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From the Departments of Psychiatry, Hillside Hospital, Long Island Jewish Medical Center, Glen Oaks, and the Albert Einstein College of Medicine, New York, NY (Drs Robinson, Woerner, Alvir, Bilder, Goldman, and Geisler) and University of North Carolina, Chapel Hill (Drs Sheitman, Chakos, and Lieberman); and Nassau County Medical Center, East Meadow, NY (Dr Mayerhoff). Dr Koreen is in private practice in Huntington, NY.
We examined relapse after response to a first episode of schizophrenia or schizoaffective disorder.
Patients with first-episode schizophrenia were assessed on measures of psychopathologic variables, cognition, social functioning, and biological variables and treated according to a standardized algorithm. The sample for the relapse analyses consisted of 104 patients who responded to treatment of their index episode and were at risk for relapse.
Five years after initial recovery, the cumulative first relapse rate was 81.9% (95% confidence interval [CI], 70.6%-93.2%); the second relapse rate was 78.0% (95% CI, 46.5%-100.0%). By 4 years after recovery from a second relapse, the cumulative third relapse rate was 86.2% (95% CI, 61.5%-100.0%). Discontinuing antipsychotic drug therapy increased the risk of relapse by almost 5 times (hazard ratio for an initial relapse, 4.89 [99% CI, 2.49-9.60]; hazard ratio for a second relapse, 4.57 [99% CI, 1.49-14.02]). Subsequent analyses controlling for antipsychotic drug use showed that patients with poor premorbid adaptation to school and premorbid social withdrawal relapsed earlier. Sex, diagnosis, obstetric complications, duration of psychotic illness before treatment, baseline symptoms, neuroendocrine measures, methylphenidate hydrochloride challenge response, neuropsychologic and magnetic resonance imaging measures, time to response of the initial episode, adverse effects during treatment, and presence of residual symptoms after the initial episode were not significantly related to time to relapse.
There is a high rate of relapse within 5 years of recovery from a first episode of schizophrenia and schizoaffective disorder. This risk is diminished by maintenance antipsychotic drug treatment.
PATIENTS WITH first-episode schizophrenia usually respond well to treatment,1- 5 but relapse is frequent during the first years of the illness and may be associated with clinical deterioration.6 Previous studies have used different definitions of relapse, employed a variety of treatments and have reported a range of relapse rates. Despite this variability, some general trends are evident. In the first year, relapse rates in published studies7- 9 are relatively low. The largest rate was 41% in patients taking placebo (n=17)8; only 17% of patients relapsed during 15 months in the study9 with the largest sample size (n=69). After the first year, relapse rates8,10- 15 rise substantially, with published rates of between 35% after 18 months15 and 74% after 5 years of follow-up.12
Relapse prevention is a major challenge in the care of patients with schizophrenia. Our opportunity to study relapse and its predictors arose in the context of a long-term study of first-episode schizophrenia and schizoaffective disorder. Our patients had extensive clinical and biological assessments at baseline, were treated according to a specific medication algorithm, and were followed up prospectively with standardized assessments. This design allowed us to closely monitor symptom recurrences and to examine the association of clinical and biological variables and medication status with relapse.
The study design and methods have been described previously.16,17 The study began in 1986; this report includes data collected until June 1, 1996. All patients were recruited from Hillside Hospital, Glen Oaks, NY; the study was conducted according to guidelines of the Long Island Jewish Medical Center, Glen Oaks, institutional review board. Written informed consent for the study was obtained from patients and, if available, from family members. Inclusion criteria were (1) a Research Diagnostic Criteria18–defined diagnosis of schizophrenia or schizoaffective disorder based on a Schedule for Affective Disorders and Schizophrenia19 interview, (2) total lifetime exposure to antipsychotic medications of 12 weeks or less, (3) a rating of 4 (moderate) or more on at least 1 psychotic symptom item on the Schedule for Affective Disorders and Schizophrenia Change Version With Psychosis and Disorganization Items rating scale (SADS-C+PD),20 (4) no medical contraindications to treatment with antipsychotic medications, and (5) no neurologic or endocrine disorder or neuromedical illness that could affect diagnosis or the biological variables in the study.
Initially, we did not limit the length of study participation. Later we established a maximum study time of 5 years and terminated the participation of patients who had been in the protocol longer (the longest duration of study participation was 475 weeks).
Assessments included the following. (1) Psychopathologic variables: SADS-C+PD20 and the Clinical Global Impression (CGI) Scale21 at baseline and every 2 weeks during acute treatment and every 4 weeks at other times and the Scale for the Assessment of Negative Symptoms22 at baseline and every 4 weeks. (2) Adverse effects/motor symptoms: the Simpson-Angus Extrapyramidal Symptom (SAEPS) Scale23 at baseline and every 2 weeks during short-term treatment and every 4 weeks at other times and the Modified Simpson Dyskinesia Scale24 at baseline and every 8 weeks. (3) Premorbid social adjustment: the Premorbid Adjustment Scale (PAS)25 was completed at baseline using information from patients and family members. "Premorbid" was defined as the period ending 6 months before the first psychiatric contact or hospitalization or 6 months before any evidence of florid psychotic symptoms. Individual PAS item ratings were averaged to provide mean scores for childhood, early adolescence, late adolescence, and adulthood. (4) Obstetric history: obtained from mothers by questionnaire and interview and from birth records when available, and scored using the McNeil-Sjöström scale.26 (5) Neuropsychologic (NP) assessments: done when patients recovered from the initial episode or reached a stable plateau. The NP battery included 38 tests from which variables were selected to provide scores in 6 scales (language, memory, attention, executive, motor, and visuospatial function)27 and a weighted global summary score for NP performance. For scale construction, raw scores were converted to standard scores (z scores) relative to the performance of a healthy control group (n=36). Patients also underwent an abbreviated NP battery assessing attention and motor function before starting antipsychotic drug therapy. For the purpose of analysis, raw scores were converted to factor scores on the basis of principal components analysis. (6) Magnetic resonance imaging brain scans were obtained during the index episode using a 1.0-T whole-body magnetic resonance imaging system (Magnetom; Siemens, Erlangen, Germany). Images acquired by a 3-dimensional gradient echo sequence (fast low angle shot) (coronal acquisition, 3.1-mm-thick contiguous slices, with a 256×256 matrix in a 24-cm field of view; number of excitations=1; repeat time=40 milliseconds; echo time=15 milliseconds; and flip angle=50°) were used for morphometric analysis.28 A semiautomated mensuration system was used for assessing whole brain, ventricular, caudate, superior temporal gyrus, and hippocampal volumes (methods described previously16,27,29,30). Presence of a septum pellucidum abnormality was rated as absent, questionable, or present using previously reported methods.31
During the initial study years, patients were rated for psychotic symptom activation in response to intravenous methylphenidate hydrochloride before starting antipsychotic treatment.16 Homovanillic acid32 and baseline and apomorphine hydrochloride–stimulated growth hormone16 levels were also obtained for a subgroup of patients by indwelling catheter serial sample collection.
For analyses of relapse predictors, some variables required additional specification beyond that described above. Obstetric complications present equaled 1 or more complications rated 5 (potentially greatly harmful/relevant) on the McNeil-Sjöström scale; baseline hallucinations and delusions equaled the mean of the ratings for severity of delusions and severity of hallucinations on the SADS-C+PD; baseline disorganization equaled the mean of the SADS-C+PD ratings for bizarre behavior, inappropriate affect, and a composite measure of thought disorder consisting of the mean of the impaired understandability, derailment, and illogical thinking items; baseline negative symptoms equaled the mean of the global ratings for affective flattening, alogia, avolition-apathy, and anhedonia-asociality on the Scale for the Assessment of Negative Symptoms; baseline depressive symptoms equaled the Hamilton Depression scale total score extracted from the SADS-C+PD33; baseline extrapyramidal signs present equaled a score of 1 (mild) or more on rigidity, cogwheel rigidity, akinesia, or bradykinesia on the SAEPS; parkinsonism present equaled a rating of 3 or more on rigidity or 2 or more on cogwheeling and rigidity on the SAEPS; and akathisia present equaled a rating of 2 or greater on akathisia on the SAEPS. To examine the effect of interepisode residual symptoms, patients were classified as having no residual symptoms, residual symptoms without prominent negative symptoms, and residual symptoms with prominent negative symptoms using the DSM-IV34 schizophrenia course specifiers.
Patients were treated openly according to a standard algorithm, progressing from one phase of the algorithm to the next until they met response criteria. The sequence was initial treatment with fluphenazine, up to 20 mg/d; after 6 weeks, the dose for nonresponders was increased to 40 mg/d for an additional 4 weeks. Patients nonresponsive to fluphenazine therapy were switched to haloperidol therapy, 20 mg/d, for 6 weeks, which was raised to 40 mg/d for 4 additional weeks if needed. Lithium was added for patients who were still unresponsive, and a trial of a neuroleptic agent from a different biochemical class—either molindone hydrochloride, up to 300 mg/d, or loxapine, up to 150 mg/d, was the next strategy (because of a protocol change during the study, lithium augmentation was not used for all eligible patients). Patients who were still treatment resistant were treated with clozapine, up to 900 mg/d. Benztropine mesylate, 2 to 6 mg/d, was given if extrapyramidal symptoms developed, and lorazepam, 1 to 3 mg/d, or propranolol, 10 to 60 mg/d, was prescribed for akathisia. Mood stabilizers were prescribed if needed. Patients who remained unresponsive were treated as clinically indicated by the research team.
Treatment response was operationally defined as a CGI global improvement scale rating of "much improved" or "very much improved" and a rating of 3 (mild) or less on all of the following SADS-C+PD psychosis items: severity of delusions, severity of hallucinations, impaired understandability, derailment, illogical thinking, and bizarre behavior. To be classified as responders, patients had to maintain this level of improvement for 8 consecutive weeks; treatment response was dated from the time response criteria were first met, ie, the beginning of this 8 weeks.
Responders continued taking the successful medication; if clinically appropriate, the dose was lowered by up to 50% in the maintenance phase of treatment. Patients who were clinically stable for 1 year were given the option of discontinuing use of the antipsychotic medication while continuing to be followed up by the study team. Patients who had symptom exacerbations after discontinuing medication use were given the antipsychotic drug that had been successful for them in the past. Continuous antipsychotic medication therapy was prescribed for the remainder of the study for all patients who developed signs of relapse. Whenever possible, we continued to follow up and assess patients who discontinued treatment against our advice; these patients were restarted on antipsychotic drug therapy if they later agreed to treatment.
The following rating scale criteria were used to define a relapse: at least "moderately ill" on the CGI Severity of Illness Scale, "much worse" or "very much worse" on the CGI Improvement Scale, and at least "moderate" on 1 or more of the SADS-C+PD psychosis items listed above; these criteria had to be sustained for a minimum of 1 week. Date of relapse was defined as the first day of this period. Patients who had nonpsychotic symptom exacerbations (eg, affective symptoms) were not classified as relapsed.
Because of the longitudinal nature of the study, length of follow-up (and the period at risk for relapse) varied among study patients. Survival analysis, which adjusts for differences in length of follow-up, was used to estimate the cumulative rate of relapse and to test the effects of potential predictors of relapse. Cumulative rates of relapse were estimated using life-table methods, with 95% confidence intervals (CIs) to indicate the precision of these relapse rate estimates.
Analyses that estimated the effects of single and multiple potential risk factors were done using Cox proportional hazards regression. To ensure that the proportional hazards assumption of Cox regression was met, we ran additional analyses incorporating the interaction terms of individual risk factors with time into the models. Because of the number of risk factors included in the Cox regression analysis, we defined statistical significance as P<.01. We thus used 99% CIs to indicate the precision of the hazard ratios from these analyses.
Cox proportional hazards regression was run with neuroleptic medication status (taking drugs vs not taking drugs) entered as a time-dependent covariate. A lag of 7 days was incorporated into the medication status time-dependent variable so that a patient was considered to be taking medication until a week after stopping medication use and considered to be not taking medication until a week after restarting medication use. These lags were instituted to model the time needed for medications to wear off after discontinuation or build up when resumed and to account for the possibility that stopping medication use constituted part of the relapse process. Additional Cox regression models examining other potential predictors of relapse controlled for medication status as a time-dependent covariate.
One hundred eighteen patients were treated in the study. The sample for the analyses presented consists of the 104 patients who were followed up for a minimum of 2 months after responding to treatment and thus were at risk for relapse. The sample included an equal number of men and women; their mean±SD age at study entry was 25.6±6.3 years (range, 14-44 years); 40% were white, 37% were African American, 12% were Hispanic, 8% were Asian, and 3% were of mixed background. Fifty percent had some education beyond high school. Seventy-eight percent had never married. Patients had been ill for an extended period before study entry: the onset of the first behavioral changes related to the illness preceded study entry by a mean±SD of 119±181 weeks, and the first psychotic symptoms began 64±146 weeks before study entry. Patients were severely ill at baseline. Their mean±SD CGI Severity Scale score was 5.4±0.94 and their mean±SD Global Assessment Scale score was 27.6±8.6. Research Diagnostic Criteria–defined diagnoses of the index episode were schizophrenia (n=71; 82% paranoid, 11% undifferentiated, 6% disorganized, and 1% catatonic subtypes) and schizoaffective disorder (n=33).
Patients were followed up for a mean±SD of 207±101 weeks. The mean±SD antipsychotic drug dose in fluphenazine equivalents during acute treatment was 24±15 mg/d. Twenty-eight patients received some treatment that did not conform to the standard medication algorithm. Nine patients were in initial pilot protocols and began treatment with conventional antipsychotic medications other than fluphenazine. Nineteen patients began treatment with fluphenazine but subsequently received medications not specified in the algorithm for a variety of clinical reasons.
Magnetic resonance imaging, NP, and obstetric measures were not obtained on all patients because of clinical condition or patient or family member refusal.
Relapse rates are presented in Table 1. The cumulative rate for first relapse for the 104 patients was 81.9% (95% CI, 70.6%-93.2%) by the end of the 5-year follow-up. For the 63 patients who recovered after the first relapse, the cumulative rate for a second relapse was 78.0% (95% CI, 46.5%-100%) after 5 years. Similarly, the cumulative rate for a third relapse was 86.2% (95% CI, 61.5%-100%) by the end of 4 years among 20 patients who were at risk after recovery from the second relapse.
A survival analysis of relapse using medication status as a time-dependent covariate indicated that the risk for a first and second relapse was almost 5 times greater when not taking than when taking medication (hazard ratio for the first relapse, 4.89 [99% CI, 2.49-9.60]; hazard ratio for the second relapse, 4.57 [99% CI, 1.49-14.02]). Survival analyses for the third relapse produced high but unstable estimates because of the small number of patients at risk.
Thirteen stable patients who had discontinued antipsychotic drug therapy dropped out of the study (5 patients had been followed up for ≥2 years after recovery from the initial episode, 4 patients were at risk for relapse for 1-2 years, and 4 patients were at risk for relapse for <1 year). These were categorized as censored observations at the time they dropped out. This raised the possibility that our hazard ratios were biased upward because they would not reflect the possibility that these patients might have remained stable without taking medication after they dropped out. To assess this possibility, we reran our analyses assuming that these 13 patients continued not taking antipsychotic drugs and did not relapse from the time they dropped out of the study until either the June 1, 1996, cutoff date for our analyses or the date that would have marked their completion of 5 years in the study. For the first relapse, the hazard ratio estimating the effect of not taking antipsychotic medications was 3.31 (99% CI, 1.66-6.61) in these analyses. Thus, even given these extreme assumptions, stopping antipsychotic drug therapy had a large effect on relapse.
Given the strong association between medication discontinuation and relapse, we next examined the possibility that antipsychotic drug therapy discontinuation was an early phase of the relapse process rather than a precipitant, ie, patients who are becoming psychotic might lose insight and stop taking medication. If this were the case, relapse onset and antipsychotic discontinuation should be temporally close; a long period between stopping antipsychotic drug use and relapse onset would not be consistent with this hypothesis. One way to examine this issue was to lengthen the lag period in our analyses during which patients were classified as taking medication after administration of their last actual medication dose. If stopping antipsychotic drug therapy occurred at or just before the time of relapse, lengthening these lag periods would cause patients in our analyses to be considered as taking medication at the time of relapse and thereby decrease the relapse risk associated with not taking antipsychotic drugs. In subsequent analyses using longer lag periods, antipsychotic drug therapy discontinuation continued to be associated with a substantial relapse risk; this suggests that stopping antipsychotic drug use was not just an early manifestation of relapse. For example, the hazard ratios associated with not taking medication for the first relapse were 4.49 (99% CI, 2.31-8.75) using a 14-day lag, 4.16 (99% CI, 2.15-8.06) using a 28-day lag, and 4.41 (99% CI, 2.27-8.57) using a 56-day lag.
Because antipsychotic medication status was such a strong predictor of relapse, the time-dependent covariate measuring medication status (using a 7-day lag period) was controlled for in analyses of other predictor variables. Analyses of predictors of the first relapse are presented in Table 2. Early adolescent premorbid adjustment was the only variable significantly related to first relapse; late adolescent premorbid adjustment and hippocampal volume were trend level predictors (P<.05). Results of subsequent analysis of individual PAS items indicated that shorter time to first relapse was significantly associated with social withdrawal in late adolescence (hazard ratio, 1.29; 99% CI, 1.09-1.61) and poor adaptation to school in early adolescence (hazard ratio, 1.38; 99% CI, 1.06-1.81); relapse was also associated at a trend level (P<.05) with poor school adaptation in childhood (hazard ratio, 1.41; 99% CI, 0.96-2.05) and late adolescence (hazard ratio, 1.17; 99% CI, 0.96-1.44).
To demonstrate the clinical relevance of our premorbid adjustment findings, Figure 1 presents the predicted cumulative relapse rates for patients in the 25th and 75th percentiles of early adolescent global PAS scores (PAS scores=0.8 and 1.7, respectively). Predicted rates were based on Cox proportional hazards regression; antipsychotic drug status was set at 0.5 (midway between taking and not taking drugs), the approximate mean for this variable. At 1 year, the relapse rate for patients in the 75th percentile was 43% larger than that for patients in the 25th percentile, but there was little absolute difference because both had low relapse rates (17.3% [99% CI, 6.2%-27.1%] and 12.9% [99% CI, 3.1%-20.2%] for patients in the 75th and 25th percentiles, respectively). With the substantial increase in overall relapse rate at 2 years of follow-up, the difference in relapse between patients in the 75th and 25th percentiles was potentially large enough (57.8% [99% CI, 39.6%-70.5%] vs 44.3% [99% CI, 26.0%-58.1%], respectively) to be clinically important.
Predicted cumulative relapse rates for patients in the 25th and 75th percentiles for early adolescent global Premorbid Adjustment Scale (PAS) scores (PAS scores=0.8 and 1.7, respectively) based on Cox proportional hazards regression. The drug status time-varying covariate was set at 0.5 (midway between taking and not taking drugs).
We found that most patients who recover from a first episode of schizophrenia or schizoaffective disorder experience psychotic relapse within 5 years. Furthermore, patients who recover from a first relapse have high rates of second and third relapses despite careful monitoring by a dedicated research treatment team.
Our study offered stable patients the option of discontinuing antipsychotic medication after 1 year of treatment. Those who did so were carefully monitored and treated at the first sign of symptom exacerbation. This conformed to clinical practice at our center when the study began and is consistent with the recently published "American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia,"35 which recommends at least 1 year of maintenance antipsychotic medication treatment for remitted first-episode patients. Our data show that medication discontinuation substantially increases relapse risk. This is consistent with earlier findings8,10 and argues strongly for maintenance medication therapy for first-episode patients with schizophrenia and schizoaffective disorder.
How long should maintenance treatment last? A definitive answer requires systematic medication discontinuation studies, but our data provide some suggestions. The almost 5-fold increase in relapse risk associated with stopping antipsychotic drug use in our analyses was based on the entire follow-up for each patient; our ability to make inferences about a particular period depends on the number of patients who relapsed during that period. We had enough patients who relapsed within 2 years (n=50) to be confident that medication use should be continued at least this long. Is maintenance medication therapy needed for first-episode patients who have been stable for longer than 2 years? We had only 15 patients who relapsed for the first time after 2 years of stability; 8 of these patients had discontinued medication use when they relapsed, suggesting the continued importance of maintenance medication treatment.
Aside from medication status, premorbid social adjustment was the only predictor of relapse in our study. Kane et al8 found a significant association between social isolation in childhood and adolescence as measured by the Premorbid Asocial Adjustment Scale36 and relapse in first-episode patients taking placebo but not in patients taking antipsychotic drugs for maintenance. Our results, based on a larger sample, indicate that premorbid social isolation predicts initial relapse independent of medication status and that poor adaptation to school also predicts relapse in first-episode patients. Thus, specific behaviors that are present long before the expression of overt psychotic symptoms predict some aspects of the course of psychotic symptoms once they develop. This raises the possibility of a subtype of patients with schizophrenia and schizoaffective disorder characterized by poor early adjustment and a severe, relapsing course.
Few of our predictor variables have been examined in other first-episode samples. Our failure to find an association between sex and relapse is consistent with previous studies.8,10 Crow et al10 found that relapse was more common in patients who had an illness onset of 1 year or longer before starting antipsychotic drug use; we did not confirm this, although this variable was associated with initial treatment response in our sample. Study differences in the treatments given and in the definitions of relapse used may have contributed to these divergent findings. Furthermore, illness duration before medication use averaged 2.8 months in the study by Crow et al vs 16.0 months in our study, suggesting differences between the studies in patient clinical characteristics, illness definition, or both. Additional studies are required to clarify the effects of illness duration before treatment on relapse.
In the 5-year follow-up of a subsample of the Northwick Park cohort, Geddes et al11 found that depressive delusions at baseline were associated with lower risk of readmission. Neither the severity of baseline depressive symptoms nor the presence of affective symptoms sufficient to warrant a schizoaffective diagnosis was related to relapse in our sample. We did, however, find a possible relationship between affective symptoms and relapse. Review of clinical profiles of the 8 patients in our sample who survived 1 year or longer without taking antipsychotic drugs and without relapse revealed that affective symptoms were prominent in this small subgroup who were relatively "invulnerable" to discontinuation of antipsychotic drug therapy.
The failure of most of our candidate variables to predict relapse is interesting given that many of them predicted treatment response to the initial episode in our sample.1,32,37- 40 This suggests either that the pathologic mechanisms of relapse differ from those of acute treatment response or—if common mechanisms initially underlie treatment response and relapse—that the pathologic process changes over time because of a deteriorative component, the effects of prolonged antipsychotic medication exposure, or both.
Our findings have some potential limitations. Our study used a standardized treatment algorithm; this allowed patients to be taking different antipsychotic drugs and different doses depending on their response to treatment. This may have introduced confounds between treatment variables and outcome that would not have been present if we had provided treatment with a set dose of only 1 antipsychotic medication. On the other hand, the treatment algorithm strategy more closely follows optimal clinical practice and thus our findings may be more generalizable to "real world" settings than would a single antipsychotic drug design. Our study preceded the widespread availability of the new generation of antipsychotic medications. Whether use of these agents as first-line treatments will produce different results is an open, and important, question.
Although many studies have addressed maintenance treatment in schizophrenia and schizoaffective disorder, relatively few studies have examined relapse in the early years of illness. The high rate of relapse we found and the salience of its relationship to medication discontinuation strongly argues for an increased attention to maintenance treatment issues in the initial stages of schizophrenia and schizoaffective disorder from a clinical and scientific perspective. The fact that so many of our patients refused maintenance antipsychotic drug therapy—even after experiencing 1 or more relapses and despite vigorous patient and family educational efforts—highlights the need for developing strategies to enhance compliance at this early illness stage.
Accepted for publication November 18, 1998.
This study was supported by grant MH41646 and Research Scientist Development Award MH00537 from the National Institute of Mental Health, Bethesda, Md, and grant MH41960 from the Hillside Mental Health Clinical Research Center for the Study of Schizophrenia, Glen Oaks, NY.
Magnetic resonance image analysis was performed in association with the Brain Morphometry and Image Analysis Center of the Long Island Jewish Medical Center, New Hyde Park, NY, supported by a grant from the Helen and Irving Schneider Family, New York, NY.
Reprints: Delbert Robinson, MD, Department of Psychiatry, Hillside Hospital, 266th Street and 76th Avenue, Glen Oaks, NY 11004 (e-mail: firstname.lastname@example.com).
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The Logistics Handbookby James F. Robeson William C. Copacino R. Edwin Howe
The Logistics Handbook encompasses all of the latest advances in warehousing and distribution. It provides invaluable "how to" problem-solving tools and techniques for all the ever-increasing logistical problems managers face -- making it the most complete and authoritative handbook to date. Special features include:* The most in-depth coverage of a wide range of topics, including information systems, benchmarking, and environmental issues* Contributions found nowhere else from the leading executives, consultants, and academics in the field, such as C. John Langley, James Heskett, and David Anderson* State of the art graphics* Information-packed appendixes of logistics publications and organizationsThis all-inclusive reference will enable the next generation of managers to thoroughly integrate their logistics operations at all levels -- strategic, structural, functional, and implementation -- into a comprehensive logistics strategy.
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Since Roger Hodgson left to pursue a solo recording career, keyboardist Richard Davies has assumed the helm of this British group. As a songwriter, Davies, who is also the lead vocalist, seems to be operating on the premise that if you cannot capture an audience with hummable hooks, then baffle them with bombast. Take the title track. At 16½ minutes, it isn't going to get played too often on the radio. Is the inordinate length of this and other tracks a blatant defiance of commercial acceptance? Or is it merely a callow attempt to fill up half an album side? True, if you throw together extraneous recordings of newscasts and other spoken voices with snippets of disjointed melodic themes and stretch until thin, you've got what could pass for the overture to a rock opera, but that's a concept whose time has come and gone. Davies hasn't helped matters with his labored vocal style and the simplistic rhyme scheme of his lyrics: "Yeah I got used/ Messed up and abused/ You let me down/ With all your runnin' 'round." Brother Where You Bound is at least a reminder of what a smooth sax player John Helliwell can be. But if you've a hankering for quality Supertramp, stick with 1979's Breakfast in America. (A&M)
Picks and Pans Review: Brother Where You Bound
updated 07/22/1985 AT 01:00 AM EDT
•originally published 07/22/1985 AT 01:00 AM EDT


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The other day Adam Herman reported on the blog that Chris Kreider was going to participate in The Big Assist IV charity hockey game last night.
Now, Julie Robenhymer over at HockeyBuzz reminds us why Kreider is such a special person on and off the ice by giving this great account from the game…
"After the game, the players posed for a team picture and then headed towards the locker rooms to shower and change….except for one. Chris Kreider saw a kid along the boards waving a pen at him. He skated over and went up and down that side of the rink signing everything handed to him…Forty-five minutes later he made his way back to the bench where a few volunteers were waiting for a picture. At this point, all of the other players had showered, changed and left the rink and while the ice was being resurfaced behind him, Kreider continued to sign autographs and take pictures with anyone and everyone who wanted one as a new line formed near the entrance to the bench."
…wow. Talk about a kid who has his head screwed on straight. In an age where most athletes refuse to give autographs without compensation, it's amazingly refreshing to see this.
…officially getting a Kreider jersey after seeing this. Who's buying me one? lol
H/T to TheNYRBlog reader Arpad K.
In other young Rangers news, Dylan McIrath has begun his journey back to good health…
First day at the physio was a success #roadtorecovery
— Dylan McIlrath (@dylan_mcilrath) July 12, 2012
…let's hope he can get healthy and start learning under the tutelage of Beukeboom real soon.
Finally, in "the only reason I'm posting this is because it's a slow news day" news, former Rangers goaltender Stephen Valiquette has retired due to injuries. He planned on playing in the Swedish Elite League this upcoming season.
…Vali will always be remember for that shootout win vs. St. Louis in 2007 as well as sucking against every team other than the Flyers and Maple Leafs.
H/T to readers Karim and Joachim.
Remember to follow me on Twitter & Facebook or e-mail me at email@example.com.


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TOTAL TRAINING FOR MICROSOFT OFFICE 2010 NEW FEATUItem#: YYP1-DGHZ9683A33K6RD | Model#: TMSO2010NF
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This series is designed for those who have experience with Office 2007 and want to quickly get up to speed on what's new and exciting in Office 2010. Each chapter covers the new or enhanced features found in the Office 2010 applications including Word, Excel, PowerPoint, Outlook, Access and OneNote as well as changes to the overall interface and the all new Web Apps. There were significant changes to the interface in Office 2007 that paved the way for Office 2010 to focus on features that will bring your work to a whole new level of professionalism, efficiency and mobility. Many of these features are not easily identified so this series takes you to them so you don't miss a thing. Are you ready to experience the power of Office 2010 to its fullest? Let's get up to speed now!
Chapter 1: OFFICE 2010 FIRST GLANCE (34 min)
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The Oakland Raiders entered the 2014 NFL draft in desperate need of young talent. The entire roster has been filled with veterans who are long-term solutions.
A quarterback of the future and a player who could make a big impact were both needed—in fact, there weren't many positions where the Raiders didn't have a need.
A great draft this year could truly be franchise-altering. Do well, and the Raiders may finally be on the right path. Do poorly, and the Raiders may be facing big changes in 2015.


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PDF DownloadPostersHotel & Travel Sponsorship & ExhibitsPress Pass Request Brochure Archives
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CHI offers comprehensive sponsorship packages which include presentation opportunities, exhibit space and branding, as well as the use of the pre and post show delegate list. Sponsorship allows you to achieve your objectives before, during, and long after the event. Any sponsorship can be customized to meet your company's needs and budget. Signing on earlier will allow you to maximize exposure to hard-to-reach decision makers.
Agenda PresentationsShowcase your solutions to a guaranteed, highly-targeted audience. Package includes a 15 or 30-minute podium presentation within the scientific agenda, exhibit space, on-site branding and access to cooperative marketing efforts by CHI.
Breakfast & Luncheon PresentationsOpportunity includes a 30-minute podium presentation. Boxed lunches are delivered into the main session room, which guarantees audience attendance and participation. A limited number of presentations are available for sponsorship and they will sell out quickly. Sign on early to secure your talk!
Invitation-Only VIP Dinner/Hospitality SuiteSponsors will select their top prospects from the conference pre-registration list for an evening of networking at the hotel or at a choice local venue. CHI will extend invitations and deliver prospects. Evening will be customized according to sponsor's objectives (i.e. purely social, focus group, reception style or plated dinner, plated dinner with specific conversation focus).
Pre-Conference WorkshopsIncludes 15-minute or 30-minute podium presentation during pre conference workshop, as well as your company logo displayed on pre conference workshop materials and onsite signage.CHI Lead GenerationCHI can help you with lead generation throughout the year. Our internal database includes over 800,000 prospects in the life sciences. By leveraging the database and mining for your specific requirements, we can produce multiple custom projects which will deliver your prospective buyers: Web Symposia, Podcasts, White Papers, Custom Market Research Surveys and more!
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November 23, 1998
The 1998 WHS cross country team recently completed a successful season with the boys winning 7th place and the girls taking eight place at the state meet in Pasco.
by E-Chieh Lin
The Woodinville High School cross-country team soared through a fantastic season, with both the junior varsity and varsity boys' and girls' teams taking first place at the Kingco meet at Lincoln Park in Seattle.
On Nov. 7, the top eight runners from both the girls' and boys' teams went to Pasco for the State Meet. The boys finished seventh, the highest place taken n a state x-country meet for Northshore, while the girls took eighth.
Leading the boys' team this year was Jonathon Gibson, a junior, who is the current Kingco champion. The girls were led by sophomores Kelsey Metcalf and Caroline Myers, who finished first and second, respectively, in Kingco.
This year's team captains were Shannon Gingel, Meghan Kelly, Amy Guierriery, Blake Croy, Jared Sheeks, and Shad Talbott.


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Research and analysis
Evaluation of the Families Going Forward training course
Report looking at the effect of practitioners' participation in Families Going Forward for different populations.
This final report sets out the results of the mixed-method intermediate evaluation. It looks at effects from practitioners' participation in Families Going Forward for different populations and offers information for programme design and development.
It looks at how practitioners' behaviour and practice changed generally as a result of the training, and in relation to outreach principles and standards.


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Government shutdown causes a bit of confusion in county
October 2, 2013
LISBON — Few of the effects of the federal government shutdown, which started on Tuesday, have local implications. But that fact seemed lost on some people. When the U.....
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The 25th Annual Putnam County Spelling Bee: Hit Musical Comedy
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The last date listed for The 25th Annual Putnam County Spelling Bee was Sunday May 12, 2013 / 2:00pm.
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Neil Simon's The Odd Couple: Mismatched Roomies in Classic Comedy
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The 25th Annual Putnam Spelling Bee was great! I loved the show, and all the singing and acting was great. Did I say great twice?! Also, there was audience participation for the spelling bee show, and I had a chance to participate in the spelling bee. I went out on the second word they gave me, but I got the first word right!!
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I hoped for better because the show had "Tony" magic associated with it. Pacing and casting just didn't work for our group, and the solo piano probably could have used some help - a trio, perhaps?— but I think it was the basic story that didn't...continued
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This is an absolutely fabulous show that will have you in stitches and tears by the end of the show. Each of the actors play both the quirky and emotional elements of their characters. Individually they are wonderful and as an ensemble they're...continued
Music & Lyrics by William Finn
Book by Rebecca Sheinkin
Conceived by Rebecca Feldman
Additional Material by Jay Reiss


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Welcome to Glock Talk
Why should YOU join our Glock forum?
- Converse with other Glock Enthusiasts
- Learn about the latest hunting products
- Becoming a member is FREE and EASY
If you consider yourself a beginner or an avid shooter, the Glock Talk community is your place to discuss self defense, concealed carry, reloading, target shooting, and all things Glock.
what kind of defense ammo do you use in your Glock?
Discussion in 'Caliber Corner' started by wickedarachnid, Feb 15, 2011.
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Maroon 5 confronts identity issues on new CD
Adam Levine knows the game.
Seconds after sitting down for an on-camera interview and before any questions are asked, the Maroon 5 frontman playfully rattles off canned responses he's used in recent months while promoting "The Voice" and the band's fourth album.
"It is our poppiest record ever. We're really embracing the pop side. Christina (Aguilera) and I are all good. We don't fight," he says brightly. "I feel great about this record! Probably our best ever!"
He lets out a stagey, fake chuckle, and it's clear that the 33-year-old Los Angeles native both relishes the spotlight and has been around long enough to get a bit tired of its glare.
Levine and guitarist James Valentine recently chatted about Maroon 5's "identity issues," educating young fans and why Levine doesn't plan to go solo.
Q Why "Overexposed" as an album title?
Levine: We thought we would say it before everybody else did. My face is on buses, which is a trip and it's weird. The "Jagger" tune propelled us into the stratosphere even more, combined with the show and a lot of things that are happening right now.
Q Do the songs address that as well?
Levine: They're love songs and they're songs about dysfunction. But also songs about having a good time. I used to have to be miserable to write a song, but that's kind of gone away.
Valentine: It's weird because when things are going well for him, he's just not inspired to write, because he's enjoying life. Then as soon as things get a little hairy, then all of the sudden songs come out, which is good for us.
Levine: But we also have the moments that I think are just speaking more universally. That kind of clarity is what's best about the record. It's not shrouded in too much metaphor and ambiguity and poetry. I used to think about it much more poetically but I don't anymore. I'm much more concerned with making everyone understand what I mean and what I'm feeling.
Q Your 14-year-old fans likely don't understand what a pay phone is, though.
Levine: I think that if you did some sort of poll, and ask: "What's a pay phone? Who is Mick Jagger?" I think you'd be shocked by how similar the responses were from that particular demographic.
Valentine: We're like history teachers!
Q Do you feel there was a pre-"Jagger" Maroon 5 and a post-"Jagger" Maroon 5?
Valentine: Definitely. "Jagger" sort of laid down a blueprint for what we're going to do next. We were due for a change, and I think we were going to go in some new directions, but with the success of "Jagger," of course we're going to try doing some more stuff like that.
Levine: Also if "Jagger" was us dipping our toe into the water, we launched into the river on this record, which was cool. I think our band has had some identity issues over the past few years and we've been wrestling between trying to stick to being a band in a traditional sense and that clearly wasn't really working.
Q Adam, could you see yourself going solo and then coming back to the band?
Levine: No. And I know I say this and "famous last words," but being a solo artist is so painfully uncool. I always loved playing music with my friends and being in a bit of a fraternity with my best friends and playing and traveling the world. To be a solo artist, I'm just not interested. I never have been. I'd sooner start another band. And why would I want to start over as myself? I have enough ego satisfaction being on "The Voice" and having my own shtick and all that stuff.


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- Applied Biosystems
- BD Biosciences
- DiscoveRX
- Fisher BioImage
- LemnaTech GmbH
- Millipore
The area of drug discovery tools is one of the newest and most important sectors of pharmaceutical research and development. The term drug discovery tools usually refers to high-content screening (HCS) and analysis and is composed of those applications that require sufficient levels of sample throughput, whereby complex cellular events and phenotypes can be studied. Elements of drug performance like toxicity and specificity can be established simultaneously using mixed cell types--primary cells, cell lines, cell subpopulations. HCS seeks to assess the impact of phenotypic and cellular changes that are brought about by gene modification (such as with RNA interference (RNAi) approaches) and/or drug (or compound) treatment.
The purpose of this examination is to describe the specific segments of the global drug discovery tools market. Within this area, the report covers those segments that are highly active in terms of innovation and growth. Specifically, this study examines the markets for small lab equipment all the way up to highly automated, large automated platforms, as well as accessory equipment such as reagents, supplies and manufacturers' original equipment manufacturer (OEM) additional equipment.
- Applied Biosystems
- BD Biosciences
- DiscoveRX
- Fisher BioImage
- LemnaTech GmbH
- Millipore
1. Overview
1.1 Objectives of the Report
1.2 Methodology
1.3 Scope of the Report
1.4 Executive Summary
2. Technologies and Product Offering for High-Content Analysis
2.1 Definition of High-Content Analysis and Why It Is So Attractive a Discipline
2.2 Classes of Measurements Possible with High-Content Analysis Approaches and Biological Functions Investigated
2.3 Instrumentation Platforms for High-Content Analysis
2.3.1 High-Content Screening Technology
2.3.2 High-Content Instruments
2.4 Reagent and Assay Platforms for High-Content Analysis
2.5 Cell-based Screening Technologies in Drug Development
2.5.1 Applications of Cell-based Assays
2.5.2 Pharma Drug Discovery Paradigm and Compound Screening
2.5.3 High-Content Analysis in the Biopharmaceutical Industry
3. Market Analysis of the High-Content Tools Space
3.1 High-Content Analysis Market Size and Growth
3.2 Market Survey to Assess Qualitative and Quantitative Parameters of the High-Content Analysis Space
3.3 Experimental and Research Trends in High-Content Analysis
3.4 Challenges and Market Drivers in High-Content Analysis
3.4.1 Barriers to High-Content Analysis
3.4.2 Drivers of High-Content Analysis
3.5 High-Content Analysis in Combination with RNAi
3.6 Market Landscape of Instrumentation for High-Content Analysis
3.7 Reagent and Assay Usage in High-Content Analysis
3.8 Trends in the High-Content Analysis Assays/Reagents Space-Major Product Vendors
3.9 Emerging Market Trends in High-Content Analysis
3.10 Market Forecasts for the High-Content Analysis Space
3.11 Use of HCS/HCA in Pharmaceutical Companies
3.12 Qualitative Opportunities and Challenges for Market Adoption
4. Strategic Analysis of the High-Content Tools Space
4.1 Analysis of the High-Content Market Structure
4.2 Description of the Drug Discovery Marketplace and Definition of the Field
4.3 Key Market Drivers and Challenges in the High-Content Analysis Space
4.4 Consolidated Picture of the High-Content Analysis Marketplace
4.5 High-Content Analysis Market Sectors and Growth Rate
4.6 Vendors of High-Content Analysis Technology
5. High-Content Analysis Technology Platforms
5.1 Methods of Digital Imaging
5.2 Fluorescence Microscopy
5.3 Major High-Content Analysis Instrumentation
5.3.1 High-Content Analysis Platforms to Support GPCR Screening
5.4 High-Content Analysis Reagents
5.5 Imaging Software
5.6 Enterprise-Level IT Solutions to Support High-Content Screening Experiments
5.6.1 Image Analysis Algorithms
5.7 Use of RNAi in High-Content Analysis
5.8 Industry Alliances to Leverage RNAi and High-Content Analysis
5.9 Emerging Trends in High-Content Analysis Technology Platforms
6. High-Content Analysis in Drug Selection, Screening and Biomarker Discovery
6.1 Stem Cells as Tools for Drug Discovery
6.2 Cellular Systems Biology for Development of Toxicity Panels in Drug Safety Testing
6.3 Drug Discovery Companies Marketing Cell-based Assays
6.4 Companies Using Cell-based Assays in Drug Discovery Programs
6.4.1 Phenotypic Drug Discovery (PDD)
6.4.2 Application of Quantitative High-Throughput Screening to HCA Cell-based Assays
6.4.3 Application of High-Content Fingerprinting to Oncology Drug Discovery: Focus on In Vitro and In Vivo Phenocopying and Cancer Stem Cell Analysis
6.5 Target Discovery and Validation by RNAi Screening
6.6 FLIM-FRET Methodology
6.7 Multidimensional Fluorescence Imaging (MDFI) Technology
7. Company Profiles
7.1 Acumen Pharmaceuticals, Inc.
7.2 Acumen Bioscience (division of TTP Group)
7.3 Applied Biosystems
7.4 BD Biosciences
7.5 DiscoveRX
7.6 Evotec Technologies (acquired by PerkinElmer)
7.7 Fisher BioImage
7.8 General Electric, GE Healthcare
7.9 Guava Technologies (now a division of Millipore)
7.10 Integral Molecular (Akceli Inc.)
7.11 LemnaTech GmbH
7.12 Millipore
7.13 Molecular Devices Corporation, now a division of MDS Analytical Techniques 7.14 NIH Chemical Genomics Center
7.15 PerkinElmer
7.16 Sangamo Biosciences, Inc.
7.17 Spotfire (acquired by TIBCO)
7.18 Thermo Scientific Cellomics
7.19 Translational Genomics Research Institute
7.20 Vala Sciences, Inc.
8. Glossary of Terms in the High-Content Analysis Space
Figure 2.1: Scope of Biological Parameters Addressed Via a Typical High-Content Analysis Experiment
Figure 2.2: Classes of Assays in Life Science Research and Drug Discovery Illustrating the Relationship between Cell-based Assays and High-Content Analysis Figure 2.3: New Paradigm for Drug Discovery and Development Illustrating the Central and Essential Role of Screening
Figure 2.4: Cumulative Known and New Drug Targets
Figure 3.1: Breakout of Market Survey Respondents by Geographical Location
Figure 3.2: Breakout of Market Survey Respondents by Affiliation-Academic, Commercial, Vendor
Figure 3.3: Segmentation of Respondent Pool Based upon Usage of High-Content Analysis in its Research Activities
Figure 3.4: Segmentation of the Survey Respondent Pool Based upon the Length of Time they have been Using High-Content Analysis in Their Research Activities
Figure 3.5: Number of Parameters Studied Simultaneously in High-Content Analysis Assays-Multivariate (Multi-Parameter) Analyses
Figure 3.6: Key Biological Processes Studied Utilizing High-Content Analysis Tools Figure 3.7: Breakout of High-Content Analysis Assays Currently Performed or Expected to be Performed in the Future by Biological Pathway (or Target)
Figure 3.8: Breakout of High-Content Analysis Experiments Performed Per Week (Distributed in our Respondent Pool) Across the Various Biological Pathways (and Targets)
Figure 3.9: Which of the Biological Processes (Pathways/Targets) Addressed Using High-Content Analysis-based Approaches are Growing in Importance and which are Declining?
Figure 3.10: In Which Environment are High-Content Analysis Assays Performed-Primary Screen, Secondary Screen, ADME/Tox Screen?
Figure 3.11: Key Challenges Faced by the Research Community in its Practice of High-Content Analysis
Figure 3.12: Various Drivers Leading the Research Community to Perform High-Content Analysis
Figure 3.13: HCA with RNAi-Current and Future Experimental Formats
Figure 3.14: HCA with RNAi-Number of Experiments Performed Per Month by the Survey Respondent Pool
Figure 3.15: Growing and Steady Usage of Various Formats where RNAi is coupled with HCA
Figure 3.16: Penetration of the Different High-Content Analysis Instrumentation Platforms into the Marketplace
Figure 3.17: Instrumentation Platforms for High-Content Analysis Ranked by Top Choice and Second Tier
Figure 3.18: High-Content Analysis Instrumentation and where they Lie on the Throughput Curve
Figure 3.19: Top Instrumentation Value Drivers in the High-Content Analysis Space Figure 3.20: Important Sub-Cellular Features Studied via High-Content Analysis Approaches
Figure 3.21: Breakout of End-Point Versus Kinetic Assays in the High-Content Analysis Space
Figure 3.22: Types of Cellular Targets Studied Using High-Content Analysis Approaches
Figure 3.23: Top-most Target Class Studied Utilizing High-Content Analysis Approaches
Figure 3.24: Distribution of High-Content Analysis Experiments across the Respondent Pool-Number of Experiments Performed Per Week
Figure 3.25: Average Reagent/Assay Costs Per High-Content Analysis Experiment
Figure 3.26: Stratification of Reagent/Assay Suppliers into the High-Content Analysis Space
Figure 3.27: Monthly Reagent/Assay Purchases for High-Content Analysis by the End-user Community from Various Vendors
Figure 3.28: Growth or Decline in Importance of the Various High-Content Analysis Vendors to the End-user Community
Figure 3.29: Percentage of High-Content Analysis Experiments that Involve GFP Across the Market Landscape
Figure 3.30: Breakout of High-Content Analysis Reagents Marketplace: Made-in-House Versus Off-the-Shelf
Figure 3.31: Breakout of Spending on Various Components of the High-Content Analysis Discipline
Figure 3.32: Historic/Forecast Growth of the Total Screening Space, Broken-out by Primary Screening, Secondary Screening (including High-Content Analysis as a Subset) and ADME/Tox, for 2004-2016
Figure 3.33: Historic/Forecast Growth of the Screening Space-Broken-out by Cell-based Assays and Biochemical Assays, 2004-2016
Figure 4.1: Drug Discovery and Development Ensemble and the Position of the Various Segments of High-Content Analysis in the Space
Figure 4.2: Relative Size and Position of the High-Content Analysis Space in the Overall Scheme of the Life Science Tools Marketplace
Figure 5.1: High-Content Analysis-Positional Biosensors Using Caspases and Monitoring the Translocation of a Tagged Protein from the Cytoplasm to the Nucleus Figure 6.1: HCA Target Classes: Breakout of Current Drug Targets into Their Constituent Classes
Figure 6.2: GPCR Assay Technologies
Table 2.1: Comparison of the Key Features of High-Content Analysis and High-Throughput Screening
Table 2.2: Impact of High-Content Analysis on Drug Discovery-Impact of Several Drivers
Table 2.3: Biological Application Areas Associated with High-Content Analysis
Table 2.4: Classes of Measurements and Targets Identified Using Phenotypic Screening (High-Content Analysis)
Table 2.5: Classes of Cellular Measurements Possible with Fluorescent Protein Biosensors
Table 2.6: Multi-Parameter High-Content Analysis Assays to Study Biological Systems in Life Science Research and Drug Discovery, Demonstrating the Breadth and Scalability of the High-Content Analysis Approach
Table 2.7: Companies Offering Systems for High-Throughput Imaging
Table 2.8: Comparison of the Major Instrumentation Platforms and Their Associated Specifications for High-Content Analysis-I
Table 2.9: Comparison of the Major Instrumentation Platforms and Their Associated Specifications for High-Content Analysis-II
Table 2.10: Price Points and Target Markets of the Various High-Content Analysis Instrument Platforms
Table 2.11: Companies Offering Flow Cytometry Products and Services
Table 2.12: Integrated Product Platforms Offered by the Different High-Content Analysis Vendors
Table 2.13: High-Content Analysis Assays Developed by Thermo Scientific Cellomics
Table 2.14: Thermo Scientific Cellomics HCS Reagent Kits (formerly called "HitKits") and Their Therapeutic Areas of Application
Table 2.15: Millipore's HCA Assay/Reagent Portfolio
Table 2.16: Cell Lines for GPCR High-Content Analysis that can be Deployed onto the BD Biosciences/Atto Pathway HT Instrument Platform
Table 2.17: Examples of High-Content Screens
Table 3.1: What Fraction of High-Content Analysis Assays are Cell-based Versus Biochemical-based
Table 4.1: Comparison of the Key Features of High-Content Analysis and High-Content Screening
Table 4.2: Snapshot of the Various HCA Assays, Demonstrating the Scalability of this Discipline
Table 5.1: Modes of Digital Imaging
Table 5.2: Modes of Fluorescence Microscopy
Table 5.3: Major High-Content Analysis Instrumentation
Table 5.4: Image Analysis Algorithms
- Acumen Pharmaceuticals, Inc.
- Acumen Bioscience (division of TTP Group)
- Applied Biosystems
- BD Biosciences
- DiscoveRX
- Evotec Technologies (acquired by PerkinElmer)
- Fisher BioImage
- General Electric, GE Healthcare
- Guava Technologies (now a division of Millipore)
- Integral Molecular (Akceli Inc.)
- LemnaTech GmbH
- Millipore
- Molecular Devices Corporation, now a division of MDS Analytical Techniques
- NIH Chemical Genomics Center
- PerkinElmer
- Sangamo Biosciences, Inc.
- Spotfire (acquired by TIBCO)
- Thermo Scientific Cellomics
- Translational Genomics Research Institute
- Vala Sciences, Inc.


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THE first group of relatives of seven South African passengers killed in the Afriqiyah Airways crash in Tripoli left SA for Libya last night to begin repatriation preparations.
"We've booked them on flights for today - tonight," said Charmaine Thome, manager of the airline management company Aviareps. Once there, they would be met by a representative from the South African embassy, then taken to a hotel, where they would be taken care of.
The South African embassy would, where possible, start identifying bodies. The families would have to do a visual identification and arrange for remains and belongings to be brought back home.
Only a young Dutch boy, Ruben van Assouw, survived the crash in Tripoli on Wednesday morning as the aircraft was about to land after its flight from OR Tambo International Airport in Johannesburg.
He had been on holiday with his parents and brother, who did not survive the crash, according to reports. He was alert yesterday.
It was not yet clear whether he would be questioned by the French investigators who are helping the Libyan civil aviation authority to determine the cause of the crash.
Airbus spokesman Linden Birns said the company would provide only technical information to the investigators, because it would be inappropriate for them to investigate the crash themselves.
SA's international relations department spokesman, Dayanand Naidoo, said the department was treating the matter with great sensitivity towards the families and did not want to cause upset by releasing names or numbers of crash victims, until they were absolutely certain about the details.
"In the meantime we remain seized with the matter of continuing to render assistance to the families who have (contacted) us," Naidoo said. The airline had posted a statement saying seven South Africans had died.
The South African ambassador in Libya had indicated that rescuers had managed to retrieve some bodies from the wreckage, which was scattered across a wide space.
Global Aviation had lost cabin crew trainer Cathy Tillett and a retired manager, Norbert Taferner, and his wife Paula, in the crash. Democratic Alliance MP Anchen Dreyer's brother Frans also died.
The Star reported that Bree O'Mara, who won the Citizen Book Prize for her novel Home Affairs, had died in the crash. The newspaper also named Nigel Peters, who ran the maintenance division of AirQuarius Aviation; Hans Wolfaardt, who did aircraft painting for AirQuarius; Anton Matthee from Stellenbosch; and Robert Webber, who was on his way to join the British army.
BBC Online reported that a South African national who lived in Swansea, Wales, Priscilla Savathree Collick, also died in the crash.
A technical team from Airbus and Dutch investigators were taking part in the probe and would examine the black boxes recovered from the wreckage. "The Airbus team has arrived in Tripoli to begin their investigation," Omrane al-Zabadi, head of media at Afriqiyah airline, said. Aviation experts said the almost brand new Airbus appeared to have hit the ground several hundred metres short of the runway in visibility of 5km to 6 km.
They said the airport approach lacked systems to provide crew with the aircraft's distance and height from the runway. Sapa, Reuters


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Wednesday, October 6th, 2010 | Posted in: Home Renovations, New Homes
This week we will be discussing ways to make your home as environmentally friendly as possible. Some of these ideas are easy to build into an existing home as remodeling projects, and some are more suitable for a new custom built home. Whichever situation applies to you, I am sure that you will find some eco-inspiration in this article.
I expect to revisit this topic at a later date, so let's just go over some of the more well known ways to make your home a little more green:
East Coast Construction can help you to build a custom green home or improve your existing home to be more environmentally friendly. East Coast Construction has decades of experience as the most trusted Outer Banks home builder and can give you the green home you desire.
East Coast is your choice for Outer Banks construction from Corolla to Hatteras and everywhere in between.
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WHOWHATWHEREWHENWHYHOW: Paul WallPosted by Harvey Soto | MSA | No Comments
MSA Interview With: Paul Wall
MSA Interview With: Paul Wall
Thanks to Paul Wall for the shout out! – Harvey Soto
Jonny Hernandez doing a bigspin heelflip at the *AMMO* BBQ Contest.
Photo By: Andrew Durso
I will be in Puerto Rico next week for the "Fejah CA$HMONEY CUP". The 14th-15th, CANT WAIT!
Yupp PAUL WALL was holding it down at the FAMOUS party at Hardrock Hotel VANITY club, TWITCH holding it down!
Fun night with Paul, Brian, Rob, and Felix… VEGAS BABY!
Make sure to watch Chaz Ortiz's part today at www.zooyork.com for free!
Steve Berra came out the closet! Jussssssssss kiddin haha.
Thanks Chase for the Berrics wax! Hyped to be brining this to PR with me!
Follow On Twitter @MannySlaysAll
Come through tomorrow to "North Domingo Baca Skatepark" for the "Game of Sk8" event in Albuquerque, New Mexico!
In other news, check out this photo from Manny's Facebook Fan Page with a caption that read "getting a custom @paulwallbaby grill! #MSA #WhatItDo #ThePeoplesChamp".
Follow On Twitter @MannySlaysAll
Check out this photo from Manny's Facebook Fan Page with a caption that read "kicked it with Paul Wall at "The Fast Life" yesterday for Twitch's summer line drop!".
Follow On Twitter @MannySlaysAll @PaulWallBaby


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Discord Between PGA And WGA TV Noms Highlights Eligibility Period Differences
'Breaking Bad', 'Modern Family', 'Boardwalk Empire' & 'Homeland' Lead WGA TV Noms
'Modern Family', 'Big Bang', 'Parks & Rec', 'Game Of Thrones', 'Mad Men' Among PGA Award Series Nominees
Seconds after the Producers Guild announced the TV series nominations for its 2012 awards, commenters started asking in disbelief: Where is Breaking Bad? Indeed, the acclaimed AMC drama was conspicuously missing from the PGA Award nominations. Underscoring what appeared like a baffling omission, the WGA announced its TV series nominations minutes later, and Breaking Bad led the pack with three nominations. But while their ceremonies are only a month apart in January-February, the PGA Awards and WGA Awards' eligibility windows vary wildly, leading to the puzzling discrepancies.
Despite taking place in January, the PGA Awards use the same edibility period rules as the Emmys, which are held in September: from June 1, 2010 to May 31, 2011. That automatically excludes all summer/fall cable fare, including new Showtime drama Homeland, the most recent seasons of Breaking Bad, Curb Your Enthusiasm, Louie, etc., as well as any new fall broadcast series. In contrast, the WGA Awards' window of eligibility is closer to that for the Golden Globes, between Dec. 1, 2010 and Nov. 30, 2011. That's why Breaking Bad, Curb and Homeland, which were not eligible at all for PGA Awards this year, landed WGA Award nominations, along with Fox's new comedy New Girl. In fact, Breaking Bad and Homeland scored the most WGA nominations, three, along with perennial favorites Mad Men and Modern Family. Meanwhile, Mad Men, which was featured prominently in the PGA Award nominations, is MIA for WGA accolades because its fifth season was delayed. Given how much the TV landscape has changed, with some of the best series airing in the summer and promising new series launching on both broadcasting and cable networks in fall, the eligibility period for the PGA Awards seems outdated and should be adjusted, so series don't get awarded for episodes that aired 1.5 years prior.
Just to be accurate, Homeland scored two nominations, and Mad Men scored none, since it wasn't eligible. Boardawalk Empire on the other hand, scored three just like Breaking Bad.
Actually Homeland did scored 3. I had forgotten about the "new show" nod. The rest is true though.
My god! All those commenters asking in disbelief! All those shows conspicuously missing! All those baffling omissions!
Yes, they've got different eligibility periods. Relax and do some very basic research on the award you're talking about before hyperventilating, please.
That said the Unions and Awards folks SHOULD make it easier for people to understand the WTF situations like this. How hard would it be to include in announcements and literature "For June 2010- May 2011." That would mean only the idiots in a hurry would miss it.
Most people think "for the past calendar year" when it comes to annual awards so why not communicate better?
Comments are closed.


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Rangers defeat Astros 4-2
Photo: G.J. McCarthy/The Dallas Morning News
Texas Rangers manager Ron Washington (right) and shortstop Elvis Andrus (1) congratulate designated hitter Adrian Beltre after his two-run homer during the sixth inning of their game Tuesday, August 20, 2013 at Rangers Ballpark in Arlington.
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This is a discussion on Running high IOPS against a single lun/SSD - Solaris Rss ; On Solaris, and I expect the same with other operatingsystems, whenever and I/O is requested some process-level lock is set. Thismeans that if you try to run very high IOPS, this lock can become 100% busy,causing all threads that need ...
On Solaris, and I expect the same with other operatingsystems, whenever and I/O is requested some process-level lock is set. Thismeans that if you try to run very high IOPS, this lock can become 100% busy,causing all threads that need this lock to start spinning. End result istwo-fold: high CPU utilization and/or lower than expected IOPS.
This is not a new problem. The problem was discovered severalyears ago when storage subsystems became fast enough to handle 5000 IOPS andmore. Since that time cpus have become much faster and Solaris code has beenenhanced several times to lower the need and duration for these locks. I haveseen Vdbench runs where we were able to do 100k IOPS without problems.
Vdbench is written in Java, and Java runs as a singleprocess. Vdbench therefore introduced what is called multi-JVM mode, theability of Vdbench to split the requested workload over multiple JVMs (JavaVirtual Machines).
By default Vdbench starts one JVM for each 5000 IOPS requested,with a maximum of 8, and no more than one per Storage Definition (SD). The 5000-numberprobably should be changed some day; it is a leftover of the initial discoveryof this problem.
So, when you ask for iorate=max with only a single SD andyou?re lucky enough to be running against a Solid State Device (SSD) guesswhat: you may run into this locking problem.
To work around this you have to override the default JVMcount:
- Specify hd=localhost,jvms=nn I suggest you request one JVM for each 50k IOPS that you expect
- Add ?-m nn? as an execution parameter, for instance ?-m4?.
There is one exception though, and that is for 100% sequentialworkloads using the seekpct=sequential or seekpct=eof Workload Definition (WD)parameter. A sequential workload will only run using one single JVM. This isdone to prevent for instance with two JVMs that the workload would look likethis: read block 1,1,2,2,3,3,4,4,5,5, etc. The performance numbers of course willlook great because the second read of a block will be guaranteed a cache hit,but this is not really a valid sequential workload.
Read More about [Running high IOPS against a single lun/SSD...


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I made the purchase of the Apple wireless keyboard late last week with the intentions of giving you lovely people my first impressions of this keyboard. However, that never materialised because of a few circumstances out of my control. The keyboard costs £57 in the United Kingdom and $69 in the United States. This article will be a mix of first impressions and the little niggles that I am finding with the keyboard. I am more than well aware that I will be called an Apple "fanboy" if I give this keyboard a good to decent rating and that I will be called an Apple "hater" if I dare to give my honest opinion on the product. The only detail that has been overlooked is the fact that I couldn't care less. This is an honest review from my perspective.
The Apple Experience
I decided to test this keyboard out in one of my local Apple stores because there was enough doubt in my mind that I wouldn't like it. So I thought that I would go to a store to see and test the keyboard to see if I would be fast enough with it and if it would suit my purposes — my purposes being writing these articles with something ultimately more portable than a laptop. I have heard many complain about not being able to touch type on the iPad's on-screen keyboard and I have never had a problem with it. I'd just rather use a physical keyboard when I am typing out articles — I'm sure that's an autistic trait in some form or another.
The front of house staff were pleasant enough with Apple taking the decision to "walk the walk" with regards to how its computers can be used in a sales environment (there were iPads telling you what every product was, how much they were, and even giving you the option to call over a specialist without the need to walk over and ask). The store staff do not crowd you and force you to make a decision. I believe that the Apple retail mantra is that you do not need to sell an Apple product but that it will sell itself. I could be wrong in that aspect, but I believe that is the mantra.
The Keyboard
I was — and still am — surprised by just how small and compact the keyboard is, but it still manages to keep full-sized keys and is actually larger than the keys and key-spacing on my regular workhorse, a wired and cheap Logitech keyboard. The keys have nice tactile feedback as well as a quiet — but still audible — click. It really feels like a nice and stable platform to do typing on. Syncing the keyboard to my iPad 2 was as simple as you would expect from Apple and I have no complaints with that. The only two complaints I have with the keyboard are the opening of the battery compartment is a bit fiddly — but that could just be me being pedantic — and the on/off button is a little too easy to push by accident. I managed to push it by accident this morning, but thanks to the tactile feedback, I realised almost instantly.
I probably am being a little too pedantic with this review, but these little things will annoy me when I am using this device. It wouldn't be fair if I said that this keyboard is good just because it comes from Apple. However, this keyboard feels nice and is certainly comfortable to type on even if you are — as I am currently — out and about yet still working. The main annoyance about this keyboard is the placement of the @ and " keys. In the United Kingdom, they swap places from our American counterparts. The " key should be on the 2 key and the @ key should be with the ' key. This keyboard is supposed to be the "British layout," but it will take some getting used to since it's more akin to the American layout. There are a few reviews on apple.com that say that the spacebar doesn't work if you hit it anywhere bar dead centre. I can tell you that they are mistaken; the spacebar works no matter where you hit it!
There are also reviews which state that there is no delete key. This is not completely accurate. There is a delete key, but it is deleting backwards (it's the backspace key) and to get that key to delete forwards (your typical DEL key), you will have to use the "shift delete" method. I can understand why there was an outcry from the Apple faithful about the lack of a typical delete key. However, If you have been taught how to touch type, then you'll more than likely use the backspace key instead of the typical delete key as it is faster and more efficient! If you find the typical delete key more efficient, then this keyboard is not for you.
- It's an Apple product
- It's got nice tactile and audible feedback
- The battery lasts a long time (anywhere between a week and a month)
- It's small and thin
- Connecting via Bluetooth is easy
- It's an Apple product
- It's expensive at £57
- The on/off button is too easily pressed by accident
- The battery cover can be a little fiddly to get back on
- In the UK the @ and " keys are in the wrong place, and I did buy the "British version"
I do like this keyboard and think that I can certainly use it to type out many articles. However, there are a few niggles that could perhaps be fixed by Apple. The main annoyance is the @ and " keys being in their American position. The rest of the keyboard and its layout are nice enough and certainly feel sturdy enough. The keyboard is also amazingly light! You do feel like if you don't type hard enough the keyboard will just float away of its own accord! I'd give this keyboard four Chris Pirillo heads out of five. There are certainly some improvements that can be made to this keyboard, and I hope Apple will listen. What's your favorite keyboard and why?


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Genel, Gulf Keystone Gain on Kurdistan-Iraq Oil Revenue Deal
Genel Energy Plc and Gulf Keystone Petroleum Ltd. rose in London trading after Iraq's central government and the semi-autonomous Kurdish region reached an agreement to end an oil revenue dispute.
Genel gained 3.7 percent, the most since Aug. 14, to 731 pence. Gulf Keystone rose 6.2 percent to 234.8 pence.
The Kurdish regional government will initially boost oil production to 200,000 barrels of oil equivalent a day with further increases scheduled for next year, according to the agreement, Rowsch Shawayes, Iraq's deputy prime minister for economic affairs, said last yesterday in an e-mailed statement.
Iraqi and Kurdish officials had disagreed over how to share revenue from oil produced from Kurdish fields after some of the world's biggest oil companies, including Exxon Mobil Corp., Chevron Corp. and Total SA, committed to doing business there.
DNO International ASA, a Norwegian company operating in Kurdistan, rose 11.7 percent, the most since March.
Genel, run by former BP Plc Chief Executive Officer Tony Hayward, is targeting production of about 200,000 barrels of oil a day in Kurdistan by the time a new export pipeline is completed next year. The company said last month it will expand further outside of Kurdistan, with more exploration acreage, as well as drill seven wells in Iraq this year and next.