pulmonary, tracheal, chest wall, mediastinal, esophageal, and upper abdominal surgery. In fact, UPMC is one of the only hospitals in the United States approved to perform lung volume reduction surgery (LVRS) for treating patients with emphysema.
With nearly 18 full-time faculty members and an accompanying growth in clinical volume, the Division of Thoracic and Foregut Surgery attracts cardiothoracic residents and fellows from around the globe.
Our cardiothoracic surgery residency programs and thoracic surgery fellowships give qualified candidates extensive exposure to the full range of general thoracic surgical and endoscopic procedures, as well as the newest minimally invasive therapies, including:
These represent only some of the innovative techniques and procedures our cardiothoracic surgeons regularly perform.
The expertise of our surgeons, coupled with the comprehensive range of diagnostic and treatment modalities offered, uniquely positions us to lead the way in treating all aspects of thoracic and foregut diseases.
» Find details on patient services and treatments at the UPMC Esophageal and Lung Institute.
The Division of Thoracic and Foregut Surgery provides esophageal and lung surgery services at:
Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by Healthwise, Incorporated. To learn more, visit www.healthwise.org
For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.
UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.
Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.
For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.
Pittsburgh, PA, USA UPMC.com


text:
Source: Forbes
quote: ...because Apple only releases one new model per year.When the whole ecosystem is counted (dozens of new Android models each year) the scale tips back the other way.
quote: They would be weighing how 5x more people choose Android than IOS.
quote: Isnt data funny? ;)
quote: Do you really think Sprint would make an iPhone deal today that put them in a 6 year hole before making any profit? Looking at all the phones on the market, the iPhone isnt even close to the top of the line.
quote: Replying To: RE: What a Nightmareby retrospooty on February 26, 2013 at 3:02 PM"Apple's profit share of the entire global phone market (not just smart phones - all phones) went from 21% in 2008, to 50% in 2010, to 57% at the start of 2011, 73% at the start of 2012, and 72% at the end of 2012."Awesome... What does that get you as a consumer? Better products? Better pricing? Better Features? Nope... None of the above.
quote: but how much of those android devices are poor mans cell phone solution or chinese knock offs? do those even count for DT arguments?


text:
BERKELEY SPRINGS - His name was Robert Wayne Hunt Sr., but many folks simply knew him as the "snowcone man."
A welcome sight for the past three years, the appearance of Hunt's white truck meant warm weather was coming - time for kids of all ages to enjoy an old-fashioned, summertime treat.
But that all changed Saturday afternoon, when Hunt - who was parked in his usual spot along U.S. 522 at the bottom of the Berkmore Place driveway leading to Reed's Pharmacy and New Day Dental - died as a result of injuries he suffered in a multi-vehicle accident.
West Virginia State Police, who are still investigating the fatality, said it occurred at about 1:30 p.m. when an International truck traveling north on U.S. 522 struck two other northbound vehicles before leaving the road to hit Hunt's parked 1997 GMC van.
Hunt, 57, was the occupant of the van and suffered internal injuries in the crash, according to a press release issued Sunday. Although he was transported to Winchester Medical Center, he was later pronounced dead as a result of the crash injuries, state police said.
Truck driver Charles Thomas Wayne was cited by police for failure to maintain control of his vehicle and driving on a revoked license.
Hunt's sudden death has come as a shock to family members but also folks in the community, who felt they knew him - if just a little - without even knowing his name.
Flowers and a cross were seen Sunday afternoon at the spot where his van was normally parked.
Local author and business woman Jeanne Mosier, owner of the Star Theatre, hadn't personally met Hunt but immediately knew who folks were talking about when she heard about the fatal accident.
"I didn't know him, but after seeing him there so often, you kind of felt like you did. This is just so terrible, so shocking to have something like this happen to someone who was so visible - to someone who was making people happy with his snowcones," Mosier said.
Even before learning details, Mosier said she felt there had been a serious accident due to the volume of traffic that backed up downtown Saturday afternoon.
At one point, she'd spoken to a driver who said traffic had been backed up on U.S. 522 to Cacapon State Park - approximately eight miles from the accident scene, Mosier said.
"This really is a loss for the community," she said.
Robert Hunt Jr. took some comfort in knowing so many others will also miss his father.
"He loved, absolutely loved selling snowballs because he liked kids and also loved this community so much. He loved this town and everybody in it, including the other shop owners," Hunt said in a telephone interview Sunday afternoon.
"My dad was a social person who liked to talk and get to know others. This is what he wanted to do because he loved it with all his heart," Hunt said.
Funeral arrangements are still incomplete, and family members don't yet know many additional details about the wreck, he said.
"We just know this truck came along and took him from us," Hunt said.
Staff writer Jenni Vincent can be reached at 304-263-8931, ext. 131.


text:
Vaughan Publishes MATLAB Text
Contact Jonathan Vaughan 315-859-4719
Posted August 25, 2014
Tags Faculty Faculty Books Jonathan Vaughan Psychology
Jonathan Vaughan, the James L. Ferguson Professor of Psychology, co-authored a revised computer programming text for behavioral scientists titled MATLAB for Behavioral Scientists, Second Edition. The book, written with David Rosenbaum and Brad Wyble of Penn State University, was recently published by Taylor & Paul/Routledge.
According to Vaughan, the textbook is "of utility to undergraduates, graduate students, and faculty in the behavioral sciences broadly defined (psychology and neuroscience)." He said the project derived from the teaching that he and his co-authors engage in with their own students, both in classes and research laboratories.


text:
From Mirror, wire reports
Wyomissing linebacker Alex Anzalone can add player-of-the-year honors to go along with a state title on his impressive high school football resume.
The 6-3, 225-pound Notre Dame recruit recovered from a miserable first half in the Class AA title game last week against Aliquippa to help guide a group of 20 experienced seniors to the school's first state championship - and the first for a team from Berks County.
Regarded as one of the top five outside linebacker recruits in the 2013 high school recruiting class, Anzalone's combination of on-field skills and leadership earned the senior Class AA Player of the Year honors as part of the 2012 Pennsylvania Sports Writers All-State Football Team.
All-state teams for Classes A and AA were released Wednesday, with the AAA and AAAA squads to be unveiled today.
Locally, the area was represented by Bellwood-Antis running back Casey Gray and teammate Keith Shawley, a defensive lineman, Moshannon Valley's Austin Mital, an offensive lineman, Bishop Guilfoyle defensive linemen Nick Ceschini, Northern Cambria linebacker Alex Atkins, Glendale defensive back Doug Twigg, and in Class AA, Penn Cambria linebacker Mack Behe.
The selection of the all-state teams are overseen by the sportswriters who cover high school football around the commonwealth. Players were nominated in all four classifications, then a statewide ballot was sent out affording all writers an opportunity to cast votes.
Anzalone had a monster two-way season for the undefeated Spartans, with nearly 1,500 rushing yards and 30-plus touchdowns to go along with more than 100 tackles on defense.
He wasn't the only Wyomissing player to make the team as one of the top 33 players in the state at the Class AA level. Anzalone was joined by kicker Jonah Bowman, who drilled a state championship record 52-yard field goal in the 17-14 victory over Aliquippa last week; along with offensive lineman Ben Wertz and defensive lineman Jeriko Reyes.
Veteran Spartans head coach Bob Wolfrum was the Class AA Coach of the Year. He has 243 wins with the Spartans and one state title along with six District 3 titles.
Anzalone was one of eight Class AA players making a repeat appearance. Hickory's DeShawn Coleman, Imhotep Charter's David Williams, South Fayette's Zach Challingsworth, Mount Carmel's Eric Joraskie, Wilkes-Barre GAR's Shakir Soto, Behe and Lewisburg's Brandon Smith each made the squad last year.


text:
Minit Maids in Charlotte There to Make Life Easier!
By Natalie Pasquarella of WSOCTV 9
October is Breast Cancer Awareness Month and some local companies are working together to make life easier for women fighting the disease.
In tonight's Family Focus, one local mother said the new free service she is receiving is really helping in her recovery.
Vacuuming floors and scrubbing bathrooms are all in a […]


text:
Top Definition
The place to go if you have ever: pissed your pants; wrecked your car; been arested for multiple DUI's; passed out outdoors; urinated in an interior corner or plant; hid beer for "later"; drank alcohol you think is foul because there is nothing else; thought hair of the dog is a good idea; lost a weekend; called up your friends to piece together why you are home without your pants; missed Thanksgiving or Christmas dinner by accident; been fired 'cause you are too drunk/hungover to got to work; woke up wondering who is sleeping next to you; intend to drink a cocktail and ended up drunk, and; you sincerely cannot stop drinking but don't want to live a miserable life.
Dude...ever since Mike's gone to AA I can keep my beer in the fridge and I don't have to worry about him watering the ficus tree.
Beküldő: miguelito 2005. május 20.
Trending Now
Can you define these popular missing words?
A 12 step program for those who wish to stop drinking and get sober and stay sober. It is not run by anybody but is a democratic group of fellow drunks. It is not religious, but there is a spiritual aspect to the program for those who want it. It's a great program where its members often find lasting deep friendships with other sober folks. It works!
example in definition
Beküldő: deedle 2005. március 25.
Alcoholic Anonymous, an organization established to help people recover from alcoholism through 12 steps and spirituality.
A A is a program for people who cannot handle their drinking.
Beküldő: jakmak52 2006. január 21.
African American, espescially used in personal ads.
Divorced AA female seeks divorced AA male, any age.
Beküldő: Itsme2003 2005. július 31.
1) an oft-forgotten bra size implying itty-bitty but quite cute boobs
2) a person of said size
2) a person of said size
1) Jenny has trouble finding AA lingerie.
2) Monica is a petite and sexy AA.
2) Monica is a petite and sexy AA.
Beküldő: Jack Sprat 2005. május 13.
The most commonly used type of battery
Hey, You got two A A batteries for my torch? I think its ran out of power!
Beküldő: My_Immortal 2006. január 26.
Alcoholics Anonymous...a place where drunks go to recover from their addiction.
Beküldő: Lise(Perrty Baby) 2005. április 10.


text:
August 29, 2013
All customers 50 or over who earn at least 10 base points on their Northern Rewards card will receive $5 in Kewadin Credits.
An additional $5 in Kewadin Credits may be earned at every other Kewadin location after earning 10 base points at that facility.
Complementary Danish/muffins and coffee.
Half price soup and salad bar at Sault, St. Ignace and Manistique.