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Epiglottitis is inflammation of the epiglottis. This is the tissue that covers the trachea (windpipe). Epiglottitis is a life-threatening disease.
The epiglottis is a stiff, yet flexible tissue (called cartilage) at the back of the tongue. It closes your windpipe (trachea) when you swallow so food does not enter your airway. This helps prevent coughing or choking after swallowing.
Swelling of the epiglottis is usually caused by the bacteria Haemophilus influenzae (H. influenzae). It may also be due to other bacteria or viruses that can cause upper respiratory infections.
Epiglottitis is now very uncommon because the H. influenzae type B (Hib) vaccine is a routine childhood immunization. The disease was once most often seen in children ages 2 through 6. In rare cases, epiglottitis can occur in adults.
Epiglottitis begins with a high fever and sore throat. Other symptoms may include:
- Abnormal breathing sounds (stridor)
- Fever
- Blue skin color (cyanosis)
- Drooling
- Difficulty breathing (patient may need to sit upright and lean slightly forward to breathe)
- Difficulty swallowing
- Voice changes (hoarseness)
The airways can become totally blocked, which can result in cardiac arrest and death.
Exams and Tests
Epiglottitis is a medical emergency. Seek immediate medical help. Do not use anything to press the tongue down to try to look at the throat at home. Doing so may make the condition worse.
The health care provider may examine the voice box (larynx) using a small mirror held against the back of the throat. Or a viewing tube called a laryngoscope may be used. This examination is best done in the operating room or a similar setting where sudden breathing problems can be more easily handled.
Tests that may be done include:
- Blood culture or throat culture
- Complete blood count (CBC)
- Neck x-ray
A hospital stay is needed, usually in the intensive care unit (ICU).
Treatment involves methods to help the person breathe, including:
- Breathing tube (intubation)
- Moistened (humidified) oxygen
Other treatments may include:
- Antibiotics to treat the infection
- Anti-inflammatory medicines, called corticosteroids, to decrease throat swelling
- Fluids given through a vein (by IV)
Outlook (Prognosis)
Epiglottitis can be a life-threatening emergency. With proper treatment, the outcome is usually good.
When to Contact a Medical Professional
Spasm may cause the airways to close suddenly. Or, the airways may become totally blocked. Either of these situations could result in death.
The Hib vaccine protects most children from epiglottitis.
The most common bacteria (H. influenzae) that causes epiglottitis is contagious. If someone in your family is sick from this bacteria, other family members need to be tested and treated.
Burns JE, Hendley JO. Epiglottitis. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 59.
Manno M. Pediatric respiratory emergencies: Upper airway obstruction and infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 166.
Roosevelt GE. Acute inflammatory upper airway obstruction (croup, epiglottitis, laryngitis, and bacterial tracheitis). In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 377.
Haemophilus influenza organism - illustration
Haemophilus influenza or...
Throat anatomy - illustration
Throat anatomy
Haemophilus influenza organism - illustration
Haemophilus influenza or...
Review Date: 2/25/2014
Reviewed By: Sameer Patel, MD, Assistant Professor of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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She was destined to have a child, and she'll be wonderful at it.
That's Kelly Rowland's take on the big news that her former Destiny's Child bandmate Beyoncé is expecting her first child with husband Jay-Z.
"I have known for quite a while, and she's happy, and Jay is happy, and that's all that counts," Rowland, 30, told PEOPLE Sunday at the House of Hype VMAs afterparty.
Asked how Beyoncé, 29, will be as a mom, Rowland replies: "I think she'll be an incredible mother, because she's always been motherly. I think that she takes after so many traits from her mother. And I just think it's going to be so natural for her. Its natural for her now!"
Rowland added that the happy couple have already started talking about baby names, but of course she wouldn't spill any secrets there.
Beyoncé Will Be 'An Incredible Mother,' Says Kelly Rowland
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Project Kenai -- a new site for hosting open source projects
By chhandomay on Sep 16, 2008
|We have
launched Project Kenai last Friday.
The primary goal of the site is to host open source projects and
encourage collaboration on them.
|Why Project Kenai? Nick Sieger, lead engineer of
the project, comments,
"We need to demonstrate credibility
in building on top of more
traditional LAMP/SAMP web stacks (not just Java EE); and we need to
show viability of Sun technologies and hardware for next-generation web
So how is it running?
From Tim's blog: Project Kenai is using Sun Fire T2000 servers along with a Sun Fire X4500 (Thumper) for storage. OpenSolaris Nevada 70b is the OS. Apache runs in front, using mod_proxy_balancer to connect to multiple redundant GlassFish V2 instances talking to a single MySQL database. The main site is a Rails application running on JRuby, deployed in GlassFish as a war file built with Warbler. Perl, Python, and other various bits of Apache-based bailing wire help integrate Mercurial, Subversion, Sympa (mailing list software) and Bugzilla into the mix as well.
Tim's blog has all the details.
Project Kenai is in invitation-only beta mode -- if you want to try, contact Tim.


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Author Affiliations: Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine (Dr Dobnig), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (Drs Scharnagl, Renner, and Maerz and Ms Weihrauch), Medical University of Graz, Graz, Austria; and Department of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Heidelberg (Dr Pilz), LURIC Study Nonprofit LLC, Freiburg (Ms Seelhorst and Dr Wellnitz), Synlab Center of Laboratory Diagnostics Stuttgart, Leinfelden-Echterdingen (Dr Kinkeldei), Division of Endocrinology and Diabetes, Department of Internal Medicine, University of Ulm, Ulm (Dr Boehm), and Synlab Center of Laboratory Diagnostics Heidelberg, Eppelheim (Dr Maerz), Germany.
In cross-sectional studies, low serum levels of 25-hydroxyvitamin D are associated with higher prevalence of cardiovascular risk factors and disease. This study aimed to determine whether endogenous 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are related to all-cause and cardiovascular mortality.
Prospective cohort study of 3258 consecutive male and female patients (mean [SD] age, 62 [10] years) scheduled for coronary angiography at a single tertiary center. We formed quartiles according to 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels within each month of blood drawings. The main outcome measures were all-cause and cardiovascular deaths.
During a median follow-up period of 7.7 years, 737 patients (22.6%) died, including 463 deaths from cardiovascular causes. Multivariate-adjusted hazard ratios (HRs) for patients in the lower two 25-hydroxyvitamin D quartiles (median, 7.6 and 13.3 ng/mL [to convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496]) were higher for all-cause mortality (HR, 2.08; 95% confidence interval [CI], 1.60-2.70; and HR, 1.53; 95% CI, 1.17-2.01; respectively) and for cardiovascular mortality (HR, 2.22; 95% CI, 1.57-3.13; and HR, 1.82; 95% CI, 1.29-2.58; respectively) compared with patients in the highest 25-hydroxyvitamin D quartile (median, 28.4 ng/mL). Similar results were obtained for patients in the lowest 1,25-dihydroxyvitamin D quartile. These effects were independent of coronary artery disease, physical activity level, Charlson Comorbidity Index, variables of mineral metabolism, and New York Heart Association functional class. Low 25-hydroxyvitamin D levels were significantly correlated with variables of inflammation (C-reactive protein and interleukin 6 levels), oxidative burden (serum phospholipid and glutathione levels), and cell adhesion (vascular cell adhesion molecule 1 and intercellular adhesion molecule 1 levels).
Low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are independently associated with all-cause and cardiovascular mortality. A causal relationship has yet to be proved by intervention trials using vitamin D.
Studies1,2 have demonstrated that low levels of vitamin D represent a problem of global dimension. A recent Workshop Consensus for Vitamin D Nutritional Guidelines3 estimated that about 50% and 60% of the older populations in North America and the rest of the world, respectively, do not have satisfactory vitamin D status. The consensus further concluded that the situation is similar in younger subjects. Reasons for this remain unclear but are likely related to factors such as urbanization, demographic shifts, decreased outdoor activity, air pollution and global dimming, and decreases in the cutaneous production of vitamin D with age. The amount of vitamin D from dietary sources is generally viewed as too insignificant in many regions of the world to have an effect on vitamin D status at the population level.3
The minimum desirable serum level of 25-hydroxyvitamin D has been suggested to be 20 to 30 ng/mL (to convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496) according to the consensus conference3 and to a study4 in which the analysis was expanded to cover potential beneficial effects of vitamin D for multiple health outcomes. Low levels of 25-hydroxyvitamin D are clearly related to compromised bone mineral density,5 to falls6 and fractures,7 and to diminished lower extremity function. In addition to higher incidences of cancer8 and immune dysfunction,9 low levels of 25-hydroxyvitamin D have been recently linked to the presence of cardiovascular disease,10,11 hypertension,12 and the metabolic syndrome.13 Results of recent nationwide investigations showed an association of low 25-hydroxyvitamin D levels with important cardiovascular risk factors11,14 and further supported the findings of preclinical and clinical investigations that demonstrated positive effects of vitamin D and its analogues on fibrinolysis, blood lipids, thrombogenicity, endothelial regeneration, and smooth muscle cell growth.15 Together, these findings strongly suggest that 25-hydroxyvitamin D has beneficial effects, some involving the cardiovascular system, that are independent of calcium metabolism.
The mediator of these effects is thought to be 1,25-dihydroxyvitamin D, produced by the kidney, by extrarenal tissues (such as the vasculature), and by immune and gastrointestinal cells that express 1α-hydroxylase, which converts 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D.16 Locally produced 1,25-dihydroxyvitamin D may act in an autocrine or a paracrine manner via activation of the vitamin D receptor, which is found in many different cell types throughout the body.16 Because the serum level of 25-hydroxyvitamin D is roughly 1000-fold higher and the affinity for vitamin D receptor 100-fold lower compared with 1,25-dihydroxyvitamin D, direct effects of 25-hydroxyvitamin D on gene transcription or activation by intracellular mitochondrial 1α-hydroxylase may be operative.17 Therefore, low circulating levels of 25-hydroxyvitamin D could in theory damage target tissues in the following 2 ways: (1) by low substrate availability for renal and extrarenal 1α-hydroxylase and decreased local intracellular conversion to 1,25-dihydroxyvitamin D and (2) by a diminished direct effect on vitamin D receptor activation.
Apart from intervention studies18- 20 in hemodialysis patients demonstrating decreased mortality associated with calcitriol treatment, as well as a recent prospective cohort study21 that found an association between mortality and elevated parathyroid hormone (PTH) levels but not between mortality and 25-hydroxyvitamin D level, there are no large longitudinal studies addressing associations of endogenous serum vitamin D levels with overall and cardiovascular mortality. To focus on this research question, we followed up a large cohort of patients referred for coronary angiography who underwent detailed baseline examinations. This allowed us to adjust our analysis for possible confounders of the association between vitamin D levels and mortality.
The Ludwigshafen Risk and Cardiovascular Health (LURIC) study22 is a prospective cohort trial designed to evaluate the effect of genetic polymorphisms and plasma biomarkers on cardiovascular health. Patients were recruited between July 1, 1997, and January 14, 2000, at the Herzzentrum Ludwigshafen (Cardiac Center Ludwigshafen) in southwest Germany (49° 29 minutes north latitude). The rationale and design of this study, baseline characteristics of the population, and definitions used for diagnosis of diabetes mellitus and hypertension have been published previously.22 In brief, our study population comprised 3316 patients of white race/ethnicity referred for coronary angiography in a tertiary care medical center. Serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were determined in 3258 patients (98.3% of the entire study population; mean [SD] age, 62 [10] years), and the analysis was restricted to this group. Study participants had to demonstrate a stable clinical condition except for acute coronary syndrome. Exclusion criteria were any acute illness other than acute coronary syndrome, any predominant noncardiac chronic disease, and a history of malignant neoplasm(s) within the past 5 years. Seventy-eight patients (2.4%) reported taking vitamin supplements on a regular basis, which usually contained B complex vitamins or vitamin D3. Because 25-hydroxyvitamin D levels (mean [SD], 22.1 [11.3] ng/mL) were only slightly higher in users of vitamin D preparations compared with the remaining cohort (mean [SD], 17.2 [9.1] ng/mL) and because age, PTH levels, and 1,25-dihydroxyvitamin D levels did not differ significantly, we decided to include these patients in the present analysis. Written informed consent was obtained from each participant, and the study was approved by the institutional review board at the Ärztekammer Rheinland-Pfalz (Medical Association of Rheinland-Pfalz).
Coronary angiography was commonly indicated because of clinical symptoms or results of noninvasive tests that suggested myocardial ischemia. Coronary artery disease (CAD) was defined as the presence of at least 50% stenosis of at least 1 of 15 segments of the 3 major coronary arteries, based on maximal luminal narrowing. We used the Charlson Comorbidity Index, which has been shown to be a valid and reliable instrument to assess comborbidity,23 to form 3 groups of patients with 0 score points (group 0), 1 score point (group 1), and 2 or more score points (group 2). A questionnaire with a scoring system ranging from 1 to 11 was used to classify the mean physical activity levels, and study participants were grouped into the following 3 categories of physical activity: below average (score, 1-3), average (score, 4-7), and above average (score, ≥8).
A fasting venous blood sample was obtained in the morning before coronary angiography. Selected variables were measured after samples were snap frozen and stored at −80°C. A summary of methods and test kits used for variables relevant to this study has been published.22 The estimated glomerular filtration rate was calculated according to the 4-variable model of the Modification of Diet in Renal Disease study.24
Serum levels of 25-hydroxyvitamin D were assayed on a weekly basis using a radioimmunoassay (DiaSorin SA, Antony, France) with intra-assay and interassay coefficients of variation of 8.6% and 9.2%, respectively. In a random sample of 100 study participants, 25-hydroxyvitamin D level was also determined using liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) with isotopic-labeled internal standard and 2 fragment mass to charge ratios of 401.4 to 382.2 (quantifier) and 401.4 to 365.3 (qualifier). Another fragment (mass to charge ratio, 413.5 to 395.4) was used to monitor 25-hydroxyvitamin D2 level, but none could be detected in any of the samples. A highly significant correlation was noted between 25-hydroxyvitamin D levels obtained by radioimmunoassay and by LC-MS/MS (r = 0.875, P < .001). Levels of 1,25-dihydroxyvitamin D (Nichols Institute Diagnostika GmbH, Bad Nauheim, Germany) were measured by radioimmunoassay on a multicrystal counter (Berthold LB2014, DiaSorin SA). Intra-assay and interassay coefficients of variation were below 10% for all described laboratory procedures.
Information on mortality was obtained from local registries. We used death certificates to classify the deceased into those who died from cardiovascular vs noncardiovascular causes. This classification was done independently by 2 experienced clinicians who were blinded to any data on the study participants except the already-mentioned information that was required to classify the causes of death. In the event of disagreement or uncertainty concerning the cause of death, the decision was made by one of us who is a principal investigator of the LURIC study (W.M.). Eighteen patients could not be contacted for follow-up, and for 23 of the deceased we had insufficient information to classify the cause of death. The latter study participants were included in the analysis of all-cause mortality but were excluded from any statistical procedure regarding cardiovascular mortality.
Because serum vitamin D levels fluctuate by month throughout the year, we decided for the purpose of this analysis not to use absolute vitamin D levels but instead to categorize individual patients' 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels into quartiles that were obtained on the basis of 202 to 358 vitamin D measurements of study patients each month. To address other possibilities of 25-hydroxyvitamin D categorization and to allow for comparisons with the quartile-based approach already mentioned, these results are also briefly mentioned in the "Comment" section.
Baseline characteristics of the 25-hydroxyvitamin D groups are given as percentages for categorical data and as medians with interquartile ranges for continuous variables. Comparisons between groups were performed using the χ2 test for categorical data and using analysis of variance and analysis of covariance with P for trend and adjustments as indicated for continuous data. If appropriate, continuous variables were logarithmically transformed before use in parametric procedures. Kaplan-Meier curves followed by log-rank test were used to evaluate differences in overall and cardiovascular mortality for 25-hydroxyvitamin D categories. Hazard ratios with 95% confidence intervals (CIs) for all-cause and cardiovascular mortality were calculated using Cox proportional hazards regression models. Hazard ratios for 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D categories were calculated by comparing the data with those of the highest 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles, respectively. We adjusted for several possible confounders in the Cox proportional hazards regression model by using different models that included important clinical variables, cardiovascular risk factors, or factors related to calcium metabolism. The backward stepwise logistic regression selection method was used, and the results of the final step are given. We tested for plausible interactions between the covariates by adding product terms to our models, and we tested for colinearity. Further assumptions underlying the Cox proportional hazards regression model were evaluated by log minus log survival and partial (Schönfeld) residuals vs survival time plots and were found valid. All statistical tests were 2-sided, and statistical significance was defined as P < .05. All data were analyzed using commercially available statistical software (SPSS 15.0; SPSS Inc, Chicago, Illinois).
After a median follow-up of 7.7 years, 737 persons (22.6% of the study population at baseline) had died. Of these, 463 deaths (62.8%) were from cardiovascular causes, 251 (34.1%) were from noncardiovascular causes, and 23 (3.1%) could not be classified because of insufficient data about the cause of death. Among patients with angiographic CAD, 319 deaths occurred from cardiovascular causes and 148 deaths from noncardiovascular causes.
Significant seasonal changes in serum 25-hydroxyvitamin D levels were found, with the lowest and highest levels appearing in March (mean [SD], 12.0 [6.8] ng/mL) and in August (mean [SD], 22.7 [9.6] ng/mL) (P < .001, analysis of variance), corresponding to an 89% difference in the mean levels. When patients were grouped into different 25-hydroxyvitamin D categories (0-10, >10-20, >20-25, >25-30, and >30 ng/mL), PTH levels began to rise significantly with the category of greater than 20 to 25 ng/mL. Respective increases in PTH levels averaged 3 pg/mL (to convert PTH levels to nanograms per liter, multiply by 1.0) (for the >20-25 ng/mL category), 5 pg/mL (for the >10-20 ng/mL category), and 12 pg/mL (for the 0-10 ng/mL category). Because 25-hydroxyvitamin D levels vary with the month of the year, the range of 25-hydroxyvitamin D quartiles fluctuates as well (Figure 1).
Monthly 25-hydroxyvitamin D level changes in the 25-hydroxyvitamin D quartiles. Black bars indicate 25-hydroxyvitamin D quartile 1 (lowest levels); light gray bars, quartile 4 (highest levels). To convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496.
Baseline characteristics according to 25-hydroxyvitamin D quartiles are summarized in Table 1. On average, patients in the lowest 25-hydroxyvitamin D quartile were older, were more likely to be female, and had more comorbidities. The mean serum PTH levels were 36% higher and the 1,25-dihydroxyvitamin D levels 31% lower among patients in the lowest 25-hydroxyvitamin D quartile compared with those in the highest quartile. Differences in corrected serum calcium and phosphate levels were absent or small.
Kaplan-Meier curve analysis followed by log-rank test showed that risk for all-cause and cardiovascular mortality increases significantly (P < .001) across 25-hydroxyvitamin D quartiles (Figure 2). Hazard ratios (with 95% CIs) for all-cause mortality (Table 2) and for cardiovascular mortality (Figure 3) among 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles are given for 3 different statistical models that include traditional cardiovascular risk factors or other variables directly or indirectly correlated with vitamin D metabolism. After adjustment for the respective other serum vitamin D level, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D associations with all-cause and cardiovascular mortality remained significant.
Kaplan-Meier plots of all-cause and cardiovascular mortality in the 25-hydroxyvitamin D quartiles (Q). Log-rank test indicated a significant difference across all 25-hydroxyvitamin D quartiles (P < .001). Multivariate-adjusted hazard ratios for patients in the lower two 25-hydroxyvitamin D quartiles (median, 7.6 and 13.3 ng/mL) were higher for all-cause mortality (hazard ratio, 2.08; 95% confidence interval, 1.60-2.70; and hazard ratio, 1.53; 95% confidence interval, 1.17-2.01; respectively) and for cardiovascular mortality (hazard ratio, 2.22; 95% confidence interval, 1.57-3.13; and hazard ratio, 1.82; 95% confidence interval, 1.29-2.58; respectively) compared with patients in the highest 25-hydroxyvitamin D quartile (median, 28.4 ng/mL). To convert 25-hydroxyvitamin D levels to nanomoles per liter, multiply by 2.496.
Cox proportional hazards regression model ratios (including 95% confidence intervals [CI]) for cardiovascular mortality are shown for 25-hydroxyvitamin D (A) and 1,25-dihydroxyvitamin D (B) quartiles (Q) for the following 3 different statistical models (M): (1) M1 (unadjusted), (2) M2 (adjusted for age, sex, body mass index, and physical activity level), and (3) M3 (variables of M2 plus active smokers, diabetes mellitus, albumin level, cystatin C level, triglyceride level, N-terminal pro-BNP level, systolic and diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol levels, and the use of statins, aspirin, β-blockers, bronchodilators, and angiotensin-converting enzyme inhibitors).
We performed a multivariate-adjusted subgroup analysis (based on covariates of model 3, described in the legend to Figure 3) for all-cause mortality among patients in different Charlson Comorbidity Index, New York Heart Association functional class, and physical activity level categories. These results are shown in Figure 4.
Multivariate-adjusted (covariates as in model 3 of Figure 3) hazard ratios for all-cause mortality in patients categorized by Charlson Comorbidity Index (A), New York Heart Association functional class (B), and physical activity level (C). Q1 indicates patients in the lowest 25-hydroxyvitamin D quartile; Q4, patients in the highest 25-hydroxyvitamin D quartile. *P < .05. †P < .01. ‡P < .005. §P < .001 compared with the reference group.
Univariate correlation analysis between 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels was weak (r = 0.36, P < .001) even after adjustment for cystatin C levels (r = 0.32, P < .001). Patients in a given 25-hydroxyvitamin D category could have 1,25-dihydroxyvitamin D serum levels ranging from low to high (Figure 5A). Patients' concurrent assignment to both vitamin D quartiles suggests a synergistic increase in all-cause mortality within a respective 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D quartile with declining levels of the respective other vitamin D level (Figure 5B).
Univariate correlation analysis. A, Distribution profile for both serum vitamin D levels among patients assigned to different 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D quartiles. Although patients with concomitantly high (column H) or concomitantly low (column L) levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were frequent, the overall correlation between the 2 endogenous D vitamins was weak (r = 0.32, P < .001). B, Effects on mortality rates when 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were considered concomitantly. Patients of column H (both high) showed the lowest and those of column L (both low) the highest mortality rates during the study period.
We split the results of multivariate-adjusted Cox proportional hazards regression models by different categories of angiographic CAD. A total of 2190 patients (67.3%) had significant CAD (≥50% stenosis). Six hundred ninety-three patients had virtually no CAD (<20% stenosis). Even in patients with CAD of less than 50% stenosis or less than 20% stenosis, there was a gradual increase in all-cause mortality for all lower 25-hydroxyvitamin D or 1,25-dihydroxyvitamin D quartiles (Figure 6).
The 25-hydroxyvitamin D (A) and 1,25-dihydroxyvitamin D (B) patient quartiles and corresponding effects on multivariate-adjusted hazard ratios (covariates as in model 3 of Figure 3) for all-cause mortality according to patients' coronary artery disease (CAD) status as determined by coronary angiography at baseline. CAD ≥ 50% indicates patients with significant CAD; patients without significant CAD are presented as 2 categories (<50% or by the most stringent criteria of <20% narrowing of ≥1 of 15 coronary artery segments evaluated). * P < .05. †P < .01. ‡P < .005. §P < .001 compared with the reference group.
We performed multivariate-adjusted comparisons among 25-hydroxyvitamin D quartiles for biological markers potentially linked to cardiovascular risk (Table 3). In addition, multiple linear regression analyses were performed for 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels, which were found to be correlated with the following log values (significant for all 25-hydroxyvitamin D correlations and for most 1,25-dihydroxyvitamin D correlations): glutathione, interleukin 6, phospholipids, C-reactive protein, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1, with standard β coefficients of 0.10 to 0.20 (P < .001 for all) after adjustments for age, sex, body mass index, and physical activity level and of 0.05 to 0.10 after additional multivariate adjustments. The direction of these correlations pointed toward an increase in cardiovascular risk at low vitamin D levels. Variables available for all patients (C-reactive protein and phospholipid levels) were also added to multivariate Cox proportional hazards regression models and were found not to significantly affect the vitamin D mortality relationship.
This study demonstrates that 25-hydroxyvitamin D levels that are in the lower 50% of the vitamin D range of our study population have a hazard ratio (HR) of 1.53 to 2.08 for all-cause mortality after adjustment for traditional cardiovascular risk factors. In subgroup analysis, the relationship of low 25-hydroxyvitamin D levels to mortality was consistent regardless of comorbidity, physical activity level, or New York Heart Association functional class. We could also exclude that variables known to be vitamin D dependent such as serum PTH, calcium, or phosphate level were driving confounders in the association between mortality and serum vitamin D levels. Therefore, a low 25-hydroxyvitamin D level can be considered a strong risk indicator for all-cause mortality in women and in men.
For this analysis, a retrospective classification of all individual 25-hydroxyvitamin D levels into quartiles was performed on the basis of 202 to 358 measurements of 25-hydroxyvitamin D levels each month. A patient belonging to the lowest monthly quartile could have 25-hydroxyvitamin D values ranging from 1.9 to 15.3 ng/mL depending on the season of the year. Although in theory such an approach of quartile-based monthly cutoffs seems logical and appealing, we reached similar results when absolute serum 25-hydroxyvitamin D levels were considered.
However, the cutoff discriminating vitamin D insufficiency and sufficiency is still a matter of debate, and there is likely a "gray area" of overlap between these 2 entities. A cutoff value of 20 ng/mL for normal 25-hydroxyvitamin D levels may be considered a more conservative threshold value because vitamin D levels below that have clearly been shown to be associated with increases in serum PTH levels,25 decreases in physical performance,26 and diminished lower extremity function.27 Using such a vitamin D classification, we calculated multivariate-adjusted HRs for all-cause mortality of 2.13 (95% CI, 1.70-2.68) for patients with vitamin D deficiency (≤10 ng/mL) and 1.33 (95% CI, 1.07-1.65) for patients with vitamin D insufficiency (>10-20 ng/mL), values that are close to the HRs obtained using the quartile-based approach. If vitamin D deficiency is defined as 20 ng/mL or less and vitamin D insufficiency as greater than 20 to 30 ng/mL or less and is compared with values greater than 30 ng/mL, the adjusted HRs for all-cause mortality were 2.34 (95% CI, 1.48-3.39) for patients with vitamin D deficiency and 1.54 (95% CI, 0.99-2.41) for patients with vitamin D insufficiency. Using yet another approach, we expressed 25-hydroxyvitamin D levels as percentiles within the respective month. Here, the adjusted HRs for all-cause mortality among patients having hydroxyvitamin D values in the lowest 25-hydroxyvitamin D quartile became even higher compared with those among patients having 25-hydroxyvitamin D values above the 10th percentile (adjusted HR, 4.91; 95% CI, 3.33-7.20; and adjusted HR, 3.04; 95% CI, 1.95-4.75). Therefore, it cannot be excluded that risk gradients become even steeper when outcomes are compared with 25-hydroxyvitamin D levels well above those seen in our study population.
At first glance, the percentage of patients with low 25-hydroxyvitamin D values seems unexpectedly high in the present study. Roughly two-thirds had serum levels below 20 ng/mL. However, our mean value of 17.3 ng/mL compares well with values reported from other large trials performed in middle European countries such as France, Italy, and Germany.28- 30
Another important aspect supporting our conclusions is that, similar to low 25-hydroxyvitamin D levels, low 1,25-dihydroxyvitamin D levels were associated with increased HRs for mortality, despite a weak correlation between the 2 (r = 0.36). This leads to the conclusion that 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels may yield similar but independent biologic effects. This is also in line with our finding that, when both variables are considered concomitantly, a synergistic effect on mortality risk seems evident (Figure 5B).
What are the major determinants of circulating 1,25-dihydroxyvitamin D levels? By multiple regression analysis with relevant variables included and with serum 1,25-dihydroxyvitamin D level set as the dependent variable, 25-hydroxyvitamin D levels (partial R2 = 9.6%) and renal function (partial R2 = 7.3% for log cystatin C) constituted the 2 most important independent predictors in the model, yielding an overall R2 of 24%. We were unable to find an independent association with age, despite a study31 demonstrating such an effect on 1,25-dihydroxyvitamin D production after infusion of PTH fragment 1-34. Consequently, availability of 25-hydroxyvitamin D substrate and renal function account for a small explainable proportion of 1,25-dihydroxyvitamin D serum levels. The question remains whether extrarenal production of 1,25-dihydroxyvitamin D contributes, at least in part, to the circulating pool of 1,25-dihydroxyvitamin D in individuals with normal renal function.
Another interesting aspect of the present study is that the association of vitamin D levels with mortality can be compared between patients with and without CAD. Low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were associated with significant increases in all-cause mortality but were consistently higher in patients without significant CAD. We conclude from these data that low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels seem to be important mediators of mortality even when there is little or no indication of overt vascular disease.
A limitation of our study is that we are unable to decide whether the association between low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels and mortality is causal or not. However, there are a few indications pointing to a possible link. Elevated C-reactive protein and interleukin 6 levels in patients with lower 25-hydroxyvitamin D levels suggests that 25-hydroxyvitamin D has anti-inflammatory properties. Similar relationships have been reported by others.32,33 Together with the effects related to oxidative stress and increased cell adhesion that we found, low levels of vitamin D may detrimentally affect vascular biologic function in multiple ways. Other mechanisms whereby low vitamin D levels may be associated with mortality include effects on matrix metalloproteinases,32,34 which were shown to affect plaque production and stability, increased susceptibility to arterial calcification,35,36 or an increase in renin messenger RNA expression.37
Further limitations of our study are related to 25-hydroxyvitamin D level determination and possibly race/ethnicity and changes of serum 25-hydroxyvitamin D levels over time. For measurements of 25-hydroxyvitamin D serum levels, we used a commercial radioimmunoassay that was validated against an LC-MS/MS as a reference method in a patient subgroup. The correlation between the 2 methods was strong (r = 0.87). We have further confidence in our vitamin D measurements because the annual variation in 25-hydroxyvitamin D level and the rise in serum PTH levels in patients with vitamin D insufficiency were similar, as expected,25 and because there was a graded biological effect with decreasing 25-hydroxyvitamin D levels. Serum 25-hydroxyvitamin D levels in a given individual seem to be constant over time. Among 100 healthy older individuals participating in a fall prevention study performed at 2 centers, we found a high correlation between two 25-hydroxyvitamin D levels that were 12 months apart (r = 0.758, P < .001; H.D., unpublished data, 2004), suggesting low intraindividual variation over time. The results of this study may further apply only to white race/ethnicity; despite low 25-hydroxyvitamin D levels in African Americans, little or no correlation to cardiovascular disease was reported.11
In conclusion, this prospective cohort study demonstrates for the first time, to our knowledge, that low 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels are associated with increased risk in all-cause and cardiovascular mortality compared with patients with higher serum vitamin D levels. Both vitamins seem to have synergistic biologic action that is largely independent of each other. Apart from the proved effects that vitamin D has on bone metabolism and neuromuscular function, appropriate serum levels (that may also be higher than in the present investigation) are associated with a decrease in mortality. Although not proved, it seems possible that at least part of this effect may be due to lowering of a risk profile promoting atherosclerosis and preventing cardiovascular end points. Based on the findings of this study, a serum 25-hydroxyvitamin D level of 20 ng/mL or higher may be advised for maintaining general health.
Correspondence: Harald Dobnig, MD, Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria (firstname.lastname@example.com).
Accepted for Publication: January 27, 2008.
Author Contributions: Dr Dobnig had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Boehm and Maerz. Acquisition of data: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, Boehm, Weihrauch, and Maerz. Analysis and interpretation of the data: Dobnig, Pilz, Renner, and Maerz. Drafting of the manuscript: Dobnig, Pilz, and Maerz. Critical revision of the manuscript for important intellectual content: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, Boehm, and Weihrauch. Statistical analysis: Dobnig and Pilz. Obtained funding: Boehm and Maerz. Administrative, technical, or material support: Scharnagl, Renner, Seelhorst, Wellnitz, Kinkeldei, and Weihrauch. Study supervision: Maerz.
Financial Disclosure: None reported.
Funding/Support: The LURIC study has received unrestricted grants from Sanofi-Aventis, Roche, Dade Behring, and AstraZeneca.
Additional Contributions: The German registration offices and local public health departments assisted with the study. Eugenia Lamont and Günter J. Krejs, MD, critically reviewed the manuscript, and Andrea Groselj-Strele, MSc, provided statistical advice. We thank the participants of the LURIC study, the LURIC study team, and the laboratory staff at the Ludwigshafen General Hospital, the University of Freiburg, and the University of Ulm.
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Welcome to the LIMA II Quest Challenge!
Become a scientist and propose Antarctic Research
The Landsat Image Mosaic of Antarctica (LIMA)
is the first-ever true-color high-resolution satellite view of
the Antarctic continent enabling everyone to see Antarctica as
it appears in real life. This new view of Antarctica will revolutionize
Antarctica research. The LIMA
web site is designed
as part of the International
Polar Year to familiarize people with
Antarctica, to explore the richness of its features, to learn about
why Antarctica matters to us all, and to explain and demonstrate
how scientists use satellite imagery to study the continent.
During this challenge, you will become
the scientists who study the features on Antarctica, as never seen
before, and using a major scientific tool: curiosity, you will
develop a research question and argue the value of studying
a feature based on this new view of Antarctica.
Educators' Guide available online.
of Events
After you have registered for the LIMA Quest Challenge you will receive an
email giving you information on how to proceed. Below you may see the anticipated
schedule of events so you can mark your calendar. Happy to have you on board!
See the growing background sources
of information to
help with your research and meet the people at LIMA at our online
October 1
10:00 a.m. Pacific
1:00 p.m. Eastern
• Challenge begins!
• Educators'
Guide available online
• Join us for the opening webcast
Meet your LIMA Experts by reading their bios
online and then join us for a live webcast in which LIMA experts
describe what they are asking your students to do for this challenge.
The Power Point slides and some helpful sites to help you get started
are included on the Archive site.
Please visit the Webcast page early to make sure are set up correctly
to receive video!
Deadline for preliminary proposals.
For instructions on how to submit a proposals see: http://quest.nasa.gov/challenges/lima/post.html
proposals were posted as received. Expert Responses have been
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Join us for
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Check to see that your browser is Java enabled. Questions may
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answered, will be online soon after the chat.
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Be sure to include information that you gained by the scientists'
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Final Proposals are being posted!
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Watch this live webcast featuring expert comments on student/scientist
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When you have had a chance to complete the challenge (viewing the
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Coccidioides complement fixation is a blood test that looks for antibodies to the fungus Coccidioides immitis. This fungus causes the disease coccidioidomycosis.
Coccidioides antibody test
A blood sample is needed. For information on how this is done, see: Venipuncture
The blood sample is sent to a lab. The health care provider looks at the clear liquid part of the blood, called serum, to see if there are antibodies to Coccidioides immitis.
There is no special preparation for the test.
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
This test is used to detect infection with the fungus that causes coccidioidomycosis. This condition can cause lung or widespread (disseminated) infection.
A normal result means no Coccidioides immitis antibodies are detected in the blood sample.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
Abnormal results mean that Coccidioides immitis antibodies are present. This can mean that you have a current or recent infection.
The test may be repeated after several weeks to detect a rise in titer (antibody concentration), which confirms an active infection.
In general, the worse the infection, the higher the titer, except in people with a weakened immune system.
There can be false positive tests in patients with other fungal diseases such as
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
Galgiani JN. Coccidioides species. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 266.
Galgiani JN. Coccidioidomycosis. In: Goldman L, Ausiello D, eds. Goldman's Cecil Medicine. Philadelphia, PA: Saunders Elsevier; 2007:chap 354.
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First printing. Mystery featuring Seattle police Detective Lou Boldt. INSCRIBED by author on title page ("for John, all my best") 375 pp. Fine in fine dust jacket. .ISBN # 0-786865636
Bookfever.com - Selling books on the internet, by mail order, at book fairs, and at Antiques Upstairs in historic downtown Jackson, California, since 1992. Over 50,000 books and magazines in stock (over 4,000 signed or inscribed by the author) - many more than are listed on our website, so please do not hesitate to contact us if you cannot find what you are looking for.FIND US ON FACEBOOK
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On the Hill Summer, brought to you by The Steadman Clinic and the Steadman Philippon Research Institute, brings you a video report about a different Lake Tahoe adventure every day.
Today's activity: Hike to Echo Peak.
Conditions: We've got a new contributor to the group, a new Michelle, and she and her pup Lucky take us to Echo Peak, via Echo Lakes. The hike is moderate to strenuous with some steep climbs, but the final climb up to that peak is well worth it as you'll see Angora Lakes, Fallen Leaf Lake, Lake Tahoe and more. This is a great all-day hike, so grab a sandwich or some snacks and get ready to have the perfect Desolation Wilderness experience.
Today's weather: We're having a hard time getting away from the Yosemite Fire smoke up at the lake, and today we're under a dense smoke advisory. Too bad, as the temps peak at 77 degrees and winds are light to moderate. — National Weather Service
What do you think of On the Hill? Any adventures you'd like to see? Contact us at email@example.com. Like On the Hill on Facebook, and check out all the videos from Vail and Lake Tahoe.


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Explore Charity Publications
Browse the YUDUfree library to find digital catalogues and other publications created by charities from all over the world.
charities Publications
BAfM Journal Spring 2015
|Published by BAFM on 21 Apr 2015
|Desc: BAfM Journal Spring 2015
|No of pages: 28
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Charities, their subjects and agenda, are the focus of 1000s of digital magazines, catalogues, eBrochures, newsletters and other publications stored in the YUDUfree library. Whether you're interested in causes that research disease, support sufferers of human actions or offer aid to victims of natural disasters, our extensive archive should be your first point of call for titles on charities. Here you can view items page by page, and add comments and bookmarks. You can also choose titles to include in your own library and to share with friends. Many YUDUfree publications are packed with pictures too, vividly bringing to life the charities that interest you.


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By issuing qualifying offers, teams are given the right of the first refusal or draft-choice compensation should the player sign an offer sheet with another NHL club. Players without an offer will become unrestricted free agents if not signed by noon EDT on Tuesday, the start of free agency.
The Flyers made offers to right winger Jason Akeson, defenseman Erik Gustafsson, defenseman Brandon Manning and left winger Tye McGinn.
Akeson, 23, appeared in all seven games for the Flyers-New York Rangers series in the first round of the Stanley Cup playoffs, posting two goals and three points.
Gustafsson, 25, appeared in 31 regular-season games for the Flyers last season, recording 10 points and adding one goal in two Stanley Cup playoff games.
Manning, 23, led the AHL Adirondack defense in scoring with 23 assists and 31 points in 73 games while also tying for the team lead with 231 penalty minutes.
McGinn, 23, appeared in 18 games last season with the Flyers, posting four goals and five points.
Other NHL teams also announced their qualifying offers -- or non-offers -- issued Monday:
--Columbus Blue Jackets: The Jackets extended a qualifying offer to leading scorer center Ryan Johansen. He led the Blue Jackets with 33 goals and 63 points in 82 games in 2013-14.
Also receiving offers were forwards Corey Tropp, Matt Frattin, Sean Collins and Dana Tyrell and defensemen David Savard, Tim Erixon, Cody Goloubef and Will Weber.
Forwards Oliver Gabriel and Jake Hansen and defenseman Anton Blomqvist did not receiving qualifying offers.
--Arizona Coyotes: The Coyotes extended qualifying offers to restricted free agent forwards Brandon McMillan and Jordan Szwarz.
Szwarz, a 2009 fourth-round pick, made his NHL debut in 2013-14 and had three goals in 26 games. McMillan had two goals and four assists in 22 games.
--Dallas Stars: The Stars announced that they extended qualifying offers to five restricted free agents, among them center Cody Eakin, who was fourth on the team in the regular season with 16 goals and 35 points, and left winger Antoine Roussel, who had 14 goals, 29 points and a team-leading 209 penalty minutes.
Also receiving offers were center Scott Glennie and defensemen Brenden Dillon and Cameron Gaunce.
Defensemen Ryan Button and Hubert Labrie, centers Dustin Jeffrey and Tristan King and right winger Austin Smith did not get qualifying offers.
--Washington Capitals: The Capitals issued qualifying offers to four restricted free agents, including goaltender Edward Pasquale, who was acquired from the Winnipeg Jets on Saturday.
Also receiving offers were center Michael Latta and defensemen Nate Schmidt and Cameron Schilling.
--Buffalo Sabres: The Sabres extended qualifying offers to five players -- forwards Marcus Foligno, Tyler Ennis and Luke Adam, defenseman Chad Ruhwedel and goaltender Matt Hackett.
Not receiving offers were defenseman Jamie McBain and goaltender Connor Knapp.
--Tampa Bay Lightning: The Lightning made qualifying offers to forwards Brett Connolly, Richard Panik, Cody Kunyk and Philippe Paradis and defensemen Dmitry Korobov and Andrej Sustr.
Tampa Bay did not make offers to goaltender Anders Lindback, forward Geoff Walker, and defensemen Keith Aulie and Charles Landry.
--Minnesota Wild: The Wild made qualifying offers to five restricted free agents: forwards Nino Niederreiter, Jason Zucker and Justin Fontaine, goalie Darcy Kuemper and defenseman Jonathon Blum.
Not receiving offers were defensemen Josh Caron and Tyler Cuma and forward Kristopher Foucault.
--Florida Panthers: The Panthers extended qualifying offers to seven players, including defensemen Erik Gudbranson and Dmitry Kulikov.


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New coach handed the reins at Philip Barbour
March 19, 2012
PHILIPPI?— New head coach Angel McCullough is hoping Philip Barbour can rebound from a disappointing 2011 campaign this season. This will be McCullough's first high school coaching job for softball....
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We decided to try for a homemade Christmas this year. I was tired of worrying about money during the Christmas season and I also wanted to teach my kids that Christmas is about family, not just presents! It became my mission to make something meaningful for my kids, something they would use all year and not just toss aside after a few weeks.
I found some amazing blogs and websites that helped me in my mission and I wanted to share them with all of you!
For my son, Ryan, I decided to make a "Fort Kit." He is very into technology and I wanted to make him something that would help him use his imagination more. I am sewing bed sheets together that I found at the secondhand store and then including things like clamps from the hardware store, a flashlight and some fun books to be read inside!
Find directions for the "Fort Kit" here.
For my daughter, Samantha, I am making a Rag Quilt. It is very bright and has lots of fun patterns on it! I am NOT an experienced seamstress at all and it is going well, so don't be scared to try this! Directions here.
For my husband, something simple ... Reinbeers!! Bottles of beer made into Reindeer! So cute! Directions herehttp://lifeofamodernmom.blogspot.com/2010/11/reindeer-rootbeer-beer.html">here.
For friends and neighbors, I am making Homemade Hot Chocolate with fun stirring spoons. It is a great way to give a homemade gift that you know they will really use!
Find directions for the Chocolate-Hazelnut Spoons here and for the homemade hot chocolate here.
Casey Park is Greeley Moms craft and activities blogger. Read her Tuesdays on Greeley Moms.
I was tired of worrying about money during the Christmas season and I also wanted to teach my kids that Christmas is about family, not just presents.


text:
Party Pics: Cowboy fans gather at Nodding Donkey near SMU
Photo: Jerry McClure/Special Contributor
Baylor alum Mo Harpole show off who she is rooting for at the Cowboys Redskins watching party at Nodding Donkey near SMU on Dec 30, 2012 in Dallas Texas.
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Childhood schizophrenia is a severe brain disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behavior. Signs and symptoms may vary, but they reflect an impaired ability to function.
Childhood schizophrenia is essentially the same as schizophrenia in adults, but it occurs early in life and has a profound impact on a child's behavior and development. With childhood schizophrenia, the early age of onset presents special challenges for diagnosis, treatment, educational needs, and emotional and social development.
Schizophrenia requires lifelong treatment. Identifying and starting treatment for childhood schizophrenia as early as possible may significantly improve your child's long-term outcome.
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Enroll Now!
I enjoyed the humor and interesting supplemental articles that were included
in the instruction. The course content was up-to-date and the examples were
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Excellent class for beginning instructors. Covered all essential materials
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This was an excellent refresher.
This course gave valuable ideas for teaching adult learners. I loved the section on how to beef up students' study skills and strategies for test-taking. I plan on incorporating and sharing many of the fun study techniques in my own class.


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Bummis Fabulous Pail Liners$37.99
Endless uses for these Fabulous Wet Bags!
Bummis Fabulous Wet Bags are a practical accessories for any cloth diaper system. You will love these conveniently sized bags in our bright and crazy Bummis Super Brite fabric. They are chic and convenient and very colourful! Double seamed on 3 sides, these bags are designed and constructed to be durable and absolutely leak resistant. They also have a snap-able handle for strollers and a zipper for odour control. Use them for anything – wet diapers, bum wipes, reusable menstrual pads, swimsuits, cosmetics, travel bag, etc.
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I have one of these bags and one of the other kind of zippered bag and I've been happy with them both. At first I balked at the price and was going to just use plastic bags, but I'm glad I changed my mind. This one does not have a flat bottom, but (the medium size) is bigger. It's actually amazing how much fits in this bag. The strap is useful when hanging it to dry indoors vs the clothesline, but otherwise it isn't integral. Dries quickly and I haven't had odor issues. (Posted on 1/3/11)
Great for the diaper bag Review by Sherrie
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I really like this wet bag for use with cloth diapers when I'm out of the house. I use the medium size which is good for an afternoon up to a day out. I used to use the small Bummis tote bag, but it only fits about 3-4 diapers, has a drawstring that doesn't completely close the bag and has a small opening so it's harder to get the dirty diapers out. The Fabulous wet bag has a large opening so the diapers come out easily. I recommend the medium size. (Posted on 11/28/10)Would you recommend this product to a friend? Without hesitation!
Good all around wet bag Review by Lesley
Price Value Quality
I purchased two of these bags (Medium size) to begin with and ended up purchasing an additional one because I loved them so much. I actually use these in our nursery and hang them on the front of our change table. When one fills up, it's time to do laundry. I usually do diaper laundry every other day and we use pre-folds. With two I was able to wash one and use the other while the laundry was going. I ended up purchasing a third because I wanted a small wet bag for our diaper bag when we go out as I only had one large wet bag (different company) and was looking for something to hold soiled and wet clothing.Would you recommend this product to a friend? Yes
Great Price and good quality. I use them every day. (Posted on 1/4/13)


text:
Probes that use the vacuum ultraviolet (VUV) region of the spectrum (10–100 eV) are very well matched to the elucidation of bonding in solids, surfaces, and molecules; to the investigation of electron–electron correlations in solids, atoms, and ions; and to the study of reaction pathways in chemical dynamics. At the lowest end of this energy range (below 1 eV) we have infrared, far-infrared, and terahertz spectroscopies, which are well matched to vibrational modes and other modes of excitation.
Soft x-ray spectroscopies employ the excitation of electrons in relatively shallow core levels (100–2000 eV) to probe the electronic structure of various kinds of matter. Elemental specificity is the watchword for this kind of spectroscopy. Each element has its own set of core levels that occur at characteristic energies. The photon-energy tunability of synchrotron radiation is essential.
Hard x-ray spectroscopy is applied in a wide variety of scientific disciplines (physics, chemistry, life sciences, and geology) to investigate geometric and electronic structure. The method is element-, oxidation-state-, and symmetry-specific. It is a primary tool in the characterization of new and promising materials. It is also used in the elucidation of dilute chemical species of environmental concern.
SINS Reveals Dopant Effects in Plasmonic Materials
New Catalyst Boosts Selective Formation of Olefins from Syngas
New Insights into Oxygen's Role in Lithium Battery Capacity
New Fuel Cell Design Powered by Graphene-Wrapped Nanoparticles
A New Universal Parameter for Superconductivity
Weyl Fermions Discovered After 85 Years
Spectroscopy of Supercapacitor Electrodes In Operando
ALS X-Rays Shine a New Light on Catalysis
Molecular Structure of Water at Gold Electrodes Revealed
New Technique Gives a Deeper Look into the Chemistry of Interfaces
From CO2 to Methanol via Novel Nanocatalysts
Iron is the Key to Preserving Dinosaur Soft Tissue
Infrared Mapping Helps Optimize Catalytic Reactions
An Inside Look at a MOF in Action
New ALS Technique Gives Nanoscale Views of Complex Systems
Covalent Bonding in Actinide Sandwich Molecules
ALS Capabilities Reveal How Like Can Attract Like
Twist Solves Bilayer Graphene Mystery
New Spectroscopic Technique Reveals the Dynamics of Operating Battery Electrodes
Ultrafast Transformations in Superionic Nanocrystals
A Spintronic Semiconductor with Selectable Charge Carriers
Iron Availability in the Southern Ocean
Flipping Photoelectron Spins in Topological Insulators
Studies Bolster Promise of Topological Insulators
A New Route to Nanoscale Conducting Channels in Insulating Oxides
A Better Anode Design to Improve Lithium-Ion Batteries
A Microscopic Double-Slit Experiment
Direct Kinetic Measurements of a Criegee Intermediate
Two Phase Transitions Make a High-Temperature Superconductor
Large Magnetization at Carbon Surfaces
Regarding Confinement Resonances
AP-XPS Measures Active MIEC Oxides in Action
Heterogeneous Morphology Found in Organic Solar Cells
Probing Strain-Induced Changes in Electronic Structure with XMCD
Superconducting Topological Insulators
Molecular Measurements of the Deep-Sea Oil Plume in the Gulf of Mexico
Platinum Nanoclusters Out-Perform Single Crystals
ALS Reveals New State of Matter
Compositional Variation Within Hybrid Nanostructures
First Observation of Plasmarons in Graphene
Site-Selective Ionization in Nanoclusters Affects Subsequent Fragmentation
Biomimetic Dye Molecules for Solar Cells
Electron Correlation in Iron-Based Superconductors
Harnessing the Bacterial Power of Nanomagnets
Bilayer Graphene Gets a Bandgap
Towards Heavy Fermions in Europium Intermetallic Compounds
Observation of a Macroscopically Quantum-Entangled Insulator
Reaction-Driven Restructuring of Bimetallic Nanoparticle Catalysts
Dirac Charge Dynamcs in Graphene by Infrared Spectroscopy
Isotope and Temperature Effects in Liquid Water Probed by Soft X Rays


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The result of the night - Renovation Fogasház part x+1
blog post
8 hackers, approx. 3 tons of moved junk, 80 sacks and a 6m↑3 container = the balcony of the space is nice and clean The story begins when we eliminated two walls of the space. The resulted junk


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African Film Series presents "Living with Hunger"
An additional film will be presented as part of the Global Studies degree program's African Film Series. Living with Hunger will be shown on Monday, December 9th at 1 p.m. in room 308 of the Gaige Technology and Business Innovation Building. This event is free and open to the public.
Living with Hunger is a British independent television production. In this vivid and thought-provoking film, Sorious Samura, a journalist of Sierra Leonean descent moves into an Ethiopian village to experience hunger firsthand. Samura spent five weeks living as one of the villagers on one "meal" per day. Those meals varied from a bean sauce and wheat pancake on "good days" to a weed, called wild cabbage, on "bad days."
At one point, about halfway through filming, Samura lost sight of his objective and begged his film crew for food. Samura stated in a BBC News interview, "I felt I was going to pass out. But these people live this life day in day out from the day they are conceived." He considers the Ethiopian people to be heroes rather than victims.
For more information about the African Film Series, contact Dr. Randall Fegley, assistant professor of history, at 610-396-6092, or via e-mail at email@example.com.


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Source: CNN
quote: It doesn't make them idiots, not everyone is an enthusiast who cares about how fast their processor is or how pretty a game looks.
quote: That is like me saying my Ivy bridge is faster than your Nehalem.
quote: The GS3 came out 7 months ago. Stop using it as your data-skewing baseline. Compare it to today's new phones and its pretty close and YOU stop overplaying the difference


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Kim Zolciak has two more reasons to be thankful this Thanksgiving. She's announced she has given birth to healthy twins .
"Guess what?!!! The TWINS have arrived!" the former Real Housewives of Atlanta star said in a colorful birth announcement she posted on Instagram Monday. "We welcomed first a baby girl and second a handsome little boy. They are both healthy, and Kroy and I are so thankful!!"
Zolciak, 35, and husband Kroy Biermann, a defensive end for the Atlanta Falcons, are now the parents of six children, which prompted the new mother to joke, "We are officially the 'Biermann Bunch' now!"
She later revealed her babies names on Instagram, too.
"The twins names are: Girl: Kaia Rose (After 'Psychic' Rose who is like a grandma to me and been a huge part of my life for 13 plus yrs) Also the twins were born on the Rose's birthday!" she explained. "Boy: Kane Ren (Ren After my OBGYN who has delivered 5 of the 6 kiddos, who has also been a big part of my life for 12 yrs and we simply adore him)."
In addition to the new twins, Zolciak is mom to daughters, Brielle, 16, and Ariana, 11, from a previous relationship, and sons Kroy Jr., 2, and Kash Kade, 15 months, with Biermann.
Thankfully, the Don't Be Tardy … star, who has been documenting her pregnancy on Instagram, wasn't tardy with her final selfie taken Nov. 18, writing, "I'm soooo over being pregnant!"
Kim Zolciak Welcomes Her Twins
Derek Blanks/Bravo
updated 11/25/2013 AT 11:00 AM EST
•originally published 11/25/2013 AT 08:50 AM EST


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A Tradition of Pride
June is the month when we celebrate our AU Pride. You may know that American University is regularly rated as one of the most LGBTQ-friendly schools in the U.S. But did you know that the university and students have actively taken part in campus and nation-wide LGBTQ rights movements for more than 50 years?
In the 1960s, the Kay Spiritual Life Center hosted Franklin Kameny, president of the first major gay rights organizations, the Mattachine Society of Washington. American University students have also attended each and every major gay rights march in Washington, including in 1979, 1987 and 2000. Students formed the first on-campus gay rights group, the AU Gay Community, back in 1976.
In 1991 AU's student senate became the first in the D.C. area to amend its nondiscrimination policy to include an Equal Opportunity Clause, protecting sexual orientation. More than 20 years ago, the first incarnation of the current Center for Diversity and Inclusion was formed and known as the Sexuality Minority Resource Center, which later became the GLBTA Resource Center.
With a rich history of university and student-led activism for LGBT rights, it is no surprise that AU is recognized for its commitment to all students and alumni.
Pride Month 2014 marks AU's third year at the Capital Pride Festival and the sixth time that Pride Eagles cheered on Washington's baseball team at the Night OUT with the Nationals, an event now in its 10th year. Along with these two great annual Pride events, the AU Pride Alumni Alliance also joined the DC Young Alumni Chapter to welcome the newest members of the alumni community this month.
As AU's LGBTQ and ally alumni community continues to grow, the Pride Alumni Alliance is looking for your feedback and suggestions. Fill out the Pride Alumni Alliance membership form to help continue to grow AU's proud legacy of, simply put, Pride.


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Hi everyone,
I'm writing an OPM COBOL program that needs to process a large number
of sequential files (around 4,000 records). It's a parsing algorithm
that needs to find a few records at an unpredictable location in the
file. Obviously in COBOL I'd having to allow for reading a high
percentage of the records in each of the files.
Alternativey I could embed the SQL.code inside of the COBOL.
Which would be faster? Is the answer obvious or should I test it both
ways. Would the relative speed depend on other factors, ie size of
computer, memory, hard disk and OS400 version? The program will be run
on many different machines.


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Samsung CLX-4195FW WiFi Color Laser All-in-One Printer - 19 ppm (Black), 19 ppm (Color), 9600 x 600 dpi, 4.3" Touchscreen LCD, 256MB, USB 2.0, WirelessItem#: S203-2636 | Model#: CLX-4195FW
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When a piece of lint is stuck to your dick and you don't notice until you are peeing and it shoots in 3 directions
I went to go piss and I had lint dick now I made a mess in the bathroom and also on my jeans.
von dunnyjake 3. Oktober 2011
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Can you define these popular missing words?
What a man gets when he tries to fornicate with a female's belly button.
von Daddylonglegs2 3. Februar 2011


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Good idea Review by Charmaine
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These straws are a great size for our 2 year old. I've even used them in some of our shorter glasses. They don't give off a metalic taste, and we just put them in the dishwasher with our other cutlery. (Posted on 6/18/10)Would you recommend this product to a friend? Yes
Great for shorter glasses/tumblers Review by Mellissa
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These are a great length and angle for shorter preschool cups. The adults in my house also use them with tumblers. They wash up simply in the dishwasher with the cutlery. No more plastic straws over here! (Posted on 1/8/12)Would you recommend this product to a friend? Without hesitation!
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Three keys to beating Nashville?
Posted 16 April 2012 - 04:14 PM
A) stop trying to " generate" chances and CAPITALIZE on chances given: Man, we had a hundred chances on Sunday...Miller had a gaping net, Zetty was stonewalled but really, Rinne is giving us a lot of looks but for whatever reason we are not burying the chances. We have had WAY to many " all mosts" for my liking. Play hard, get into position and hammer it home!
B) Sixty minutes. Can we play an entire game of hockey? We look sleepy and disengaged in the 1st period. At times I have felt like the team has either tried to sit with a lead or seem to realize with 5 minutes left, that we are down one goal and play like wildfire for the last 5 minutes. Try and control the pace and I think we can dominate.
C) don't get suckered into playing their game. Right now Nashville is trying to bully us and then we retaliate. This always seems to result in a stupid penalty. They are hard enough to score on at even stretch, we don't need to tempt fate. They need to play their game and let Nashville adjust to us and p,yang without the puck.
Like I said, here re a hundred more things they should be doing but I thought I'd ask the corps what you would like to see them. Do in game four ( besides win handily)
Posted 16 April 2012 - 04:18 PM
2) Time machine for Johan Franzen.
3) Stop setting the Red Wings' clocks 20 minutes slow.
Posted 16 April 2012 - 04:22 PM
- 8 Legged RedWing and ComradeWasabi like this
- uk_redwing
HockeyArchive Twitter
Posted 16 April 2012 - 04:23 PM
i'd say that's it. all bad things stem from killing 8 penalties a game.
- Rick D likes this
Posted 16 April 2012 - 04:23 PM
Posted 16 April 2012 - 04:25 PM
Kronwall just needs to hammer a few of their star players and get them out of the series.
yes where are the "kronwalled"?
Posted 16 April 2012 - 04:27 PM
Yes totally agree kylee....we seem to want to have every person touch the puck or something.....drive the net, let it rip and the rebounds are coming out ( addendum....avoid trapper hand!) Great point!
I very much agree with the OP. May I add to this? how about stop trying to "set up" everything and just drive the net and get to the slot. It'll go a long way there is NO WAY Nashville can hang with a high intensity fast tempo Red Wings
Posted 16 April 2012 - 04:35 PM
Posted 16 April 2012 - 04:45 PM
2) Crash the net, I'm so tired of seeing every Wings possession making 7-8 passes around the perimeter and settling for point shots and bad angle shots with no one screening the goalie or even close enough to the net to have a chance at the rebound.
3) Be the aggressor, we have been spending way too much time reacting.
Thanks MabusIncarnate
Posted 16 April 2012 - 04:49 PM
Kronwall just needs to hammer a few of their star players and get them out of the series.
you don't beat a team by taking out a few of their star players,that is not how you win a series
Posted 16 April 2012 - 04:57 PM
Posted 16 April 2012 - 05:11 PM
2. Get to the front of the net!!!!!!!!
3. We MUST out work them!!!!! We have got to want it more. Hustle!!!!
- Nightfall, Motown4013 and Cloune like this
Posted 16 April 2012 - 05:18 PM
2. Play a consistent second period.
3. Play a consistent third period.
Posted 16 April 2012 - 05:21 PM
1.stay the hell out of the box!!!!!!!
2. Get to the front of the net!!!!!!!!
3. We MUST out work them!!!!! We have got to want it more. Hustle!!!!
although i agree with you, i feel the seriousness of this matter warrants more exclamations.
- McAwesome and Get Rid of Mickey like this
The Diagnosis is - Baby Wiener. You got a Baby's Wiener.
Posted 16 April 2012 - 05:23 PM
Posted 16 April 2012 - 05:37 PM
We need more net presence and rebound-hunger. I'm tired of watching the Preds get two to three shots on net per attack while it seems 50% of the time the Wings can't even get one. I see some perimeter play, a shot that goes wide, is blocked, or Rinne rebounds it away, then suddenly the Preds are already in the neutral zone with the puck, racing toward Jimmy.
Consistency. I think I've seen this one maybe three times the whole season so I'm not sure if it's even realistic to ask for it.
Special teams has been the silver lining for us, but we're playing with fire. We (Franzen) have been taking too many stupid penalties, whether you want to include referee incompetence or not. The Preds' power play has looked dangerous and has exploited our PK, but they haven't had the puck luck to collect the tally.
Additionally, we need to start generatin power play opportunities, and not rely on s***ty reffing to hand us two minutes every so often. This is where speed and tenacity and hunger come into play, especially in the Predator's zone.
The Wings have all the tools they need to close this out in 6. Whether they want to use those tools is entirely up to them.
Posted 16 April 2012 - 05:54 PM
2. Playing full 60 minutes
3. Stay out of the box
4. Take Command of Powerplay opportunities.
5. Get Cleary and Franzen off this roster, lol (sorry this one was a joke)
- Nightfall likes this
Posted 16 April 2012 - 05:54 PM
2. When having the puck in the middle of the ice, 10 feet from the net, you should probably shoot.
3. Skate hard! No coasting. Make a decision and play the decision hard. No half in, half out.
Notice I say nothing about Nashville. Because if the Wings play to their best of their ability, it does not matter what Nashville does. The refs? Another matter entirely. But that being even, the Wings have a level that I haven't seen Nashville reach.
Edited by Hockeytown Red Wings, 16 April 2012 - 06:00 PM.
"During Robert Langs time in Detroit, he caused me anguish. Other times he brought me and my family great joy. Robert Lang occasionally coasts, and spends time searching for the best pane of glass to best view the reflection of his flowing mullet. Other times he is a strong-armed force with the puck. I never knew what to expect from Robert Lang. He is The Enigma. " - A2Y
Posted 16 April 2012 - 06:37 PM
Insert done youth into the line up
Clear the crease
Posted 16 April 2012 - 06:47 PM
2) Match their physicality with some of our own so they know we aren't backing down
3) Get an early lead. Nashville is a defensive team so it will be a lot easier to stop them from coming back than to play from behind.
4) Throw puck at the damn net. Stop trying to set up the fancy passes. They are all over it. Throw the puck at the net and grind away will be the only way to win.
Edited by CrimsonFlame, 16 April 2012 - 06:48 PM.
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Beret Hats
Berets are soft flexible round flat hats, classified by some as a cap. They are available in a variety of fabrics such as wool, fur, knit, bamboo, and crocheted cotton. They date back to pre-Roman times where they were worn throughout Europe. Historically, berets have been a part of many countries military attire, usually adorned by either a cloth or metal badge. Culturally berets are associated with the arts, often worn by directors, painters, bohemians, intellectuals, and poets. They have been strongly associated with women's fashion since the mid twentieth century.
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Fallout: New Vegas Review
Despite the numerous bugs, New Vegas is a magnificent RPG, one that stands head and shoulders above its predecessor. More importantly, it's also the game that Fallout fans have been waiting for.
For years now the Fallout games have been telling us that war never changes. The series itself, meanwhile, has been in an ongoing state of flux: Fallout 2 initially appeared to be an expanded facsimile of its predecessor, and yet buried beneath its surface lay a number of important tonal differences - notably an increased fondness for juvenile humour and tongue-in-cheek nods to pop culture. Next came Fallout: Tactics, a curious but not entirely unsuccessful attempt to at squad-based strategy. Then the franchise entered its darkest period: Interplay descended into financial turmoil, the third true game - known at the time as "Van Buren" - was cancelled, and the entire Black Isle team was laid off. To add insult to injury, these losses were followed by the release of Fallout: Brotherhood of Steel - a dire, Interplay-developed shooter that dragged the license into a dark alley where nasty things were done to it. Long-time fans affectionately dubbed the game "Fallout: PoS".
Then, of course, there was Fallout 3. When Bethesda announced it had acquired the Fallout brand from Interplay, the established fanbase greeted the news with a fair amount of wailing and gnashing of teeth. It was an understandable reaction, up to a point: the preceding disappointments were very painful for a lot of us. But while the final product split opinion among veteran devotees, the fact remains that Fallout 3 saved the brand. True, it departed considerably from some of the established lore, but it was a pretty damn good game in its own right, and one that brought Fallout to a colossal new audience. Ironically, many of these newcomers are now worried about the fact that New Vegas has been developed not by Bethesda, but by Obsidian - a studio now home to many Black Isle refugees.
Please forgive me for the extended history lesson, but it's important to consider all this when appraising New Vegas, particularly if you're one of the many people who only joined the party in 2008. You'd be forgiven for expecting this game to be a re-skinned reprisal of the game we played two years ago. That's really not the case. Sure, much of the core experience remains unchanged: it's the same engine, after all, and while the setting has shifted from Washington to the Mojave - trading Fallout 3's green hues for a dusty orange colour scheme - the basic mechanics and presentation are pretty much identical. This is another epic post-apocalyptic RPG, played from the first-person perspective, with a combat system that lets you pause time to cue up carefully-aimed shots. So far, so Fallout 3 - but the contrasts lie in what Obsidian has done with these returning elements, alongside their approach to quests and the tone of the adventure.
For all its side quests and distractions, Fallout 3 was ultimately a fairly clear-cut tale of Good vs. Evil. It was the story of one character's life, beginning with their birth in Vault 101 - one of the town-sized shelters which protected a lucky minority from the nuclear war that ended life as we know it. When your Dad went missing, you followed him out into the Wasteland - a world of mutants, gunfights, and the struggling remnants of humanity. Eventually you became aware of a fascist threat to what was left of civilisation, and you took appropriate action. You could destroy the bad guys or you could help them achieve their goals, but either way there was never any doubt about who the villains were.
New Vegas, on the other hand, begins with you being shot in the head. You're no Vault-dweller - you're just an everyday courier who happened to take the wrong job. A helpful robot digs you out of your shallow grave, and then you set out to find the men who installed a 9mm hole in your skull. As you follow your would-be murderers, you'll see a lot of strange and terrible things: insects the size of cars, roving packs of bandits, innocent people left to die on crosses. You'll meet pin-striped gangsters, slavers who model themselves after the Roman Empire, and the soldiers of a bureaucratic republic out to colonise the entire Wasteland. And throughout these encounters you'll wonder to yourself, "Where are the good guys?"
Obsidian's New Vegas is a land of violence, deception and muddy morality. The good/bad karma system of Fallout 3 has been replaced with a localised reputation mechanic, one that finds individual settlements and organisations reacting to your every decision. The last game boasted a wealth of quests and mini-assignments, but here almost every conversation will lead to a new entry on your to-do list. There is somewhere in the region of 90 major quests to undertake, plus dozens upon dozens of smaller tasks to handle. Sometimes there will be an obviously kind or cruel way to complete your objectives, but often you'll be left to decide for yourself what constitutes the "right" way to proceed.


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A closed figure formed by three or more line segments that intersect only at their endpoints.
rotational symmetry
A figure can be rotated less than 360 degrees around a central point and coincide with the original figure.
A repeating pattern of plane figures that completely cover a plane with no gaps or overlaps.
Triangle Sum Theorem
The theorem that states that the measures of the angles in a trianlge add up to 180 degrees.
corresponding angles
Angles formed by a transversal cutting through 2 or more lines that are in the same relative position.


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I have concluded there really is only one way to figure out what our rights should be. Analyze the actual words. Words have meaning. These words were chosen with great brilliance and deliberation. To extract any other conclusion from the words that are written is to intentionally engage in ineffective dishonesty.
Seriously, let's examine the Second Amendment.
In the first phrase, the dependent clause, many people want to focus on the "militia" aspect. What is a militia? It's basically an army made up of citizens. You don't have to have a standing militia to mitigate the possibility you "might" need one and there is nothing in the Constitution that mandates a militia. The only "necessary" part of that clause is "the security of a free state."
"Arms" are "to carry." You can't carry a tank. You can't carry a thermonuclear weapon. You can't risk a crowd of citizens with a grenade launcher. Just don't go there. "Arms" are portable weapons with which you shoot a projectile(s), and the armament to support that weapon.
"Shall not be infringed:" It doesn't seem very ambiguous to me. Words have meanings. They mean what they say. The Constitution says, "the right to keep and bear arms shall not be infringed." Which of those words is unclear? "Infringed?" What dictionary definition are you using? Saying that you can only have magazines of this size but not that size or "this thing that shoots" but "not that thing that shoots" ... that is an infringement.
Wait! Does that mean fully automatic weapons? Yeah, it kind of does. I'll get to that in a minute.
So, what do I want? What do I believe adheres to the Constitution? I would have an absolutely reliable database by which we can verify criminal and mental history. In that database will be - people who cannot have a gun. That reliable database needs to be easily and quickly accessible by licensed gun dealers. Won't that allow straw-man purchasing? Yep. Won't that allow people to sell or give guns to criminals? Uh-huh, it does.
That is a fact of liberty!
Liberty means other people may be able to do something you don't like, if the Constitution protects it. An AR-15 is an "arm." A 30-round magazine is "armament." It may mean a machine gun. Yes... fully-automatic. 100 rounds of ammo is protected. So is 1,000 or 1,000,000.
Getting all freaked out about the inanimate object used to commit a crime is just plain stupid. Freaking out about the type of gun or accessories used to commit a mass murder is like freaking out about cars because of DUIs.
No, it's not an "apples to apples" comparison, buts it requires the same bad logic.
Slander, libel, "fire" in a theater - those present an immediate and obvious threat or harm to another person. Are you in danger the moment someone buys an AR-15 or a 30-round magazine?
The focus should be on people, not on an inanimate object that has no inherent threat potential. A gun is morally neutral. Morally neutral, with maybe a slight leaning towards "good." Why? On its own, whether being carried by someone, sitting in a gun safe or lying on a coffee table, a gun presents no apparent threat. Zero. None!
It is a fact the mere possibility of the presence of a gun deters crime (good) and, yes, will attract some crime (evil).
A gun in the hand of a person bent on evil will be used for evil and a gun in the hand of a good person will be used for good, but the gun itself - the "thing" - has no inherent morality.
When that "thing" is not being actively used, then I believe the balance of "good" vs. "evil" tips towards the "good." How many lives have not been lost because a gun may or may not have been in a home? Our society is done more good by the mere possibility of a gun in a home or a restaurant or a theater than it is done harm when a criminal or a psycho decides this is the day he doesn't care who gets in their way.
So, how does this address this issue of school shootings or mass shootings, etc? It doesn't. It simply explains that enhanced gun laws are not the answer and, therefore, a different approach needs to be sought.
James Smith,


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on January 3, 2013 - 12:02 PM
A band of moderate to heavy snow is expected to start falling during tonight's rush hour and could cause slick and otherwise difficult driving conditions.
The National Weather Service issued a "special weather statement" late Thursday morning to warn motorists about the system headed this way. Counties affected include Erie, Niagara and Genesee.
Snow could come down at a rate of an inch or more per hour between 4 p.m. and 7 p.m., said meteorologist Jim Mitchell. Winds will also gust at about 30 mph.
While the system won't bring large amounts of snow, the "snow bursts" could reduce visibility on roads to less than 1/4 mile and make roads slippery, Mitchell said.
"It's more the timing," Mitchell said, explaining that the snow's arrival during rush hour might cause more problems than its quantity. He pointed out that the snow won't be heavy enough to warrant a storm advisory.
A little more snow is expected to fall overnight, perhaps an inch.
Friday is expected to be windy, with gusts in the 45-mph range.