text:
Full CoverageBreaking News
Bentonville Public Schools readies construction plans for second high schoolUPDATED 4:57 AM CDT Sep 18, 2013
There is relief for Bentonville school leaders now that 70 percent of voters have approved a tax increase for a second high schoolVideo Transcript
THEIR PLANS MOVING FORWARD. RIGHT NOW, I'M STANDING ON THIS HUGE OPEN AREA NEAR SEBA AND GAMBLE. SUPERINTENDENT MICHAEL POORE TELLS 40/29 NEWS THIS EMPTY LOT OF 20 PLUS ACRES OF LAND WILL BE THE SITE OF THE SECOND HIGH SCHOOL. HE SAYS BENTONVILLE PUBLIC SCHOOLS TASK RIGHT NOW IS GETTING THE SECOND HIGH SCHOOL BUILT ON THIS LAND. POORE TELLS 40/29 NEWS BY THE END OF TODAY, HE EXPECTS TO HAVE WHAT HE CALLS A PROJECT PLAN FROM HIS CONSULTANTS AND ARCHITECTS ON HIS DESK. HE SAYS THIS PLAN WILL LIST SEVERAL THINGS THE DISTRICT NEEDS TO GET DONE IN ORDER TO GET 25-HUNDRED STUDENTS IN THE BUILDING BY FALL OF 2016. HE SAYS THAT INCLUDES A TIMELINE FROM GROUNDBREAKING THROUGH THE NEW SCHOOL YEAR. POORE SAYS THE THOUGHT OF DOING IT ALL IS SURREAL. MICHAEL POORE- BENTONVILLE PUBLIC SCHOOLS SUPERINTENDENT "You know ever since I've arrived herethis is the start of my third year and so, you know, it's been the dominate conversation. So to have it on the verge of us finally having, hopefully a successful solutionit's gratifying that we're almost there." HE SAYS FOR PEOPLE CAN LOOK AT FULBRIGHT JUNIOR HIGH SCHOOL, BRIGHT FIELD MIDDLE SCHOOL AND WILLOWBROOK ELEMENTARY TO GET AN IDEA OF WHAT THEY HOPE THE SECOND HIGH WILL LOOK LIKE. LIVE IN CENTERTON. JONATHAN ROZELLE. 40/29 NEWS. PRAIRIE GROVE AND WEST FORK VOTERS-- ALSO APPROVED TAX INCREASES FOR SCHOOL IMPROVEMENTS. IN ALMA -- A MILLAGE INCREASE DID NOT PASS. THE DISTRICT WANTED EXTRA MONEY TO HIRE MORE SCHOOL RESOURCE OFFICERS AND-- INSTALL
More Video
CommentsThe 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
Latest from 40/29 News
Advertising40/29 Favorites


text:
Briefs of Leading Cases in CorrectionsTexas Jails: Law and Practice
Briefs of Leading Cases in Corrections (3rd edition)Susan E. Ritter, Rolondo del Carmen and Betsy A. Witt
In this collection, briefs are presented from 100 recent United States court decisions in six areas of corrections: prison law, probation, parole, the death penalty and sentencing.
Cincinnati, Ohio: Anderson Publishing, 2002 (Soft cover, $25.95). Available from the publisher, (800) 582-7295.
Ritter is an associate professor in the Criminal Justice Department.
Texas Jails: Law and PracticeSusan E. Ritter, Rolondo del Carmen and Betsy A. Witt
This book was specifically prepared to assist sheriffs, jailers, county commissioners, legislators and policy makers to better understand the legal complexities involved in administering the county jails of Texas. This book includes the results of a survey of jail practices used in managing the state's jails.
Huntsville: Sam Houston State University Press, 1990 (Soft cover, $9.95). Available through SHSU Criminal Justice Center, (409) 294-1706.
The University of Texas at Brownsville website uses Javascript.
To access this page as it is meant to function please use a Javascript
enabled browser.

subset: commoncrawl


text:
Photos: High school football in McKinney
Photo: KELLIE ANFOSSO/kellie1982.smugmug.com
McKinney North quarterback Ben Dutze (16) hands off to junior running back Ronald Jones (24), who rushed for 237 yards and three touchdowns in a 42-39 overtime win over Wylie East.
To post a comment, log into your chosen social network and then add your comment below. Your comments are subject to our Terms of Service and the privacy policy and terms of service of your social network. If you do not want to comment with a social network, please consider writing a letter to the editor.


text:
Enhance your driving experience with Buick IntelliLink† infotainment system on the 2012 Regal. Combined with the latest in voice-recognition and Color Connected Radio technology, Buick IntelliLink puts you in command of your navigation and entertainment needs. And it's all accessible in one location through the high resolution, full-color touch screen.
Buick IntelliLink is the command center for all your infotainment needs – from hands-free phone book access to making calls to even playing your favorite music or radio stations.
Connect any compatible smartphone and Bluetooth®† enabled devices at the touch of a button.
Buick IntelliLink on the 2012 Regal connects you to Pandora®†, Stitcher™ SmartRadio† or SiriusXM®† Satellite Radio with over 140 channels, including commercial-free music, plus talk, sports, news, weather and more.
Use simple voice commands and the Nuance®-powered voice recognition software will find whatever you're looking for.
You don't have to take your eyes off the road to access entertainment on the 2012 Regal. Your favorite Pandora® Internet radio stations, satellite radio or music from your phone can be controlled with simple voice commands or the Buick IntelliLink touch screen.
Nothing should distract you from the sport-injected performance of the 2012 Regal. That's why, you can manage Buick IntelliLink through the touch screen, voice commands or steering wheel controls.
Keep the features you use the most front and center, on the customizable Buick IntelliLink homepage.
Embedded in the Buick IntelliLink system, Gracenote® indexes all your music, assigns voice tags, fills in missing song information and associates album art with your tracks when possible.
So you can focus on the road, Buick IntelliLink enables you to pair your phone to the system and then carry out a range of tasks with just your voice.
Connect up to 5 different devices from smartphones to Bluetooth®-enabled music players such as an iPod®† Touch.
Buick IntelliLink can help you tune in to your favorite music—whether its on AM/FM radio or CD player in your car, Internet radio, your phone, or on your iPod® Touch.
Play satellite or Internet radio, or your personal music collection from your smartphone by the sound of your voice.
Powered by Nuance®, Regal's enhanced voice-recognition technology lets you initiate phone calls, listen to music or access Pandora and Stitcher Smart Radio apps without any complicated series of steps, leaving you to enjoy the sport-inspired Regal to the fullest.
Connect your device and carry out a range of actions using simple phrases.
Dial by name or by number without touching your phone.
Buick IntelliLink downloads and saves the entire phone book from your phone, so you can access every number every time you step into the vehicle.
To help you make the most of your ride, Buick IntelliLink can pair several devices and carry out most tasks on your phone. It's all seamlessly integrated into the 2012 Regal.
Play Internet radio or stream music from your MP3 players and memory sticks using the conveniently located USB† port.
Connect up to five devices including smartphones and Bluetooth®-enabled devices like an iPod® Touch.
Play music from multiple sources hassle-free with Intellink's Bluetooth® Audio Streaming.
1. The Manufacturer's Suggested Retail Price excludes destination freight charge, tax, title, license, dealer fees and optional equipment. Click here to see all Buick vehicles' destination freight charges.
2. EPA estimated.
Apple Trademarks
"Made for iPod" means that an electronic accessory has been designed to connect specifically to iPod and has been certified by the developer to meet Apple performance standards. iPod is a trademark of Apple Computer, Inc., registered in the U.S. and other countries.
Gracenote® Trademarks
Music and video recognition technology and related data are provided by Gracenote®. Gracenote is the industry standard in music recognition technology and related content delivery. For more information, visit www.gracenote.com.
PANDORA Internet Radio Trademarks
© 2005-2011 PANDORA Media, Inc., All Rights Reserved. PANDORA and the Music Genome Project are registered trademarks of PANDORA Media, Inc.
"Stitcher SmartRadio", the Stitcher logo, along with related marks that may appear on the Service ("Marks"), are the service and trademarks of Stitcher. All other trademarks, service marks and logos used on this Service, with or without attribution, are the trademarks, service marks or logos of their respective owners. Without Stitcher's written permission, you agree not to display or use, in any manner, the Marks.
Bluetooth® Trademarks
The Bluetooth® word mark and logos are owned by Bluetooth® SIG, Inc. and any use of such marks by General Motors is under license. Other trademarks and trade names are those of their respective owners
© 2002- 2011 Nuance Communications, Inc. All rights reserved.


text:
Anniversary Celebration Packages
Celebrate those years together!
Ultimate Pure Romance Package
Create a romantic Costa Rica vacation that the two of you will never forget!
Fall Season Special
Valid for travel Sep 1 - Oct. 31
Flamingo Resort Brochure
Fly Nature Air
Security Statement
We want our Hotel website www.resortflamingobeach.com (hereinafter referred to as the "Site") visitors to feel confident about using our Site to plan and purchase their accommodations, so we are committed to protecting the information we collect. All personal information you provide is encrypted and secure.
Secure Reservations If you decide to make an online reservation at the Site, you will be linked to a reservation interface and a third party booking engine ("Booking Engine") provided by iHotelier, a TravelClick Interactive company. While it appears to be part of our site, the Booking Engine is in fact provided by a third party and is governed by its privacy practices. We understand that security remains the primary concern of online consumers and have chosen the Booking Engine Vendor carefully. The Booking Engine Vendor participates in the VeriSign Secure Site Program, a top security certification program, and:
- Has a VeriSign Secure Server ID.
- All information sent to this site, if in an SSL session, is encrypted, protecting against disclosure to third parties.
Protecting your information We would like our Site visitors to feel confident about using the Site to plan and purchase their accommodations, so Hotel is committed to protecting the information we collect. Hotel has implemented a security program to keep information that is stored in our systems protected from unauthorized access.
Our Site is hosted in a secure environment. The Site servers/systems are configured with data encryption, or scrambling, technologies, and industry-standard firewalls. When you enter personal information during the reservation process, or during a customer email sign-up, your data is protected by Secure Socket Layer (SSL) technology to ensure safe transmission.


text:
- Text Size:
- ASmall Text
- AMedium Text
- ALarge Text
A sewage leak has officials concerned in Orange County. They're warning people to stay out of Lake Baldwin, and to keep pets out, too.
Fifty gallons of sewage recently leaked into the lake, according to Baldwin Park's property owner's association.
Officials believe the overflow occurred on Anissa Avenue near Upper Park Road.
Health officials said they are testing bacteria levels in the lake and will continue to do so until it is returned to acceptable condition.


text:
Maureen Bradley, Daniel Cephas
Maureen Anne Bradley and Daniel Alexander Cephas were united in marriage on Dec. 21, 2013 at First Presbyterian Church of the Covenant. The 4 p.m. wedding was officiated by the Rev. William Glaze. Maureen is the daughter of Timothy and Koreen Bradley of Erie. Daniel is the son of Floyd and Shirley Cephas of Pittsburgh.


text:
Football truly a game in the key of life
This 'experience of enchantment', the World Cup is what life should be like all the time
Published 15/06/2014 | 02:30
THE mood now, after a few days of the World Cup, is one of the deepest serenity. It is a common misconception that the World Cup, especially one held in Brazil, is a thing of noisy celebration, of dancing all night long in the streets of Rio de Janeiro, of happy, face-painted people waving to the cameras. And yes, there is a bit of that.
But we must remember that the definitive sound of Brazil is not necessarily that of the raucous carnival, it is that of Astrud Gilberto singing The Girl From Ipanema, a number that is so laid back it makes the meditations of a Buddhist monk seem like a million Motorhead fans banging their heads in unison to Ace of Spades.
It is a song that seems unplugged from all of life's exertions, that creates a rhythm with which we are not familiar in the physical world, that belongs to some chimerical dimension to which we would like to go some day, perhaps never to return.
That is how many of us are feeling today, that is how relaxed we are.
It is "an experience of enchantment", a description that I take from an essay in Sports Illustrated by the author and philosopher Simon Critchley.
On the game in general, he writes that "for an hour and a half a different order of time unfolds and one submits oneself to it. A football game is a temporal rupture with the routine of the everyday: ecstatic, evanescent, and most importantly, shared. At its best, football is about shifts in the intensity of experience.
"At times it's like Spinoza on maximising intensities of existence. At other times it's more like Beckett's Godot, where nothing happens twice."
You won't be getting that from Robbie Savage on the BBC, but they have done well with their choice of signature tune – they will never again have an idea as brave and as brilliant as Nessun Dorma being the theme for Italia 90, but Stevie Wonder's Latin-flavoured Another Star is a fine touch, a song that has already made its way so deep into the better part of our consciousness, we may not be able fully to release ourselves from it until September.
It is taken from the monumental 1976 album Songs in the Key of Life, which is arguably the best album title of them all, and which reminds us that football is not just a part of life, a diversion or an adornment, it is a game in the key of life – and the World Cup is what life should be like all the time.
Mr Wonder wouldn't usually allow a song of his to be used by some TV programme, but he would know that this one is worthy of his favour, that it is rare enough for the multitudes to be assembled for a single purpose that carries at every moment the promise of excellence.
Again I quote Critchley, who believes that "the World Cup is about ever shifting floors of memory and the complexity of personal and national identity. But at its best it is about grace. A truly great player, like Pele, like Johan Cruyff, like Maradona, like Zidane, has grace; an unforced bodily containment, an elegance of movement, a kind of discipline where long periods of inactivity can suddenly accelerate and time takes on a different dimension in bursts of controlled power. When someone like Zidane does this alone, the effect is beautiful; when four or five players do this in concert, it is breathtaking..."
But that profound peace which has descended upon us, born of the certainty that there will be three matches today, and three more tomorrow, is informed by the knowledge that soon there will be just two matches a day, and eventually there will come a day when there will be just one match, and then no match.
There is a terrible poignancy in this, but we must accept it. Just as death heightens the intensity of living, so we must bear the weight of this knowledge lightly, to appreciate all the more these days of transcendence.
Today, for example, you may be inclined towards the view that there is something else you might be doing instead of watching, say, Switzerland v Ecuador. You may be hearing an inner voice telling you that this might be an opportunity to "take time out" from the journey, to "catch up" on some of the chores of your existence.
You must not listen to that voice of everyday anxiety. I have a friend who decided in a capricious moment that he didn't need to watch a match between the Arsenal and Reading in an early round of the Carling Cup, for no good reason except that he didn't really give a damn about it, and he believed that neither the Arsenal nor Reading gave a damn about it either.
Turned out that it finished 7-5 to the Arsenal, after extra time, that the Arsenal came back from being four down after 37 minutes, that it was enormously entertaining and eventually quite enthralling.
My friend learned a hard lesson that night – you should never not watch a football match.
You should never not watch a football match in the normal run of things, but during the World Cup, the rule is reinforced a thousand-fold.
At this time, it is the only rule.
Sunday Independent


text:
jrg wrote:
> On 10/21/2008 12:18 PM Peter J Ross scribbled:
>> In alt.os.linux.ubuntu on 20 Oct 2008 05:38:01 GMT, andrew
>>> On 2008-10-19, Dan C
>>>> On Sun, 19 Oct 2008 11:25:43 -0400, Pete wrote:
>>>>> What is the best Linux for a beginner (besides Ubuntu)?
>> Currently, 220.127.116.11. Beginners shouldn't mess with development
>> versions.
>> (Sorry, I just couldn't resist that.)
>> Perhaps try Linspire and aim to progress beyond it ASAP.
> not very enlightening...
>>>> Slackware.
>>> And of course Dan is totally correct. A full install of
>>> slackware, perhaps using KDE, would be an excellent starting
>>> point. The legend of slackware being difficult to install and
>>> use is for the most part only a legend. It is simple and
>>> clear, close to the intentions of the original software
>>> authors, and it encourages an enquiring mind.
>> The problem is that many beginners neither have nor wish to
>> acquire an enquiring mind. They just want something that works
>> much the same way as Windows.
>> In my opinion, the best distro for a beginner is anything that
>> recognises enough hardware to make Internet search engines
>> useable.
> most all do, not so??
>> In my experience, this was Mandrake 8.x. My WinModem worked, so
>> I was able to look stuff up.
> you saying that that is the 1st distro that recognized a
> winmodem?? thats kinda hard to swallow.
>> Being able to look stuff up is good, whether one is a beginner
>> or not.
> but separating the chaff from the wheat is another ballgame - 4
> million google hits on grub can be daunting for a newb and finding
> the correct answer within those 4 mill is a pita
When using Google, including +solved with your grub example makes a
huge and illuminating difference.
(My pet OS for Linux newbs using a box with minimal ram is "Puppy
Linux" live CD. IMO Puppy's snappy performance easily compensates for
the minimal hastle needed for net access,)
"I don't believe in evil, I believe in right and wrong, and very
often they are the same thing"-Paul Theroux, in Milroy the Magician.


text: The figure shows a safe, of mass 430kg hanging by a rope from aboom with dimensions a=1.9m and b=2.5m. The boom consists of ahinged beam and a horizontal cable. The uniform beam has a mass mof 85kg. If the (square) beam is of Douglas fir, what must be itsthickness to keep the compressive stress on it to 1/6 of itsultimate strength?


text: Talk:Ryetalyn Back to page 41,392pages on this wiki Add topic edit this page History Coincidence or not? Edit "Ryetalyn" sounds similar to "Ritalin". So do these aliens have ADD? --LauraCC (talk) 15:08, April 18, 2015 (UTC) It seems "Ritalin" redirects to "Ryetalyn". --| TrekFan Open a channel 17:43, April 18, 2015 (UTC) Retrieved from "http://memory-alpha.wikia.com/wiki/Talk:Ryetalyn?oldid=1710654"


text:
Home > Our Impact > Country Profiles > Russia
Stretching over 6 million miles across eastern Europe and northern Asia, Russia is the largest country in the world. Russia borders 14 countries and spans 10 time zones.
While about 8 percent of people are unemployed, about 13 percent of Russians still live below the poverty line.
The HIV and AIDS prevalence rate in Russia is only 1 percent, but with such a large population, there are more than 940,000 people living with the virus.
Human trafficking is a major issue in Russia. Women are especially vulnerable and are trafficked to more than 50 different countries.
Explore areas where you can help us build a better world for children.
World Vision is committed to partnering with the people of Russia to improve their lives today and to help enact sustainable solutions for the future of their children, families, and communities. Highlights of current programs include:
World Vision involvement in Russia began in the late 1980s when it assisted children and families following an explosion at the Chernobyl nuclear power plant. Since then, some major accomplishments include:
Geography and people
Stretching over 6 million miles across eastern Europe and northern Asia, Russia is the largest country in the world. Russia borders 14 countries and spans 10 time zones.
Variety fills Russia's landscapes, ranging from forests to mountains to plains. The northern region of Siberia has mainly forests, with tundra in the north and steppes in the south. The Volga, Europe's longest river, runs through central Russia.
Russia's climate varies from humid weather in the European regions to arctic conditions in Siberia and the northern tundra areas.
Natural resources include oil, natural gas, diamonds, coal, timber, and the largest mineral reserves in the world.
Over 120 ethnic groups live in Russia, including Tatars, Ukrainians, and Bashkirs. The largest group is Russian, making up about 80 percent of the population. The official language is Russian, but people also speak over 140 other languages and dialects.
The Principality of Muscovy, established in the 12th century, moved past more than 200 years of Mongol rule and gradually conquered its surrounding territories. By the late 1800s, Tsar Alexander II had pushed Russia's borders to the Pacific Ocean.
The Russian army's repeated defeats in World War I led to widespread rioting and the overthrow of the imperial household in 1917. Vladimir Lenin seized power a few years later and established the Union of Soviet Socialist Republics (U.S.S.R.), beginning nearly 70 years of communist rule.
Mikhail Gorbachev, president of the Soviet Union from 1985 to 1991, introduced political and economic reforms and began establishing warmer relations with the West. These steps led to the disintegration of the U.S.S.R. into Russia and 14 other independent republics in December 1991.
Russians elected their first president in 1993. Free elections continue today. Also, tension continues between Russia and neighboring Georgia after their conflict in 2008.


text:
If only we could trump last year's Christmas card… sigh! I've been racking my brain for a almost a year now and have decided there's nothing we can ever do to match it.
Last year we had Finley, the hairiest headed white baby many had ever seen. So while driving to Kansas City last October we had an epiphany – "Hairy Merry Christmas" – and the idea was born! This year there hasn't been an epiphany yet, but we'll be headed to KC tomorrow and I'm hoping to have one (it will never trump last year's, but I'm hoping to have one). If you have one (an idea) for us, please share.
{ 0 comments }


text:
Gannon, Mercyhurst look to bring all-Erie title game to ESU
The Gannon men could be sitting on the Division II tournament bubble. Mercyhurst faces an uphill climb.
But for both the Golden Knights and the Lakers, it's a whole lot better than sitting at home back in Erie.
Today at No. 2 East Stroudsburg's Koehler Fieldhouse, top PSAC West seed Gannon (19-8, 13-3) faces No. 2 PSAC East club West Chester (19-8, 11-5) at 1 p.m., and No. 3 West seed Mercyhurst (17-11, 11-5) takes on PSAC East top seed East Stroudsburg (25-1, 15-1) at 3:30 in the PSAC tournament semifinals.
The way Gannon has been playing since its swing to East Stroudsburg (lost 75-60) and West Chest (lost 74-73) on Jan. 3-4 to fall to 6-7, the Knights have gone 13-1 since their move to No. 5 in the Atlantic Region. West Chester is not in the top 10, but the Golden Rams have the same record and a sweep of GU could be deflating in hopes of a first Atlantic Region berth since the 31-4 2008-09 Elite Eight team.
"We can't worry about that, but focus on playing another very good basketball team,'' Gannon coach John Reilly said. "West Chester is clearly the best team behind East Stroudsburg on that side of the conference.''
Gannon has improved immensely, adding junior guard Girbran Smith into the lineup to go with ironman junior guard Adam Blazek, named the PSAC West athlete of the year, and getting effective play from its power forwards, juniors Raphel Thomas-Edwards and A'Darius Porter and senior Rogerio Livramento, and flexible senior forward C.J. Oldham, tabbed the West defensive athlete of the year.
"We've been playing much better, but so are they,'' Reilly said.
Gannon survived a grueling 73-69 double-overtime win over Slippery Rock Tuesday in the quarterfinals, with Blazek playing all 50 minutes and hitting a huge go-ahead 3.
"Adam is relentless, wants the ball in those situations, and never seems to get tired,'' Reilly said.
Mercyhurst stunned No. 11 Indiana 67-56 Tuesday, getting 16 points from ever-improving sophomore guard and scoring leader Jean Onana, and a surprising 13 (5-of-6 shooting) from 6-foot 8-inch sophomore forward Sean Beins.
"We stayed with IUP the first two games and this time we stuck to our game plan, got contributions from everyone on a team that is very deep, and stayed in control,'' Mercyhurst coach Gary Manchel said of his club's first win ever at Indiana.
Beins, shooting 57 percent (27-of-47) in limited play, provided a big boost.
"Sean is a scorer, but he's still trying to get used to our matchup on defense, and he did an excellent job,'' Manchel said.
The Lakers lost to West Chester 80-72 and East Stroudsburg 60-54 on the Jan. 3-4 crossover trip.
The championship game is Sunday at 3:30 p.m. and will be televised live by the PCN Network, with two teams from Erie hoping it will be in front of a studio audience.
BOB JARZOMSKI can be reached at 870-1678 or by e-mail. Follow him on Twitter at twitter.com/ETNjarzomski.
"We were leading (East Stroudsburg) at halftime, and they got the lead and made free throws,'' Manchel said. "They bring pressure for 40 minutes, but we were able to handle that the first time. We're just looking forward to playing them. And wouldn't it be something if we were playing Gannon Sunday hundreds of miles away from Erie."


text:
Day 1 | Day 2 | Short Courses | Download Brochure
7:15 am Registration
7:30 – 8:25 Problem-Solving Breakout Discussions with Continental Breakfast
These interactive discussion groups are open to all attendees, speakers, sponsors, & exhibitors. Participants choose a specific breakout discussion group to join. Each group has a moderator to ensure focused discussions around key issues within the topic. This format allows participants to meet potential collaborators, share examples from their work, vet ideas with peers, and be part of a group problem-solving endeavor. The discussions provide an informal exchange of ideas and are not meant to be a corporate or specific product discussion.
Latin American Market Access for Personalized Medicine
Carlos Gil Ferreira, M.D., Executive Director, INOVA-CANCER; Director, Clinical Research, Brazilian National Cancer Institute
Clinical Perspectives of Next Generation Sequencing
Divyaa Ravishankar, Senior Industry Analyst, North America & Europe, Life Sciences, Frost & Sullivan
New Partnership Paradigms in Companion Diagnostics/Personalized Medicine
Matthew J. Hawryluk, Ph.D., Senior Director, Corporate & Business Development, Foundation Medicine, Inc.
8:25 Chairperson's Opening Remarks
Catherine Brownstein, M.D., Harvard Medical School and Boston Children's Hospital
8:30 Regulatory Challenges in Co-Development of CDX and Drugs: A Diagnostics Perspective
Tracy Bush, Ph.D., Director and Global Coordinator, Companion Diagnostics, Regulatory Affairs, Roche Diagnostics
Globally, Pharma and Diagnostics operate under different regulations, with different statutory requirements and timelines. Drug and diagnostic codevelopment timelines are not always optimally aligned to meet the needs of the various regulatory processes. This presentation will explore various regulatory challenges that ensue when the standard diagnostics development pathway is asked to flex to meet the needs of a drug clinical program; and offer possible pathways for their resolution.
9:00 Global Clinical Trial Design Considerations When Incorporating a Companion Diagnostic
Sabah Malek, Associate Director, Global Regulatory Affairs, Eisai, Inc.
A well thought-out clinical trial, especially one that will be the basis for the approval of two products from different divisions within FDA not to mention different governing bodies in the EU, is imperative for a successful launch. Since the recognition of personalized medicine, FDA and other health authorities have been resolute regarding the ideal co-development plan for targeted therapeutics and companion diagnostics. However in practice, this proves to be difficult for numerous reasons. One example of this is the identification of the need for a companion diagnostic in a mature program.
9:30 NGS-Based Companion Diagnostics: Points to Consider
Jennifer Dickey, RAC, Ph.D., Office of In Vitro Diagnostics, DIHD, US Food and Drug Administration
While there has not yet been a companion diagnostic approval of a Next Gen Sequencing-based assay, there has been considerable interest in using gene panels or single gene sequencing to select the patient population that will benefit from targeted therapy. This talk will highlight points to consider in developing a NGS-based companion diagnostics
10:00 Sponsored Presentation (Opportunity Available)
10:15 Cellular Multiplex™, a Pathway Approach to Companion Diagnostics
Bruce K. Patterson, M. D., CEO, InCellDx, Inc
Cellular Multiplex™, a diagnostic approach that allows multiplexing of proteins using antibodies, mRNA using in situ hybridization, and DNA cell cycle using dyes. Morphologic measurements such as mean corpuscular volume, nuclear area, and nuclear-to-cytoplasmic ratio can be determined. It provides prognostic information, companion diagnostic functions when deployed in our novel bioinformatics algorithms.
10:30 Coffee Break in Exhibit Hall with Poster Viewing
PLENARY SESSION: Think Tank on Next-Generation Sequencing Diagnostics
11:00 Chairperson's Opening Remarks
Harry Glorikian, Healthcare Consultant
11:10 Discussion: Regulatory Review of Clinical Sequencing Assays
Moderator: Harry Glorikian, Healthcare Consultant
Guest Speaker: Jennifer Dickey, RAC, Ph.D., Office of In Vitro Diagnostics, DIHD, US Food and Drug Administration
In November of 2013, the FDA issued the first clearances of Next Gen Sequencing- (NGS) based assays. There have additionally been a number of clinical trials approved recently that utilize NGS-based assays for patient enrollment or stratification. In light of the expanding roles that new sequencing technologies are playing in clinical decision making, this talk will focus on critical elements that FDA considers when evaluating NGS validation using the recent clearances/approvals as examples. There will also be a discussion of any new communications that FDA has issued in regard to the regulatory review of NGS- based assays. Following the discussion there will be a Q&A with the audience.
Co-Organized with
11:55 Next-Generation Sequencing in Clinical Practice: Case Reports of Clinical Utility and Reimbursement
Moderator: Elaine Lyon, Ph.D., Medical Director, Molecular Genetics, ARUP
Case Presenters:
Andrea Ferreira-Gonzalez, Ph.D., Professor, Pathology; Director, Molecular Diagnostics Lab, Virginia Commonwealth University
Madhuri Hegde, Ph.D., FACMG, Professor, Human Genetics; Executive Director, Emory Genetics Laboratory, Emory University School of Medicine
The landscape of next-generation sequencing diagnostics is changing rapidly. Clinical laboratories are offering highly complex tests using new technologies, but face challenges in reimbursement. To be reimbursed for these tests, laboratories will need to address clinical utility as well as clinical validity. Clinical cases that demonstrate the utility of genomic oncological and inherited disease testing will be presented. Experiences with reimbursement of these tests will be discussed.
12:40 pm Close of Conference
2016 Brochure
Download Now
Premier Sponsors
View All Sponsors
View Media Partners
Related Products


text:
Isaac Mizrahi has been given a golden ticket to continue his questionable red-carpet behavior at the Academy Awards, despite criticism of his antics for E! on the night of the Golden Globes – in which he quizzed Eva Longoria on her pubic hair, groped Scarlett Johansson's breast and peered down Teri Hatcher's dress.
"I've hired Isaac because I felt the red carpet work on television, not just on E!, had become predictable, staid and frankly boring. What I wanted is someone who would bring surprise," the network's president and CEO, Ted Harbert, tells the Associated Press.
But despite Harbert's defense of Mizrahi, the Academy is not so willing to welcome the outrageous designer on its red carpet on Oscar night March 5.
"I have no idea what plans E! has on Oscar night. If they're suggesting they would do something similar on our red carpet, we would have some good discussions with them," said academy spokesman John Pavlik. "I can predict we would be extraordinarily angry if that happened on our carpet. I cannot predict what we would do afterwards."
For the record, Mizrahi, 44, tugged on Hatcher's bronze halter to look for a hidden speech. "Come on, you've got to have the speech somewhere," he said, prompting Hatcher to respond: "Oh my God, he touched my stomach and then he pulled down my dress!"
Earlier, he asked fellowDesperate Housewives star Longoria what her "hair was like down there. ... Is it bikini? Your body hair? Was it done tonight?"
Fascinated by Johansson's skintight red Valentino dress, Mizrahi squeezed her breast – twice. "What's going on!" she demanded.
To Keira Knightley, he chirped: "You had carbs (today), darling? That's a no-no in Hollywood. It's like a (breach of) security." To Jessica Alba: "Are you wearing underwear?"
Mizrahi's remark to Charlize Theron about her Oscar-winning role as a "scary dyke with bad teeth" in 2004's Monster elicited a formal complaint from the Gay and Lesbian Alliance Against Defamation – prompting the statement from Harbert afterwards that "E! Networks does not generally condone the use of that word, (but) we are totally confidant that Isaac is the last person on Earth who could be accused of even the slightest degree of homophobia."
Mizrahi, who is openly gay, has not responded formally to any of the static about his appearance.
Mizrahi Booked for Oscars, Despite Groping
Lisa Rose/JPI


text:
Saturday's girls basketball highlights, Feb. 16: Mercyhurst Prep edges McDowell
Brenna Robbins was a major first-half force, pouring in 15 points to send Mercyhurst Prep to a 39-33 victory over McDowell in a non-region game at Mercyhurst Prep on Saturday.
Robbins wound up with 18 points to lead Mercyhurst Prep (15-7), which was hosting the "Shooting for a Cure" game.
Robbins' big first half carried the Lakers to a 19-18 lead and McDowell (12-10), led by Krissy Fromknecht's 10 points, remained close, staying within six heading into the final quarter. But Mercyhurst Prep scored the first two baskets of the fourth quarter to build the lead to 10 and held on for the win.
Robbins also finished with 12 rebounds and had four assists for Mercyhurst Prep.
Villa Maria 55, Central Tech 14: At Villa Maria, the Victors used a balanced offensive attack to put the game away early in a regular-season non-region finale.
Villa (20-2 overall) outscored Central 43-4 in the first half.
Morgan Putnam led Villa Maria with nine points, all coming on 3-pointers.
No player scored more than four points for Central (9-13).
Nine players scored for the Victors, who finished the season as Region 6 champions.


text:
Apply Online
Thank you for your interest in a career with Trinity Protection Services, Inc. Trinity Protection Services, Inc. is continually seeking to identify highly talented and hard working individuals that have a passion for developing their career in the security industry. We offer a creative, collaborative and challenging environment that is committed to diversity and professional development.
Trinity Protection Services, Inc.
Current Employment Listings
Employment listings are updated regularly and include a wide variety of career opportunities within our company. You may apply for positions in person OR you may apply using the online application.
|Job Title
|Security Sales Representative
|DC Metro Area
|Armed Security Guard
|DC Metro Area
Apply online
To Apply Online simply click the job post and follow the link to the application.
Apply in Person
Please visit our offices at:
Trinity Protection Services, Inc.
9315 Largo Dr W, Suite 170
Largo, MD 20774
Office: (301) 333-7450
Fax: (301) 333-7485
Monday 2 pm - 5 pm
Wednesday 2 pm - 5 pm
Friday 2 pm - 5 pm


text:
|Welcome to the MANGA Forum.
|You will have to register before you can post: log in or sign up at the top of the page to proceed. To start viewing messages, select the forum that you want to visit from the selection below.
i wonder if this is set in an alternative universe, or if it is a sequel to the original story.


text:
Helicopter, exhaust tests, highway plan are dinner topics
April 13, 2013
HUGHESVILLE — Sixty years and going strong — that was the message as the Lycoming County Pomona Grange as it celebrated its 60th annual Legislative Banquet here Friday night....
"Mirabito described reasons why he voted against the privatization of liquor saying a study in 2009 by the Center for Rural Pennsylvania indicated alcohol consumption by youth was much higher in rural areas than in urban areas. "Prices will probably go up if there is privatization and deaths by consumption and accidents will go up," he said."
At least he had the good sense to AVOID saying this was an "informed"-opinion.
2 Agrees | 2 Disagrees | Report Abuse »
Showing 1 of 1 comments
Post a Comment
You must first login before you can comment.


text:
Top Definition
To tour/visit/salivate over a city's local yarn shops for extreme fiber enthusiasts.
"My BFF and I are going to Boston to do a yarn crawl. I just finished knitting a sweater and am jonesing for new yarn."
po QHatshepsut Април 12, 2010
Trending Now
Can you define these popular missing words?


text:
Cell phone users across the country are receiving suspicious text messages that claim to be from Walmart. The texts tell consumers they won a free gift card... and all they have to do is click a link and enter some information.
Unfortunately, there is no gift card. It's a scam to steal your credit card number and other personal info.
About the scam:
This scam has several versions. In one, the text reads "You just won a free $1000 Walmart Gift Card, enter "1000" at LINK." In another, it says: "Walmart $1000 gift card for the first 1000 users to go to LINK and enter code 2938." The texts also use different URLs, including:
• promocenterdaily.com/walmart_gift
• promocenter.ws/walmart
• walmartgift.mobi
See a screen shot of a scam message here.
The text message is a twist on the classic email phishing scam, where scammers pose as a legitimate organization and send out emails containing links to scam sites. Phishing scams using SMS technology are known as "smishing."
More information
For more information, please see the statement on Walmart's website.
See BBB.org's complete scam directory for more information about breaking scams in your area.
Receive BBB Scam Alerts directly to your email.


text:
item(s) in cart
My Account X
ROLL ON TO ZOOM INBack Forward
detailsback to top
Product DescriptionTopflight Teal Decoys are the newest series of true, custom-style painted teal decoys from Avian-X. Created to capture the true personality and body anatomy of a feeding flock of Teal as they search the water surface for food. The perfect combination of low-heads and feeders produces the looking that passing Teal are searching for. All Topflight Series decoys feature the innovative weight-forward swim keel design; simply snap the line through the swim clip to add natural motion to the decoys, whether in current or in the slightest breeze. Combined with non-chip paint and advanced rubberized molding material for long-lasting realism. The Green-Winged Teal includes four drakes (two low-heads, two feeders) and two hens (one low-head and one feeder). Decoys are slightly over-sized, measuring 10" breast to tail.


text:
They Might Be Giants Nanobots/Idlewild/Megaforce
For more than three decades now, the Brooklyn, N.Y., band They Might Be Giants has been releasing its own brand of music to an ever-growing audience.
The do-it-yourself mentality of core members John Linnell and John Flansburgh has resulted in a variety of musical styles and concepts.
One of the more curious recordings came on the band's 1992 album "Apollo 18." Called "Fingertips," the song was actually 21 different songs, each lasting just a few seconds. It has remained a fan favorite, especially when performed in its entirety live in concert.
On They Might Be Giants's latest, "Nanobots," the band revisits the "Fingertips" idea with nine of the album's 25 tracks clocking in at under a minute, and while they don't pack quite the same novelty punch as "Fingertips," the songs demonstrate that the two Johns still have what seems to be a bottomless well when it comes to song writing.
As for the rest of the music on the album, songs such as "You're on Fire" and "Replicant" will remind longtime TMBG fans of classic albums such as "Lincoln" and "Flood."
Local fans will be able to check out some of the new material firsthand when TMBG performs live on April 11 at the Music Farm.
Key Tracks: "You're on Fire," "Lost My Mind," "Replicant"
Doug MacLeodThere's a Time/Reference
One of the best parts of reviewing music is the chance to discover an artist whose work was previously unknown to me.
This week's discovery is blues guitarist Doug MacLeod. He's been recording and performing music for more than 30 years, and on his latest release, "There's a Time," the musician delivers a set of deceptively placid tunes played mostly with acoustic guitars.
Where some blues artist such as Stevie Ray Vaughan and Buddy Guy like to wail on their electric guitars, MacLeod takes the strong, quiet approach.
MacLeod's effectiveness as a performer comes just as much from his voice as it does from his guitar. That voice, with its unidentifiable drawl (MacLeod was born in New York and lives in Los Angeles), is as smooth and thick as honey, and is perfectly suited for telling stories while MacLeod's fingers pick out a melody on his guitar.
Standout tunes on the new album include the bouncy "Rosa Lee," the positive "The Up Song" and "The Night of the Devil's Road," which benefits beautifully from the haunting sound of MacLeod's resonator guitar.
Listening to "There's a Time" shows why MacLeod has been at his trade successfully for the past three decades, and this new album is a great jumping-on point if you, like me, were not previously aware of MacLeod's talents.
Key Tracks: "Rosa Lee," "The Up Song," "The Night of the Devil's Road"
Jimi Hendrix People, Hell & Angels/Legacy
Make a list of the greatest rock guitarists in history, and chances are that Jimi Hendrix will be at the top of it.
The late musician certainly deserves that honor.
Although he really only made music professionally for about seven years before his untimely death in 1970, Hendrix changed the way guitar players think about creating music.
The surviving members of Hendrix's family keep a pretty tight rein on the rights to his recorded material, and while it might seem like we've heard everything the artist recorded in a studio already, the slow trickle of studio material continues.
The latest release, "People, Hell & Angels," calls itself a collection of 12 previously unreleased studio tracks.
In reality, while the music we hear on this new album might be made up of unreleased recordings, the fact is that many of the songs have appeared on other releases.
Sure, what we heard on those earlier albums might have been a different take or even a completely different studio recording, but what we're getting here are retreads and tracks that are in some cases cobbled together from several takes.
"Let Me Move You" is one of the few truly new pieces of material, and Hendrix doesn't even sing on the track.
For the Hendrix completist, this is OK to add to the collection, but casual or first-time listeners would do well to look elsewhere.
Key Tracks: "Somewhere," "Let Me Move You," "Hey Gypsy Boy"
By Devin Grant


text:
Personal Description:
In loving memory of our dear Chi Omega sister, Nancy Baird Grove, who died June 3, 2010 of ovarian cancer. At a Westminster College reunion in 2008, many celebtated Nan's victory over breast cancer. Unfortunately, she was later diagnosed with ovarian cancer. We will always be grateful for that time of joy and reuniting but regret that there will be no way to repeat that event. We ask Chi Omega sisters and others who knew Nan to join us in supporting the Ovarian Cancer Research Fund by donating and helping other women in the future.
Personal Description:
At Westminster College, Nan joined the Chi Omega sorority the second semester of her freshman year and was loved by all its members for her warm personality, true friendship and her genuine laugh.
She taught elementary school for 24 years with love, dedication and a concern for all races and ability levels. As an elementary school principal she shared these traits with her faculty as well as the students. She served as President of the Delta Kappa Gamma Soociety for female educators and received the Pennsylvania State Achievement Award. In retirement she volunteered as a docent for the Jamestown Settlement – still teaching.
Nan was blessed with a wonderful husband and companion in Bruce Grove who cared for her and supported her in her fight with cancer. A couple of weeks before her death she was still emotiomally strong and said "I'm a fighter and always have been." At that time she was still concerned about others and asked about the welfare of her friends and family.
Last updated on: 09/08/2010
Nan Baird was a Chi Omega sorority sister and what fun we all had! Her laughter as a young woman will always be with me. As a grown-up, Nan was a dedicated professional educator. She contributed much to many. We will miss her!
Amy Ferguson – 09/09/2010
Dear Nan- we shall miss you. I remember your radiant smile and happy disposition. I feel so fortunate to have seen you at the last reunion – rest well dear Chi O sister.
Susan McCord Hanley – 10/20/2010
Nan was my lovely sorority sister who lived down the hall our freshman year at Shaw. She was kind, beautiful and caring. I still remember her classy outfits and adorable figure. She will be missed. Love, Judy
Judy Oakley – 01/24/2011
Qqdwqdsaas ascaassc fdrewe:
It must be confessed that on this occasion the British
had remained in the background while there was any prospect of a
kadaaudibiz kadaaudibiz – 04/23/2011
Interesting that otiesby seemed to have no influence on risk for women with a family history; I suppose the substantially larger genetic risk simply overwhelmed the tiny increase in risk associated with otiesby.
Bruni Bruni – 02/27/2012


text:
Dallas Mavericks (0-2, 0-1 road) vs. OKC Thunder (3-0, 1-0 home)
TV: TNT (Cox 31, HD 730)
Stream: Click here
Radio: WWLS The Sports Animal (98.1 FM, 640 AM, 97.1 FM Tulsa)
Time: 7:00 CT
Offensive Rating: Thunder – 106.8 (11th), Mavs– 93.8 (26th)
Defensive Rating: Thunder – 101.4 (12th), Mavs – 110.4 (24th)
Pace: Thunder – 93.4 (11th), Mavs – 99.7 (2nd)
View from the enemy: The Two Man Game
The Thunder have seen the bad guys from Big D twice already, but those didn't count. This one does, so here's the real chance at a little payback for the Western Conference Finals. The Mavs are spinning a bit so far, looking a tad complacent after winning their title. But that's a team that will get it together at any time, and it could start tonight with a statement over the 3-0 Thunder.
Dallas coming in: The Mavs last played Tuesday, getting walloped by Denver.
Three Big Things
1. All eyes on Russ and KD. Tonight's game is on TNT so you can be sure there will be an iso camera locked on Westbrook and KD during every timeout, high-five or bathroom break. How will Westbrook respond not just to the noise of today, but to his 0-13 performance last night? I get the feeling KD might have a slow night and Westbrook carries OKC. Seems like it would be fitting.
2. Defending Dirk. It was the biggest challenge for the Thunder last season and Serge Ibaka seems to have got a better feel for it. We'll see Nick Collison, KD, Perk and Ibaka all try their hand at Dirk tonight.
3. Who's motivated more? The Thunder are 3-0 and are coming off a rough and tumble game in Memphis last night. The Mavs are rested but wounded. Dallas would seem to want to take this as an opportunity to announce they're fine, but the Thunder don't tend to drop games easily on their home floor.
Tip at 7:00 CT. Go Best Friends.


text:
Purchasing a new Compaq notebook battery is something easy to be done. There are several reasons why you need to replace your battery: perhaps it is outdated and it doesn't last long per charge, perhaps you just want an extra one for when you are on the road, so you can enjoy portability and so. No matter what, notebook batteries are not designed to last for a lifetime, in time they start to discharge faster than usual and you have no other choice than to replace it. A notebook battery depends also on how you use the system and if you keep the notebook plugged in a socket all times. If you want to search for a Compaq notebook battery, you should know several things at first.
Think about the main reason why you need to replace your battery, if you simply need a new battery, just like the one you had, then you will have no problems what so ever. But if you are looking for an upgrade, you need a six or nine cells battery, these will provide a longer battery life and you will be able to enjoy portability more than before.
To conclude, just keep in mind that compatibility is very important when it comes to replacing parts and also to make sure that you buy a genuine component, so you can be sure you will take advantage of it and you spend your money wisely. Every user wants to have the best thing in its possession and wants guarantee, but sometimes it is just a matter of keeping yourself close to your target and just knowing where to look for it.
Comments are closed.


text:
Watch stocks you care about
The single, easiest way to keep track of all the stocks that matter...
Your own personalized stock watchlist!
It's a 100% FREE Motley Fool service...
In this video from Wednesday's Investor Beat, host Chris Hill and Motley Fool analysts Evan Niu and David Meier dissect the hardest-hitting investing stories of the day.
New home sales grew 25% in October, with strong data on private sector jobs also being reported. Is the economy stronger than many had realized? In the lead segment on Wednesday's Investor Beat, Chris, Evan, and David discuss the broader economy and how strong it actually is today, why the market is reacting so poorly to this news, and what these macroeconomic issues mean for investors.
It's no secret that investors tend to be impatient with the market, but the best investment strategy is to buy shares in solid businesses and keep them for the long term. In the special free report, "3 Stocks That Will Help You Retire Rich," The Motley Fool shares investment ideas and strategies that could help you build wealth for years to come. Click here to grab your free copy today.


text:
Top Definition
Jacking off over material you'd normally find offensive. Then, AFTER you've gotten yur rocks off you are thoroughly disgusted with yourself.
Melvin felt deeply ashamed and suffered from "jacker's remorse" after masturbating over the naked pictures he found of his mother.
додав Mitchell_L 02 Червня 2009
Trending Now
Can you define these popular missing words?


text:
On News 88.9 KNPR
On Classical 89.7
1289 S. Torrey Pines Dr.
Las Vegas, NV 89146
Main Number: 1-702-258-9895
Toll Free: 1-888-258-9895
an member station
David Bert seeks a respite from the city by visiting Chloride Arizona. Just 4 miles off US 93, but a million miles from the hustle and bustle of Las Vegas.
Add some items to your playlist to play them.


text:
The circumferential resection margin is the primary determinant of local recurrence and a major factor in survival in rectal cancer. Neither chemotherapy nor chemoradiation compensates for a margin positive for cancer.
To identify treatment-related factors associated with hospital margin-positive resection and to develop a tool that could be used by individual hospitals to assess their outcomes based on their unique mix of patient and tumor characteristics.
Retrospective review of the National Cancer Data Base, 1998-2007.
Community and academic/research hospitals.
Individuals with histologically confirmed localized rectal/rectosigmoid adenocarcinoma.
All individuals underwent radical resection for rectal cancer with or without neoadjuvant therapy.
Main Outcomes and Measures
Rate of margin positivity determined and adjusted for patient- and tumor-related factors to calculate expected margin positivity per hospital. An observed to expected ratio was calculated based on patient- and tumor-related factors to identify treatment-associated variation.
The overall margin-positive resection rate was 5.2%. Patients with margins positive for cancer were more likely to be older, male, and African American; not have private insurance; and have their cancer diagnosed later in the study period. Associated tumor-related factors include rectal location, higher American Joint Committee on Cancer stage, signet/mucinous histology, and poor/undifferentiated grade. Among hospitals that were significantly low outliers, 47% were comprehensive community hospitals, and 43.9% were academic/research hospitals; of those that were significantly high outliers, 52.3% were comprehensive community hospitals, and 17.8% were academic/research hospitals. High-volume centers made up 80% of significantly low outlier hospitals and 17% of significantly high outlier hospitals. The rates of chemotherapy and radiation were similar, but low outlier hospitals gave more neoadjuvant radiation (26.3% vs 17%).
Conclusions and Relevance
After adjustment for patient- and tumor-related factors, we identified both low and high outlier hospitals for margin positivity at resection, as well as potentially modifiable risk factors. The nomogram created in this model allows for the evaluation of observed and expected event rates for individual hospitals, providing a hospital self-assessment tool for identifying targets for improvement.
In 2012, there were an estimated 40 290 cases of rectal cancer diagnosed in the United States. Colorectal cancer is the second leading cause of US cancer death, with rectal cancer accounting for approximately one-third of colorectal cancer deaths.1 For cases without metastases, the primary treatment is radical resection with proctectomy and en bloc radical lymphadenectomy; for locally advanced cases, primary treatment is perioperative radiation and chemotherapy. The widespread adoption of sharp total mesorectal excision has improved local control and survival by improving radical lymph node clearance and decreasing the risk for a surgical margin positive for cancer (hereafter referred to as a positive margin). Accordingly, local recurrence rates have decreased to 5% to 10% from as high as 50%.2- 4 Circumferential resection margin status has been identified as one of the most important determinants of local recurrence risk. Positive resection margins are associated with metastatic disease and decreased survival.5,6 Unfortunately, neither radiation nor chemotherapy can compensate for a positive margin in rectal cancer.7,8 Therefore, the achievement of a negative resection margin is a primary goal of surgery for rectal cancer.
A number of tumor-related factors are associated with the risk for margin positivity at rectal cancer resection. Tumor location in the distal third of the rectum, T4 status, advanced local nodal stage, need for abdominoperineal resection, and anteriorly located tumors are associated with a higher risk of margin positivity. Patient- and treatment-related factors have also been identified, including American Joint Committee on Cancer (AJCC) stage and advanced age.7,9- 14
Factors influencing the risk for margin positivity at resection can be categorized as patient-, tumor-, and treatment-related factors. To further investigate these relationships, we used a large hospital-based national database to examine risk factors for margin-positive resection of rectal cancer. We specifically sought to identify treatment-related factors associated with margin-positive resection and to develop a tool that could be used by individual hospitals to assess their outcomes based on their unique mix of patient and tumor characteristics.
Data from the National Cancer Data Base (NCDB) were used for our study. The NCDB is a joint program of the Commission on Cancer of the American College of Surgeons and the American Cancer Society and is used as a surveillance tool to assess patterns of care for patients with cancer.15 More than 1500 cancer programs in the United States are accredited by the Commission on Cancer of the American College of Surgeons; the NCDB captures approximately 76% of newly diagnosed cancer cases. Hospitals contributing to the NCDB are classified as academic/research hospital cancer programs, comprehensive cancer programs, or community hospital cancer programs. Data collected for each cancer case include patient characteristics, cancer staging, tumor characteristics, types of treatment administered, and outcomes.
Rectal or rectosigmoid cancers (International Classification of Disease for Oncology codes C199 and C209) were identified within the NCDB between 1998 and 2007 (Figure 1). All patients with histologically confirmed adenocarcinoma who had undergone a partial or complete proctectomy (excluding cases of local tumor excision/destruction), were 18 to 90 years of age, and had received no prior cancer diagnosis were included. Patients who died within 30 days of cancer diagnosis, had stage IV disease, or had an unknown margin status were excluded. Finally, hospitals reporting a margin-positive rate of 0 were excluded because they may have been subject to either very low procedure volume or coding discrepancies that precluded analysis.
AJCC indicates American Joint Committee on Cancer, sixth edition; O/E ratio, observed to expected ratio.
We analyzed data on the basis of patient-, tumor-, and treatment/hospital-related variables. The primary outcome measure was the individual hospital rate of margin-positive resection adjusted for patient- and tumor-related risk factors. Demographic data included patient age (categorized in groups as 18-49, 50-75, and 76-90 years), sex, race, year of diagnosis, insurance status, median quartile income, percentage of residents in the patient's neighborhood without a high school diploma, and area-based measures of residence as metropolitan, urban, or rural. The patients' educational and income levels were assessed by matching patients' zip codes to files derived from 2000 US Census data coded as quartiles. Tumor characteristics included anatomic location (rectosigmoid vs rectum), AJCC (sixth edition) tumor stage, tumor size, histology, and grade. Treatment-related variables included type of facility (community cancer program, comprehensive community cancer program, or academic/research program), yearly hospital surgical volumes categorized by quartiles, receipt of chemotherapy or radiotherapy and the sequence of treatment, and specific type of surgery (low anterior resection, coloanal anastomosis, or abdominoperineal resection).
We sought to ascertain the hospital rate of margin positivity after adjustment for patient- and tumor-related risk factors in order to identify potentially modifiable treatment-related factors. We first developed a patient-level multivariable risk model for margin positivity using multiple logistic regression analysis incorporating important patient- and tumor-related clinical variables, leaving the treatment-related factors unadjusted in the model for post hoc comparison.
This risk model was used to calculate the expected number of patients with a positive margin for each hospital by summing all patients' risk estimates by hospital. The observed number of margin-positive cases was then divided by the expected number of events (based on patient- and tumor-related factors) to create an observed to expected (O/E) ratio for each hospital. To estimate the significance of the O/E ratio, the probability (P) that a hospital had exactly the observed number of events (X = k) was determined based on the binomial function P(X = k), where k denotes the actual number of events observed within the hospital, n denotes the hospital volume, and P denotes the model-derived expected probability of the event.16 Finally, hospital- and treatment-related factors were compared on the basis of statistically significant outlier status.
A nomogram was constructed using multivariate logistic regression analysis and internally validated for model discrimination and calibration by bootstrapping with 200 resamples. Model discrimination was first quantified using the concordance index to measure the predictive accuracy of the model by analyzing all possible pairs of patients. After quantifying the model discrimination, the model calibration was graphically assessed using a calibration plot.17
All statistical analyses were performed using Stata MP software version 11.0 (release 2010), and the R software (www.r-project.org/) with the RMS package was used to construct the nomogram. Because the analysis used preexisting data with no personal identifiers, it was exempt from review by our institutional review board.
A total of 85 190 patients (treated in 1064 hospitals) met the study criteria and were eligible for analysis. The identification of cases and a flowchart of the analysis are shown in Figure 1. Demographic and tumor data for all patients are summarized in our Table. The overall rate of margin-positive resections for the entire cohort was 5.2%. Patients with a margin-positive resection were more likely to be older, male, and African American; to have their disease diagnosed in the more recent years of the study period (2004-2007); and to not have private insurance. Other demographic factors, including median income quartile, educational level, and residence (rural vs urban), were not associated with risk of margin positivity.
Baseline patient and tumor characteristics and margin status are summarized in our Table. Tumors located in the rectum with a higher AJCC stage (final pathology stage), signet or mucinous histology, or classified as poorly differentiated or undifferentiated were associated with a higher risk for positive margin. Tumor size was not associated with margin status.
An adjusted risk model for margin positivity was developed based on patient and tumor characteristics. Nearly 64% of patients in the patient sample were between 40 and 75 years of age. The margin-positive rate was lowest in this group. On multivariate analysis, patient-related factors associated with a small to moderate increased risk for margin positivity (adjusted odds ratio [AOR] 1.0-1.50) included age older than 75 years, male sex, African American race, and more recent year of diagnosis (2004-2005 and 2006-2007). A stronger association was observed with lack of private insurance with a 63% relative increase in margin positivity (8.5%; AOR, 1.54 [95% CI, 1.29-1.84]).
Tumor-specific factors were evaluated on the final pathologic specimen. Factors significantly associated with a moderately increased risk for margin positivity included poorly differentiated grade and tumor location in the rectum. Stronger associations were observed for signet ring cell or mucinous histologic type, and more advanced T or N category. The highest rates of margin-positive resection were associated with AJCC stage IIB tumors (margin-positive rate, 23.6%; AOR, 21.8 [95% CI, 18.74-25.36] vs stage I tumors) and signet ring histology (22.4%; AOR, 2.49 [95% CI, 2.02-3.07] vs non–signet ring, nonmucinous adenocarcinomas) (Table). Notably, 24% of patients with stage IIB cancer received neoadjuvant radiation, and 20.3% of these patients had a positive margin at resection. As expected, the margin-positivity rate for the adjuvant group was higher at 31.5%.
The O/E ratio of margin-positive resection was determined for individual hospitals (Figure 2) and plotted logarithmically to compare the ratios of observed to expected margin-positive resection rates according to the model-derived expected probabilities. Hospitals with an O/E ratio of 1 had exactly the same number of observed margin-positive cases as expected according to patient and tumor characteristics. Those with an O/E ratio of more than 1 had a greater number of observed margin-positive tumors than expected; those with an O/E ratio of less than 1 had fewer observed margin-positive tumors than expected. These were further designated as significantly high (referred to as "high outliers") and significantly low outliers (referred to as "low outliers") on the basis of the probability of H0: O = E, defined by P < .05. This allowed us to make comparisons among the hospitals on the basis of outlier status, taking into account hospital characteristics and treatment patterns.
O/E ratio indicates observed to expected ratio.
Of the total 1064 hospitals examined, 173 were significant low or high outliers. Of the low outliers (significantly fewer than expected margin-positive resections), 9.1% were community cancer programs, 47% were comprehensive community hospitals, and 43.9% were academic/research hospitals (Figure 3). Of the high outlier hospitals (significantly greater than expected margin-positive resections), 29.9% were community cancer programs, 52.3% were comprehensive community hospitals, and 17.8% were academic/research institutions.
CoC indicates Commission on Cancer of the American College of Surgeons and the American Cancer Society; O/E ratio, observed to expected ratio; Q1-Q4, 4 quartiles. The grey bars represent percentages within each category.
Hospitals were stratified by yearly surgical volume into quartiles, and differences in positive-margin rates between significantly high- and low-volume hospitals were assessed (Figure 3). Among the low outlier hospitals, more than 80% were the highest quartile for volume (10.7-98.9 cases per year). No hospitals from the lowest quartile for volume (1.0-4.4 cases per year) were low outliers. However, high volume did not preclude high outlier status because 17.8% of the high margin-positive outliers were high-volume hospitals, whereas the remaining hospitals were fairly evenly distributed among mid–high-volume (32.7%), mid–low-volume (23.4%), and low-volume (26.2%) quartiles.
The treatment-related variables assessed included receipt of chemotherapy or radiation therapy and their sequence. We also examined type of surgery (low anterior resection, coloanal anastomosis, or abdominoperineal resection) to examine differences between the significant outlier groups. Rates of chemotherapy (54.1% vs 54%) or radiation therapy (46.5% vs 45.8%) between the low and high outlier hospitals did not differ meaningfully. However, there were notable differences in the sequence of surgery and radiation. Among low outlier hospitals, 56.6% of the patients who received radiation received it prior to surgery, whereas among high outlier hospitals, only 37.3% of patients received radiation prior to surgery. Finally, there was little difference between the low and high outlier groups with regard to specific operation. The majority underwent a low anterior resection, whereas coloanal anastomosis was a more common procedure in the low outlier hospitals (8.5%) than in the high outlier hospitals (5.5%).
We used the logistic regression model (Table) to construct a nomogram for determining the expected rate of margin positivity for a given hospital (Figure 4). The nomogram has a bootstrap-corrected concordance index of 0.7474 (eFigure in Supplement), indicating good performance. The calibration plot demonstrates that the predicted probability derived from the nomogram corresponds well with the observed probability and is slightly overestimated only when greater than 0.3. This nomogram can thus be used to determine an individual hospital's expected rate of margin-positive resection for comparison with its observed rate within the NCDB.
To calculate the probability of a positive margin (ie, a margin positive for cancer), first obtain the value for each predictor by drawing a vertical line straight upward from that factor to the points' axis, then sum the points achieved for each predictor, and locate this sum on the total points' axis of the nomogram where the probability of a positive margin can be located by drawing a vertical line downward.
Resection margin status is a primary determinant of long-term oncologic outcome among patients with rectal cancer. In our study, we used the NCDB to investigate the relationship between patient-, tumor-, and treatment-related variables and the risk for margin positivity during resection for rectal cancer. The analysis demonstrates a number of patient-related risk factors for margin-positive resection, including older age, male sex, African American race, and public insurance. Tumor-related risk factors include more advanced AJCC stage (especially T category), signet or mucinous histology, and poor/undifferentiated grade.
Using the adjusted risk model, we determined the ratio of observed to expected rates of margin positivity and identified 173 of 1064 hospitals that were significant high or low outliers. High outlier status was associated with a lower rate of neoadjuvant radiotherapy, lower hospital volume, and nonacademic/research hospital type, whereas low outlier status was associated with a higher rate of neoadjuvant radiotherapy, high hospital volume, and academic/research hospital type. However, it was highly notable that neither academic/research hospital type nor high hospital volume precluded high outlier status.
The historically high rates of local failure following resection of rectal cancer were dramatically improved with the widespread adoption of the sharp total mesorectal excision technique.4,7,18,19 Total mesorectal excision improves the clearance of regional lymph nodes and the achievement of negative circumferential resection margins. Previous studies14,20- 22 of risk factors for circumferential resection margin positivity have focused on tumor-related factors such as T and N categories, tumor size and location, vascular invasion, and the need for abdominoperineal resection. Other studies23- 25 have reported associations between higher provider and hospital volumes and improved outcomes for oncologic procedures. In the present analysis, we have identified additional patient- and tumor-related factors associated with an underlying risk for margin-positive resection. In addition, we have identified the use of preoperative radiotherapy and treating facility characteristics as important treatment-related factors accounting for outlier status and significant variance from risk-adjusted expected rates of margin positivity. We then developed a nomogram that individual hospitals can use to determine their own risk-adjusted expected margin-positivity rates. With this nomogram, individual hospital-based cancer programs can use their own previously abstracted data to determine their expected rate of margin-positive resection and compare it with the benchmark-expected rate based on their individual patient and tumor mix. If significant variance is identified, it can alert the cancer program to consider quality improvement initiatives to decrease their rates of margin positivity.
Resection margins have a significant effect on both local recurrence and disease-free survival.5,6,26- 28 Neither preoperative radiotherapy nor adjuvant chemotherapy can compensate for margin positivity; however, randomized trials29- 31 have demonstrated that neoadjuvant radiotherapy can improve local control. Furthermore, preoperative combined modality chemotherapy and radiation has been associated with improved local control, margin-negative resection, and the potential for sphincter preservation and disease-free survival compared with postoperative therapy.31- 33 Our analysis indicates that patients who receive preoperative radiation therapy are more likely to have been treated in a low outlier hospital and that those who receive postoperative therapy are more likely to have been treated in a high outlier hospital, thus identifying a simple, key, potentially modifiable treatment-related factor that may help hospitals improve their negative resection margin rates.
In this analysis, we have focused on comparing the ratio of the observed to expected rates of margin positivity within the NCDB. Outlier status was not exclusively predicted by hospital volume, nor by academic/research or nonacademic/research hospital type (ie, no hospital type was exempt from high outlier status, nor could a hospital be ensured low outlier status). Thus, the analysis is applicable and relevant for all types of individual hospitals that want to compare their observed rate to their risk-adjusted expected rate. All facility types may have factors in their practice that may be targeted to improve rectal cancer outcomes. High outlier hospitals can look for modifiable treatment-related factors to alter their clinical practice to improve rates and outcomes. Using the O/E ratio allows a hospital to evaluate itself while controlling for its mix of patient- and tumor-related risk factors. We have created a simple-to-use nomogram to facilitate this evaluation.
Our study has important limitations, as well as strengths. Analysis of a large database is subject to data constraints, incorrect or missing data, and an inability to account for pathologic or surgical variability. The Commission on Cancer does conduct abstraction training, as well as annual quality-control audits, to minimize these errors in the database. We also noted that the rate of margin positivity was higher during the later years of the study, suggesting a secular trend in reporting bias as the importance of margin status has become increasingly recognized. However, the analysis remains valid for individual hospitals during the reporting period because their individual patient and tumor characteristics served as the basis for the model. Moreover, our study includes only data from Commission on Cancer hospitals, so hospital selection bias may exist. The percentage of minorities in our study is smaller than expected (7% African American in our study vs 12.6% in the 2010 US Census), suggesting this potential for bias. Information regarding provider specialty or experience was not available, and the NCDB did not collect data on comorbid conditions until 2003; therefore, the effect of these variables is unknown. However, while less surgeon familiarity with rectal cancer surgery may have been associated with margin positivity, being an academic/research or higher-volume program did not preclude high outlier status. Finally, while the nomogram was not independently validated, the information is taken from the NCDB, which collects data on approximately 76% of incident cancer cases in the United States and thus represents the majority of the US population with rectal cancer. For internal validation, we did perform bootstrapping and identified good performance with a concordance index of 0.75. The calibration plot also demonstrates that the predicted probability derived from the nomogram corresponds well with the observed probability.
In conclusion, the rates of margin positivity have decreased since the introduction of the total mesorectal excision, but margin positivity remains a major determinant of local recurrence, metastases, and overall survival. Our study identified both patient- and tumor-related risk factors for margin positivity, as well as treatment-related factors such as the use of preoperative radiation therapy and facility characteristics, that are associated with rates of positive-margin resection. Although type of hospital and volume were associated with outcomes, no hospital was immune to being a high outlier for margin positivity. The nomogram for determining the risk-adjusted expected rate of margin positivity that has thus been developed in our study permits hospitals to evaluate their own performance and identify potential areas for process improvement.
Accepted for Publication: February 1, 2013.
Corresponding Author: George J. Chang, MD, MS, Department of Surgical Oncology; University of Texas MD Anderson Cancer Center, 1400 Pressler St, FCT 17.6000, Houston, TX 77030 (email@example.com).
Published Online: June 26, 2013. doi:10.1001/jamasurg.2013.2136.
Author Contributions:Study concept and design: Hu, Cormier, Skibber, Nelson, Chang.
Analysis and interpretation of data: Russell, You, Hu, Cormier, Feig, Rodriguez-Bigas, Chang.
Drafting of the manuscript: Russell, Hu, Cormier, Chang.
Critical revision of the manuscript for important intellectual content: You, Cormier, Feig, Skibber, Rodriguez-Bigas, Nelson, Chang.
Statistical analysis: Russell, Hu, Cormier, Chang.
Obtained funding: Chang.
Administrative, technical, and material support: Russell, Feig, Skibber.
Study supervision: You, Skibber, Nelson, Chang.
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was supported by the National Institutes of Health/National Cancer Institute grants K07-CA133187 (to Dr Chang) and CA016672 (MD Anderson Cancer Center support grant).
Additional Contributions: We thank Kathryn Hale for her assistance with the manuscript editing and Christina Caraway for her technical assistance with manuscript preparation.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Surgery editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers' bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
eFigure. Bootstrap-corrected calibration plot for the nomogram
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Breast Cancer
The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Cancer, Family History
All results at
JAMAevidence.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
I'm thrown between hope and despair here, no not really but right now it's like living in/on a roller coaster for a meteopathic person like me, one day of bright lovely sunshine is followed by at least one day of total greyness and I have to say that I feel cheated. Sure, the spring proceeds and it flowers and blossoms all over the place but where's the warming sun? I want to be able to go outside and sit in the sun every day now. Close my eyes and listen to the humming and buzzing and the chattering. Feel the sun warm up my body and my soul. Especially the latter, how nice it would be if the sun could just melt away all the strange things I feel that I have accumulated there lately. Well, some people say that the soul doesn't exist. And I suppose I should be happy that at least there are a lot of flowers and blossoms to light up the greygreygrey. I suppose I just should get on living instead of complaining so I'll make yet another try but I can't remove that little angry voice that is buzzing inside my head though…
If you want to make your day a bit happier check out Sean's (Hedonia) Eatsdropper and if you want to make my life happier, send him your Eatsdroppings so that he can go on posting them! The address is found in the linked post right above.
This is the dessert that I made for the Swedish Cyber Chef that I wrote about yesterday. I have to say that it is really good. Very good even. I'm sorry if I sound like a big bragger but I'm just so satisfied with it.
2 portions
1 egg
1 egg yolk
50 ml / 0.2 cup sugar
4 tblsp Crema di Limoncello, it probably works as well with normal Limoncello
2 tsp gelatin powder (remember that the European teaspoon (and tablespoon) measure is slightly less)
150 ml / 0.63 cup fresh cream
– Mix the gelatin powder with 2 tblsp water and leave it to absorb.
– Whip egg, egg yolk and sugar in a bowl until it's white and fluffy, then add the Crema di Limoncello, a little at a time.
– Heat up the egg cream in a bain-marie or double boiler, whipping all the time and when it has thickened you add the gelatin, stir really, really well and put the bowl aside and leave it to get cold. Stir often.
– Meanwhile you whip the cream, not too hard though, it should still move a little when you incline the bowl but it must not be runny.
– Mix the whipped cream with the egg cream very carefully, mix well but with a light hand to to speak.
– Put the mousse in whatever you want to serve it in and then put it in the fridge for at least 2 hours.


text:
|[TowerTalk] non-conductive lightweight mast
|email@example.com (Pete Smith)
|Mon, 14 Jan 2002 08:08:50 -0500
At 06:45 AM 1/14/02 -0500, Tom Rauch wrote: >> The Loop Mast and Hadware kit that Gary (K9AY) sells includes 24 feet >> of fiberglass support mast. >> >> 73 de Mike, W4EF > >You do not need a fiberglass mast. That antenna has a moderately >low impedance. > >All you need is an ground-insulated mast (conduit is fine) with a >short stub of PVC at the top to keep it away from the wire. This appears to be correct. Since posting my original inquiry, I have modeled the antenna with and without a conductive mast, grounded and floating, and there appear to be only miniscule differences in pattern shape and maximum gain. I will probably use fiberglass, if only because the K9AY loop will be reasonably close to my 80-meter array and I would rather not have any more conductive stuff around than necessary. BTW, there are surplus fiberglass masts available for much less money than the kit. I'll be testing one shortly and will hopefully be able to offer an endorsement for this and other purposes. 73, Pete N4ZR The revised World Contest Station Database is online at www.pvrc.org ________________________________________________________________________ Where do you get ICE bandpass filters & beverage matching boxes? The same place that pays for the hosting of this list: The eHam Store. Order online at http://store.eham.net. ----------------------------------------------------------------------- ----- FAQ on WWW: http://www.contesting.com/FAQ/towertalk Submissions: email@example.com Administrative requests: firstname.lastname@example.com Problems: email@example.com
|<Prev in Thread]
|Current Thread
|[Next in Thread>
|Previous by Date:
|[TowerTalk] non-conductive lightweight mast, Tom Rauch
|Next by Date:
|[TowerTalk] Engineering/Permit Help; Tower in remote location, krishna
|Previous by Thread:
|[TowerTalk] non-conductive lightweight mast, Tom Rauch
|Next by Thread:
|[TowerTalk] non-conductive lightweight mast, Bill Aycock
|[Date] [Thread] [Top] [All Lists]


text:
cambio CarSharing. A car when you need one.
Welcome to cambio Hamburg
We are here for you!
Opening hours: Mo / We / Fr till 17h und Tu & Th 9 till 18:30h
Induction-meetings and opening hours of our sales offices you can find here.
cambio. Always among the best.
As certified in the 2016 ADAC CarSharing test, cambio belongs to the best of its industry.
Become Customer
112 Stations in 39 Stations,
9 Car Types, 4 Price Classes
cambio. Cars for all occasions.
A compact car for the city, an estate car for the holidays and a transporter, just in case? No problem!
Combine cleverly
Entry deals for tram and bus users.Your benefit
CarSharing. This is how it works!
cambio is the inexpensive alternative to buying or leasing a car for companies that want efficient and flexible mobility.


text:
I am out of the words.
I am out of the words to say about Kevin Durant.
So I'm just going to do this: !!!!!!!!!!!!!!!!!!!!!!!!!!!
Durant said it last night after the Rockets game: "There's always another level I can go to." And I think we saw a little of that level tonight.
A career-high 54 points on 19-28 shooting, 5-9 from 3, four rebounds, two steals and six assists.
Let it wash over you for a moment. Maybe open a window and scream out of it. I currently have two fans running inches from my face trying to cool me down. Kevin Durant has played some insane basketball the last six years, and had some unbelievable games. But this right here might be his masterpiece.
Said Durant: "As a leader my main objective is to serve my teammates. How can I help them out. Some nights I've got to put it up, I've got to score. Some nights I've got to do other things. Tonight, they found me and I was able to hit a few shots. And I just tried to do the best I could to lead the team and lead us to victory. It's far from just me. Kendrick Perkins did a great job of rebounding. Serge did a great job hitting shots. Everybody just played hard and of course they're going to see me hitting a few shots, but it's the small things that go into a game that help us win and everybody did them tonight."
After KD hit his third straight 3 in the fourth quarter, it started to hit me. I'm watching maybe Durant's best game ever, and I'm going to have to write about it. I'm going to have to say something about what I saw, what I sat 20 feet away from and attempt to summarize it in an acceptable way. I came to the conclusion very quickly that like Draymond Green checking Durant, I was going to fail.
What Durant did tonight was all-time special. It's not like what we saw was shocking or anything, though. The incredible thing about KD is that he's absolutely capable of repeating this all over again on Sunday. But this, this was just beautiful to watch. It was like everything he's been doing the last few weeks without Russell Westbrook finally came together and worked over a 48 minute span. It was all within the flow. None of it was forced, even the last five minutes when it was entirely clear that it was get-the-ball-to-Durant time.
Oh, and it was against a really good Western opponent on national television. It's still too early to make any real MVP statement, but this is absolutely the kind of game you file away in the memory bank for later. The way Durant carried his team — again — against a good team behind a transcendent performance… that's what MVP seasons are made of.
"That's premature man. It's still early in the season," Durant said of the MVP talk. "I try not to think about that type of stuff. Of course as a player, you'd love to win an MVP award. Can't think about that, can't take my focus off the team. Every day I've got to just keep chipping away, keep enjoying the process and we'll see what happens."
Durant's studio 54 is obviously the story, but a Thunder win is also kind of notable. They picked up back-to-back wins over the Rockets and Warriors, and did it one night behind a historic defensive performance, and the next behind a supernova scoring night from KD. I don't know if they're necessarily figuring things out, or if Kevin Durant is just currently orbiting around our planet like a satellite, but the Thunder are playing the best they've ever played without Russell Westbrook.
"I've always felt that we have a good system," said Scott Brooks. "I'm just glad we didn't change the starting lineups and put KD coming off the bench. That was one of my better moves I've done in the last two games."
In conclusion, Kevin Durant.
- Brooks' first line postgame: "I thought it was a good team win." Yeeeeeeeeeeah.
- Durant's average now: 30.6 ppg.
- Something to remember: This was on the second night of a back-to-back for KD. Played 43 minutes last night and had 36.
- OK, one thing to talk about in this one is how awkward things got between Durant and Jackson late in the fourth quarter as KD was going off. It's not that Jackson refused to feed KD, it's just that instead of giving it up and getting completely out of the way, he was trying to insert himself juuuuust a little too much in it. At one point after Jackson failed to get it to him, KD said as they ran back "Just throw me the ball." It's not that KD was mad, but he was, I'll say, annoyed at Jackson's inability to force feed the ball to him.
- Here's my guess on what happened: I don't think Jackson was hogging or trying to torpedo KD's moment. I think he was just trying a little too hard to get KD a good shot. Like he was diligently trying to run point guard and do his job and set Durant up with a clean look. When really, all he needed to do was pass the damn ball to Durant and go stand by halfcourt.
- An impressive moment from KD late in the fourth: He had a 2-on-1 break sitting on 54 and instead forcing the issue for more points, he made the right play and dropped it to Ibaka for a layup.
- KD hit a bunch of shots from the right wing in the fourth quarter. On that he said, "I've been working on that shot, the right wing. It used to be the shot I missed the most. People that put in the work like we do throughout the summers and the seasons, I'm starting to make it a little bit better. I think I'm starting to get a little worse on the left wing. I've got to figure out how to be good on both sides."
- What does KD do after dropping a career-high 54? Walks to the shower singing the Sesame Street theme song. (UPDATE: KD actually might've been singing this New Edition song. All I heard was "sunnnn-ny dayyyyyys" and both songs have that in them, so it's kind of hard to know.)
- Brooks on the offense OKC was running in the fourth: "We have to get a set to put him in spot where he feels comfortable, which is any time you cross halfcourt. But tonight we were running the plays and if they're guarding him one-on-one, he's going to have the ability to score."
- The Warriors did what the Rockets could not with 1:37 left in the third, scoring their 20th and 21st points of the second half.
- Perk played a pretty nice game despite a few customary offensive snafus.
- It does say something about your starting center though when you see "12" next his name for rebounds and you go, "whoa!"
- Serge Ibaka with another tremendous performance supporting Durant: 21 points on 8-11 shooting and eight rebounds. Ibaka's last two games, he's got 42 points, 23 rebounds and shot 18-24 from the floor.
- What Draymond Green is to the Warriors is what Perry Jones should strive to be for the Thunder. That might be setting the bar a bit low for the potential Jones has, but I'm talking that kind of impact player.
- Durant: "When I've got it going, I look at the bench and see how my teammates are reacting and that just gives me an extra push. Then I hear the fans. It's unbelievable playing for this city and playing in this building."
- The second quarter was absolutely brutal tonight. There were 21 free throws taken… in the final 2:30 of the quarter! For such a wonderfully fun offensive game, it was completely ruined with whistles for a solid six minutes.
- Subtle thing that's different about Jackson's pullup jumper this season: When he plants on it, he jumps back just a touch. Not to fade on it, just he stops his momentum by pushing back just a tad. Seems like he keeps him a lot more squared on target than he used to be.
- You know KD had a great game when Stephen Curry goes for 37 on 11-18 shooting with 11 assists and NO ONE is talking about it.
- The Warriors shot 16-27 from 3. And lost!
- For as incredible as the offense was in this game, the Warriors missed 15 free throws, and the Thunder missed nine. Kind of strange.
- Curry had 22 at the half, and while he still had 15 in the second, I thought Thabo Sefolosha did a great job making him work. Scott Brooks nailed it pregame saying that they wanted to "get into Curry's handle" because he's a bit turnover prone. He had seven tonight.
- There have been 16 40-point games in the NBA this season. KD has four of them.
- There has been one 50-point game in the NBA this season. KD has the one of them.
- Derek Fisher's two-handed block on Draymond Green at the end of the first quarter might be my favorite play of the season.
- That Perk fadeaway.
- That Perk eurostep.
- It looked like Durant was going to play the entire second half tonight when he started the fourth quarter, but he checked out after one possession just 32 seconds in. The Thunder ran a skip pass play with Durant passing to Fisher on that possession, so it was obvious Brooks was trying to sneak a quick go-to play in for three points and then give KD a breather. Fisher missed, but pretty slick bit of game management.
- Durant sat for a minute and a half before checking back in.
- I maintain that Steven Adams needs a big bushy Selleck-esque mustache.
- Had a couple people suggest on Twitter that Adams and Collison need a nickname. I'm going with Bash Brothers. Adams is such a Portman.
- I don't know what the deal is with Adams, but man, he gets some bogus fouls called on him. Fouled out tonight after just 11 minutes, making this two straight he's been disqualified. First two of his career, in fact.
- Pregame in the locker room, Royal Ivey was giving Perry Jones crap about going to Baylor, asking him how much money he got paid because why would anyone live in Waco. It's good to have Royal back.
- Some have been making a big deal about The Peake and the lack of an MVP chant for Durant. I remember the past few seasons there have been LOUD ones for him, just later in the year. I really think this is a complete non-issue, and really, a weird thing to care about.
- Durant was asked about the MVP chants: "It is 20,000 people here. It's kind of hard not to hear it."
- You know you've watched something special when you feel completely inadequate to write about it. I mean, that was just awesome.
Next up: Home against the Kings on Sunday


text:
The annual fund raising event for the Jackson Bottom Wetlands Preserve on Hillsboro's south side has announced the winners in three categories, plus the $1000 Grand Prize winner. Judging took place last week on March 16.
- Tori Parker and Stephan Gray - Grand Prize winners
- Abi Johnson - 1st Place in the Youth category
- Mike Jeffords - 1st Place in the Functional category
- Bryon Shaver - 1st Place in the Ornamental category
The auction will be held May 1 from 6:30p to 9:30p at Jackson Bottom's Education Center off Oregon 219. Other items will also be up for bid, including golf packages, wine, and hotel stays, among others. Tickets are $35 per person.