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What is Hypothyroidism?
Hypothyroidism, also called underactive thyroid, is a condition in which the thyroid gland does not produce enough hormones. Hypothyroidism can be caused by the autoimmune disorder Hashimoto's thyroiditis, irradiation or surgical removal of the thyroid gland, and medications that reduce thyroid hormone levels. Anyone can develop hypothyroidism, but people who are most at risk include those who are over age 50 and female. However, only a small percentage of people have full-blown (overt) hypothyroidism. Many more have mildly underactive thyroid glands (subclinical hypothyroidism).
Symptoms of hypothyroidism include:
Diagnosis and Treatment
Hypothyroidism can cause serious complications if left untreated. Fortunately, it can be easily diagnosed with blood tests that measure levels of thyroid-stimulating hormone (TSH) and the thyroid hormone thyroxine (T4). Your doctor may also want to test for antithyroid antibodies and check your cholesterol levels. Based on these test results, the doctor will decide whether to prescribe medication or simply have you get lab tests every 6 - 12 months.
The standard drug treatment for hypothyroidism is a daily dose of a synthetic thyroid hormone called levothyroxine. This drug helps normalize blood levels of T4, TSH, and a third hormone called triiodothyronine (T3). Many prescription medications can interact with levothyroxine and either increase or decrease its potency. (Make sure your doctor knows all medications you are taking.) Large amounts of dietary fiber can also interfere with levothyroxine treatment. People who eat high-fiber diets may need higher doses of the drug.
The thyroid is a small, butterfly-shaped gland located in the front of the neck that produces hormones, notably thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes in every part of the body. These thyroid hormones have a major impact on the following functions:
These hormones can also alter the actions of other hormones and drugs.
The regulation of thyroid function is a complex process. It involves four hormones and iodine.
Iodine.Iodine is the material used to make the hormone thyroxine (T4). Eighty percent of the body's iodine supply is stored in the thyroid.
Thyroid Hormones. Four hormones are critical in the regulation of thyroid function:
Hypothyroidism occurs when thyroxine (T4) levels drop so low that body processes begin to slow down. Hypothyroidism was first diagnosed in the late nineteenth century when doctors observed that surgical removal of the thyroid gland resulted in the swelling of the hands, face, feet, and tissues around the eyes. They named this syndrome myxedema and correctly concluded that it was due to the absence of thyroid hormones, which are normally produced by the thyroid gland. Hypothyroidism is usually progressive and irreversible. Treatment, however, is nearly always completely successful and allows a patient to live a fully normal life.
Hypothyroidism is separated into either overt or subclinical disease. That diagnosis is determined on the basis of the TSH laboratory blood tests.
Subclinical, or mild, hypothyroidism (mildly underactive thyroid), also called early-stage hypothyroidism, is a condition in which thyrotropin (TSH) levels have started to increase in response to an early decline in T4 levels in the thyroid. However, blood tests for T4 are still normal. The patient may have mild symptoms (usually slight fatigue) or none at all. Mildly underactive thyroid is very common (affecting about 10 million Americans) and is a topic of considerable debate among doctors because it is not clear how to manage this condition.
Mildly underactive thyroid does not progress to the full-blown disorder in most people. Each year, only about 2 - 5% of people with subclinical thyroid go on to develop overt hypothyroidism. Other factors associated with a higher risk of developing clinical hypothyroidism include being an older woman (up to 20% of women over age 60 have subclinical hypothyroidism), having a goiter (enlarged thyroid gland) or high levels of thyroid antibodies, or having immune factors that suggest an autoimmune condition.
Many permanent or temporary conditions can reduce thyroid hormone secretion and cause hypothyroidism. About 95% of hypothyroidism cases occur from problems that start in the thyroid gland. In such cases, the disorder is called primary hypothyroidism. (Secondary hypothyroidism is caused by disorders of the pituitary gland. Tertiary hypothyroidism is caused by disorders of the hypothalamus.)
The two most common causes of primary hypothyroidism are:
Hashimoto's thyroiditis, atrophic thyroiditis, and postpartum thyroiditis are all autoimmune diseases of the thyroid. An autoimmune disease occurs when the immune system mistakenly attacks the body's own healthy cells. In the case of autoimmune thyroiditis, a common form of primary hypothyroid disease, the cells under attack are in the thyroid gland and include, in particular, a thyroid protein called thyroid peroxidase. The autoimmune disease process results in the destruction of thyroid cells.
Hashimoto's Thyroiditis. The most common form of hypothyroidism is Hashimoto's thyroiditis, a genetic disease named after the Japanese doctor who first described thyroid inflammation (swelling of the thyroid gland). Women are about 7 times more likely than men to develop this disease.
An enlargement of the thyroid gland, called a goiter, is almost always present and may appear as a cyst-like or fibrous growth in the neck. Hashimoto's thyroiditis is permanent and requires lifelong treatment. Both genetic and environmental factors appear to play a role in its development.
The other main type of autoimmune thyroid disease is Graves' disease, which causes hyperthyroidism (overactive thyroid).
Atrophic Thyroiditis. Atrophic thyroiditis is similar to Hashimoto's thyroiditis, except a goiter is not present.
Riedel's Thyroiditis. Riedel's thyroiditis is a rare autoimmune disorder, in which scar tissue progresses in the thyroid until it produces a hard stony mass that suggests cancer. Hypothyroidism develops as the scar tissue replaces healthy tissue. Surgery is usually required, although early stages may be treated with corticosteroids or other immunosuppressive drugs.
Autoimmune Thyroiditis Due to Pregnancy. Hypothyroidism may also occur in women who develop antibodies to their own thyroid during pregnancy, causing an inflammation of the thyroid after delivery.
Subacute thyroiditis is a temporary condition that passes through three phases: hyperthyroidism, hypothyroidism, and a return to normal thyroid levels. Patients may have symptoms of both hyperthyroidism and hypothyroidism (such as rapid heartbeat, nervousness, and weight loss), and they can feel extremely sick. Symptoms last about 6 - 8 weeks and then resolve in most patients, although each form carries some risk for becoming chronic.
The three forms of subacute thyroiditis follow a similar course.
Painless Postpartum Subacute Thyroiditis. Postpartum thyroiditis is an autoimmune condition that occurs in up to 10% of pregnant women and tends to develop between 4 - 12 months after delivery. In most cases, a woman develops a small, painless goiter. It is generally self-limiting and requires no therapy unless the hypothyroid phase is prolonged. If so, therapy may be thyroxine replacement for a few months. A doctor will also prescribe a beta-blocker drug if the hyperthyroid phase needs treatment. About 20% of women with this condition go on to develop permanent hypothyroidism.
Painless Sporadic, or Silent, Thyroiditis. This painless condition is very similar to postpartum thyroiditis except it can occur in both men and women and at any age. About 20% of patients with silent thyroiditis may develop chronic hypothyroidism. Treatment considerations are the same as for postpartum subacute thyroiditis.
Painful, or Granulomatous, Thyroiditis. Subacute granulomatous thyroiditis, also called de Quervain's disease, comes on suddenly with flu-like symptoms and severe neck pain and swelling. It is thought to be caused by a viral infection and generally occurs in the summer. It is 3 - 5 times more common in women than men. It recurs in about 2% of patients. Hypothyroidism persists in about 5% of patients. Treatments typically include pain relievers and, in severe cases, corticosteroids or beta blockers.
Up to half or more of patients who receive radioactive iodine treatments for an overactive thyroid develop permanent hypothyroidism within a year of therapy. This is the standard treatment for Graves' disease, which is the most common form of hyperthyroidism, a condition caused by excessive secretion of thyroid hormones.
By the end of 5 years, many treated patients develop hypothyroidism. Such patients need to take thyroid hormones for the rest of their lives. Other forms of treatment for overactive thyroid glands using either antithyroid drugs or surgery may also result in hypothyroidism.
Too much or too little iodine can cause hypothyroidism. If there is a deficiency of iodine, the body cannot manufacture thyroxine. Millions of people around the world have hypothyroidism because of insufficient iodine in their diets. Too much iodine is a signal to inhibit the conversion process of thyroxine to T3. The end result in both cases is inadequate production of thyroid hormones. Some evidence suggests that excess iodine may trigger the process leading to Hashimoto's thyroiditis.
Patients who have complete removal (total thyroidectomy) of the thyroid gland to treat thyroid cancer need lifetime treatment with thyroid hormone. Removing one of the two lobes of the thyroid gland (hemithyroidectomy), usually because of benign growths on the thyroid gland, rarely produces hypothyroidism. The remaining thyroid lobe will generally grow so that it can produce sufficient amounts of thyroid hormone for normal function. However, to prevent the formation of additional nodules, many doctors recommend thyroid hormone treatment.
Patients with Graves' disease who have surgery to remove most of both thyroid lobes (subtotal thyroidectomy) may develop hypothyroidism. It is important to find an experienced surgeon for this procedure and to have the thyroid checked at 6- or 12-month intervals.
Lithium. Lithium, a drug used to treat bipolar disorder, has multiple effects on thyroid hormone synthesis and secretion. Many patients treated with lithium go on to develop hypothyroidism and some develop a goiter. Most patients develop subclinical hypothyroidism, but a small percentage experience overt hypothyroidism.
Amiodarone. The drug amiodarone (Cordarone, generic), which is used to treat abnormal heart rhythms, contains high levels of iodine and can induce hyper- or hypothyroidism, particularly in patients with existing thyroid problems.
Other Drugs. Drugs used for treating epilepsy, such as phenytoin and carbamazepine, can reduce thyroid levels. Interferons and interleukins, which are used to treat hepatitis, multiple sclerosis, and other conditions, can induce either hypothyroidism or hyperthyroidism. Some drugs used in cancer chemotherapy, such as sunitinib (Sunent) or imatinib (Gleevec), can also cause or worsen hypothyroidism.
Radiation Therapy. High-dose radiation for cancers of the head or neck and for Hodgkin's disease can cause hypothyroidism up to 10 years after treatment.
Several medical conditions involve the thyroid and can change the normal gland tissue so that it no longer produces enough thyroid hormone. Examples include hemochromatosis, scleroderma, and amyloidosis.
In rare instances, usually due to a tumor, the pituitary gland will fail to produce thyrotropin (TSH), the hormone that stimulates the thyroid to produce its hormones. In such cases, the thyroid gland shrinks. When this happens, secondary hypothyroidism occurs.
Hypothyroidism in newborns (known as congenital hypothyroidism) occurs in one in every 3,000 - 4,000 births, making it the most common hormonal disorder in infants. It usually persists throughout life.
Permanent Congenital Hypothyroidism. In most cases of permanent congenital hypothyroidism, the thyroid gland is missing, underdeveloped, or not properly located. In other cases, hormone production is impaired or the pituitary or hypothalamus glands function abnormally. Genetic abnormalities may be a factor in congenital hypothyroidism, but in many cases the cause is unknown.
Temporary Hypothyroidism in Infants. Temporary hypothyroidism can also occur in infants. Possible causes include various immunologic, environmental, and genetic factors, including those in the mother:
Children with temporary congenital hypothyroidism should be followed up regularly during adolescence and adulthood for possible thyroid problems. The risk for future thyroid problems is highest when girls born with this condition reach adulthood and become pregnant.
Many people have some degree of thyroid disease, mostly subclinical hypothyroidism (mildly underactive thyroid). Only a small percentage has full-blown (overt) clinical hypothyroidism.
Women are much more likely than men to develop hypothyroidism. While hypothyroidism most often occurs in middle-aged and older women, it is also common during pregnancy.
Pregnancy affects the thyroid in a number of ways. The thyroid gland may increase in size and changes in reproductive hormones can cause changes in thyroid hormone levels. Pregnancy also boosts iodine requirements in both both the mother and the fetus. In addition, some women develop antibodies to their own thyroid during pregnancy, which causes postpartum subacute thyroiditis and can increase the risk of developing permanent hypothyroidism.
The risk for hypothyroidism is greatest after age 50 and increases with age. However, hypothyroidism can affect people of all ages.
Genetics plays a role in many cases of underactive and overactive thyroid. Many people with hypothyroidism have a family history of thyroid problems, particularly Hashimoto's thyroiditis. .
Smoking affects thyroid function and significantly increases risk for thyroid disease, particularly autoimmune Hashimoto's thyroiditis and postpartum thyroiditis. Smoking also increases hypothyroidism's negative effects on the arteries and heart.
People with certain medical conditions have a higher risk for hypothyroidism. These conditions include:
Symptoms of hypothyroidism tend to develop slowly over a long period of time and vary widely from patient to patient.
Early Symptoms. Common early symptoms of hypothyroidism may include::
Later Symptoms. Symptoms of severe, untreated hypothyroidism may include:
In the U.S., nearly all babies are screened for hypothyroidism in order to prevent cognitive developmental problems that can occur if treatment is delayed. Symptoms of hypothyroidism in children vary depending on when the problem first develops.
Hypothyroidism increases the risk for physical and mental problems.
Myxedema Coma. Myxedema coma is a rare, life-threatening complication of untreated hypothyroidism. Symptoms include a severe drop in body temperature (hypothermia), delirium, reduced lung function, slow heart rate, constipation, urine retention, seizures, stupor, fluid build-up, and finally coma. It is uncommon but may develop in untreated patients subjected to severe stress, such as those with infection or an extreme cold, or after surgery. Certain drugs (such as sedatives, painkillers, narcotics, amiodarone, and lithium) may increase the risk. Emergency treatment is required.
Suppurative Thyroiditis. Suppurative thyroiditis is a life-threatening infection of the thyroid gland. It is very rare, since the thyroid is normally resistant to infection. People with pre-existing thyroid diseases, such as Hashimoto's thyroiditis, however, may be at higher than average risk for suppurative thyroiditis. It often begins with an upper respiratory infection. Symptoms include fever, neck pain, rash, and difficulty swallowing and speaking. Immediate treatment is required.
Thyroid hormones, particularly triiodothyronine (T3), affect the heart directly and indirectly. They are closely linked with heart rate and heart output. T3 provides particular benefits by relaxing the smooth muscles of blood vessels. This helps keep the blood vessels open so that blood flows smoothly through them.
Hypothyroidism is associated with:
The evidence for subclinical hypothyroidism's effects on heart disease is mixed. Some studies, but not all, indicate that subclinical hypothyroidism increases the risks for coronary artery disease and heart failure. However, many doctors believe that treatment of subclinical hypothyroidism will not help prevent or improve heart problems.
Depression. Depression is common in hypothyroidism and can be severe. Hypothyroidism should be considered as a possible cause of any chronic depression, particularly in older women.
Mental and Behavioral Impairment. Untreated hypothyroidism can, over time, cause mental and behavioral impairment and, eventually, even dementia (memory loss). Whether treatment can completely reverse problems in memory and concentration is uncertain, although many doctors believe that only mental impairment in hypothyroidism that occurs at birth is permanent.
The following medical conditions have also been associated with hypothyroidism. Often the causal relationship is not clear in such cases:
Hypothryoidism can interfere with fertility and increase the risk for miscarriage and preterm births. Many women with overt hypothyroidism have menstrual cycle abnormalities and some fail to ovulate. In women who do become pregnant, overt hypothyroidism can affect normal fetal development.
Women who have a history of miscarriages often have antithyroid antibodies during early pregnancy and are at risk for developing autoimmune thyroiditis over time. Postpartum thyroiditis is a specific type of autoimmune thryoditis that develops within the first year following delivery. It can overactive thyroid (thyrotoxicosis) followed by underactive thyrpid (hypothyroidism).
Children of Untreated Mothers. Children born to untreated pregnant women with hypothyroidism are at risk for impaired mental performance, including attention problems and verbal impairment.
Effects of Hypothyroidism During Infancy. Transient hypothyroidism is common among premature infants. Although temporary, severe cases can cause difficulties in neurologic and mental development.
Infants born with permanent congenital (inborn) hypothyroidism need to receive treatment as soon as possible after birth to prevent intellectual disability, stunted growth, and other aspects of abnormal development (a syndrome referred to as cretinism). An early start of lifelong treatment avoids or minimizes this damage. Even with early treatment, mild problems in memory, attention, and mental processing may persist into adolescence and adulthood.
Effects of Childhood-Onset Hypothyroidism. If hypothyroidism develops in children older than 2 years, intellectual disability is not a danger, but physical growth may be slowed and new teeth delayed. If treatment is delayed, adult growth could be affected. Even with treatment, some children with severe hypothyroidism may have attention problems and hyperactivity.
Doctors diagnose hypothyroidism after completing a medical history and physical exam of the patient and performing laboratory tests on the patient's blood. The standard test for diagnosing hypothyroidism is to measure blood levels of thyroid stimulating hormone (TSH). Based on the results of the TSH test, your doctor may order additional thyroid tests. .
The doctor will check your neck for signs of an enlarged thyroid (goiter), which may be a sign of Hashimoto's thyroiditis. The doctor will also check your heart, eyes, hair, skin, and reflexes for signs of hypothyroidism.
In diagnosing hypothyroidism, blood tests measuring thyroid hormone levels are needed to make a correct diagnosis. In some cases, antibody tests are also helpful.
TSH (Thyroid-Stimulating Hormone). Measuring TSH is the most important indicator of hypothyroidism. However, certain medical conditions, such as pregnancy, can affect thyroid levels. In general, TSH results indicate the following:
Thyroxine (T4). If TSH levels appear abnormal, your doctor may order a free T4 test. Low levels of T4 suggest hypothyroidism. A high TSH level and a low T4 level confirm a diagnosis of primary hypothyroidism.
Much less commonly, patients will have normal TSH levels but low T4 levels. This combination suggests secondary hypothyroidism, a condition where thyroid function is impaired due to problems in the pituitary gland.
Antithyroid Antibodies. A test for anti-thyroid antibodies may be ordered if your doctor suspects your hypothyroidism is due to the autoimmune condition Hashimoto's thyroiditis. (Swelling in the neck may be a sign of this condition.) This test usually checks for thyroid peroxidase (TPO) antibody. An alternate test checks for thyroglobulin antibodies. High levels of these substances indicate that the immune system is making antibodies that are attacking the thyroid and interfering with its function. If your test results show high levels of anti-thyroid antibodies, but your TSH and T4 levels are within normal limits, your doctor will probably delay treatment until your thyroid function levels become underactive.
Other Blood Tests. Because hypothyroidism can affect the heart, your doctor may order tests to check your cholesterol and creatine kinase levels.
Ultrasound.An ultrasound test uses sound waves to visualize the thyroid gland. It can evaluate swelling in the the thyroid and show if thyroid nodules (lumps) are solid, filled with fluid, or have signs of cancer. Thyroid nodules are very common and are usually benign. The ultrasound and other imaging tests do not measure thyroid function.
More Advanced Imaging Tests. Other tests used for visualizing the thyroid gland include computed tomography (CT) scans or magnetic resonance imaging (MRI).
Radioactive Iodine Uptake Test (RAIU Test). The thyroid uptake test is a nuclear medicine test that uses a radioactive iodine tracer. The patient drinks a liquid or capsule containing the iodine. A special gamma probe isplaced on the neck to measure how much of the tracer the thyroid absorbs from the blood. A low uptake indicates hypothyroidism.
Thyroid Scan (Scintigraphy). Thyroid scintigraphy, or scan, is another nuclear medicine test. It provides pictures that help the doctor evaluate the structure and function of the thyroid gland. This procedure also uses the radioactive iodine tracer. A special gamma camera then takes images of the thyroid. Thyroid scans may be performed to evaluate a goiter (swollen thyroid) or thyroid nodules. They can help identify areas of the gland that may have cancer.
Needle aspiration biopsy is used to obtain thyroid cells for microscopic evaluation. It may be useful to rule out thyroid cancer in patients with thyroid nodules, abnormal findings on a thyroid scan or ultrasound, or those who have a goiter that is large or feels unusual on physical exam. Much like drawing blood, the doctor injects a small needle into the thyroid gland and draws cells from the gland into a syringe. The cells are put onto a slide, stained, and examined under a microscope.
Professional organizations differ widely on hypothryoidism screening recommendations. Most do not recommend widespread routine screening for healthy adults.
For organizations that do recommend screening, the American College of Physicians recommends that women over 50 years old be screened for thyroid disorders every 5 years. The American Academy of Family Physicians believes that adults do not have to be screened until they are over 60. The American Thyroid Association recommends that all adults begin their screening at age 35 and every 5 years thereafter.
Screening in Pregnant Women. Current guidelines recommend targeting screening of women before or during pregnancy based on symptoms or medical history. Factors that indicate screening include:
Women with these factors should have their thyroid checked before pregnancy, or within the first weeks of pregnancy, and should be retested during each trimester.
Screening in Infants. In the U.S., most newborns are routinely screened for hypothyroidism using a thyroid blood test.
Hypothyroidism can mimic other medical conditions.
Age-Related Disorders. Some symptoms of hypothyroidism and aging are very similar. Menopausal symptoms often resemble hypothyroidism. Many other problems related to aging -- such as vitamin deficiencies, Parkinson's and Alzheimer's diseases, and arthritis -- also have characteristics that can mimic hypothyroidism.
Depression. Drowsiness, fatigue, and difficulty concentrating are signs of clinical depression as well as hypothyroidism. The two disorders often coexist, particularly in older women, so diagnosing one does not rule out the presence of the other.
Diseases of Muscles and Joints. Joint and muscle aches may be initial symptoms of hypothyroidism. Most likely, however, such pain is not caused by hypothyroidism if other thyroid symptoms remain absent. Numerous conditions can cause muscle and joint pain, and if thyroid levels are normal the doctor should look for other causes.
Hypothyroidism cannot be cured but the condition can be controlled by taking daily synthetic thyroxine (T4) medication, usually for life.
Treating Overt Hypothyroidism. In general, doctors prescribe thyroid medication for patients who have TSH levels above 10 mU/L. The exact dosage depends on many factors including:
Treating Subclinical Hypothyroidism. Considerable debate exists about whether to treat patients with subclinical hypothyroidism (slightly higher than normal TSH levels, normal T4 levels, and no obvious symptoms). In general, current evidence does not support treating most patients in this group.
Doctors who recommend against treatment argue that thyroid levels can vary widely, and subclinical hypothyroidism may not persist. In such cases, overtreatment leading to hyperthyroidism is a real risk. Most professional organizations recommend against treating subclinical hypothyroidism and suggest monitoring patients for changes in thyroid levels that would warrant treatment.
Your doctor may recommend treating subclinical hypothyroidism in the presence of other factors, including:
Treating the Elderly and Patients with Heart Disease. Thyroid dysfunction is common in elderly patients, with most having subclinical hypothyroidism. There is no evidence that this condition poses any great harm in this population, and most doctors recommend treating only high-risk patients. Elderly patients, particularly people with heart conditions, usually start with very low doses of thyroid replacement, since thyroid hormone may cause angina or even a heart attack. Patients who have heart disease must take lower-than-average maintenance doses.
Treating Newborns and Infants with Hypothyroidism. Babies born with hypothyroidism (congenital hypothyroidism) should be treated with levothyroxine (T4) as soon as possible to prevent complications. Early treatment can help improve cognitive and other developmental factors. However, even with early treatment, mild problems in mental functioning may last into adulthood. In general, children born with milder forms of hypothyroidism will fare better than those who have more severe forms.
Oral levothyroxine (T4) can usually restore normal thyroid hormone levels within 1 - 2 weeks. It is critical that normal levels are achieved within a 2-week period. If thyroid function is not normalized within 2 weeks, it can pose greater risks for developmental problems. Infants should continue to be monitored closely to be sure that thyroxine levels remain as consistently close to normal as possible. These children need to continue lifelong thyroid hormone treatments.
Treatment During Pregnancy and for Postpartum Thyroiditis. Women who have hypothyroidism before becoming pregnant may need to increase their dose of levothyroxine during pregnancy. Women who are first diagnosed with overt hypothyroidism during pregnancy should be treated immediately, with quick acceleration to therapeutic levels. Although not well proven, doctors often recommend treating patients diagnosed with subclinical hypothyroidism while pregnant.
Women with subclinical hypothyroidism who are not treated should be evaluated throughout the pregnancy to see if they progress to overt hypothyroidism. There are no risks to the developing baby when the pregnant woman takes appropriate doses of thyroid hormones. The pregnant woman with hypothyroidism should be monitored regularly (thyroid tests every 4 weeks during the first half of pregnancy) and medication doses adjusted as necessary. If postpartum thyroiditis develops after delivery, any thyroid medication should be reduced or temporarily stopped during this period.
Women who are considering becoming pregnant should be sure to take a prenatal multivitamin that contains 150 - 200 micrograms of iodine in the form of potassium iodide or iodate. (Not all prenatal vitamins contain this recommended amount, so be sure to check the label.) Women who are pregnant should also take a multivitamin containing 150 - 200 micrograms of iodine. Breastfeeding women need to maintain a daily intake of 250 micrograms of iodine to ensure that their infants are provided with 100 micrograms of iodine a day.
Treatment of Hypothyroidism and Iodine Deficiency. People who are iodine deficient may be able to be treated for hypothyroidism simply by using iodized salt. In addition to iodized salt, seafood is a good source. Except for plants grown in iodine-rich soil, most other foods do not contain iodine. The current RDA for iodine is 150 micrograms for both men and women, with an upper limit of 1,100 micrograms to avoid thyroid injury. Some, but not all, brands of multivitamin supplements contain the RDA of iodine.
The goal of thyroid drug therapy is to provide the body with replacement thyroid hormone when the gland is not able to produce enough itself.
A synthetic thyroid hormone called levothyroxine is the treatment of choice for hypothyroidism. This drug is a synthetic derivative of T4 (thyroxine), and it normalizes blood levels of TSH, T4, and T3.
Brand Names. A number of levothyroxine brands are available. Synthroid is the oldest brand and has been used for over 40 years. In the past, manufacturers of levothyroxine did not need to meet as strict standards as in the production of other drugs. This resulted in thyroid products with varying quality. The FDA has issued stronger requirements that have largely corrected this problem.
Generics versus Brand-Name Products. Generic brands are available and are subject to the same FDA guidelines as brand-name products. There is still debate over whether generic thyroid preparations are as effective as brand products.
Any change, such as being switched between brand-name and generic or between two different generics, requires additional testing of thyroid hormone levels. Many doctors still prefer to use brand-name products, noting that the cost difference between brand and generic thyroid drugs is not substantial. Regardless of which type is used, once a patient is stable, doctors generally recommend sticking with one type or brand since potency often varies from one drug to the next.
Natural Thyroid Hormone. Dried powdered thyroid hormone (such as Armour Thyroid, S-P-T, Thyrar, and Thyroid Strong) is made from animal glands. It was once the most common form of thyroid therapy, but it is no longer generally recommended because potency varies. Some people argue that, with stricter FDA regulations, this natural form is better controlled and may even reduce the risk of developing autoimmunity factors. Dried thyroid also contains both T3 and T4 and is favored as a natural treatment by many alternative practitioners. However, studies need to be conducted to evaluate its benefits.
T3 and T4 Combinations. Triiodothyronine (T3), the other important thyroid hormone, is not ordinarily prescribed except under special circumstances. Most patients respond well to thyroxine (T4) alone, which is converted in the body into T3. In addition, the use of T3 may cause disturbances in heart rhythms. Some patients treated only with thyroxine continue to have mood and memory problems or other symptoms.
Combination products containing T4 and T3, such as liotrix (Thyrolar), are available, but there is controversy concerning their benefits. Several recent studies report that T3 and T4 together do not work better than T4 alone. It does not appear that combination products offer any advantage for normalizing TSH levels.
Levothyroxine needs to be taken only once a day. It is slowly assimilated by body organs, so it usually takes up to 6 weeks before symptoms improve in adults. Nevertheless, many patients feel better after 2 - 3 weeks of treatment. The speed at which specific symptoms improve varies:
Levothyroxine can help reduce blood pressure in hypothyroid patients with hypertension, although blood pressure medications may still be needed.
Appropriate Dosage Levels. Initial dosage levels are determined on an individual basis and can vary widely, depending on a person's age, medical condition, other drugs they are taking, and, in women, whether or not they are pregnant. For example, pregnant women with hypothyroidism may need higher than normal doses.
Daily Regimen. Because thyroid replacement is usually lifelong, setting up a regular daily routine is helpful. Here are some tips to remember:
Annual Evaluation. Many factors can cause changes that require modifying the thyroxine dosages. A dose that is appropriate for one year may be too low the next. To maintain normal thyroid levels, some patients may need to take gradually increasing doses of thyroid hormone every year or two. Doctors recommend that patients be reevaluated 6 months after normal TSH levels have been reached and then once a year thereafter.
Specific factors, such as changes in health or diet, new medications for other conditions, or simply switching brands, can also cause changes in thyroid hormone levels that require different doses. If patients change dose levels or thyroxine brands, they should be checked again at least 6 weeks later.
Because levothyroxine is identical to the thyroxine the body manufactures, side effects are rare. Over- or under-dosing, however, is fairly common, although rarely serious in the short term.
Symptoms of under-dosing include:
Symptoms of over-dosing include:
Side Effects of Overdosing. Overdosing can cause symptoms of hyperthyroidism. A patient with too much thyroid hormone in the blood is at an increased risk for abnormal heart rhythms, rapid heartbeat, heart failure, and possibly a heart attack if the patient has underlying heart disease. Excess thyroid hormone is particularly dangerous in newborns, and their drug levels must be carefully monitored to avoid brain damage.
Drug Interactions with Levothyroxine. Many drugs interact with levothyroxine and may either enhance or interfere with its absorption. These drugs include:
Large amounts of dietary fiber may also reduce the drug's effectiveness. People whose diets are consistently high in fiber may need larger doses of the drug. Since thyroid hormones regulate the metabolism and can affect the actions of a number of medications, dosages may also need to be adjusted if a patient is being treated for other conditions. Even changing thyroxine brands can have an effect.
Thyroid replacement hormone is sometimes prescribed inappropriately. It should be used only to treat diagnosed hypothyroidism. In some cases of infertility, women with menstrual problems and repeated miscarriages and men with low sperm counts have been treated with thyroid hormones even when there was no evidence of thyroid abnormalities.
Other inappropriate uses for thyroid hormones are for weight loss and to reduce high cholesterol levels. Thyroid hormones have also been given to treat so-called metabolic insufficiency. Vague symptoms suggesting low metabolism, such as dry skin, fatigue, slight anemia, constipation, depression, and apathy, should not be treated indiscriminately with thyroid hormone. No evidence exists that thyroid therapy is beneficial unless the patient has proven hypothyroidism. Indiscriminate use of thyroid hormones can weaken muscles and, over the long term, negatively affect the heart.
American Academy of Pediatrics, Rose SR; Section on Endocrinology and Committee on Genetics, American Thyroid Association, Brown RS; Public Health Committee, et al. Update of newborn screening and therapy for congenital hypothyroidism. Pediatrics. 2006 Jun;117(6):2290-303.
Brent GA and Davies TF. Hypothyroidism and thyroiditis. In: Melmed S, Polonsky KR, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 13.
Cooper DS, Biondi B. Subclinical thyroid disease. Lancet. 2012 Mar 24;379(9821):1142-54. Epub 2012 Jan 23.
De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012 Aug;97(8):2543-65.
Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: an update. Am Fam Physician. 2012 Aug 1;86(3):244-51.
Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012 Dec;22(12):1200-35. Epub 2012 Nov 6.
Gencer B, Collet TH, Virgini V, Bauer DC, Gussekloo J, Cappola AR, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation. 2012 Aug 28;126(9):1040-9. Epub 2012 Jul 19.
Gyamfi C, Wapner RJ, D'Alton ME. Thyroid dysfunction in pregnancy: the basic science and clinical evidence surrounding the controversy in management. Obstet Gynecol. 2009 Mar;113(3):702-7.
Jones DD, May KE, Geraci SA. Subclinical thyroid disease. Am J Med. 2010 Jun;123(6):502-4.
LeFranchi S. Hypothyroidism. In: Kliegman RM, Stanton BF, St. Geme III JW, et al, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 559.
Tseng FY, Lin WY, Lin CC, Lee LT, Li TC, Sung PK, et al. Subclinical hypothyroidism is associated with increased risk for all-cause and cardiovascular mortality in adults. J Am Coll Cardiol. 2012 Aug 21;60(8):730-7. Epub 2012 Jun 20..
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Work for Adidas AG?Claim Your Profile
adidas AG is a Germany-based producer of sportswear and sports equipment. The Company operates globally. adidas AG offers its products through three main brands. The adidas brand covers footwear, apparel and hardware in two segments: the Sport Performance segment develops modern products, focusing on running, football, basketball, tennis and training, and the Sport Style segment is aimed at fashion-conscious consumers.

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on February 3, 2013 - 12:17 AM
NEW ORLEANS – Tight end Vernon Davis practically revels in his disappearance from the San Francisco passing attack over the last six weeks of the regular season.
Just about the time Colin Kaepernick checked into the 49ers offense as the starting quarterback, Davis checked out. Kaepernick took over with eight games to go. Over the last six games, Davis caught just six passes and had no touchdowns.
No touches? No problem, says Davis.
"The difference between me now and when I first came into the league, was that it was all about me," Davis said this week as he prepared for Super Bowl XLVII. "I came in with the attitude to catch balls and get statistics and things like that. I didn't care about the team. I was about Vernon, always. But now I could care less about catching balls and getting statistics because I understand that the team is much bigger."
For many tight ends, a six-game disappearance would be no big deal. But Davis, a 6-foot-3, 250-pounder in his seventh year, is an athletic freak. Coming out of college, he ran the 40-yard dash in 4.38 seconds. No tight end has run faster over the past 12 years. He broad jumped 10 feet, 8 inches, fourth best among tight ends since 2000.
Davis averaged 67 catches and nine touchdowns over the previous three seasons, and his 13 TD catches in 2009 was an NFL single-season record until New England's Rob Gronkowski broke it last year.
If the lack of use bothered him, he has done a great job of hiding it. Over and over the past two months, Davis has unwaveringly embraced the team approach.
"I didn't see many balls," Davis said. "At first I started to wonder: What's going on? But I read something that said, 'In order to be great you have to be a servant. You have to be a slave,' " Davis said. "It's a way of saying that you have to be humble, and that's something that I've learned here. I meditated on that and continued to do my job. I'm not worried about statistics and things like that."
Davis got the chance to show his true value in the Niners' 28-24 NFC Championship Game victory over Atlanta. He caught five passes for 106 yards and a touchdown.
Davis looms as a huge worry for the Baltimore Ravens' defense in today's game at the Superdome because he is a matchup nightmare in the passing game.
New York Jets coach Rex Ryan this year said of Davis: "The guy runs a 4.3, the best tight end, the No. 1 tight end in football, in my opinion. You got that Gronkowski kid, but this guy is a 4.3 speed guy."
Ryan's ranking may be a stretch. Davis has improved his blocking and is acceptable in that area. But he's not a monster blocker like Gronkowski, who is 6-6 and 268 pounds. (Gronkowski runs a 4.68 40-yard dash.)
Davis' team-first epiphany came during a game on Oct. 26, 2008. After receiving an unsportsmanlike conduct penalty, Davis was banished to the locker room by then Niners head coach Mike Singletary. A Hall-of-Famer and old-school disciplinarian, Singletary had enough of Davis' underachieving.
"I would rather play with 10 people and get penalized all the way, rather than play with 11 when right now that person is not sold out to be a part of this team," Singletary famously railed after the game.
"When Singletary sent me to the locker room, that was a moment right there that changed my whole life around," Davis said. "After the game in the locker room I told Singletary that I wanted to leave. He said, 'OK, you'll leave. We'll get you to another team.' We shed tears. After that my focus went to another level."
The next season, Davis went "supernova," catching 78 passes for 965 yards and 13 TDs.
"I had to figure this thing out," Davis said. "I had to find out who I really was as a player. I think Singletary really helped me channel my emotions."
Davis is a thoughtful guy. He majored in studio art at the University of Maryland and he likes to paint in his spare time. His acrylic on canvas works were on display earlier this year at a San Francisco gallery. He recently opened an interior-design company. He has a foundation that supports art scholarships, a football academy and a halfway house for addicted and abused women.
Davis on painting: "It relaxes my mind and takes me to a whole nother place that I can't go with football. It takes me away when I'm stressed or I have some things I want to get off my mind. I go to the canvas and I paint."
Davis also managed to get himself named as honorary captain of the U.S. curling team for the 2010 Winter Olympics. The connection began when he was asked by a reporter how he might fare sliding a curling stone down the ice. He decided to see for himself and visited a Bay Area curling club. One thing led to another, and Davis paid his own way to Vancouver to offer moral support to the U.S. team.
The team. It has become Davis' mantra.
"Everything that I do, I put my teammates first," Davis said. "To me, that's the mark of a true leader."
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Top Definition
a double cheeseburger from mc donalds that you ask to have with only cheese, lettuce and big mac sauce on it. a big mac for the price of a double cheeseburger.
Bro lets go to mickey d's and get some boogey down big macs, they cost like 2 bucks less than a real big mac.
de John Watson 30 Iunie 2008
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BARDANE - Despite the clouds and wind Wednesday evening, local vendors pulled into The Black Dog Coffee Company in Bardane to unload the fresh goods they had to offer busy commuters on their way home from work.
From hot pepper jelly to fresh pork, the market offered fast ideas with none of the fluff - no music, no social time, just down to business and dinner.
"It's early yet, so we don't have all of the things that we will have," Brian Bircher, owner of The Black Dog Coffee Company said.
Article Photos
Journal photos by Michelle Horst
Inge Ledden of Cottage Herbs shows her variety of products to Brian Bircher of The Black Dog Coffee Company during Wednesday's farmers market in Bardane.
Sister Sue's Famous Jelly lines tables at Wednesday's farmers market in Bardane.
As the season continues, he said more farmers will bring out fruits and vegetables.
As Bircher greeted customers, Shepherd Ogden was busy planting lettuce in the flower beds in front of the vendors, adding a touch of green to the market.
Ogden, agricultural officer for the Jefferson County Development Authority, worked with Bircher and other board members of the Charles Town Farmers Market to develop a faster option for people who are looking for fresh, local food, but are in a hurry to get home.
Inge Ledden of Cottage of Herbs in Shepherdstown set out a variety of herbal teas and dips for passersby to test out. She also had soups and lavender cookies, which she said tasted like shortbread.
"We don't use any salt, sugar or preservatives," Ledden said. "Gluten free and no MSG."
Other vendors, including Good Stuff Breads and Sister Sue's Homemade Jams & Jellies, had tables which quick treats set up.
Raspberry habanero, strawberry kiwi, Mountain Dew and other favors not usually found in jellies, filled the rainbows of colored jars lining Sister Sue's table. Hot pepper jellies from "mild" to "ghost" were marked with 'X' to warn of their level of heat - from one 'X' all the way to five.
Bircher said that although the market is new, many of the products can be found year-round in his coffee shop. He sells all local products, and had a room featuring items from the state which he calls the "West Virginia Room."
Depending on the number of vendors and level of interest, the market hopes to remain open until the Charles Town market closes, which is in October.
Next Wednesday, vendors will again line up outside the coffee from from 4 p.m. until 7 p.m. with their goods.
- Staff writer Michelle Horst can be reached at 304-263-8931, ext. 138, or www.twitter.com/mhorstJN.


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Marchesa Palatial Garden 5-piece Place Setting by Lenox
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The election's over, but there's a lot of work to do. Here's what some Americans on their way to work in the Wall Street area want from President Obama in his second term.
(USA Today) And Wall St. got off to a very down and rocky day. On Wednesday, stocks were trading sharply lower, one day after the re-election of President Obama. In afternoon trading, the Dow Jones industrial average was down about 275 points, or 2.1%.
Investor reaction is decidedly negative over the defeat of the more business-friendly Mitt Romney and the continued gridlock in Congress that makes it tough for lawmakers to avert a fiscal policy crisis by year-end.
The benchmark Dow remains below the psychologically significant 13,000, not seen since Aug. 3. The Standard & Poor's 500 index and Nasdaq composite index were also down 2.1% or more in afternoon trading, with stocks in nearly every industry lower.
Wall Street pros said negative sentiment was amplified Wednesday after European Central Bank President Mario Draghi expressed concerns ahead of the U.S. market open about the outlook for Europe's economies, especially Germany.
Others said much of the sell-off is coming from computerized trading programs, which trigger huge sell-offs of stocks when certain price levels are hit versus investors who are making decisions in the moment based on changes about what they think of the outlook for stocks.
USA Today/Gannett News Service


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In The Dead Celebrity Cookbook, author Frank DeCaro has collected and presented an array of recipes by beloved (and dead) stars – everyone from Arthur to Frank Sinatra to Katharine Hepburn to Lucille Ball.
"I miss those days when celebrities still had mystery about them," DeCaro, formerly the movie critic for The Daily Show with Jon Stewart, says about his decision to write the book. "A glimpse inside their radar ranges seemed, for any fan, like a window into the world of glamour and excitement."
With each recipe, DeCaro provides his commentary as way of an introduction.
For Arthur's chapter called Thank You for Feeding a Friend, which spotlights the actress's vegetarian breakfast recipe, he writes: "Food was always good for a giggle on The Golden Girls, too. Sophia could turn the word cannoli into a sexual double entendre, and Rose's Scandinavian recipes, her geneukenfleuken cake, for instance, were always played for laughs.
Want to try Bea Arthur's dish? Read on to get the recipe:
Frank Decaro
Bea Arthur's Vegetarian Breakfast(Serves 2)
1 tablespoon margarine
2 medium tomatoes, sliced
¾ cup chopped fresh mushrooms
Salt and pepper, to taste
4 slices bread, toasted
Preheat oven to 250.
Melt the margarine in a small sauté pan over medium heat.
Add the tomatoes and mushrooms, and sauté until soft, about 4 minutes.
Season to taste with salt and pepper.
Put some tomato-mushroom mixture on each piece of toast.
Heat in the oven for 2 minutes before serving.


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Source: Ford
quote: however I'm concerned with one fundamental issue which could cause premature engine wear. When I first started learning about cars many moons ago, I learned that 70% of engine wear happens at start-up and that once an engine is operating at its normal temperature, its rate of wear & tear is minimized during steady conditions (such as freeway/highway cruising). Furthermore, I learned that you don't really waste a lot of gas idling at stop unless you're idling for several minutes (and that you idle for maybe 15-20 seconds on an average stop light). Anyone have any thoughts on this?
quote: - And regarding FUD, I'm all for technological advancements but I interpret each and every innovation with a jaundiced eye. Case in point:
quote: @ Boingo Twang - Relax there before you burst a blood vessel; I was honestly asking because you're correct, my archaic vehicle (by your standards) doesn't have a fuel monitoring device. I guess to rephrase my point/question, would you incur more/same/less engine wear & tear if you manually turned off and then manually started up your engine at every stop light?


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The start of 2014 brought a major change in the way most Americans use light bulbs. Incandescent light bulbs, the standard for more than a century, have all but disappeared from store shelves as a result of new efficiency requirements. The 2007 Energy Independence and Security Act required new light bulbs to become about 25 percent more efficient, with the changes gradually taking effect between 2012 and 2014. Since traditional incandescent bulbs can't meet the new standards, they have faded from the scene over the past two years, starting with the 100-watt bulb and ending with the 40-watt bulb. A few types of specialty incandescent bulbs -- such as appliance bulbs, three-way bulbs and bug lights -- remain available, but for the most part the Edison light bulb has gone the way of the dinosaur.
Although old-fashioned incandescent bulbs are off the table, there's no reason to get stuck in the dark. Assuming you use a standard light fixture with a medium-base Edison socket, you now have three basic choices in bulbs. New halogen incandescents are the most similar to the old-fashioned bulb in both shape and light quality. They're essentially just incandescent bulbs with a bit of halogen gas trapped inside, which helps "recycle" the tungsten gas that burns off the filament. These bulbs are efficient enough to meet the new standards, but only just. They also cost significantly more than an old incandescent bulb without lasting significantly longer. If you're looking to save money, consider a more efficient bulb.
Compact fluorescent lamps, or CFLs, have been around for decades, but people disliked their awkward shape, bluish flickering light, delayed startup and high price tag. New CFLs have resolved all of these problems. Costing as little as $2 per bulb, modern CFLs light up instantly, fit virtually anywhere an incandescent bulb can and have no discernible flicker. Soft white CFLs also match the light color of an incandescent extremely well.
However, CFLs still have their limitations. Although they come on right away, they take several seconds or even minutes to come up to full brightness, and most won't work with a dimmer switch. Although CFLs last longer than incandescent bulbs, switching them on and off frequently can greatly shorten their lifespan, so they're not ideal for fixtures that are used for only short periods. Also, CFLs contain a tiny amount of mercury, a hazardous substance. This means they have to be recycled, not just tossed in the trash, and you must take some minor precautions when cleaning up a broken bulb. The U.S. Environmental Protection Agency has more details about disposing of CFLs.
The most efficient light bulbs on the market use light-emitting diodes, or LEDs. LED bulbs use only slightly less energy than CFLs, but their lifespan is significantly longer. Most manufacturers claim their bulbs can run for 25,000 hours -- more than 22 years in a fixture that is used three hours a day -- and switching them off and on doesn't shorten their life. Unlike CFLs, they come on at full brightness right away, and most work with dimmer switches (although not with every dimmer). While LEDs struggle to distribute light evenly in all directions, their biggest drawback is their cost, which ranges from $10 to $40 per bulb. However, LED prices have dropped significantly in the past year and are likely to continue falling as demand ramps up. Even at today's prices, the reduced energy use and long lifespan of these bulbs means they will save money over the long run.
Because new light bulbs produce more light than an incandescent with fewer watts, wattage has become an outdated gauge of brightness. All new bulb packaging includes a "Lighting Facts" panel that displays the actual brightness of the bulb in lumens, a measure of light output. The panel also includes facts about wattage, color temperature, mercury content and the bulb's estimated yearly energy costs. All this makes it easier to compare different types of bulbs directly, rather than trying to relate them to outdated incandescent bulbs.
To select our Best Reviewed light bulbs, we looked at professional comparison tests from sources such as ConsumerReports.org and Good Housekeeping, which measure the light output, durability and efficiency of different bulbs. Then we checked their recommendations against user reviews at retail sites such as HomeDepot.com and BestBuy.com, which provide useful information about real-world performance. Based on all these sources, we identified CFL and LED bulbs that stand out for their light production, lifespan, energy use and price.
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By clicking on Sponsored Links you will leave ConsumerSearch.com. The web site you will go to is not endorsed by ConsumerSearch.


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Penn State York to Honor Athletes April 10
Penn State York will honor its student athletes at the 43nd Annual Athletic Awards Banquet on Thursday, April 10 at 6 p.m. The banquet will take place at Heritage Hills Golf Resort & Conference Center, 2700 Mt. Rose Ave., York, Pa.
Scholar athletes, outstanding players, and a variety of other awards will be presented followed by a dinner. Award recipients and coaches attend the banquet at no charge.
Tickets for the event for guests can be purchased for $10 in the Penn State York Student Affairs Office. For more information please call Chris Beaverson, athletic director, at (717) 505-8949 or email him at email@example.com.
To learn more about Penn State York's athletic programs, visit the website.


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New Hampshire Democratic Party Chair Ray Buckley was re-elected to a third term to lead all other state Democratic chairs in the nation, making him one of the most powerful Democratic Party leaders in the nation.
Buckley, of Manchester, was re-elected as chair of the Association of State Democratic Chairs, at a gathering of members in Washington on Tuesday, a day after President Barack Obama's second inauguration. Being chair of that group automatically makes him a vice chair of the larger Democratic National Committee.
For the most part Buckley's role will be in influencing internal party business. That said, he is in a strong position to defend the state's first-in-the-nation presidential primary spot as the party adopts rules.
Also on Tuesday, Democratic National Committee Chair Debbie Wasserman Schultz was re-elected to another term.


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Top Definition
To perpetually only be in one's boxers, preferably sitting at your desk in a dorm room with the door open while working at your laptop. In some cases, using the elevator wearing nothing but boxers/shorts.
Mostly done by skinny southern boys.
Mostly done by skinny southern boys.
When I walked by the room in the afternoon, he was totally hursting!
Por Elena07 23 de abril de 2009
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AZ Pregame: VIDEO - Tyler Nielsen
Hawkeye Insider Top Stories
Game Balls: Iowa at RutgersHanding out game balls to the top performers of Iowa's 14-7 victory over Rutgers.
Hawkeye InsiderSaturday at 3:33 PM
Iowa 14 Rutgers 7: Derek's TakeawaysIowa escapes Piscataway with a 14-7 win over Rutgers. Derek Young of Hawkeye Insider provides his takeaways.
Hawkeye InsiderSaturday at 12:21 PM
Jaleel Johnson Focused on RutgersIowa defensive tackle Jaleel Johnson directing his focus to Rutgers.
Hawkeye InsiderFriday at 7:32 AM
Boettger on the O-Line StrugglesIowa tackle Ike Boettger addresses the offensive line issues.
Hawkeye InsiderFriday at 4:56 AM
Josey Jewell Looking to Bounce BackIowa linebacker Josey Jewell looking for the Hawkeyes to bounce back against Rutgers.
Hawkeye InsiderThursday at 1:59 PM


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We've taken a handful of NCAA team schools, see how well you know the locations of these teams in our quiz.
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use.blog comments powered by Disqus


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This exclusive offer includes:
This musical adventure offers a live jazz concert, a delicious candlelight dinner with special products from Lazio Region and a tour of the city centre by night, all in a historical cable car, restored and converted in a travelling restaurant. 10% VAT included, City tax excluded.
You Can Choose Between Gourmet italian Gift Box or a Souvenir d'Italie!
Gourmet Italian Gift Box:
Souvenirs d'Italie:
A precious marble small sculpture reproducing one of the famous Roman masterpieces


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Order as many items as you like with our $4.99 flat rate shipping.
This item ships within one business day.
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There is a great force in this universe. One so powerful that it baffles physics and scientists. One that cannot be conveyed in words. A force simply known as Pittsburgh Pirates team spirit. What constitutes such a great force that inspires millions across the globe? One, it has a dominant team of warriors who will stop at nothing to achieve victory; and two, it has legions of die-hard fanatics like you. Show your love for the greatest thing in the universe, the Pirates, in this satin jacket from Starter. Made of glossy satin to make your pride shine, this jacket features a twill throwback Pittsburgh logo embroidered on the front left chest and team-spirited accents. You may just be the #1 Pirates fan out there!
- Imported
- Lining: 100% Polyester
- Locker loop
- Midweight jacket suitable for moderate temperatures
- Officially licensed
- Quality embroidery
- Rib-knit collar, cuffs and waist
- Sewn-on accent stripes
- Shell: 100% Nylon
- Snap-button front
- Tackle twill applique
- Two front pockets
- Two interior slip pockets (one zippered)
- Imported
- Brand: Starter
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Special event items are produced by manufacturers only after the outcome of a game or event. These are advanced sale items and will ship immediately after they are received in our warehouse.
Manufacturer direct items are shipped directly from the manufacturer. These items are not available for international or expedited shipping.
Customized items can be personalized with options such as your name, your favorite number, and/or designs. Some options may be limited by league rules.


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Top Definition
A mixture of diarrhea, and vaginal juice. Tends to occur when a woman wipes her runny fecies downward towards the vaginal area. Thus pushing the diarrhea into the vaginal area. Soon after she spreads her legs it dries into a spicy brown powder resmbling Curry spice.
Oi mate I went down on a whore last night and that cunt had Cunt Curry.
Redd666가 작성 2011년 12월 04일 (일)
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Ever wonder about human behavior and the human mind? The psychology major teaches students about the world around them by focusing on its smallest component -- the individual. By learning the methodology and principles of psychology, students are able to examine the behavior, thought, feelings and interactions of humans.
Psychology, the study of human behavior and the mind, helps students develop skills in critical thinking, research methods, scientific writing, ethical decision-making, oral presentations and socio-cultural awareness. Psychology is a broad field with countless career opportunities. The School of Professional Studies offers the Bachelor of Arts in Psychology with a concentration in Clinical Counseling. This degree will prepare students to enter careers in human or social services and will prepare students for graduate level counseling licensure programs.
Working closely with professors in small class sizes, students are challenged to refine their critical thinking and analytical skills through rigorous coursework. Students learn not just about the inner workings of the brain but also personality, perception, thinking and social interaction. The psychology major at WPU gives students an opportunity to do hands on research and develop a truly unique perspective on society.
Students enrolled in the Psychology program can earn their degree through Saturdays@Peace, online classes or a combination of these formats to create a schedule that works for you.
Each graduate has lifetime access to Career Services at Peace. Our trained advisors work individually with each student and graduate, helping them chart the next step in their professional lives. Nowhere else is our dedication to our outcomes is our results: over 90% of William Peace University graduates go on to graduate school or a job.
With over 150 years of experience in the downtown Raleigh area, William Peace University and its advisors have professional relationships in the Triangle and North Carolina that few can match. Our graduates have gone on to graduate school and careers ranging from counseling to business law to community relations.
At $250 per academic hour, tuition is competitive with any degree program in North Carolina, but offers the experience and credibility that come with a William Peace University education.
To learn more, contact Tonita H. Few at 919.508.2214 or firstname.lastname@example.com.
Tab 2: Requirements
The courses listed below are for the 2012-13 Academic Catalog and are subject to change. Please reference the Academic Catalog for further information and course descriptions. If you are a current student, please reference the catalog in which you come under.
Liberal Education Requirements 49 credit hours
ENG 112 Composition 3
ENG 214 Writing About Studies in Fiction 3
ENG 314 Professional Writing 3
ENG 400-L Senior Writing Lab 1
Empirical Reasoning
STA 201 Statistics 3
Natural Science Elective 4
Social Science Elective 3
Ethical Reasoning
PHL 400 Interdisciplinary Ethics Seminar 3
Critical Thinking about Culture and Society
Religion Elective 3
Critical Thinking Elective 3
Critical Thinking Elective 3
Critical Thinking Elective 3
Critical Thinking Elective 3
Professional Readiness
COM 101 Public Speaking 3
PSS 450 Professional Development Seminar 3
BSA 120 Personal Finance 1
BSA 180 Media Literacy 1
Internship or Upper Level Psychology Elective 3
Psychology Core Courses 34 credit hours
PSY 101 General Psychology 3
PSY 300 Research Methods 4
PSY 470 Senior Seminar 3
Choose one course from three of the four major areas: 9
Cognitive and Biological
Culture and Development
Social, Personality and Applied
Clinical and Abnormal Psychology
Psychology Concentration - Clinical/Counseling
PSY 240 Abnormal Behavior 3
PSY 440 Counseling Theories & Techniques 3
PSY 395 Psychology Research 3
PSY 322 Psychology of Adulthood and Aging 3
PSY 341 Child, Family and Youth Services 3
General Electives 37 credit hours
Total Credit Hours 120 credit hours
Tab 3: Advisory Board
Program Coordinators and the faculty who teach lead all programs of study, here at William Peace University. Additionally, there are Advisory Boards comprised of experts in the business field who serve as advisors to the program, ensuring what is taught in the classroom is what is needed for the careers of tomorrow.
Tab 4: Careers
Our curriculum is outcome focused, preparing students for positions in social work, counseling, psychology as well as other non-major specific careers. WPU psychology majors have also gone onto law school and graduate programs in social work, school counseling and sports psychology.
Psychology majors develop skills such as effectively listening, observing, analyzing and interpreting. They are also taught the importance of ethical practice, showing concern for others and critical and inferential thinking. Graduates go on to various careers in areas such as pharmaceutical sales, social work, life skills training, community relations and clinical psychology.
Recent employment by psychology majors:
Autism Society of North Carolina
Blue Cross Blue Shield
Blue Ridge Center
Brain Injury Association of North Carolina
Cary Family YMCA`
Cary School of Gymnastics
Family Alternatives
Girl Scouts of North Carolina Coastal Pines
Guardian ad Litem, NC
Interact of Wake County
Ligon Middle School
North Carolina Highway Patrol
Person County
Planned Parenthood
Residential Services
Social Security Administration, Disability Determination Services
The Mariposa School
Triangle Family Services
Urban Ministries
Recent graduate school acceptances:
The University of North Carolina at Chapel Hill School of Law, Rehabilitation
North Carolina Central University School of Counseling
The University of North Carolina Wilmington School of Social Work
North Carolina State University School of Counseling
East Carolina University School of Psychology, School Counseling and Social Work
University of Tennessee, Sports Psychology
Case Western Reserve, Social Work


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Sources: The Verge, Engadget, Anandtech
quote: It will take over, because it will run Windows apps. Not only all the apps we've been using for years, but the enterprise apps that are used at work. It will make the tablet a useful device in the office
quote: ARM tablets running Win8 ARM will NOT, repeat NOT run any apps from the x86 world. Microsoft is developing office for arm, but don't think for a moment Win8 ARM = Win8 for x86-64.
quote: Of course you will be able to recompile x86 apps to run on ARM. That's just common sense.


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The rock-solid Pro Guide™ V-175 SC instills confidence by providing maximum stability through all conditions.
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A bow livewell and huge 29-gallon (109.78 L) aft livewell protect your catch while you and your crew decide what hot spot to explore next.
Have a question about the 2012 Tracker Boats Multi-Species Deep V Pro Guide V-175 SC?


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May 29, 2010
May 27, 2010
Cast members, in costume, will perform the pop-hit medley. Surprise "guest performers" are likely to include "Glee" stars Lea Michele and Matthew Morrison (both Broadway babies), Green Day's Billie Joe Armstrong and, possibly, Jon Bon Jovi. Elton John, the producer of the Tony-nominated play "Next Fall," might pop up as well. Tony host Sean Hayes will certainly sing something from "Promises" with his un-nominated co-star, Kristin Chenoweth.
Read more: http://www.nypost.com/p/entertainment/theater/tonys_take_medley_turn_oXJMUzEb3u0S68IvarXZYO?CMP=OTC-rss&FEEDNAME=#ixzz0pGSBlw7S
May 27, 2010
May 26, 2010
Green Day makes the cover of Big Cheese Magazine - Issue 123, follow the link to pre-order your copy today!
May 26, 2010
In partnership with the City of New York, the United States Navy and Fleet Week Committee, The Intrepid Sea, Air & Space Museum will celebrate the 23rd annual Fleet Week, May 26–May 31, 2010. Fleet Week is America's tribute and "thank you" to the men and women who serve in the armed forces.
Most Fleet Week activities will be held at the Intrepid Sea, Air & Space Museum on Pier 86 (46 Street and 12 Avenue, Manhattan). Included in the week's festivities are cast performances by 5 new Broadway shows.


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Watch 1980s video clip of WWUH in the News!
When the University of Hartford was incorporated just over 50 years ago by business and community leaders, they envisioned a center of education and culture for Greater Hartford. At its core, it would be a university for the community created by the community.
The University has come a long way since its humble beginnings on Hartford's last remaining farm, evolving from a local school for commuters into a comprehensive university that attracts students from throughout the world. Yet it remains true to its original mission of serving as a valued resource for individuals, families, businesses, and communities throughout the Hartford region, offering hundreds of programs that serve the University and its neighbors every day. For over 45 years listener supported WWUH has served an important role in the University's community service mission.
Beyond the Classroom - Robert Davis (Part 1)
Join Beyond the Classroom host, David Schonfeld, on Thursday, December 12 from 12 noon to 12:30 p.m (repeated at 7:30 p.m.).
In Program #15, David talks to Robert H. Davis.
Robert H. Davis is Professor of Theater in the Hartt School at the University of Hartford.
In this wide-ranging interview, Bob talks to David about his background in theater and teaching, theater in the Hartford area, Hartford Stage's "A Christmas Carol", Hartt's Partnership in Training with Hartford Stage, dialect coaching, and voice training.
In the next broadcast, Program #16, Bob discusses the differences between stage and film, the Theater program at Hartt, collaborations with other Hartt programs, the art of memorization, breathing for relaxation, and improvisation.
|Originally recorded
|First broadcast


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Wonder Wax - Quick And Less Pain Hair Removal
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Availability: Ships on Oct-13-2016


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Line of Duty Deaths
Line of Duty Deaths"They will be remembered—not for the way they died, but for how they lived."The IACP wishes to acknowledge the following officers, who made the ultimate sacrifice for their communities and the people they served. We extend our prayers and deepest sympathies to their families, friends and colleagues.
From The Police Chief, vol. LXXX, no. 9, September 2013. Copyright held by the International Association of Chiefs of Police, 515 North Washington Street, Alexandria, VA 22314 USA.


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on March 29, 2013 - 8:31 AM
March 20, 1931 – March 27, 2013
Eugene W. Salisbury, of Blasdell, an attorney and village justice who was a mentor and role model for municipal judges across the state, died Wednesday in Sisters Hospital after a short illness. He was 82.
Mr. Salisbury was Blasdell village justice for 50 years and was a leader in judicial organizations locally and statewide.
He was a member of the State Commission on Judicial Conduct, where he was the first judge and first Western New Yorker to serve as chairman.
A lecturer in judicial training programs, he instructed hundreds of judges and in the 1970s wrote two handbooks for the courts, "The Manual of Procedure for Town and Village Courts of New York State" and "Forms for Town and Village Courts, New York State," which he updated annually.
"He is the person in my mind who probably has a better grasp on what it means to be a judge than anyone," Aurora Town Justice Douglas W. Markey said when Mr. Salisbury retired from the bench.
He was a past president of the New York State Magistrate Association and received its Magistrate of the Year Award in 1967. The award was renamed in his honor when he retired in 2001.
Among his many other honors, he was named Jurist of the Year in 2001 by the Erie County Judges and Police Conference and Citizen of the Year by the Western New York Chapter of the Industrial Relations Research Association.
Mr. Salisbury was a police officer in Blasdell for five years before becoming village justice in 1961. He also served as village attorney.
Born in Lackawanna, he was a graduate of Blasdell High School and served in the Army in the Korean War, attaining the rank of first lieutenant. He was awarded the Purple Heart and the Bronze Star.
He graduated cum laude from the University of Buffalo Law School and was managing editor of the Buffalo Law Review. He took part in the honors program at the National Labor Relations Board.
He was a senior partner in one of Buffalo's leading law firms, Lipsitz, Green, Fahringer, Roll, Salisbury & Cambria, specializing in labor law. He joined the firm in 1961 and continued to practice until his death.
He appeared in "Best Lawyers in America," "Who's Who Worldwide," "Who's Who in Business and Finance" and "Who's Who in American Law."
He also was a member of Hamburg Council 2220, Knights of Columbus.
He enjoyed investing in the stock market, physical fitness, world travel and his vacation home on Chautauqua Lake.
Surviving are his wife of 61 years, the former Joanne Weller; three sons, Mark M., David D. and Scott E.; two daughters, Ellen M. Schranz and Susan M. Wanat; and a brother, Donald.
A Mass of Christian Burial will be offered at 9:30 a.m. Monday in Our Mother of Good Counsel Catholic Church, 3688 South Park Ave., Blasdell.


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Sal Pace for Congress
Sal Pace for Congress
Democrat Sal Pace is out with the second television ad of his campaign, a spot featuring his retired father who just moved to Colorado.
�Dad�s a retired auto mechanic living on Social Security, and he just had a heart attack. Without Medicare, he wouldn�t have health care,� Pace says in the ad.
Text on the screen says, �Congressman Scott Tipton voted to raise Medicare premiums by $6,400.�
The ad ends with the words �Real life� and features Pace visiting his dad at home and doing household chores. However, it was not filmed at his dad�s real house.
�The word disingenuous comes to mind when you use a fake house and are doing fake chores in an ad about �real life.� This misdirection is a perfect parallel to Sal�s campaign,� said Tipton�s campaign manager, Michael Fortney, in a news release.
Tipton voted twice to convert Medicare into a voucher program. But independent fact-checking groups such as Politifact and FactCheck.org have called the $6,400 claim outdated and misleading. It�s outdated because it is based on an analysis of a Republican budget from 2011 that since has been replaced by one with fewer cuts to Medicare beneficiaries. And the cuts would not apply to current retirees, such as Pace�s father, but only to people age 55 or younger.
Pace stood by the ad�s assertions.
�People 55 and under are still paying into Medicare after a lifetime of hard work,� Pace said in an interview.


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Wall Street Decline Takes Its Toll...
NSCLC is "Major Battlefield" as Merck,...
LC-MS Gains Favor Due To the...
Expanding Use of NGS Has Largely...
In the development of a new biological product, it is important to remember that a successful R&D development project needs to be converted from a bench-scale concept to a bioproduction platform. This process-development stage requires identifying ways to increase cell numbers in order to meet annual dosage demands, as well as to minimize direct contact with the cell product by developing a closed system for all culture manipulations. Identifying a bench-scale platform that can scale to cGMP production scale eases the scaling process.
Corning Life Sciences first introduced the use of gas-permeable film surfaces for cell culture with the HYPERFlask® Cell Culture Vessel and recently expanded to include the newly developed HYPERStack Vessels. These cell culture vessels simplify the transition from bench to production floor. The HYPERStack™ Vessels have been designed for closed system use to meet the needs of large-scale adherent cell culture.
The gas-permeable technology and product design differs from traditional cell culture products as the cells attach to an ultrathin, gas-permeable polystyrene film, instead of a relatively gas-impermeable, injection-molded polystyrene surface. The gas-permeable film allows for the elimination of the air gap within the flask resulting in an overall reduced vessel height. For optimal cell attachment and growth, the gas-permeable film is Corning CellBIND® Surface treated to create a more hydrophilic, oxygen-rich surface.
In order to optimize cell growth in an aerobic environment, gas exchange between the culture medium and cells needs to be optimized. The gas-permeable film is used to build growth chambers, as depicted in Figure 1, where the gas exchange between the cells and the atmosphere occurs in the tracheal spaces located directly beneath the cell layer. This differs from the traditional culture methods wherein the gas exchange occurs between the media surface and a large air gap above the cultures, such as in a traditional T-flask. The ultrathin gas-permeable film technology ensures not only efficient gas exchange between the medium and the cells but also enables even gas exchange across the entire surface area.
The design also allows for the stacking and manifolding of multiple growth chambers in a compact design. For comparison purposes, a HYPERStack-36 Vessel, which provides 18,000 cm2 growth surface area, requires a similar amount of incubator space as the Corning CellSTACK® 10 layer Culture Chamber, which consists of 6,360 cm2 cell growth surface area. This results in the HYPERStack Vessels having high efficiency with regard to cell growth surface area per unit volume occupied. Additionally, because the dimensions of the HYPERStack Vessels maintain the perimeter footprint of the traditional Corning CellSTACK Culture Chambers, these vessels are compatible with existing automation equipment.
In order to scale up production without significantly increasing cost, ideally there is no requirement to significantly add equipment or space to the production area (i.e., incubators, cleanroom space). The data in Figure 2 demonstrates that the product output from HYPERStack Vessels is approximately three times higher when compared to vessels that utilize traditional multilayered flask technology while occupying the same space in the incubator or warm room.
MDBK cell growth in the traditional two-layer multilayered vessel was compared to growth in the HYPERStack-12 Vessel (Figure 2A). CHO-K1 and Mesenchymal Stem Cells (MSC) were cultured in either the HYPERStack-36 Vessel or traditional 10-layer vessels and total cell yield compared (Figure 2B and 2C, respectively). This is significant for large-scale manufacturing, as the end result is an increase in the product throughput per manufacturing area, thereby controlling costs.
Another key feature incorporated into this vessel design making the scaling to production level easier, is the use of BSE/TSE-compliant C-Flex tubing for liquid manipulations. All liquid transfer is conducted through the liquid-handling tubing connected to one manifold while air escape and entry occurs through the other manifold. (Figure 1). For closed systems, addition and removal of fluids occurs between the HYPERStack Vessel tubing set and various auxiliary vessels, such as media bags, tube welding, or the use of aseptic connectors.
Working with an optimized set of flexible bioprocess containers, such as TheraPEAK™ bioprocess containers by Lonza, a product expansion project can be conducted from vessel seeding through culture expansion and harvest in a completely closed system. Utilizing a closed system not only greatly reduces the risk of culture loss due to contamination, but makes the process more suitable for cGMP manufacturing.
The Lonza Walkersville cell therapy development team has developed closed systems allowing up to 70 vessels to be handled in a single harvest, yielding 10 billion cells or greater harvests for many cell types.
The HYPERStack cell culture vessel family has been developed as a modular system, with the HYPERStack-12 as the single module. These modules can be stacked, allowing the process to be scaled as required for the manufacturing facility and the annual dosage requirements of the product. Currently, the HYPERStack-12 and HYPERStack-36 Vessels are available, and the HYPERStack-120 Vessels are expected to be available by the end of 2011.
The modularity and stacking ability of the HYPERStack Vessel allows process-development departments the option of increasing the lot size by using either multiple smaller HYPERStack Vessels or a single larger HYPERStack Vessel. The Table depicts a potential scaling strategy based on the amount of product required.
The Corning gas-permeable family of products, which began with the HYPERFlask Cell Culture Vessel and has recently expanded with the addition of the HYPERStack Vessel, are useful for easing the scaling process from benchtop to cGMP production.
The gas-permeable film construction of the HYPERStack Vessels ensures equal gas exchange for all cell culture compartments in the vessels. The "tracheal space" eliminates the need for an internal air gap, making the vessels more compact, saving laboratory and production space.
Depending on the optimal lot size for production requirements, either the HYPERStack-12 with 6,000 cm2 of cell growth surface area or the HYPERStack-36 with 18,000 cm2 of surface area can be selected. For manufacturing-scale production, the 60,000 cm2 HYPERStack-120 layer Vessel may be the optimal choice.
Elizabeth Misleh is a research associate II at Lonza, Jacob Pattasseril is engineering manager, CT R&D at Lonza, Cindy Hunt is alliance manager at Lonza, Pilar Pardo is cell biologist at Corning Life Sciences, Renee Gallagher is cell scientist at Corning Life Sciences, Vitaly Klimovich ([email protected]) is assistant product line manager at Corning Life Sciences, and Greg Martin is senior product development engineer at Corning Life Sciences.
Elizabeth Misleh is a research associate II at Lonza, Jacob Pattasseril is engineering manager, CT R&D at Lonza, Cindy Hunt is alliance manager at Lonza, Pilar Pardo is cell biologist at Corning Life Sciences, Renee Gallagher is cell scientist at Corning Life Sciences, Vitaly Klimovich ([email protected]) is assistant product line manager at Corning Life Sciences, and Greg Martin is senior product development engineer at Corning Life Sciences.
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on March 1, 2013 - 8:59 PM
LOCKPORT – A Cambria man, arrested after a Sept. 7 raid on his home, pleaded not guilty Friday in Niagara County Court to charges that he was growing marijuana and had an illegal handgun.
Kevin L. Stockburger, 52, of Shawnee Road, is charged with second-degree criminal possession of marijuana, unlawfully growing cannabis and fourth-degree criminal possession of a weapon.
Officers said they seized 1.3 pounds of marijuana and a ,38-caliber Smith & Wesson revolver from the home. Stockburger is free on $1,000 bail.


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Don't let it get away!
Keep track of the stocks that matter to you.
Help yourself with the Fool's FREE and easy new watchlist service today.
Although we don't believe in timing the market or panicking over market movements, we do like to keep an eye on big changes -- just in case they're material to our investing thesis.
What: Shares of Chinese online gaming portal Changyou.com (NASDAQ: CYOU ) fell throughout the day, finishing with a 10% loss as Wall Street digested the news that the company's earnings for the upcoming quarter might be weaker than expected because of higher operating costs.
So what: The raw numbers all look good. Changyou beat the fourth-quarter revenue consensus of $168.7 million with a $173.5 million top line, and its earnings per share of $1.42 came in $0.09 better than analyst forecasts. Looking ahead, Changyou expects revenue in the $168 million to $174 million range, ahead of the Street's consensus, and $1.38 to $1.44 in EPS, against the $1.38 consensus.
However, part of Changyou's slide can be blamed on Sohu.com (NASDAQ: SOHU ) , which offered weak guidance for the upcoming quarter, and which indicated that shrinking margins would crimp Changyou's profitability in the future. The other part of this slide can be pinned on rising operating costs, which were up 20% sequentially and 17% on a year-over-year basis. Much of this was due to a 35% spike in year-over-year product development costs and a big 59% spike in year-over-year product development costs.
Now what: Sohu provided a worse forecast than Changyou, yet it declined by only half as much today. Changyou's gross margin on both a GAAP and an adjusted basis, at 84% for both, was actually higher than the prior quarter, and roughly in line with the year-ago quarter's 85% margin. Changyou's operating and net margins also remained stable despite the large increase in costs. There's nothing wrong with spending more to lure in new gamers, especially with such a long runway remaining in China. Today's drop brings Changyou back to even for the past 52 months, but at a 5.5 P/E, it seems like there's more upside than downside for this well-positioned Chinese game purveyor.
Want more news and updates? Add Changyou.com to your Watchlist now.
The Motley Fool's chief investment officer has selected his No. 1 stock for the next year. Find out which stock it is in our brand-new free report: "The Motley Fool's Top Stock for 2013." I invite you to take a copy, free for a limited time. Just click here to access the report and find out the name of this under-the-radar company.


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Top Definition
A person who exploits their body in a dormitory. (Dorm Whore)
That person hooked up with at least seven different people from the same dorm. Dang, what a skritt!
von P. Willy 16. November 2008
Trending Now
Can you define these popular missing words?
someone who affects everyone and everything around them needlessly only so the individual can gain something
two people are attempting to make up after a break-up, the skritt will purposely attempt to keep the two separated if she/he will gain something.
von useyourmojo 23. April 2011


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Wednesday, October 9, 2013
Cypress Gardens welcomes around 10,000 schoolchildren on field trips every year.
The schools keep the swamp gardens going during the workweek, said Cypress Gardens director Dwight Williams.
"It's nice to stay busy during the week and the kids really seem to enjoy it," he said.
Teachers are offered 15 different educational programs that each last between 30-45 minutes. They pick three programs from the list and rotate 15-25 students through the three stations.
Programs include dip netting on the swamp bank, digging for fossils and exploring rotten logs in the "Big Bug Hunt."
The most popular program is the swamp safari where children take part in guided boat tours.
"The tour really sinks in with the kids and is a big deal to them," said education coordinator Liz Vaughn. "They see turtles and alligators ... they ask if there are sharks in there, and it connects them to what is in their backyard here in South Carolina."
Schools can also sign up for a limited guided tour with two programs from the list or can do self-guided tours. Summer camps also make trips to the gardens and are offered one program per group.
The children and teachers aren't the only ones who benefit from the program, said Vaughn.
"A lot of these kids don't go outdoors much because they're in school all day and go home to play video games. Seeing them learning and enjoying the outdoors, that's what is exciting about working here."
To arrange a field trip or receive more information contact environmental education coordinator Traci Cook at (843) 553-0515.
© 2016 The Berkeley Independent an Evening Post Industries company. All Rights Reserved.
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As CEOs from either side of the debates, one from a utility and the other from a national rooftop solar company, we rarely agree on the topic — until now. A landmark bill in the Massachusetts Legislature is the first major example of our two sides finding comprehensive common ground on solar policy.
If passed, the bill would help ensure a stable solar future for Massachusetts. It would also continue Massachusetts' strong track record of leadership on renewable energy and set an example for other states across the country, write Lynn Jurich, CEO of Sunrun, and Marcy Reed, president of National Grid Massachusetts.