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From the Veterans Affairs San Diego Healthcare System (Drs Morello, Stoner, Moorhouse, and Sahagian and Ms Leckband), and the Department of Neurosciences, University of California at San Diego Medical Center (Drs Moorhouse and Sahagian), San Diego, Calif.
Reports of gabapentin use in diabetic peripheral neuropathy pain stimulate a need for controlled trials to determine its comparative efficacy to the therapeutic standard of amitriptyline hydrochloride.
To determine the efficacy of gabapentin compared with amitriptyline in treating diabetic peripheral neuropathy pain.
Prospective, randomized, double-blind, double-dummy, crossover study.
Veterans Affairs San Diego Healthcare System, Ambulatory Care Clinic.
Twenty-eight veterans were referred by their primary care providers. Two patients withdrew before randomization because of no neuropathic pain after washout; a third withdrew for unexpected surgery that required analgesics. Three patients withdrew because of adverse effects and 1 for protocol violation.
Patients with stable glycemic control and neuropathic pain randomized to 6 weeks of therapy with gabapentin, 900 to 1800 mg/d, or amitriptyline hydrochloride, 25 to 75 mg/d, with a 1-week washout before crossover.
Main Outcome Measures
Pain relief measured by pain scale with verbal descriptors and global pain score assessment at treatment end.
Participants and investigators were blinded throughout. Mean dosages were of gabapentin, 1565 mg/d, and of amitriptyline hydrochloride, 59 mg/d. Sixty-five percent of patients reached maximum dose with gabapentin and 54% with amitriptyline. Mean score diary analysis showed pain relief with gabapentin and amitriptyline was not significantly different (P=.26). Global data were obtained from 21 of 25 enrolled patients who completed the study. Moderate or greater pain relief was experienced in 11 (52%) of 21 patients with gabapentin and 14 (67%) of 21 patients with amitriptyline. There were no significant period or carry-over effects (P=.35).
Although both drugs provide pain relief, mean pain score and global pain score data indicate no significant difference between gabapentin and amitriptyline. Gabapentin may be an alternative for treating diabetic peripheral neuropathy pain, yet does not appear to offer considerable advantage over amitriptyline and is more expensive. Larger trials are necessary to define gabapentin's place in treating diabetic peripheral neuropathy pain.
DIABETIC PERIPHERAL neuropathy (DPN) is one of the most common symptomatic, long-term complications in patients with both type 1 and type 2 diabetes mellitus.1 At initial diagnosis, 7.5% of patients will already experience DPN pain, and approximately 45% will be afflicted with this complication after 25 years.2 At this time, however, the exact cause of DPN is not well understood.3,4
Two main types of diabetic neuropathy involve the autonomic or somatic nervous systems.3,5 The most common type of DPN is somatic or sensorimotor neuropathy with peripheral symptoms of burning, shooting, tingling, and allodynia.3 Typically, the sensorimotor neuropathy presents in a distal symmetric pattern, with a glove-and-stocking distribution.
Although DPN pain is prevalent among patients with diabetes, current treatment options, including antidepressants, anticonvulsants, antiarrhythmics, and topical capsaicin, are limited by their variable efficacy and adverse effects.6- 12 Amitriptyline hydrochloride is effective in approximately 60% to 75% of patients treated for DPN, which is consistently greater than that reported with other agents.6,7 Of concern with all available drug therapies are the extensive adverse effects, particularly anticholinergic effects of the tricyclic antidepressants.
In 1993, gabapentin, a γ-aminobutyric acid analog, received Food and Drug Administration approval for adjunctive treatment of partial seizures, with and without secondary generalization in adults with epilepsy.13 Despite extensive studies,14- 18 gabapentin's mechanism of action is unknown. Yet, even without this mechanism of action fully elucidated, there has been an increasing number of case reports of gabapentin's use in neuropathic pain syndromes such as reflex sympathetic dystrophy, postherpetic neuralgia, migraine, trigeminal neuralgia, erythromelalgia, Guillain-Barré syndrome, or other intractable pain states in dosages ranging from 900 to 2400 mg/d.18- 31 Most recently, a placebo-controlled clinical trial32 in patients with DPN pain has established the efficacy of gabapentin to provide pain relief.
Gabapentin, with its low adverse effect and drug interaction profile, may offer an effective treatment for DPN pain. The primary purpose of this study was to determine the comparative efficacy of gabapentin with amitriptyline, the standard therapy, in the treatment of DPN pain.
From March 1997 to December 1997, patients who were veterans were referred by primary care providers, neurologists, diabetologists, and anesthesiologists at the Veterans Affairs San Diego Healthcare System (VASDHS). Patients were included if they were 18 years or older, had diabetes mellitus with stable glycemic control defined as a hemoglobin A1c level between 0.043 (4.3%) and 0.079 (7.9%) within 3 months, experienced chronic daily pain for more than 3 months, during which both the quality and location were consistent with DPN pain, as diagnosed by a neurologist (D.F.M. and G.A.S.), and had an estimated creatinine clearance of 0.50 mL/s (30 mL/min) (Table 1 and Table 2).33
Patients were excluded from the study if they had non-DPN pain more severe than DPN pain; allergy or adverse reaction to gabapentin or amitriptyline; severe depression by diagnosis or as assessed with the Beck Inventory34; were pregnant; were receiving treatment for seizures; had cardiovascular symptoms of postural hypotension, symptomatic coronary artery or peripheral vascular disease; or a creatinine clearance of less than 0.50 mL/s (<30 mL/min). Patients who had received prior treatment with gabapentin or amitriptyline were not excluded, regardless of whether treatment was deemed a success or failure. Patients were excluded, however, if their previous dosage exceeded the study's maximum dosage of either drug.
Use of any medications for DPN pain that patients were taking before the study was discontinued for 2 weeks before entering the study and throughout the study period. All other regular use of analgesics was discontinued; however, patients were allowed up to 4 doses per day of acetaminophen, 325 mg, for severe pain or pain other than DPN. The study was approved by both the University of California at San Diego and VASDHS human subjects committees, and all patients gave informed, written consent.
The study consisted of two 6-week treatment periods with a 1-week washout period between treatment arms. The neurologist (D.F.M. and G.A.S.) and clinical pharmacist (C.M.M., S.G.L., and C.P.S.) screened referred patients for study inclusion, and baseline demographics were obtained. Patients receiving treatment for DPN pain began a 2-week washout period before randomization. Patients were given a daily pain diary and were randomized by the VASDHS clinical research pharmacist, the only unblinded investigator for the study, to receive either gabapentin or amitriptyline in a double-blind design per protocol; all other investigators and patients remained blinded until study termination. At the end of each treatment period, patients were seen within 24 hours for a neurologic examination and to administer a global pain assessment rating. The clinical pharmacist (C.M.M., S.G.L., and C.P.S.) conducted pill counts to assess study medication compliance at the end of each treatment period. Following a 1-week washout period, patients were crossed over to the alternative drug therapy. Although 1 week was sufficient for the complete elimination of either study drug, efficacy evaluation was based on the patient's pain ratings recorded during the final week of each treatment, thus allowing an additional 5 weeks for dissipation of drug effects.
During each treatment period, drug dosage was titrated for 2 days to minimize adverse effects, after which the dosage was adjusted based on the patient's clinical response and adverse effects (Table 3 and Table 4). Daily doses of gabapentin ranged from 900 to 1800 mg, and amitriptyline hydrochloride, from 25 to 75 mg. To preserve the double-blind study design, placebo was used to maintain a 3-times-per-day dosage regimen for each study drug (Table 3). Patients received 2 bottles of study medication and were instructed to take the 9 AM and 3 PM doses from the first bottle and the 9 PM dose from the second bottle, which were labeled accordingly.
The clinical pharmacist called patients on days 2, 4, and 6 of the first week and days 1 and 4 of the fourth week of each treatment arm to assess pain control and adverse effects. Patients were interviewed for frequency and severity of the 20 most common adverse effects of the 2 study drugs and any other adverse effects experienced. The purpose of the call was to adjust drug dosage to the maximum tolerated for pain control without intolerable adverse effects. Patients continued to take the maximum tolerated dosage for the remainder of the treatment arm.
The Pain Scale Rating System and Global Rating Scale were used to measure pain relief. Patients rated their pain by completing a daily pain diary in which they chose from a scale of 13 words describing pain intensity, ranging from none to extremely intense.35- 37 These verbal descriptors were quantified, based on a ratio-scale technique described by Gracely et al,35 which has been shown to be reliable and consistent in previous studies35- 39 involving human clinical and experimental pain; it distinguished active treatment from control. The pain diary was collected at the end of each treatment period. A neurologist evaluated patients at baseline and at the end of each treatment arm. In this evaluation, the neurologist asked patients to make a global rating of their overall pain relief (complete, a lot, moderate, slight, none, or pain worse) at the end of each treatment arm compared with their baseline pain before entering the study.
For statistical purposes, the verbal descriptors in the pain diary were converted to numerical equivalents using the Pain Scale Rating System as described by Gracely et al.36 The mean pain scores in each final treatment week were compared within patients by paired, 2-tailed t test. Period and sequence effects were examined for scores in the final treatment week by a t test. Global Rating Scale scores were analyzed with a paired, 2-tailed Wilcoxon signed rank test. A 1-sample sign test was used to analyze the frequency and severity of adverse effects between amitriptyline and gabapentin, and the Wilcoxon signed rank test was used to analyze the frequency and severity of adverse effects with time for each medication.
Study drugs were prepared at a Food and Drug Administration–registered repackaging facility. Since this was a double-blind design, all capsules were identical in taste, color, size, and shape.
Twenty-eight patients were eligible for study; 3 withdrew before randomization: 2 because of no neuropathic pain after washout and 1 for unexpected surgery requiring analgesics. Twenty-five patients were enrolled in the study. Because of adverse effects, protocol violation, or voluntary withdrawal, 4 patients withdrew from the study (2 each from the gabapentin and amitriptyline treatment arms). In addition, 3 patients were crossed over early per protocol because of intolerable adverse effects (2) or intolerable pain (1); 1 of whom also dropped out of the study. Thus, whereas 21 patients underwent both treatment arms of the study, 19 completed 6 weeks of treatment with both study drugs (Figure 1). For statistical analyses of mean pain diary scores, all patients were included to prevent bias of study results by omitting those with early crossover due to intolerable pain or adverse effects. Data analysis excluding early crossover patients did not produce statistically significant differences (P=.13).
Profile of the study. DPN indicates diabetic peripheral neuropathy. Amitriptyline was given as amitriptyline hydrochloride.
Of the 25 enrolled patients, 12 were initially randomized to the gabapentin treatment arm, 11 of whom crossed over to amitriptyline. During the gabapentin treatment arm, 1 patient experienced adverse events (diarrhea and ankle edema) and voluntarily withdrew from the study. In addition, 2 patients taking gabapentin were crossed over to amitriptyline early (week 4) because of intolerable adverse effects (sedation and dizziness) or intolerable pain, respectively; 1 of whom eventually withdrew from the study because of adverse events.
Thirteen of the 25 patients were initially randomized to the amitriptyline treatment arm, 11 of whom crossed over to gabapentin. During the amitriptyline treatment arm, 1 patient experienced adverse events (bilateral ankle edema and dizziness), which resulted in discontinuation of drug use, and 1 voluntarily withdrew from the study after crossover because of increasing pain from arthritis that exceeded DPN pain. One patient taking amitriptyline crossed over to gabapentin early (week 4) because of intolerable adverse effects (sedation and constipation).
The clinical characteristics of the patients enrolled in the study were consistent with the general diabetic population, with the exception of a higher male-to-female ratio (Table 1). Study patients experienced typical features of DPN pain (Table 2), for which they had received prior treatment, including amitriptyline (14), nonsteroidal anti-inflammatory drugs (3), nortriptyline hydrochloride (1), gabapentin (1), carbamazepine (1), opioid analgesics (1), and capsaicin (1). Only 1 patient had prior treatment with 2 medications and 1 with 4 medications. At the time of study enrollment, only 1 patient was receiving gabapentin and 9 receiving amitriptyline required washout before study entry.
After excluding data of patients who did not fully complete both treatment arms, the weekly mean pain scores of the remaining 19 patients are shown in Figure 2. In patients treated with gabapentin followed by amitriptyline, pain scores steadily declined during the first 2 weeks of dosage titration, followed by a plateau effect of pain relief. The pain returned during the 1-week washout period and then declined during the second treatment arm. A similar response was seen in patients treated with amitriptyline followed by gabapentin.
Pain diary or pain intensity scores. Weekly mean pain intensity scores are plotted for 19 patients who completed pain diary entries for both 6-week treatment arms. Each curve depicts a single group of patients receiving both arms of consecutive drug treatments and the intervening washout period, with groups crossing over, either from amitriptyline hydrochloride to gabapentin (solid squares) or from gabapentin to amitriptyline (circles). Four verbal descriptors are shown next to equivalent numerical pain scores. No statistically significant differences were found between each weekly pain score within each treatment group, ie, amitriptyline at week 0 vs gabapentin at week 7, amitriptyline at week 1 vs gabapentin at week 8, etc (by 1-way analysis of variance and Fisher Protected Least Significant Difference post hoc test for comparing weekly mean pain scores between drugs).
Comparing the baseline pain scores in 21 patients who underwent both treatment arms to the end-of-treatment pain scores, there was a statistically significant difference in pain score reduction in patients treated with both gabapentin (P<.001) and amitriptyline (P<.001) by 2-tailed, paired Student t test. However, the mean difference between drugs in pain intensity scores during the final week of treatment favored amitriptyline by 0.091 unit (95% confidence interval, −0.074 to 0.256), in which 0.35 units was the difference between moderate and mild pain.35 Thus, there was no statistically significant difference in pain intensity scores between gabapentin and amitriptyline by the end of treatment (P=.26).
Based on the global description of pain relief for patients who underwent each treatment arm (Table 5), moderate or greater pain relief was experienced in 11 (52%) of 21 patients during gabapentin treatment and 14 (67%) of 21 patients during amitriptyline treatment. There was no statistically significant difference in pain relief between groups (P>.1 by 2-tailed, paired Wilcoxon signed rank test), significant period or carryover effects were not detected, and there was no correlation between global score and maximum dosage achieved.
Figure 3 shows the mean changes in pain intensity during the first 6 weeks of each study drug for the 19 patients who fully completed their first treatment arm. Mean (±SE) pain diary scores decreased by 0.31±0.064 unit when patients were treated with gabapentin and 0.44±0.089 unit with amitriptyline. Although the mean pain score change from baseline favored amitriptyline, there was no statistically significant difference by paired t test (P=.3).
Pain intensity score change from baseline. Each curve plotted represents the mean change in pain intensity score from baseline for the first treatment arm in the 9 patients who received gabapentin and 10 who received amitriptyline hydrochloride for the full 6 weeks of treatment. A 0.35-unit reduction was the difference between moderate and mild pain. Although mean change from baseline pain relief favored amitriptyline, there was no statistically significant difference at the end of treatment with a paired t test (P=.3).
Symptoms possibly related to study drugs caused 3 patients to withdraw from the study (1 receiving gabapentin and 2 receiving amitriptyline) and 2 patients (1 each receiving gabapentin and amitriptyline) to cross over early to the alternative treatment arm. Seventeen patients receiving amitriptyline and 18 patients receiving gabapentin experienced adverse effects (Table 6). With the exception of weight gain with amitriptyline, there was no statistically significant difference in occurrence of adverse effects between drugs (P>.05). Prevalent adverse effects included sedation, dry mouth, dizziness, postural hypotension, weight gain, ataxia, and lethargy.
Comparing the frequency and severity of adverse effects at study weeks 1 and 4 showed that, with amitriptyline, dry mouth worsened with time (P<.005) and pruritus was worse than with gabapentin at week 1 (P<.03) but was not statistically significant from gabapentin at week 4. The frequency and severity of dizziness with gabapentin diminished with time (P=.02).
After dosage titration based on individual response, the mean dosages of gabapentin and amitriptyline hydrochloride were 1565 and 59 mg, respectively. Of patients treated with gabapentin, 65% reached 1800 mg/d, 26% reached 1200 mg/d, and 9% were maintained with 900 mg/d. With amitriptyline, 54%, 29%, and 17% of patients reached 75, 50, and 25 mg/d, respectively. Medication compliance, defined as the total percentage of doses taken, was 94.8% with gabapentin and 96.4% with amitriptyline.
This study was designed to evaluate the efficacy and safety of gabapentin compared with amitriptyline, the current standard of therapy for DPN pain. Study results indicate that, although both gabapentin and amitriptyline provide statistically significant pain relief by the end of treatment, there was no statistically significant difference between the 2 drugs, as measured by daily pain diary scores and global ratings of pain relief. As expected, amitriptyline provided moderate or greater pain relief in 67% of patients, which is consistent with previously reported efficacy rates.6,7 Gabapentin provided moderate or greater pain relief in 52% of patients and reduced pain diary scores by 0.31 unit, indicating a less-than-moderate impact on pain relief compared with a 0.44-unit reduction with amitriptyline (Figure 3). This is similar to the recently reported efficacy of 60% for gabapentin compared with 33% for placebo.31
The limited number of patients enrolled in our study introduces the probability of a type II (β) error.40 Sample size could not be determined since there were no published studies describing gabapentin's efficacy in DPN pain at study initiation. Post hoc analysis revealed that a sample size of approximately 260 patients per paired crossover study would be necessary to provide 80% power to detect a mean difference between treatments of approximately one third of the difference between mild and moderate pain at a .05 significance level. Larger controlled trials are needed to determine if there is any detectable difference in efficacy between amitriptyline and gabapentin.
Accepting patients with well-controlled diabetes might have limited the study size, yet hyperglycemia can decrease the pain threshold, thereby interfering with study results. Our patients maintained a stable hemoglobin A1c level throughout the study, reducing the potential of hyperglycemia interference. Allowing patients who had received prior treatment with either gabapentin or amitriptyline into the study may have potentially introduced bias, since those who were taking one of these drugs and in whom DPN pain had been successfully controlled would not likely volunteer to discontinue use of the drug, whereas those who entered the study were more likely to experience treatment failure.
Dosage ranges in this study were based on current literature and practice standards at the VASDHS. Review of amitriptyline for neuropathic pain within our institution indicated that 25 to 75 mg/d was the most prevalent dosage range. Gabapentin dosage remained within the manufacturer's guidelines for seizure treatment. Higher dosage ranges may have achieved greater efficacy and should be evaluated in future studies. To measure the full potential of each drug, it might be useful to titrate the dosage upward, either to complete pain relief or to the maximum tolerated dosage.
All study patients were initiated with a 2-day dosage titration to diminish the occurrence of benign effects. Although gabapentin is often cited as having a relatively safe adverse effect profile, both gabapentin and amitriptyline had a similar rate of adverse effects. The frequency and severity of reported adverse effects did not appear to subside with time, with the exception of worsening dry mouth with amitriptyline and resolving dizziness with gabapentin. Similarly, dizziness and somnolence were predominant adverse events reported by Backonja et al32; however, this was attributed to a forced 4-week dosage titration to 3600 mg/d. This information may be useful for patients when initiating therapy with either agent, since a slower dosage titration may decrease the frequency and severity of adverse effects.
Both gabapentin and amitriptyline in the dosages used in this study appear to provide pain relief in DPN pain; however, mean pain diary and global pain relief score data indicate no statistical difference between them. With the exception of weight gain, dry mouth, and dizziness, the frequency and severity of adverse effects were similar with each drug.
Although gabapentin provides pain relief in patients with DPN pain, it should be reserved as an alternative to patients in whom a less costly agent fails, such as amitriptyline, or for whom tricyclic antidepressants are contraindicated. Our results suggest that larger controlled trials are necessary to further define gabapentin's place in the treatment of DPN pain.
Accepted for publication January 25, 1999.
We acknowledge Stephen D. Funk, PharmD, VASDHS research clinical pharmacist, who maintained the integrity of the double-blind design as the unblinded investigator; Veterans Affairs Clinical Research Pharmacy Coordinating Center at Albuquerque, NM, Mike R. Sather, RPh, MS, Frank Lueddeke, and Roy W. Fetter, who aided in the preparation of study drug; Christopher S. Morello, PhD, University of California at San Diego, who performed statistical analysis of the data; Patricia Hlavin, MD, independent physician reviewer of adverse events for the study duration; and Philip O. Anderson, PharmD, manuscript reviewer.
Corresponding author: Candis M. Morello, PharmD, Veterans Affairs San Diego Healthcare System, Pharmacy Service (119), 3350 La Jolla Village Dr, San Diego, CA 92161.
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Recent Event Highlights: Bowling Green hockey sweeps Ala.-Huntsville, Auburn University moves into Huntsville, Flash Mob at the University of Alabama, Flashmob at University of Alabama, University of Alabama TOMS One Day Without Shoes, Home sales in state drop - The Huntsville Times - al.com, and 97 more...
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Bowling Green hockey sweeps Ala.-Huntsville
...may be home to a branch of the University of Alabama system, but that's not stopping Auburn University from moving in. Auburn opened a research center in Huntsville on Wednesday in an attempt to capture more of the federal research dollars that are funneled...
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A flash mob at the Ferguson center at the University of Alabama. I heard a rumor about it the day before so I had to go see for myself. 9/2/2010 Thanks for watching :)
The LessThanUThink campaign executed a flashmob at The University of Alabama's student center on Sept. 2, 2010.
TOMS One Day Without Shoes at the University of Alabama. TOMS is a nonprofit organization that utilizes the One-for-One ideology that for every pair of TOMS you buy, TOMS donates a pair to a child in need. The UA chapter of TOMS campus reps held an one day without shoes to raise awareness about children with no shoes as well as the TOMS mission. The event was help April 8th commencing in a walk around the Quad.
Change In Alabama Gun Laws Could Be On The WayWKSRThis comes just two weeks after the fatal shootings at the University of Alabama in Huntsville. Democratic Sen. Roger Bedford of Russellville got the Senate ...and more »
Press-Register - al.com (blog)Home sales in state dropThe Huntsville Times - al.comStatewide, 2072 homes were sold in January, compared with 2892 in December and 1984 in January 2009, according to the university's Alabama Center for Real ...Little change seen in Tuscaloosa area home salesTuscaloosa NewsHome sales increase in January compared to a year agoal.com (blog)Alabama's housing affordability rose in 4th quarter of 2009, says UA reportPress-Register - al.com (blog)The Birmingham News - al.com (blog) -The Huntsville Times - al.comall 10 news articles »
UAH takes shot at GSCEast title at West AlabamaThe Huntsville Times - al.comIt's been seven years since the University of Alabama-Huntsville won a men's basketball championship. The Chargers won the Gulf South ...
Patriot-NewsESU professor suspendedAllentown Morning CallGadsden says officials referred to the shooting at the University of Alabama-Huntsville this month during the meeting. She says the posts were clearly meant ...Pa. prof: Suspended over hit man Facebook postingWashington PostESU professor suspended for comments made on Facebook pagePocono RecordPa. prof says she was suspended over Web postsNewsday (subscription)Chronicle of Higher Education (subscription) (blog)all 282 news articles »
Washington PostBishop's parents to aid in inquiryBoston Globe... in an Alabama jail facing a capital murder charge for allegedly opening fire at a faculty meeting at the University of Alabama's Huntsville campus Feb. ...University Fires Alabama Professor Charged With MurderFOXNewsUniversities mull role of tenure in UAH shootingseSchool News (subscription)Trials and tribulations of tenureLafayette Online (subscription)Toronto Star -Worcester Telegram -Kansas City Star (blog)all 582 news articles »
Washington PostAmy Bishop's Husband Wanted Revenge, Report SaysCBS News (blog)Photo: College professor Amy Bishop, charged with capital murder in the shooting deaths of three faculty members at the University of Alabama-Huntsville. ...Parents angry Bishop's daughter back in classroom of UAH massacre victimBoston HeraldFeds in Boston reviewing 1993 mail bomb probeWashington PostPapers Link Husband of Professor to '93 ThreatNew York TimesWHDH-TV -Boston Globe -Seattle Timesall 1,211 news articles »
al.com (blog)Counselors available for UAH students returning to campusWAFFUAH Business Professor John said, "I think the campus itself is very resilient and the faculty is resilient. I think we will come back but obviously this is ...Campus evaluates safety after tragedy at UAHUAB KaleidoscopeUAH tragedy should not overshadow excellenceThe Decatur Daily (subscription)UAH Students Return with Heavy HeartsWNCFMontgomery Advertiser -al.com (blog) -The Huntsville Times - al.com (blog)all 29 news articles »
Washington PostAlabama shooting puts spotlight on tenure processWashington PostFILE - In this Friday, Feb 12, 2010 file photo, Amy Bishop is detained by Huntsville, Ala. police, on the University of Alabama in Huntsville campus in ...1st service for prof in Ala. university killingsThe Associated PressGov. Patrick orders State Police to review role in 1986 Bishop shootingBoston GlobeDoctor targeted by '93 mail bomb calls for comprehensive probe of Ala. campus ...Los Angeles TimesNew York Times -The Daily Titan -NECNall 1,782 news articles »
Los Angeles TimesUniversity of Alabama-Huntsville professor says shooter acted methodicallyDallas Morning NewsAssociate professor Joseph Ng said he was one of 12 people at a biology department meeting Friday at the University of Alabama-Huntsville. ...Within Seconds, Alleged Alabama University Shooter Amy Bishop Changed Three ...CBS News (blog)Survivor: Ala. university shooter fired suddenlyThe Associated PressAmy Bishop case: Why no red flags were waved before shooting spreeChristian Science MonitorExaminer.com -Gather.com -NECNall 2,189 news articles »
Today, the Kyoto Protocol will reach the fifth anniversary of its entry into force. But John Christy says that new research is casting doubt on claims that the earth is warming. Some even suggest the world may not be warming much at all. The temperature records cannot be relied on as indicators of global change, he said. He is a professor of atmospheric science at the University of Alabama in Huntsville, a former lead author on the Intergovernmental Panel on Climate Change (IPCC).
Speaker: Dr. John Christy Feb 8, 2010 - AU Hotel and Dixon Conference Center - Society of American Foresters About the Speaker Dr. John R. Christy is Professor of Atmospheric Science and Director of the Earth System Science Center at the University of Alabama in Huntsville where he began studying global climate issues in 1987. In November 2000 Gov. Don Siegelman appointed him to be Alabamas State Climatologist. In 1989 Dr. Roy W. Spencer, a NASA/Marshall scientist, and Christy developed a global temperature data set from microwave data observed from satellites beginning in 1979. For this achievement, the Spencer-Christy team was awarded nasa's Medal for Exceptional Scientific Achievement in 1991. In 1996, they were selected to receive a Special Award by the American Meteorological Society "for developing a global, precise record of earth's temperature from operational polar-orbiting satellites, fundamentally advancing our ability to monitor climate."
The HinduAlabama campus reels after shootingUSA TodayClasses at the University of Alabama-Huntsville have been canceled this week to allow faculty and students to ...Three killed in University of Alabama-Huntsville shootingLos Angeles Times (blog)After a Shooting, Colleagues Try to Regain FootingNew York TimesThree Killed in Shooting at Alabama UniversityWall Street JournalThe Associated Press -San Francisco Chronicle (blog) -ABC Newsall 5,031 news articles »
A biology professor at the University of Alabama-Huntsville has been charged with murder in the shooting deaths of three fellow biology professors at the campus. (Feb. 13)
Coverage of the shootings at the University of Alabama-Huntsville campus Friday, Feb.12. Featured are press briefings and scenes from the area minutes after the shootings that killed three professors and injured three others. A UAH professor is charged with capital murder in connection with the deaths. Video from huntsvillenewswire.com
moxnews.com February 12, 2010 ABC News
HUNTSVILLE, Ala. (Feb. 12) -- A woman opened fire during a biology faculty meeting at the University of Alabama's Huntsville campus Friday, killing three biology professors and injuring three other employees at the school, officials said. The shooter was caught outside the Shelby Center, a science building, without incident, and no students were harmed, according to university spokesman Ray Garner. Local media reported the shooter was a faculty member, though Garner said he could not identify her. Officials said a man was also being detained. Two shooting victims are taken from the Shelby Center on the campus of the University of Alabama in Huntsville. Robin Conn, The Huntsville Times / AP Medical workers take two shooting victims from the Shelby Center on the campus of the University of Alabama-Huntsville to an ambulance on Friday. Police said no charges had been filed and they were interviewing the woman suspect and a man identified as "a person of interest." University spokesman Ray Garner said the three killed were Gopi K. Podila, the chairman of the Department of Biological Sciences, and two other faculty members, Maria Ragland Davis and Adriel Johnson. Two others are in critical condition, and a third who was wounded was upgraded to fair condition. The injured were identified as department members Luis Cruz-Vera and Joseph Leahy and staffer Stephanie Monticello. Their specific conditions were not released. Nick Lawton, the son of a biology professor at the school ...
If you don't know, I am a student at UAH, which suffered a tragic loss with the shooting and killing of at least 3 professors by another member of faculty. I was in the building just a couple hours before the shooting happened......Leave your support, love, prayers, and responses
...the University of Alabama to an ambulance after multiple people were shot Friday in Huntsville, Ala. Officials at the University of Alabama's Huntsville campus say three people have been killed and another three injured in the campus shooting. Robin Conn/Associated...
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Teachers killed...Olympic crash probe...Afghan offensive...Toyota suit9&10 NewsHUNTSVILLE, Ala. (AP) — Gunfire at a faculty meeting has left three people dead and three others injured at the University of Alabama's Huntsville campus. ...Olympic tragedy...Afghan assault under way...Deep South deep freeze9&10 Newsall 3 news articles »
San Francisco Chronicle (blog)University shooting at Alabama-Huntsville: Dr. Amy Bishop is suspectSan Francisco Chronicle (blog)A university shooting at Alabama-Huntsville University has neuroscientist Dr. Amy Bishop as the key suspect (the Huntsville Times reports Bishop's ...
...Feb. 12, 2009 in Huntsville, Ala. A team of physicians was reportedly treating three shooting victims from the University of Alabama Huntsville. (AP Photo/The Decatur Daily, Gary Cosby Jr.)Two shooting victims are taken from the Shelby Center on the campus...
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Campus mayhem...Taliban targeted...Haiti mourns quake victims9&10 NewsHUNTSVILLE, Ala. (AP) — A shooting on the campus of the University of Alabama-Huntsville has left three faculty members dead. Two other faculty members and ...AP Top News at 7:21 pm EST -Friday, February 12, 2010KMPH Fox 26all 3 news articles »
Globe and MailThree killed by woman in University of Alabama shootingsThe GuardianAP A woman opened fire in a biology department meeting at the University of Alabama's Huntsville campus yesterday, killing three people and injuring three ...BREAKING NEWS: UAH Shooting 3 Killed, 3 InjuredTuscaloosa News (subscription)At least three dead in UAH campus shootingUPI.com6 Shot, 3 Killed in Alabama Campus ShootingNew York TimesWTAQ -National Post (blog) -DesPardes.comall 804 news articles »
More school shootings!Examiner.comToday at 4:15 pm, a female murdered three people at the University of Alabama in Huntsville. Police has arrested the suspect and is still investigating the ...and more »
Three people were killed and one wounded in shootings at the University of Alabama at Huntsville on Friday, and the suspected shooter was in custody, a university spokesman told local television. www.reuters.com Amy Bishop shot, killed her brother in 1986 www.thebostonchannel.com Female Gunman Woman Shot Shooting Biology Professor
...Update: Via ... Global Temperature Trend Update - February, 2010 reason.com 43 hours ago — Every month University of Alabama in Huntsville climatologists John Christy and Roy Spencer report the latest global temperature trends from satellite data. Below...
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University Of Alabama Shooting: 3 Dead, 1 Hurt: ReportNPR (blog)The Huntsville Times reports three people were killed and one injured. It occurred at a facility named the Shelby Center, after Sen. ...
USA TodayReport: El Nino fueled record global warmth in JanuaryUSA TodayChristy and fellow UAH scientist Roy Spencer use data gathered by microwave sounding units on NOAA and NASA satellites to get accurate temperature readings ...
The Huntsville Times - al.com (blog)Riley, lawmakers say new UAH systems center could be the next Hudson-Alpha, a ...The Huntsville Times - al.com (blog)Griffin is an eminent scholar at UAH, and he will head the center, which will study the way complex systems interact in major research, commercial and ...and more »
Created @ UA in 2010 as part of Campus moviefest, the world's largest student film festival.
Created @ UA in 2010 as part of Campus moviefest, the world's largest student film festival.
Created @ UA in 2010 as part of Campus moviefest, the world's largest student film festival.
Created @ UA in 2010 as part of Campus moviefest, the world's largest student film festival.
Created @ UA in 2010 as part of Campus moviefest, the world's largest student film festival.
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...half off the usual adoption fee. See all MARF animals online. The field of biology is now the largest major at Alabama A&M University. The 2010 Hot Dogs and Cool Cats Calendars are in stock and available for purchase at the Greater Huntsville Humane Society...
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...meeting with university leaders at Alabama State University. He also met university officials and students at the University of Alabama at Birmingham and the University of Alabama at Huntsville. Kalam toured the Marshall Space Flight Center in Huntsville....
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Kayla Cates, a senior nursing student from Alabaster, Alabama, talks about Homecoming and the Capstone College of Nursing's preparation for the 2009 UA Homecoming Parade.

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The New York website Gothamist reports "the official transfer of title of Space Shuttle Orbiter Enterprise from NASA to the Intrepid" has been made. "The contract was signed by Lynn Cline, NASA's Deputy Associate Administrator for Human Exploration and Operations and Susan Marenoff-Zausner, President of the Intrepid Sea, Air & Space Museum."
NASA Administrator Charles Bolden Jr.'s decision on future homes for the shuttle fleet was controversial from the moment it was announced. Houston has grumbled that Johnson Space Flight Center did not get an orbiter to display, and an Ohio senator complained that the New York museum didn't own the property on which it plans to display Enterprise. The remaining orbiters that have flown in space - Atlantis, Endeavour and Discovery - are going to the Kennedy Space Center in Florida, the California Science Center in Los Angeles and the National Air and Space Museum annex in Virginia near Washington. Enterprise never flew in space but was built as a test vehicle.


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Minimum information about a marker gene sequence (MIMARKS) and minimum information about any (x) sequence (MIxS) specifications. Nature biotechnology, 2011/05/01, Volume 29, Issue 5, p.415-20, (2011) Read More / View Supplemental Materials Abstract
A catalog of reference genomes from the human microbiome. Science (New York, N.Y.), 2010/05/21, Volume 328, Issue 5981, p.994-9, (2010) Read More / View Supplemental Materials Abstract
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Grover Maurice Thompson
(Click to enlarge)
Thompson, Maurice Grover, Carpenter
Birth: 06 JUL 1919, Ardmore, Lower Merion Township, Montgomery County, Pennsylvania
Death: 12 APR 2010
Gender: Male
Parents:Father: Thompson, Grover ClevelandFamily:
Birth: 25 JUN 1884, Pinchtown, Straban Township, Adams County, Pennsylvania
Death: 27 JUN 1953, Bryn Mawr, Lower Merion Township, Adams County, Pennsylvania
Mother: Heacock, Mae
Birth: 10 MAY 1890, Philadelphia, Philadelphia County, Pennsylvania
Death: 27 JUL 1963, Bala, Lower Merion Township, Montgomery County, Pennsylvania
Marriage: 03 JUL 1945, Charleston, South Carolina
Spouse:Goettge, Jeanette KatherineChildren:
Birth: 21 APR 1922, Dover, Tuscarawas County, Ohio
Death: 13 OCT 2001, New Oxford, Adams County, Pennsylvania
Gender: Female
Parents:Father: Goettge, Theodore
Birth: 10 OCT 1884
Death: 08 JUN 1960, Dover, Tuscarawas County, Ohio
Mother: Archinal, Katherin Louisa
Birth: 11 JUL 1891, Dover, Tuscarawas County, Ohio
Death: 08 APR 1964, Dover, Tuscarawas County, Ohio
Thompson, Grover Cleveland, II, Postal Inspector
Gender: Male
Thompson, Theodore G.
Gender: Male
Thompson, Cynthia K.
Gender: Female
Thompson, Sandra L.
Gender: Female
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Incarceration with or without strangulation of a hiatus hernia is a serious complication occuring more frequently in the paraesophageal type than in the sliding variety. Most case reports of strangulation1-5 have been in patients with post-traumatic diaphragmatic hernias or pleuroperitoneal hernias rather than in those with hiatal hernias. It is not uncommon to find in a large paraesophageal hiatus hernia that there is a portion of the colon, as well as stomach, in the hernial sac. It is, however, distinctly unusual to find a hiatus hernia in which stomach has been replaced by a portion of the proximal transverse colon with the occurrence of incarceration and, in addition, obstruction of the duodenum as the result of external pressure by the colon. The following case demonstrates this sequence of events and appears to be unique in the literature.
Report of a Case
The present admission was the
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Maxim Government Services (MGS) has built a reputation of sustained success in matching highly qualified, fully credentialed physicians with top permanent and locum tenens positions at government agencies and medical facilities throughout the country. MGS staffs a variety of permanent placement and locum tenens specialties to satisfy the unique staffing needs of your organization, including:
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Montreal's Quintessential Restaurants: Dine Out with Montrealers
By Sherel Purcell
Montréal Local Expert
Choosing restaurants in Montreal is a breeze. The most obvious method is to drop in to those that appear to cater to a local crowd and not just tourists! An easier method to choose your perfect dining spot is to follow my suggestions so you can reserve ahead, especially on weekends. Standards are generally quite high in Montreal restaurants and prices reasonable. Like most places, lunch is often the better deal.
Don't overlook local hotel restaurants especially if you hear a lot of French - because who knows food better? Consider restaurants a bit off the beaten tourist track too like those in East Montreal, The Village or newer hotspots like Griffentown and the Pointe St. Charles neighborhoods on the western edge of the city.
Quality restaurants with multiple locations like Premiere Moisson and L'Academie are not really chains and should not be regarded as such. Some of the fussiest palates on the planet live in Montreal making it almost impossible to get a bad meal here as Quebec in general and Montreal in particular reject large, international chain restaurants. Dining in Montreal is all about authenticity, quality and enjoying the dining experience. Montreal restaurants therefore become a tourist attraction in themselves.
Commerce Gastropub
Commerce is a modern neighbourhood bar, the creative result of MTL Cuisine and renowned chef Martin Juneau. The shared vision of the partners was to give Old Montreal's financial district a space that would be reuniting each other's taste in matters of food, decor and ambiance.Commerce Gastrobar is best described as a chic neighborhood hangout that's set in one of the most beautiful spots in Montreal, just south of Square Victoria on McGill Street. Commerce serves as a gathering place for foodies, business people and residents of Old Montreal for lunch, dinner and the famous Montreal cinq a sept, or the after-work happy hour. The decor is contemporary yet warm, thanks to gleaming wooden tables and antique lighting. (1 (514) 871-1500)
Chez Schwartz Charcuterie
Celine Dion has purchased Schwartz's but vows to keep it the same. Let us hope so. The grubby hole in the wall fixture on St. Laurent (The Main) offers only one real choice: the perfectly smoked meat brisket sandwich served with fries and a pickle best washed down with a cherry coke. It's cramped, noisy and the garish lighting encourages a fast turnover which is just as well as the line moves faster so more can get their fix of the sweet meaty deli treat. (514-842-4813)
Parlez-vous Francais? You will have a better time at this hip French Bistro if you do. Young, upwardly mobile Francophones flock to L'Express to see and be seen and to eat the best steak tartare et pomme frites on the planet or the tantalizing duck and foie gras. Calf liver, salmon and ravioli top the favorites list of this Plateau neighborhood haunt. All is washed down with a wide assortment of wine, including some good French vintages best purchased by the half bottle. A dessert of rich creme caramel tops off the perfect French meal. (514-845-5333)
Rumi Grill
Rumi Grill Restaurant Montreal can best be described as a cross between a grill house and a tearoom. For over a decade Rumi Grill has been serving lamb, beef, chicken and seafood in either half kilo or whole kilo portions accompanied by pickled vegetables and a choice of spicy sauces.Persian saffron, Aleppo pepper and pomegranate provide seasoning for many of the dishes. Vegetarians can choose from a variety of dishes including falafel wheels, hummus, baba ghanoush and muhammara dip. An assortment of home made, non alcoholic drinks include a basil lemonade and a ginger drink along with a good selection of teas, as might be expected from a "Silk Road" tearoom. (5146706770)
Restaurant L'Académie-Montreal
L'Academie focuses on great mussels (moules) with creative sauces. "Moules et frites" offers diners a large serving of steamed mussels in a variety of cream or tomato-based sauces.The best tomato - based sauce, a savory marinara, tops the "Moules Italien". "Moules Roquefort" caters to those looking for a rich, roquefort cheese sauce. With any dish, order an extra plate of the fresh french bread to soak up the extra sauce. Three floors filled with chatty patrons and waiters rushing by with generous platters make for a lively setting. Thursday night seems to be the most popular when service can get a bit slow. Reservations are recommended but the lines seem to move well should you show up without booking. (4509881015)
At Milos, traditional Greek architecture meets raw industrial space that produces a casual taverna atmosphere. The understated elegance appeals to sophisticated diners thanks to the formal white tablecloths and well-designed lighting. Patrons can see the fresh fish resting on large ice beds and watch their food being cooked from the open concept kitchen. Tempura - like vegetables and saganaki cheese are fried just right to match the tender crispiness of fish selections lightly dusted with oregano and other spices. Portions of the "fish of the day " platters - sold by the pound - are large enough to share. The taramosalata, Greek sardines with lemon, oregano and olive oil, lamb chops, and avgolemono soup are all good too. The yogurt is made from local goats milk, and much of the produce and herbs are organically grown on regional farms. (514-272-3522)
Au Pied de Cochon
This popular spot for Québecoise cuisine caters to serious carnivores, especially pork lovers, for which the restaurant is famous. Chef Picard, an avid game hunter, has little patience for vegetarians. Ten choices of foie gras include a favorite atop a mound of poutine. "Duck in a Can" is stuffed with thyme sprigs, foie gras, carrots and celery delivered with a can opener. In keeping with the Québecoise theme, finish the meal with a slice of sugar pie. The noisy, convivial atmosphere is better suited to a night out with old friends than a first date. The later the evening, the livelier it gets. Reservations are highly recommended. (514-281-1114)
Casa Tapas
While Casa Tapas, Montreal's favorite Spanish restaurant serves full meals, it's better known for its extensive tapas menu. A night out here is perfect for small groups sharing small plates. The dining room is comfortable and inviting with sufficient space between tables so even when the restaurant is crowded (Thursdays to Sundays - be sure to reserve)patrons never feel intruded upon. Diners are greeted by the "wine wall" suggesting the impressive wine list dominated by Iberian selections as they enter the classic space done in muted colors and white table linens. With the vegetable offerings, choose something containing more than two principle ingredients. The most successful of the seafood choices include the lightly seared scallops served with figs. Mussels served in a variety of sauces are another crowd - pleaser. (514.848.1063)
Boulangerie Première Moisson
With over 17 locations, Montreal natives and visitors alike can always find a reliable outlet for breakfast and lunch at reasonable prices. Premiere Moisson (First Harvest) Bakeries can are found on trendy Montreal streets such as Sherbrooke, Mont Royal and Bernard. Attractive display cases crammed with pork and brie sandwiches crowd the olive sourdough rolls stuffed with sliced tomato, basil and bocconcini. Homemade cabbage rolls and lasagna served with soups are popular lunch and take out items too. The fussy Quebecoise palate demands quality, value-added ingredients like flaxseeds, oats and soy. True to its home-style roots, Premiere Moisson follows age-old baking techniques allowing bread to rise atop burlap in drawers without artificial heat or steam. Flavors develop naturally as does preservation qualities. The bread bakes on stone decks in non-polluting natural gas ovens that prevent the bread from drying out. (450-455-2827, 866-455-2827)
Carte Blanche
One wall of Carte Blanche is a color-field painting by Belgium artist, Andre Claes which balances the chic black and white decor. Popular with local media and Quebec film and TV stars, Carte Blanche is the ideal venue for a special occasion, a first date or a small get-together. The young owners hail from a small village in the center of France (former home of actor, Gerard Depardieu)and stick with traditional recipes like apple tarte tatin from the late 1800's. Pure, simple and traditional best describe Chef Andre's creations. Specialities include shepherd's pie made with blood pudding and carmelized apples served with a maple chutney and a perfectly seasoned duck confit cassoulet. Seafood lovers enjoy a sesame seed-encrusted salmon filet served with a lime and ginger caramel sauce or perfectly seared sea scallops dressed in a light, tangy oil topped with sun dried tomato pieces. (5143138019)
About Sherel Purcell
Sherel Purcell is a travel writer who specializes in golf, Montreal and Quebec, contemporary art, cycling and food and wine. Her articles appear on USA Today's 10Best, About.com, Aol, Matador, Vacay, Travel+Escape and other large sites as well as print magazines including Dreamscapes (Globe and Mail) and Frommer's Budget Travel. Her travel photos have appeared in the video, "A New York Minute" on the Smithsonian website and Brand USA. She has received an editorial award from Parenting Publications of America and a nomination from "See America".
Read more about Sherel Purcell here.
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Two siblings with nephrogenic diabetes insipidus are reported.
One had unilateral obstructive uropathy due to an ectopic ureterocele; this was associated with a sodium-wasting state which led to transient sodium depletion postoperatively.
His older affected sister had massive.dilatation of the entire urinary tract, but no evidence of organic obstruction or vesicoureteric reflux. Upper tract dilatation is believed to result from functional obstruction at the ureterovesical junction, due to the greatly increased flow of urine and marked distension of the bladder. The reservoir function of the bladder is overloaded by the polyuria and by voluntary retention, leading to marked bladder enlargement.
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Miami Heat talking points: Scoreless fourth quarter for Tim Duncan | Video
The Heat have to like where they stand after beating San Antonio 98-96 on Sunday in Game 2 of the NBA Finals.
7:00 am Jun. 9, 2014
The Heat have to like where they stand after beating San Antonio 98-96 on Sunday in Game 2 of the NBA Finals.
7:00 am Jun. 7, 2014
Spurs guard Tony Parker did not seem to mind the temperature, but he knows San Antonio got a discount on its Game 1 victory by not having to face LeBron James in his entirety.
8:34 pm Jun. 5, 2014
No need to change what works.
7:00 am Jun. 5, 2014
The NBA Finals will mostly be dictated by each team's stars. The Heat are counting on LeBron James, as well as Dwyane Wade and Chris Bosh to a lesser extent. San Antonio's chances start with …
7:10 pm Jun. 1, 2014
The Spurs pulled out an overtime victory in Game 6 of the Western Conference finals Saturday without much help from All-Star Tony Parker. He sprained his left ankle earlier in the series and it flared …
2:44 am Jun. 19, 2013
San Antonio's Tony Parker, Tim Duncan and Manu Ginobili react with varying degrees of emotion to the Spurs' 103-100 overtime loss in Game 6.
5:42 pm Nov. 29, 2012
Gregg Popovich apparently didn't see tonight as a showcase game.
The Spurs coach, who has never been hesitant to defy conventional wisdom or league authority, decided that his team — which hasn't lost on the road this season — was tired at the end of a long road trip, and put his three best players and another starter on a plane back to San Antonio.
So, no, you won't see Tim Duncan, …
2:44 pm Aug. 4, 2009
The Heat opens the 2009-10 season with a home game against New York on Oct. 28. But the real story of the Heat's new schedule is the Heat had better be …
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All Things DWEEZIL
The Latest Greatest news and information!!!
Total Immersion Guitar Bootcamp
"Learn And Destroy"
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by David McCain
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Yes, that IS his head!! Hahaha
Thats not Yusefs head,too much hair! LoL {-
Crest February 2014
Zappa Mag covers
New Zappa fan!
Zappa The Crest 2012 short
Steve Morse Band Jan 23 2012


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The search for missing Malaysian Airlines flight 370 has been put on hold for the second time in three days, thanks to poor weather conditions in the South Indian Ocean.
Australian authorities said Thursday morning a Thailand satellite detected at least 300 hundred objects floating in the ocean, in the search vicinity.
Anond Snidvongs, director of Thailand's space technology development agency, said Thursday the images showed "300 objects of various sizes" in the southern Indian Ocean about 2,700 kilometres southwest of Perth.
300 Objects found on the Indian Ocean captured by THAICHOTE Thai Satelite Image sending to ML for #MH370 SAR (5/5) pic.twitter.com/uWXjCTHnoT
— yoware [HD] (@yoware) March 27, 2014
300 Objects found on the Indian Ocean captured by THAICHOTE Thai Satelite Image sending to ML for #MH370 SAR (5/5) pic.twitter.com/uWXjCTHnoT
Anond says the objects were about 200 kilometres from the area where a French satellite on Sunday spotted 122 objects.
Meanwhile, a Chicago law firm will be suing the airline, Boeing and the Malaysian government for millions of dollars.
The Montreal convention, signed in 1999, stipulates that Malaysia Airlines will have to pay at least $172,000 to the families of all 239 passengers.
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Golden Bough Botanicals has been a supplier of premium quality herbs, medicinal herbs, spices and specialty teas since 1974. Our business has evolved to include organic herbs and spices, fruit powders, pure essential oils, organic essential oils, fragrances, cosmetic, candle and soap making ingredients and pot pourri decorative botanicals.
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Vice President Biden visited the Toledo Chrysler plant recently. He talked about the $85 billion auto bailout and said the administration wants to "strengthen middle-class security" in a country "where hard work pays off, responsibility is rewarded and everyone plays by the same set of rules."
That's insulting to Delphi salaried retirees whose pensions were cut 30-70 percent by the Obama administration's actions. The Obama administration made a political choice and used our tax dollars to help some while kicking to the curb those they considered too weak to fight back, and they could do that to anybody else they feel is weak.
That is the real Obama administration in spite of what they say. In fact, in 2008, then-candidate Obama said "Pension protection is something we should put at the top of our priority list. ... If a company goes bankrupt, then workers need to be our top priority, not an afterthought."
Politicians' actions speak much louder than their words. If you are part of a large and powerful group, then believe what he says. If not then he doesn't think you matter anyway. They did it to the Delphi retirees; they can do it to others, too.
Bruce Gump


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|Home Decor
|Wall Hanging
I love creating, designing and quilting and you can find me blogging at Freemotion by the River. I enjoy showing others how easy and fun quilting can be.View all patterns by designer (23) »
If you are looking for a new wall hanging or table topper for the holidays or as a gift this will be one you enjoy making! It is a very easy pattern to piece and included directions for 2 different sizes.
There are also full-sized templates in 2 different sizes and with 2 different flowers for you to use.
This pattern includes 12 pages of clear directions and photos. You'll want to make more than one!


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The Poinsettia Bowl is only 10 days away.
Crazy, right? It seems like yesterday that James Lark demolished New Mexico State.
This year's matchup should be as entertaining as ever, as two former MWC rivals, BYU and San Diego State, will be pitted against each other. Although there are still several question marks when it comes to Cougar starters, particularly at quarterback, there are also many interesting matchups to watch out for.
In this slideshow, we'll look at positional matchups that BYU should win (not cornerback vs. wide receiver, but receiver vs. receiver). Some of these picks may be surprising, but here are players that I think will be their Aztec counterparts.


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Welcome to the forums oneflip
My user name is oneflip as you can tell!
Hello all.
Some one add me so we can play each other.
Welcome to the forums oneflip
"To know, is to know that you know nothing. That is the meaning of true knowledge."quote by Confucious
Spoiler Alert!
TNOG.ORG - Games events in Manchester
MikeDBloke - PSN
I was into weird games before people knew what they where
@D_Bloke - My inane prattle
Originally Posted by Darkprinny
Its complicated. lol


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MonsterTrak - http://www.monstertrak.com/
Find jobs and internships; and post your resume.
America's Job Bank - http://www.ajb.dni.us/
Homepage of the public employment service, a state operated program which provides labor exchange to employers and job seekers through a network of 1,800 U.S. Offices.
BestJobsUSA - http://www.bestjobsusa.com/
Provides resources, tools, and information to help with career advancement for candidates.
Career Builder - http://www.careerbuilder.com/
Targeted to college graduates. Includes job listings, employer profiles, resume positing services, online job fairs and a career resource center.
Careerjet - http://www.careerjet.com/jobs-in-usa-55.html
In one simple search, job seekers have access to a huge selection of jobs that are sourced from various internet sites saving the trouble of having to visit each site individually.
Chegg.com - http://www.chegg.com/
Check out internships and entry level jobs from top employers.
Craigslist.org - http://www.craigslist.org/
Local jobs, classifieds and forums for 567 cities in over 50 countries worldwide - community moderated
Dice.com - The Career Hub for Tech - http://www.dice.com/
Job search for Technology Professionals
EmploymentGuide.com - http://www.employmentguide.com/browsejobsnew.html
Search for openings in a specific market or conduct a keyword and location search
FlipDog.com - http://www.flipdog.com
Search for jobs in a local area, or by most popular cities, states and categories
Glassdoor.com - http://www.glassdoor.com/index.htm
Glassdoor has more jobs than any other job site
Indeed - one search, all jobs- http://www.indeed.com/
A search engine that gives job seekers access to all the job listings from major job boards, newspapers, associations and company career pages.
Jobs.com - http://www.jobs.com
Search for jobs by a variety of locations, domestic and international
Job Hunt - http://www.job-hunt.org/
A megalist of on-line job search resources and services.
Job Smart - http://jobsmart.org/
Provides information on the job search, specific to the state of California.
**Provides links to over 150 salary surveys on the web.**
Jobster - http://www.jobster.com/
Search jobs and build your career network.
Monster Board - http://www.monster.com/
An interactive database providing listings of job opportunities with America's hottest companies. Includes relocation, resume information and employer profiles.
Riley Guide - http://www.rileyguide.com/
Rated top 5% of career assistance websites. One stop career shopping. Internet search information and job resources listed by career area and geographic region.
Federal Jobs - http://www.usajobs.gov/
A searchable database of U.S. Federal Government information and jobs provided by the Office of Personnel Management
Opportunity Knocks - http://www.opportunitynocs.org/
Create an account, post your resume and search for jobs and companies.
Simply Hired - http://www.simplyhired.com/
The biggest, smartest job search engine on the web. They search thousands of job sites and companies.
Nittany Lion Career Network Instructions:
For Students (PDF)
For Employers (PDF)
Upcoming Events
View Calendar (PDF)
Internship Registration Forms
Student Form (PDF)
Employer Form (PDF)
- Career Services


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Simon Geere from London writes: "About five years ago I bought a Tumi briefcase from the Terminal 4 outlet at Heathrow Airport. It cost close to £400, if I recall; however, it was just what I was after, as it came with a shoulder strap, it could fit my laptop and, when placed on the floor, it stood upright, useful for when travelling to work on the Tube.
"The shoulder strap broke last year and so I sent it off to Tumi's UK service centre and within a week or two it sent back a brand new strap. Then last


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See everything on sale inside our October Sale Flyer.
Shop Our Sale Flyer
Browse your favorite woodworking catalog!
Shop Our Catalog
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Join us on your favorite social network! Share your projects and learn from other woodworkers.
Please Note: This item can only be shipped ground to the 48 contiguous states. Some
items cannot be shipped via air due to being flammable, magnetic, contains batteries,
hazardous fumes or where contents are under pressure. Please use a physical address
not a PO Box during checkout.
(6 reviews)
Product Information:
(based on
of respondents would recommend this to a friend.
Best Uses
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Best tool to have in shop
John Payne
Willis Texas
About Me
Best Uses
Comments about
Lumber Wizard 4.0 Metal Detector with Laser Light
The Lumber Wizard saves us a fortune in money and time as it works great.
Bottom Line
Yes, I would recommend this to a friend
Works Great
Woodworking Pro
Dumfries, VA
About Me
Avid Do-It-Yourselfer
Got a Lumber Wizard 4 as a gift a year or so ago and since using it I have easily saved several planer and jointer knives. Seems relatively flawless and is easy to use. Tuning is a must in order to scan deeper. Also found that battery voltage is important so use Duracell batteries as the manufacturer suggest. Glad to own one.
Works great and saves my butt on blades
Barry Jackson
Lufkin, Texas
This metal detector works great. I've had both the 3.2 version and the 4. Both have performed great. Although as other reviews say tuning is required but that is with any metal detector. The depth these detect is ideal for finding most metals that will damage blades, knives, etc. Well worth the money. I suspect some of the other reviewers have no patience or understanding of how to properly tune and use.
About what I would expect.
Joliet, IL
My job- remove all metal and nails from 130 very old reclaimed 10"x10" hardwood beams. Unit has met my expectations to this point -I'm 37 working hours into de-nailing these beams. Today, the alarm buzzer had an issue and now it's very difficult to hear the tone. The volume has gone way down. I think the tone/buzzer is dying. I bought the unit about 10 months ago and stored it in heated storage. The unit does require frequent fine tuning, more as time has gone on. Today it seemed like I needed to adjust the unit much more. It would start just not picking anything up and I'd need to adjust it. I've gotten very good at it. I hope they can fix the buzzer issue. We're hard of hearing as it is. We probably have another 30 hours to go on these beams. I'm going to have to go buy another lumber wizard 4.0 so that we can keep going properly. I am not aware of another choice for identifying the metal in these beams. The lumber wizard has found metal that we would have never been able to see. We cannot afford metal in our material or we'll hit it with out cutting tools and damage blades. I was hoping this tool would have lasted through this job, but I'll have to buy another tonight to keep going. By the way, one 9V battery has lasted 7-8 hours of on time. I wish it had a rechargeable battery, but I understand that most people won't use it for a continious 6 hours at a time like I have been.
Doesn't work
Conway, AR
Being a very busy solo entrepreneur, I did not get around to trying it the first 90 days, so Woodcraft supplied contact info and referred me to the manufacturer. I tried calling the manufacturer several times, and the automated message says they are "not available to take your call, please e-mail". I e-mailed the manufacturer and have not heard from them for 3 days as I write this review.
I suspect, as with the only other posted review, a person will spend more time fetching a screwdriver and adjusting the "fine tuning" than actually using the unit. Mine was stored at 75 degrees and 40% humidity well within specified recomendations. I followed adjustment guidelines time after time, and no mater where I stand or where the fine tune is set the unit does not work. The lazer only comes on for a second when adjusting fine tuning after the alarm goes off(most of time for no reason holding the unit still). The only logical conclustion is I received a dud. However, If you read into it on the company's website, you'll find they say it's very sensitive and you should be 6 feet away from any metal. Think about the practicality of holding a small detector in your hand 6 feet away from your belt buckle, pocket change, pocketknife, phone, metal in shoes. How many people have shops with a 12' diameter + (length of board x 12)(sq. ft.) of metal free space? You'll also need a ceiling over 12 feet high if you have rebar in your concrete and lights etc. on your ceiling.
Ask yourself if you constantly have to adjust and double check (before and after each scanning), and move around to find a metal free zone. How much satisfaction will you receive?
Bottom Line
No, I would not recommend this to a friend
Good idea, bad quality-JUNK
We use unit to find nails in reclaimed lumber for kitchen cabinetry. Product does find metal, great for lumber- when working. Have had unit for less than 6 months, have used for maybe 20 working hours. At this time it has completely stopped working, no technical support available. When it was working it had to be re-tuned every few minutes, website claiming unit only needed re-tuning during major weather changes. Around here the weather does not change every few minutes. Hard to keep an employee working with unit needing constant babying, but now it doesn't work at all.
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BIRMINGHAM, Alabama -- Metro Birmingham's traditional retail hot-spots are bouncing back following the industry downturn that left big empty spaces dotting the market.
In Hoover, for example, the Riverchase Galleria has a redevelopment plan underway, while the Patton Creek shopping center is filling up its major vacancies.
Other new developments, including a Target store that will join Homewood's Colonial Brookwood Village, are poised to kick off soon.
But problems remain, namely the closed Century Plaza mall on Birmingham's eastern side, as well as empty big boxes lining Center Point Parkway and other areas that were hurting even before the slump.
Mom-and-pop businesses are still struggling, too, and the small vacancies they leave behind add up.
Area retail real estate professionals say some retailers are back in an expansion mode, after sinking sales amid the recession and a string of corporate bankruptcies closed thousands of stores across the nation in recent years.
"I think it's improving, but I don't think there's a lot of velocity behind it," said Emris Graham, senior vice president for EGS Commercial Real Estate. "Most of the vacant boxes that are in good retail locations have been filled, but there are still some large, like Bruno's, boxes that are in neighborhood areas that remain vacant."
The bankruptcies of Birmingham-based Bruno's Supermarkets, along with Goody's, Circuit City, Linens 'N Things and others, left vacancies in many markets. Some companies went out of business while others reorganized with a smaller footprint.
Other companies have capitalized on those bankruptcies by landing prime real estate, and some used the spaces as a vehicle to enter the Birmingham market.
At Patton Creek, the former Circuit City is now a Buy Buy Baby, while Christmas Tree Shops moved into the Linens 'N Things space.
Meanwhile, at The Summit shopping center in Birmingham, a combo Toys 'R Us/Babies 'R Us opened earlier this month in the former Bruno's space.
But while the big spaces get a lot of attention, the bulk of the vacancies along major corridors such as U.S. 31 and U.S. 280 are small shops, said Hugo Isom, a partner with The Shopping Center Group.
"The Achilles heel to the retail real estate market in Birmingham is in the small shop space," he said. "Those are often mom and pops, and those small, independent-run businesses are under huge pressure."
At the same time, parts of the metro area that already were suffering from changing shopping patterns saw those problems compounded by the downturn, Isom said.
Hardest-hit areas
Shopping centers along Center Point Parkway have been hit hard by retail growth in Trussville, while centers in Fairfield and Midfield have lost shoppers to newer options in the McCalla area.
Some of those empty spaces, as well as the closed Century Plaza mall, will require out-of-the-box solutions, he said.
"I don't believe market conditions will fix those areas," Isom said. "There has to be some intervention, local government has to intervene and create something."
The Shopping Center Group manages the Wildwood North shopping center at Interstate 65 and Lakeshore Parkway, which has lost all of its big anchors through a combination of bankruptcies and other exits.
But a redevelopment is in the works for the center, and a number of national retailers have shown interest there, as well as in another one across the street hit hard by vacancies.
"I think Wildwood's coming together," Isom said. "Plans are in the works to get them both filled up, but it's slow moving right now."
Conversely, the Hoover area is stable, he said.
Earlier this month, General Growth Properties announced a plan to spend at least $60 million redeveloping the Galleria, Alabama's busiest shopping mall. The plans include bringing Iowa-based Von Maur department store to fill a vacant anchor space, and other deals are pending.
And, on the perimeter of the Galleria, natural foods retailer Earth Fare plans the enter the Birmingham market by opening a grocery store in the vacant CompUSA space.
The Summit thrives
Robert Jolly, president of Retail Specialists Inc., said he's seen some encouraging signs in the market, particularly in the traditionally popular shopping areas.
At The Summit, for instance, stores that have exited have been replaced seamlessly, he said.
"Obviously, that's the most dynamic venue in town, and they've done a nice job of re-leasing their vacant space without the market even noticing," he said.
Retail Specialists represents Izzo's Illegal Burrito, one of several restaurant chains to open recently at The Summit.
That fast-casual restaurant sector is strong, and in some areas, space is even scarce.
That's largely because major shopping center development has slowed, so the coveted outparcels surrounding them are not as plentiful, said Bryan Holt, principal with Southpace Properties.
"I think our biggest problem is that Walmart and Target are, for the most part, done developing in the metro Birmingham area, and they've led every major development since the Galleria, with the exception of The Summit," he said.
As a result, Holt expects to see more in-fill development, with the so-called "junior anchor stores," such as TJ Maxx, Office Depot and others leading the way.
The Birmingham area may have all the Walmarts it needs, Holt said, but there's still room for other anchors.
"We've got holes, and we've got to figure out how we get it done when the 800-pound gorilla (of Walmart) is not forcing the issue," he said.
Join the conversation by clicking to comment or email Kent at firstname.lastname@example.com at 8:28 a.m. to add dateline.


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Hiking Maps of Mars
|Data from Mars Express is being used to produce topographic maps of Mars. The image above is at a scale of 1:200 000. Click image for larger view.
Credit: ESA
Scientists using data from the HRSC experiment onboard ESA's Mars Express spacecraft have produced the first 'hiker's maps' of Mars. Giving detailed height contours and names of geological features in the Iani Chaos region, the maps could become a standard reference for future Martian research.
The maps are known as topographic maps because they use contour lines to show the heights of the landscape. The contour lines are superimposed upon high-resolution images of Mars, taken by the High-Resolution Stereo Camera (HRSC) onboard Mars Express. On Earth, such maps are used by hikers and planning authorities.
They are known in the UK as ordinance survey maps. Every country has its own equivalent. The contour lines themselves were determined using data from the HRSC.
|The smallest scale topographic maps being produced are at 1:50 000, where the contour lines are just 50 meters apart. Click image for larger view.
Credit: ESA
This data has been transformed into three-dimensional computer models of Mars, known as the HRSC Digital Terrain Models (DTMs).
The new maps have been produced under the leadership of the Principal Investigator(PI) G. Neukum (Freie Universität Berlin), as part of the effort of the science and experiment team of the HRSC experiment, by J. Albertz and S. Gehrke of the Institute for Geodesy and Geoinformation Science, Technische Universität Berlin, in cooperation with the German Aerospace Centre (DLR), Institute of Planetary Research, Berlin.
They used the HRSC DTMs of the Iani Chaos region to produce a series of topographic maps at different scales, from 1:200 000 down to 1:50 000.
The researchers chose the Iani Chaos region because of its major topographical interest. It is covered in individual blocks and hills that form a chaotic pattern across the landscape.
|ESA's Mars Express spacecraft launched in June of 2003 and has since made many important observations from orbit around Mars.
Credit: ESA
These 'islands' of rocks are likely all that remains of a previous surface of Mars. The areas in between the islands collapsed when cavities formed below the surface. Initially these cavities may have been supported by the presence of ice, which melted due to volcanic heat. As the water flowed out into Ares Vallis, towards the northern lowlands of Mars, the landscape collapsed and formed the Iani Chaos region we see today.
The contour lines help the eye to understand the morphology of the surface shown in the images. On most of the maps, each line represents a difference of 250 metres in height. The maps also display the names of geographical features and the lines of Martian longitude and latitude.
The maps are a demonstration of the kind of products that can be derived from the HRSC experiment. The HRSC is on the way to providing enough data to create such maps for the whole of Mars. This would generate 10 372 particular map sheets, each covering an equal area of the Martian surface. The maps would be to a scale of 1:200000. Such reference maps will be of great value as future robotic and human missions to Mars are developed.
Related Web Sites
Mars Express Mission (ESA)
Faceless Cydonia (European Astrobiology Magazine)
MRO Glitches
A Traveler's Guide to Mars
How Safe is Travel to Mars?


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Christmas Tree Decorating Hints and TipsSo it's time to set up the ol' Christmas tree again! The most enjoyable time of the season for many is setting up this bit of decoration. However, if you are looking for some help in doing so this year, read on and I can guide you through the basics of making a beautiful tree.
If you haven't selected a tree yet, we have a fine and wide choice available, so let's call that step one. Odds are a lot of you already have step one either done or planned out, so we can continue on.
The first actual step, of course, is to set the tree up. It is very important to follow the manufacturer's instructions provided, as there are differences between different types of trees. Be sure to shape the branches and needles so that they cover more area, fluffing them out from the normally folded tight starting position.
For best results, the first decoration to add is the Christmas lights, stringing up any sets that don't come with the tree. It is advisable to test any light strands before attaching them to the tree. If you do not, you may find yourself having to disassemble your entire tree setup to get at a deeply buried, burned out string. Start from the top down, as the shape of the branches will make it easier to work that way. There is some range to the proper number of lights you can use. As a rule of thumb, if your tree is at least 4 feet high, you are going to want a minimum of 100 bulbs per foot of the tree, ranging up to 200 per on average. So for a 6 foot tree, that would equal around 600-1200 lights. Basic style lights should be placed first to form the foundation. Lights that are novelty shaped or special function should be placed after, since their role is to make an impression, and should not be used to fill empty spaces. It may seem common sense to string lights around the tree, going around the diameter, but that actually may turn out poorly. Not only will half of the lights be on a side that faces the wall, barring the tree being in the exact center of a room, as you work the lights will be steadily pulled inward, behind the branches and losing their brightness to obstruction. Another option, instead, is to string the lights vertically, going roughly from top to bottom and back in a zigzag or parallel pattern. This maximizes coverage and makes sure to waste as few of the lights as possible to obstruction. At this point, due to often sharing cord space with the lights, it may be wise to add the tree topper. As it is an item separate from the other decorations, and has its own space on the tree, this can be added at any time, really. Be sure that you have considered the tree's ceiling clearance with the selection and placement of the topper. If there is a space shortage, consider folding down the top branch of the tree, which usually sticks straight up, to gain a few more inches.
Next to be placed are garlands, tinsel, and other long strings of decorations. Some trees don't use this, of course, but if you do, you'll want several feet per foot of tree, as it will need to wrap around multiple times. The basic decoration is to start at the top and spiral downwards with the strands, perhaps adding some twists and bends to break up any visual monotony.
Now comes the part that most consider the most fun: the ornaments! Even the simplest and newest ornaments can have meaning, and older or family treasured ones carry a wealth of emotional meaning.The first thing to note is that you want to use the ornaments to fill any holes in the decorations so far. To accomplish this, it may be best to have ornaments that can be considered as background. You will want at least 20 ornaments of this type per two feet of tree. Another 10 or so per the same space can be dedicated to ornaments that you want to display most prominently.
At this point your tree is all done. Sit back and relax, secure in the knowledge that you have created something to be treasured for the whole season.
Hints, Tips, Technical and More
Hints and Tips
- Alternate Ornament Uses
- Artificial Christmas Tree Shaping
- Artificial Vs. Real Christmas Trees
- Artificial Christmas Tree Profiles
- Artificial Garland Shaping
- Artificial Wreath Shaping
- Battery Operated Lamps Help
- Christmas Decoration Storage
- Christmas Safety
- Christmas Lights Not Working
- Christmas Tree Decorations
- Common Tree Questions
- Do It Yourself Cone Trees
- Do It Yourself Decorative Fences
- Do It Yourself Driveway Arches
- Do It Yourself Lettered Signs
- Do It Yourself Mini Trees
- Do It Yourself Ornament Wreaths
- Do It Yourself Snowman Trees
- How To Decorate A Large Christmas Tree
- How Many Lights For a Tree
- How To Buy an Artificial Tree
- How To Hang Outdoor Lights
- How to Create a Village Base
- How To Create A Village Scene
- How To Decorate Indoors for Christmas
- How To Decorate Outdoors for Christmas
- How To Display Department 56
- How To Display Lemax Villages
- How To Hide Extension Cords
- How To Set Up A Nativity Scene
- How To Use The Light Keeper Pro
- More Christmas Tree Decorating
- What To Do Once You Purchase a Tree
- Why You Should Buy Artificial Trees
Common FAQ's and Technical
- About Amps Watts and Volts
- Animated Lights
- Artificial Christmas Tree Types
- Battery Operated Candle Lamp Instructions
- Battery Operated Christmas Lights
- Battery Operated Lights
- Bubble Christmas Lights
- C7 and C9 Christmas Lights
- Christmas Icicle Lights
- Christmas Light Bulb Sizes
- Christmas Light Fuses
- Christmas Light Projectors
- Christmas Light Shows
- Christmas Micro Lights
- Christmas Net Lights
- Christmas Night Lights
- Christmas Rope Lights
- Christmas Tree Accessories
- Christmas Wall Trees
- Christmas Yard Art Help
- Commercial Christmas Light Standards
- Fiber Optic Christmas Trees
- Flameless Candels
- Flocked and Frosted Trees
- GE Christmas Tree Help
- GE Constant on Lights Help
- GKI Lighting Help
- How Department 56 Collectibles are Made
- How Department 56 Snowbabies Are Made
- How Department 56 Villages are Made
- Inflatable Yard Art
- LED Christmas Light Help
- LED Lighting
- Light Keeper Repair Technical
- Luminaria Bags
- Santas Best and GE Tree Help
- Shatterproof Ornament Help
- Timer Help
- Topiary Christmas Trees
- UL and CSA Approved Chrismas Lights
- Woven Christmas Yard Art


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North Vancouver's North Shore Credit Union has long been a leader in the application of customer relationship management software to the commercial banking business model. The firm's refreshing, customer-centric "member intimacy" strategy for customer relationships has earned it industry recognition and a healthy share of the commercial banking business in the region
In this 6-minute video presentation, Fred Cook, the Chief Information Officer at North Shore Credit Union takes us behind the scenes of a financial services CRM success story. He articulates both the organization's strategy, and how that strategy has been mirrored in the CDC Pivotal CRM system to create "member intimacy."
If you have a CDCSoftware.com account please Login below.
Don't have an account? Register Now


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WineAccess Travel Log
Read stories from the world's greatest wine trails.
More About This Wine
About Joseph Phelps
Joseph Phelps Vineyards was born out of owner Joseph Phelps's love for the Napa Valley, which he discovered while his construction firm was building a winery near St. Helena. Today, Joseph Phelps Vineyards produces several wines that are 100% estate grown, including the flagship Insignia, a lush, highly concentrated blend of Bordeaux varietals.
1999 Joseph Phelps Cabernet Sauvignon Backus Vineyard Oakville Napa Valley
Producer: Joseph Phelps
Style: Red Wine
Grape Type: Cabernet Sauvignon
Origin: California
Region: Napa
Appellation: Oakville
92(+?) Points | Stephen Tanzer's IWC - May/June 2002
(bottled a month prior to my visit) Saturated ruby, with purple tones. Primary aromas of cassis, bitter chocolate, mocha, menthol and licorice, along with a peppery nuance. Cool, extremely primary black fruit flavors are not yet expansive but hint at the sweetness to come. Finishes with big, chewy tannins and excellent persistence.