text:
Author Affiliations: Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Importance Although approximately 30% to 50% of patients experience a complete response after regional chemotherapy for in-transit melanoma, a subset of patients will develop rapidly progressive disease. In the current era of an expanding armamentarium, including both regional and systemic options for treating advanced melanoma, identifying perioperative factors that predict disease progression may obviate unnecessary morbidity associated with regional therapy and avoid delays in systemic therapy.
Objective To identify patient-related clinical and pathological variables, as well as procedural factors, that correlate with disease progression.
Design Using a prospectively maintained database, we identified patients who either underwent first-time melphalan-based isolated limb infusion (ILI) or first-time hyperthermic isolated limb perfusion (HILP) for in-transit melanoma. Response was defined using modified Response Evaluation Criteria in Solid Tumors for cutaneous disease at 3 months after treatment. Survival analyses were performed using the Kaplan-Meier method, with the differences in survival curves compared using a log-rank test. Potential preoperative and procedural predictors of in-field progressive disease were analyzed using logistic regression.
Participants Of the 258 patients included in the database, 215 were identified as having undergone first-time regional therapy. Of these 215 patients, 134 underwent ILI, and 81 underwent HILP.
Exposure Regional therapy (ILI or HILP).
Main Outcomes and Measures Complete response or progressive disease.
Results Of 134 patients who underwent ILI, 43 (32.1%) experienced in-field progressive disease. Of 81 patients who underwent HILP, 9 (11.1%) experienced in-field progressive disease. The median survival for patients with in-field progressive disease was 20.3 months for the ILI cohort and 15.0 months for the HILP cohort. In general, patients with progressive disease were younger, with advanced-stage melanoma and increased tumor burden. Compared with patients who experienced a complete response, patients with in-field progressive disease after ILI were younger (odds ratio, 1.06 [95% CI, 0.90-0.98]; P = .002). For patients who underwent HILP, no clinically relevant preoperative predictors of in-field progressive disease were identified. Procedural variables, including chemotherapeutic dosing, degree of acidosis or base deficit achieved, and peak temperature attained, were not predictors of in-field progressive disease after ILI or HILP.
Conclusions and Relevance Patient, clinical, and procedural factors are unreliable predictors of in-field progressive disease after regional therapy in patients with in-transit melanoma. Defining the potential utility of molecular markers in predicting response or failure of regional therapy should be the focus of future research efforts.
The incidence of melanoma is increasing faster than that of any other malignant disease in the United States, with more than 70 000 new cases expected in 2012.1 Of these cases, 50% will represent disease limited to an extremity, and even after appropriate therapy, up to 10% of these cases will develop into subdermal lymphatic metastases occurring between the primary tumor and its draining lymph node basin.2,3 This pattern of advanced disease of the extremities represents in-transit melanoma and is classified by the American Joint Committee on Cancer as either stage IIIB or stage IIIC, depending on regional lymph node involvement.4
Patients presenting with unresectable in-transit melanoma are often treated with regional therapy in the form of hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI), both of which allow for the circulation of chemotherapy at doses much higher than can be administered systemically. Although the complete response rate to regional therapy at our institution is approximately 55%, up to one-third of patients will develop a rapidly progressive disease.5 In the current era of an expanding armamentarium, including both regional and systemic options for treating advanced melanoma, it is important to identify patients likely to experience progression so as to obviate the potential morbidity associated with regional therapy and, perhaps more importantly, to avoid delays in systemic therapy. Therefore, the purpose of our study was to identify patient-related clinical and pathological variables, as well as procedural factors, that correlate with disease progression.
With institutional review board approval, our prospectively maintained regional therapy database, including records from 258 patients treated between 1995 and 2010, was reviewed. All patients were classified as having stage IIIB or IIIC and stage IV cancers based on the American Joint Committee on Cancer classification.4 Response to therapy was evaluated 3 months after treatment as defined by the modified Response Evaluation Criteria in Solid Tumors for cutaneous lesions.6 Only patients undergoing first-time regional therapy were included for analysis, focusing on in-field disease, defined as lesions distal to tourniquet placement. Toxicity was evaluated according to Common Terminology Criteria for Adverse Events version 3.7
Isolated limb infusions were performed as previously described by our group.8 In brief, after placement of percutaneous catheters by interventional radiology into the contralateral limb such that the catheter tips terminate in the middle of the diseased extremity, chemotherapy (using melphalan with or without dactinomycin) was rapidly infused into the arterial portion of the circuit and circulated for 30 minutes after the extremity was warmed to 37.0°C. Melphalan was dosed at 7.5 mg/L for the lower extremity and at 10 mg/L for the upper extremity; dactinomycin was dosed at 75 and 100 μg/L for the lower and upper extremities, respectively.9 After the 30-minute circulation of chemotherapy, 0.5 to 1 L of isotonic crystalloid solution was flushed through the circuit for manual washout. Limb volume was calculated for both ILI and HILP by integrating the measured extremity circumference at 1.5-cm intervals up to the level of anticipated tourniquet placement, and chemotherapy dosing was typically corrected for ideal body weight (IBW) based on evidence that such modification reduces severe toxicity rates without altering response rates.10 Of the 134 patients undergoing ILI, 117 (87.3%) received melphalan dosing based on IBW.
Hyperthermic isolated limb perfusions were performed as previously described.11 In brief, the vessels to be cannulated were surgically isolated and then subsequently connected to a cardiopulmonary bypass circuit. A concurrent lymphadenectomy was often performed prior to vessel cannulation depending on the clinical scenario. Once extremity temperatures reached 38.5°C, chemotherapy was perfused through the circuit for 60 minutes, followed by a 15-minute washout with isotonic crystalloid solution. The HILP was performed using melphalan (10 mg/L for the lower extremity and 13 mg/L for the upper extremity). Of the 81 patients undergoing HILP, 22 (27.2%) received melphalan dosing based on IBW.
The concentration of circulating melphalan was obtained for a small number of patients. Concentrations were determined in the extremity circuit beginning at time zero and at 5-minute intervals for 30 minutes. The systemic melphalan concentration was also determined after 30 minutes of regional therapy to evaluate for tourniquet leak.
Rapidly progressive disease was defined as a 20% increase in the size of a preexisting lesion or the occurrence of a new lesion either in-field or out-of-field within 12 weeks of regional therapy.6 For the purposes of statistical clarity, only patients with in-field progression were included for analysis. Both a physical examination to evaluate suspicious lesions and palpable lymphadenopathy and imaging were used to survey for response. After the first 3-month evaluation, patients were initially followed up every 3 months for 1 year and then every 6 months thereafter to determine progression-free survival.
Positron emission tomography/computed tomography was used as a routine surveillance tool to assess disease status prior to therapy and to detect local and systemic progression beginning approximately in 2004. Pathological confirmation via punch biopsies, fine-needle aspirations, computed tomography–guided biopsies, or surgical resections was performed when necessary. In the absence of a physical examination or positron emission tomographic/computed tomographic findings, we also began to routinely perform sentinel lymph node biopsies on patients with in-transit disease, mapping the in-transit disease starting in 2010.
For the purposes of identifying predictors of rapidly progressive disease, these patients were compared with those experiencing a complete response. Survival analyses were performed using the Kaplan-Meier method, with the differences in the survival curves compared using a log-rank test.12 Potential preoperative and procedural predictors of in-field progressive disease were analyzed in a univariate fashion, with statistical significance set at P < .05. All statistical analyses were performed using the commercially available software Stata version 11.1 (StataCorp).
Of the 258 patients included in the database, 215 were identified as having undergone first-time regional therapy. Of these 215 patients, 134 underwent regional therapy in the form of ILI, and 81 underwent regional therapy in the form of HILP. Response to regional therapy defined 3 months after treatment is included in Table 1. For the purposes of our study, 43 patients (32.1%) in the ILI cohort had progressive disease and were compared with 40 patients (29.9%) who experienced a complete response in the same cohort. Similarly, 9 patients (11.1%) in the HILP cohort progressed within 3 months and were compared with 36 patients (44.4%) who experienced a complete response to HILP. Patients found to have stable disease or a partial response to regional therapy were not included in this analysis.
Clinical and pathological variables, as well as procedural factors, were evaluated to identify differences between patients with progressive disease and patients who experienced a complete response, in both the ILI (Table 2) and HILP (Table 3) cohorts. In the ILI cohort, the only variable differing between patients with progressive disease and patients who experienced a complete response was age, with the patients who experienced progressive disease being younger (60 years vs 70 years; P < .001). The stage of disease, disease burden, and melphalan dosing were similar between groups, and although not statistically significant, the proportion of patients with progressive disease who had melphalan toxicity was twice that of patients who experienced a complete response (25.6% vs 13.2%; P = .16) in the ILI cohort. There were no differences in perioperative variables between patients who experienced a complete response and patients with progressive disease after HILP. In addition, the trend in toxicity was similar in the HILP cohort, with twice the proportion of patients with progressive disease who had melphalan toxicity compared with patients who experienced a complete response (55.6% vs 25.0%). More patients who underwent ILI (117 of 134 [87.3%]) had a melphalan dose corrected for IBW compared with patients who underwent HILP (22 of 81 [27.2%]). Logistic regression models were used to identify potential predictors of progressive disease after ILI (Table 4) and after HILP (Table 5). Of the variables tested on univariate analysis, only younger age (odds ratio, 1.06 [95% CI, 0.90-0.98]; P = .002) was associated with progressive disease 3 months after ILI. Other clinical, pathological, and procedural variables did not correlate with progressive disease, including disease stage and disease burden, technical variables such as melphalan dosing and peak temperature attained, and the development of drug-induced toxicity. Similarly, there were no significant perioperative variables associated with progressive disease after HILP, including disease stage, disease burden, and procedural factors. Multivariate analyses were not performed owing to the low effective sample size. To evaluate survival specific to in-field progressive disease after ILI or HILP, Kaplan-Meier curves were created (Figure 1). The median survival for patients with in-field progressive disease was 20.3 months after ILI compared with 15.0 months after HILP (P = .82).
Figure 1. Overall survival rate of patients with progressive disease after undergoing either isolated limb infusion (ILI-PD) or hyperthermic isolated limb perfusion (HILP-PD), determined using the Kaplan-Meier method.
Melphalan pharmacokinetic data, including the circulating drug concentration within the extremity, were obtained for 17 patients who experienced a complete response and 19 patients with progressive disease. The average peak melphalan concentration after regional therapy was 23.63 μg/mL in patients who experienced a complete response and 26.24 μg/mL in patients with progressive disease. Figure 2A demonstrates the range of peak melphalan concentrations reached in patients who experienced a complete response and in patients with progressive disease, with the averages already mentioned represented by the horizontal bars. In addition, the average circulating melphalan concentration was determined at 5-minute intervals for 30 minutes in both patient populations (Figure 2B). The area under the curve was determined to be 416.90 and 465.50 μg · min/mL for patients who completely responded after regional therapy and for patients who progressed after regional therapy, respectively.
Figure 2. Pharmacokinetics of melphalan, which does not correlate with response to regional therapy. A, Dot plot comparing the peak melphalan concentration in patients exhibiting a complete response (CR) or progressive disease (PD) after regional therapy for in-transit melanoma. B, Circulating melphalan concentration within the extremity determined at 5-minute intervals for 30 minutes during regional therapy for in-transit melanoma. These curves represent the melphalan concentration at each time point for 17 patients with a CR and for 19 patients with PD, with the averages shown at the bottom.
Advanced melanoma of the extremities develops in up to 10% of patients with disease limited to an extremity.2,3 With a diagnosis of in-transit melanoma, patients may progress through an algorithm that includes treatment strategies such as surgical resection, intralesional therapy, regional chemotherapy, or systemic chemotherapy.13 Regional therapy including ILI and HILP has become the mainstay of therapy for treating in-transit disease at our institution. Although complete response rates approach 55% after these procedures, a significant proportion of patients will develop a rapidly progressive disease.5 Therefore, the objective of our study was to identify predictors of progressive disease, so as to identify patients likely to progress in such a way that alternative strategies can be prioritized. In our review of 215 patients who have undergone a first-time ILI or HILP, no patient-related clinical or pathological variables or technical factors proved to be a significant predictor of progressive disease. Although the rate of 5-year survival after resection of early-stage melanoma approaches 91%, systemic chemotherapy for advanced melanoma has historically been generally ineffective, with an overall response rate of approximately 20% and a complete response rate approaching only 5%.14- 16 Newer agents, such as the BRAF -specific inhibitor vemurafenib, benefit only 50% to 60% of patients with melanomas harboring the BRAF mutation and result in a 6-month survival rate of 84%, but median progression-free survival is only 5.3 months.17 The use of ipilimumab improved the survival of patients with metastatic melanoma, but its side effect profile may not be tolerated by many patients.18
The current body of literature includes a number of studies reporting single-center experiences with ILI and HILP. The less invasive regional therapy technique, ILI, has been reported to elicit a complete response in approximately one-third of patients.19,20 The more aggressive therapy, HILP, which requires the surgical isolation of the vessels to be cannulated with higher doses of chemotherapy circulated throughout the extremity, results in complete response rates between 40% and 80%.8,21- 26 The complete response rates in our cohort are similar to these other single-center studies, with complete responses in 30% of patients undergoing an ILI and in 44% of patients receiving an HILP. However, in our study, the rate of progressive disease, defined by the modified Response Evaluation Criteria in Solid Tumors6 as an increase in size of a preexisting lesion by 20% or the appearance of a new lesion within 12 weeks of regional therapy, was 32% for the ILI cohort and 11% for HILP cohort. Of note, correcting the melphalan dose for IBW in ILI is associated with similar complete response rates but lower partial response rates; correcting the dose for IBW also reduces toxicity.19 Whether the same is true in HILP is currently unknown. In our study, more patients who had undergone an ILI did have their doses corrected for IBW compared with those who had undergone an HILP, which may explain the higher progressive disease rate in the ILI cohort. Furthermore, the peak concentration of circulating melphalan during regional therapy does not appear to correlate with progressive disease because the small number of patients in our study with available pharmacokinetic data had similar peak drug concentrations, regardless of their response.10 The area under the curve, used as a surrogate for circulating melphalan concentration over a 30-minute period, was also similar between patients who experienced a complete response and patients with progressive disease, and therefore it did not predict response. Ultimately, the clinical meaningfulness of a patient who experienced a partial response is similar to that of a patient with stable disease or a patient with progressive disease in that the patient still requires additional interventions to achieve a NED (no evidence of disease) status.
The median survival for patients with progressive disease is 20.3 months after an ILI and 15.0 months after an HILP, whereas the median survival after a complete response may be as high as 100 months.20,27- 29 The ability to identify patients likely to experience progressive disease despite optimal regional therapy is necessary, so as to avoid delays in more appropriate therapy, such as systemic chemotherapy. Furthermore, the identification of other modifiable factors not investigated in our study, such as the role of papaverine hydrochloride to improve drug delivery to cutaneous vessels, or the identification of patients with favorable tumor biology, may yield the potential to further optimize treatment and individualize care, ultimately resulting in improved outcomes for this challenging patient population.29,30
Thus, regional therapy remains an important option for these patients. Interestingly, there is currently an ongoing trial from Memorial Sloan Kettering Cancer Center in New York, New York, investigating how augmentation of the immune response with ipilimumab in the context of regional therapy can improve outcomes and response rates (NCT01323517). If immunologic manipulation does indeed augment regional therapy, correlative scientific studies evaluating immunologic profiles of responders and nonresponders may prove to be more sensitive predictors of response than the patient- and treatment-related variables explored in our study. Rational combination therapies for individual patients, including immunologic therapy, targeted agents, and cytotoxic chemotherapy, may ultimately provide the most effective strategy.
The present study has several limitations. It focused only on in-field progressive disease for the purposes of statistical clarity; however, there does exist a population of patients with out-of-field progressive disease. Furthermore, by only comparing patients who experienced a complete response with those with progressive disease, in a retrospective fashion, our study may be underpowered; therefore, the variables tested could be potential predictors of progressive disease if analyzed within a larger series of patients. In addition, approximately 12% of patients were lost to follow-up and were therefore not evaluated or included in the analysis; data from these patients would have increased the power of our study.
Despite these limitations, we conclude from our study that patient-related clinical and pathological variables, as well as procedural factors, cannot reliably predict progressive disease after regional therapy for advanced melanoma of the extremities. Until more sensitive predictors of progressive disease are developed, we will continue to recommend regional therapy for patients with in-transit disease confined to a single extremity. Further research in the realm of molecular markers in the context of tumor signatures, as well as research to determine the potential benefit of immunologic augmentation, may be the key to identifying patients most likely to benefit from regional therapy and therefore improve their survival and eliminate unnecessary morbidity.
Correspondence: Michael E. Lidsky, MD, Department of Surgery, Duke University Medical Center, 2301 Erwin Rd, Durham, NC 27710 (firstname.lastname@example.com).
Accepted for Publication: August 28, 2012.
Published Online: April 3, 2013. doi:10.1001/jamasurg.2013.695
Author Contributions: Dr Tyler served as the senior author and had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Lidsky, Turley, Beasley, and Tyler. Acquisition of data: All authors. Analysis and interpretation of data: Lidsky, Turley, and Tyler. Drafting of the manuscript: Lidsky, Turley, Beasley, and Tyler. Critical revision of the manuscript for important intellectual content: Lidsky, Turley, Sharma, and Tyler. Statistical analysis: All authors. Obtained funding: Tyler. Administrative, technical, and material support: Tyler. Study supervision: Tyler.
Conflict of Interest Disclosures: Dr Tyler is on the speaker's bureau of Novartis, has been a Scientific Advisory Board Member for Roche/Genentech, and has received clinical trial support from Merck/Schering Plough Corporation.
Previous Presentation: Presented in part at the Seventh Annual Academic Surgical Congress Meeting; February 15, 2012; Las Vegas, Nevada.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Surgery editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers' bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
Country 103.7, The Gator
by: AirKast, Inc. • 46
All Android applications categories
All Android games categories
by: AirKast, Inc. • 46
Say hello to your official brand new Country 103.7, The Gator radio app!
We've completely redesigned the app for a spectacularly enhanced user experience. Still the same great features you know and love from our previous app, just with many more interactive capabilities.
No registration required. FREE APP.
You spoke, we listened... check out the upgrade features below:
- Alarm clock - wake up to your favorite station. Record a personal reminder to play before waking to the radio
- Sleep feature - now also fall asleep while listening to your music or talk show
- Portrait style screen layout to accommodate external speaker and docking stations
- Interactive ticker tape on main screen with station provided information feeds or local news feed
- Ability to load and view station's program schedule in your local time zone
- Enhanced audio and graphics quality
- Ability to share the station's app via Facebook, twitter and e-mail
Experience Country 103.7 The Gator from the convenience of your Android!
Stream the biggest hits in country from Carrie Underwood, Kenny Chesney, Zac
Brown Band, Miranda Lambert, Keith Urban, Taylor Swift, Sugarland, Brad
Paisley, and more! Listen each weekday to the most entertaining shows: The
Gator Morning Show with Big D & Bubba, mid-days with Polly Peterson, JJ
Thomas in the Afternoons, and Big Stew at night. Stream all day for Country
103.7 The Gator contests with great prizes like cash, concert tickets, gift
certificates and more! Country 103.7 The Gator plays the biggest hits and
the biggest stars all day with limited commercials and 103.7 minutes of
non-stop music to start your workday! Country 103.7 The Gator is an
interactive radio player that gives you the freedom to listen and interact
with Country 103.7 The Gator anytime, and you can check out lyrics as songs
play, see artist album information, discover fresh new music, add your
favorites, buy songs, build playlists and more!
Tags: wruffm , country 103.7 the gator playlist , country 103.7 list of songs , theamzwrufg , 103.7the gator , wxcy sleepez tickets , 103.7 the gator , 103.7 the gator playlist , 103.7 gator country
Users review
from 46 reviews
Download Country 103.7, The Gator
Free - V184.108.40.206 - 12M
More actions

subset: commoncrawl


text:
WirelessDevNet.com Press Release
O2 Secure Wireless, Inc. (OTC PINK: OTOW), a developer of domestic and international hi-speed wireless Internet facilities, Mobile Internet solutions and the OTOW Network, announced today its plans to launch the first version of its consumer digital music store, showcasing some of today's hottest acts through dedicated artist feature sites to the developing markets in Haiti, Dominican Republic, Costa Rica and Mexico.
By unifying label and independent artist content, the OTOW Network underpins the Company's broader strategy in the direct-to-consumer space. In this first of a series of releases, music fans will be able to pre-register at http://otownetwork.com/ to become part of the upcoming OTOW "universe" for their favorite artists and those they have yet to discover. With plans to rapidly expand the service offering in early 2015, the OTOW Network intends to queue up event-based and local music scene microsites in Haiti, Dominican Republic, Costa Rica and Mexico as well as additional access channels via smartphones and tablets. Also planned in Q1 2015, OTOW users may explore new and favorite artists through a music discovery application, currently in beta, and enhance their experience through premium music services.
"We want to expand the opportunity to showcase fan sites in which feature a group's entire catalog, rare tracks, and exclusive reunion tour recordings," said Val Kazia, CEO of O2 Secure Wireless Inc. "The OTOW Network intends to serve as a new multi-dimensional destination for music fans, but also a new outlet for artists wishing to cut through the noise of the big retail outlets and build brand awareness at a more personal level in OTOW's developing markets."
The new OTOW Network site will be designed, monitored, and managed by a content merchandising staff to showcase in-demand artists, albums, and tracks of the moment and also the hidden gems and up-and-coming artists. Web and mobile feature sites can quickly be created for artists or event promoters looking to raise their profile and offer exclusives. Record labels, event promoters, and recordings artists seeking more information about the OTOW Network Mobile services, should visit the OTOW Network (http://otownetwork.com/)."
"OTOW's ongoing strategy of integrating OTOW's domestic and international hi-speed wireless Internet facilities and Mobile Internet solutions technology to distribute high demand content is on target to produce various advertising and subscription revenue streams from multiple sources for the Company. Completion of the negotiations with the mobile content suppliers are expected to be completed this quarter. The parties have agreed that to maintain the confidentiality of all of the parties in order to protect any competitive interests during the period of the negotiations," commented Val Kazia, CEO of O2 Secure Wireless Inc.
About O2 Secure Wireless
O2 Secure Wireless is a Company that is currently developing numerous wireless tower facilities in the U.S. The Company is also instrumental in the development of wireless broadband communication services domestically. Under a merger with Earthcom Service Inc., the Company is currently being structured to provide affordable flat rate pre-paid wireless services in developing countries internationally.


text:
Reception to honor students in the arts
Penn State Berks will hold a reception honoring students who have published works in the second edition of the college Literary Arts Magazine on Thursday, April 23, beginning at 7:00 p.m. in the Freyberger Gallery. The reception is free and open to the public and light refreshments will be served.
The second edition of the Literary Arts Magazine features fifteen Berks students, some of these students will read from their works at the reception. Marilyn J. Fox, Arts Coordinator at Penn State Berks, published the college's first student literary arts magazine last spring.
"I created the magazine so that students involved in writing, poetry, and photography would have a venue for their work, as well as a beautiful piece for their portfolio and a keepsake," Fox commented.


text:
Computer Lab Activities, Interactive Whiteboard Activities
Solids, Liquids, and Gases: A StudyJams! Activity
Reinforce key concepts about the states of matter and keep students engaged with this interactive StudyJams! Activity.
- Grades: 3–5
What is matter? Scholastic's "Study Jams: Solids, Liquids & Gases," for grades 3–5, uses an engaging three-minute animated video to explain how matter changes states through heating or cooling.
Students can also:
- Sing karaoke (music and lyrics are provide) about matter
- Take a multiple-choice quiz on what they've learned
- Consult a list of related vocabulary words.
Learning Objectives
Students participating in Solids, Liquids & Gases will:
- Recognize that matter has three forms: solid, liquid, and gas
- Demonstrate understanding that each state of matter has distinct properties
- Explain the role of heat in changing matter from one property to another
- Subjects:Matter and Elements, States of Matter


text:
Watson, William, 1826-
From Library of Congress Name Authority File
Watson, William, 1826-
Instance Of
Scheme Membership(s)
Collection Membership(s)
- Watson, William, b. 1826
- Watson, William, of Skelmorlie, Scotland
Additional Information
Birth Date
- 1826
Exact Matching Concepts from Other Schemes
Earlier Established Forms
Watson, William, b. 1826Watson, William,b. 1826
- found: Life in the Confederate Army, 1995: CIP t.p. (William Watson) data sheet (b. 1826)
- found: LC data base, 02/03/95 (hdg.: Watson, William ; usage William Watson)
- found: Life in the Confederate Army, 1995: t.p. (William Watson) p. 2, etc. (b. 1826 in Skelmorlie, Scotland; moved to the Caribbean ca. 1845; moved to Louisiana ca. 1850; served as a Confederate soldier and a blockade runner during the U.S. Civil War; returned to Scotland after the war; civil engineer, seaman; businessman)
- found: RLIN, 23 Aug. 2001 (hdg: Watson, William, of Skelmorlie, Scotland)
Change Notes
- 1995-02-03: new
- 2013-04-04: revised
Alternate Formats


text:
Alternative Products
Family photos are great, but if you're staring at the same one all day every day, well -- we wouldn't blame you if the fun starts to wear off a bit by the time you get home. So why risk the resentment? Give the gift that will save families and relationships the nation over with customizable 2.4" Desktop Digital Photo Frames!This great photo frame keeps things lively and fun with built-in memory for approximately 25 photos and a built-in rechargeable lithium battery. The screen measures 2.4" diagonally. Includes USB cord, installation disc, and instructions. All they'll have to do is load the photos!Imprint your logo or slogan and earn the right to feel personally responsible for keeping families together. A great holiday gift for all!
724 North Highland Avenue Aurora, Illinois 60506
P: (866) 312-5646 F: (866) 314-5646 email@example.com
Quality Logo Products, Inc. is your number one source for stress balls and promotional items.
Copyright 2003 - 2016 Quality Logo Products, Inc., Registration No. TX7-524-201. All Rights Reserved.


text:
The University of Northern Colorado football team will be playing with a mental advantage this week.
It's Austin Ervin, whose physical presence at Saturday's 1:35 p.m. game against the University of Northern Iowa will be a stark reminder on how to keep everyday facts in perspective but also inspire the Bears to take advantage of every physical gift they have.
Ervin suffers from closed-lip bilateral schizencephaly, which causes him to have 80 to 100 life-threatening seizures each day. He had his third brain surgery in May to help his condition.
Nobody should have to endure a challenge so brutal. Everybody should have a support system as caring, genuine and caring as the UNC football team.
Ervin's connection to the Bears began when freshman defensive back Tyler Bloyer learned about the situation while in high school through a church program.
Bloyer wanted to help.
He made contact with Ervin's family in Las Vegas, Nev., and the wheels of success began to turn.
Ervin was able to attend a UNC spring practice, but he was anything but a normal visitor.
UNC head coach Earnest Collins Jr., and running backs coach Terrance Robinson, who has a degree in child development, made sure Ervin's trip was one to remember.
He signed a National Letter of Intent, received a jersey with his name on it, a helmet and took part in the Bears' activities.
He ate with the Bears, sat in on team meetings and attended practice (www.youtube.com/austinervin). He also took in a UNC volleyball practice. He had his wrists taped, was fitted with shoulder pads, threw the ball around at practice and took in high fives and low fives.
The courageous 14-year-old brought tears to the eyes of several UNC players.
The anticipation of Ervin returning to the UNC campus this weekend has the Bears excited and Collins busting at the seams to let everybody know.
Last spring, Ervin didn't want to leave, as the Bears not only adopted him as one of their own, they made him feel special. He even received a locker with his own personal nameplate.
In the YouTube video, Robinson reminds that "tomorrow is a promise, but the next two hours isn't even a promise (for Austin)."
His day-long visit to the Bears was a gift.
The entire scenario speaks volumes about what Collins is all about — giving, caring and developing young men.
In the video, Seth Lobato talks about what a great opportunity it was for the Bears to let Austin forget about his daily challenges and hang with the Bears.
Bloyer was pleasantly surprised with the reception his UNC teammates and the school's athletic department have shown Ervin.
Robinson called the day with Ervin as "a magical time for me."
The Bears have wristbands and T-shirts available that read "#LiveLikeAustin" as a reminder to live for the moment. Proceeds from the wristbands and shirts will go toward Ervin's foundation.
Ervin's father, Kurt, addressed the Bears last spring and explained that people are always asking what they can do to help. His answer was that the best way to bless somebody is to bless their child.
On Saturday, the Bears will continue to give their blessing to Ervin and have asked their fan base to join in by attending the game or making a donation through UNC football's director of operations Zak Bigelow at email@example.com
Win or lose Saturday, the day will be a winner for the Bears' biggest fan.
Samuel G. Mustari covers sports for the Tribune. Reach him at (970) 392-4437 or by email at email@example.com or follow him on Twitter @samuelmustari or @GTribSports


text:
Neither a large 2009 multicenter study nor a 2011 meta-analysis showed any clinical benefit from the use of ICU telemedicine. Lilly et al report the results of a large single-center study in which they progressively implemented ICU telemedicine among 6,290 patients in 7 ICUs (a stepped-wedge design), with non-telemedicine groups acting as controls at each [… read more]
Optimal duration of anticoagulation after VTE (Review, Circulation)
Optimal duration of anticoagulation after VTE: Goldhaber SZ, Circulation 2011;123:664-667. FREE FULL TEXT
AHA Scientific Statement on Management of VTE Badness (Review, Circulation)
A 44-page guideline from the American Heart Association on the management of massive & submassive pulmonary embolism; proximal deep venous thrombosis, and chronic thromboembolic pulmonary hypertension. Circulation 2011;123:1788-1830. FREE FULL TEXT
Catheter-based reperfusion in pulmonary embolism (Review, Circulation)
A handful of people with pulmonary embolism have absolute contraindications to anticoagulation. Authors here describe these as: Any prior intracranial hemorrhage, known structural intracranial cerebrovascular disease (eg, arteriovenous malformation), known malignant intracranial neoplasm, ischemic stroke within 3 months, suspected aortic dissection, active bleeding or bleeding diathesis, recent surgery encroaching on the spinal canal or brain, [… read more]
Tension pneumothorax or tension bulla? (Image, NEJM)
Very interesting … Vega ME. Images in Clinical Medicine, N Engl J Med 2011;365:1915. FREE FULL TEXT
Lung cancer screening with chest CT: Pro/Con (Ann Intern Med)
A nice pro/con soundoff between Gerard Silvestri (con) and James Jett & David Midthun (pro) over whether lung cancer screening with chest CT should be national policy, in the wake of the positive findings of the National Lung Screening Trial. Silvestri (of MUSC) argues that we don't have a handle on the harms of screening [… read more]
Asthma update: What we know we don't know (is a lot) (Review, J Allergy Clin Immunol)
This is a great article by a leader in the field (William Busse), and it's free — you should download it and save it. His theme is "Filling in the information gaps," and there are a lot of them. Filling them in will take a lot of time, funding, and a bigger shovel than anyone's got right now. A [… read more]
Pro/Con debate on mild hypothermia after out-of-hospital cardiac arrest (BMJ)
Here's a free "head-to-head" discussion with arguments for and against implementation of routine mild hypothermia for all patients with out-of-hospital cardiac arrest. The benefits of hypothermia after out-of-hospital ventricular fibrillation cardiac arrests are reasonably well-established, and multiple society guidelines (SCCM's, AHA's) advocate the practice. The question is whether to induce mild hypothermia / targeted temperature management in all [… read more]
Septic shock: Beta-lactam levels unpredictable, need close monitoring (Review, Crit Care)
Goncalves-Pereira and Povoa meta-reviewed 57 reviews of pharmacokinetics of common beta-lactam antibiotics (piperacillin, meropenem, cefepime, ceftazidime, etc.) on patients in ICUs. The results were troubling or at least confusing: studies reported wide variability in pharmacokinetics of beta-lactam antibiotics in critically ill patients, with volume of distribution and drug clearance varying more than 2-fold for the [… read more]
Moviegoing U.K. teens smoke more (Thorax)
Hunt et al used the Beach method (I can't find what that is) to ascertain the degree of U.K. adolescents' exposure to moviestars' smoking in films. Those teens who went to a lot of movies that had smoking were twice as likely to smoke as those with low exposure to film smoking. Those with parental [… read more]
Montelukast improved peak flow during acute asthma exacerbations (RCT, Thorax)
Leukotrienes are important inflammatory mediators in both chronic asthma and acute exacerbations. Well-known for their benefits in the management of chronic asthma, leukotriene receptor antagonists haven't been tested in acute asthma. Ramsay et al randomized 87 adults admitted to the hospital for asthma exacerbations to receive daily montelukast 10 mg or placebo for 4 weeks, [… read more]
FACTT post-hoc: Transfusion might cure, kill or both during shock & acute lung injury…who knows? (Crit Care)
Perhaps the most contentious debate in critical care is whether and when to transfuse blood to patients, especially those with acute lung injury and/or septic shock. FACTT showed less fluids (which could include blood) are better for ALI/ARDS, but transfusion wasn't controlled and its contribution to the outcomes is unknown. Practicing physicians vary widely in [… read more]
New H3N2 swine flu emerges, in isolated cases only (MMWR)
Two kids under 5, one in Indiana and the other in Pennsylvania, have contracted a new reassorted swine flu: H3N2. The Pennsylvania child had had direct contact with a pig at an agricultural fair; the Indiana kid had been cared for by someone who had come in contact with a pig recently. Both children recovered [… read more]
Effects of asthma treatment on airway remodeling (J Clin All Immunol Review)
Surprisingly little is really known about airway remodeling in asthma, including its clinical course, or how treatment may modify it. Two examples: rather than occurring as a late sequela of unchecked inflammation, numerous recent studies show remodeling can occur in tandem with inflammation starting in early childhood. A recent NEJM article generates the hypothesis that [… read more]
Reversed Halo Sign (Image)
Walker et al give us a nice picture and high-yield tutorial on the reversed halo sign, in this case from cryptogenic organizing pneumonia: J Thorac Imaging 2011;26:w80. (FREE)
Lebrikizumab, an IL-13 inhibitor for asthma, improved lung function but not clinical outcomes (NEJM, RCT)
Asthma's complex and protean inflammatory processes vary between individuals, some of whom have elevated levels of interleukin-13 despite maximal treatment with inhaled steroids. IL-13 prompts airway epithelial cells to secrete periostin, which acts on fibroblasts and may contribute to airway remodeling in asthma. Lebrikizumab is a monoclonal antibody inhibiting IL-13. Corren et al used a [… read more]
Parapneumonic effusions, empyema doubled in U.S. over past decade
Grijalva et al analyzed the Nationwide Inpatient Sample (data from U.S. hospitalizations) and found that the rate of hospitalization for parapneumonic empyema doubled from 3 per 100,000 in 1996, to 6 in 2008. The rate of empyemas due to Streptococcus pneumoniae was stable; the increases were in non-pneumococcal infections like Staphylococcus. Mortality was unchanged overall [… read more]
How to reduce asthma exacerbations (Asthma Review)
An excellent free full text review by Paul O'Byrne. What's new here: Did you know that formoterol is used as a first-line rescue inhaler, outside the U.S.? Formoterol has a steeper dose-response curve than salmeterol: repeated doses have an additive bronchodilator effect. The use of budesonide/formoterol as a combination maintenance AND rescue inhaler (added prn [… read more]
Don't exempt the mentally ill from smoking cessation efforts
Widespread beliefs among physicians that people with mental illness are more addicted, or less desirous or capable of quitting smoking, are wrong and perpetuate a deadly problem, argues J.J. Prochaska. You should nag mentally ill folks to quit smoking as you would anyone else, she urges. NEJM 2011;365:196-198. FULL FREE TEXT
Heroes come home from Iraq, Afghanistan with constrictive bronchiolitis
King et al report a series of 80 otherwise healthy young vets who failed a 2-mile run fitness test due to dyspnea at Fort Campbell, KY. Many had been exposed to sulfur fires or other inhalational exposures. Among 49 who underwent open lung biopsy, 38 had constrictive bronchiolitis, an extremely rare condition in otherwise healthy [… read more]


text:
I totally forgot my password.
By creating an account, you'll speed up your checkout process, be able to view past orders, and we'll keep you in the loop on sales, events, and special offers.
Formerly based in Seattle, Crystalyn Kae's creations are now handcrafted in New York City. This independent handbag line features animal-friendly designs created out of glazed canvas and supersoft vegan ultra suede.
2 Item(s)
© 2016 MooShoes. All rights reserved.


text:
The part of a neuron that contains the nucleus and keeps the entire cell alive and functioning is the___.
_______receive messages from other neurons and_______send messages to other neurons.
Dendrites receive messages, and axons send messages to other cells.
A fatty substance that is wrapped around the shaft of axons in the nervous system and whose function is to insulate neurons and speed up the neural impulse is called a
myelin cell
A group of axons bundled together coated in myelin that travels together through the body is called___.
Juan's toe was severed and was quickly sewn back on by a surgeon. As a result, he regained some function and feeling in his toe. Which of the following are responsible for Juan's ability to regain function and feeling in his toe?
Neurilemma enable damaged neurons to repair themselves


text:
We love receiving pictures from fans everywhere around the world and we're lucky to have these shared with us quite often. One of our super-fans Chanda saw that we had shared an awesome bag family on Facebook, and she was sure she could one up it! When we received her photo, we were stunned by her truly amazing bag family. It's definitely one of the single largest Timbuk2 collections we've seen in a while.
I think I count 20! I will get there one day, I am currently only at 5


text:
To the Editor: The Paricalcitol Capsule Benefits in Renal Failure-Induced Cardiac Morbidity (PRIMO) trial by Dr Thadhani and colleagues1 failed to show any improvement in left ventricular mass index (LVMI) in patients with chronic kidney disease (CKD) after daily oral administration of paricalcitol for 48 weeks. Similar outcomes have been reported in other prospective studies of patients with CKD receiving erythropoiesis-stimulating agents.2,3
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
Download citation file:
The summary below is from the full report titled "The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality. A Randomized Clinical Trial." It is in the 15 February 2005 issue of Annals of Internal Medicine (volume 142, pages 233-239). The authors are N.R. Anthonisen, M.A. Skeans, R.A. Wise, J. Manfreda, R.E. Kanner, and J.E. Connett, PhD, for the Lung Health Study Research Group.
Smoking cigarettes increases a person's risk for many health problems, including cancer, heart disease, and lung disease. Several studies have shown many benefits for smokers who quit. However, no studies have proven that smoking cessation programs lead to better long-term survival. Chronic obstructive pulmonary disease (COPD), a disease of the air sacs and air passages of the lungs, is one of the many health problems to which smoking contributes. People with COPD are short of breath and sometimes cough and wheeze. Damage to the lungs and symptoms slowly worsen over time, especially if people do not stop smoking. Smoking cessation is particularly important for people with COPD who want to slow the worsening of their disease.
To see if a smoking cessation program improved long-term survival in people with mild COPD.
5887 middle-aged people with early COPD (they had abnormal results on lung tests but did not consider themselves to be sick). The people were participating in a large study called the Lung Health Study, which examined whether a smoking cessation program and treatment with a drug called ipratropium could prevent worsening of disease in people with mild COPD.
The researchers assigned participants to attend a special smoking cessation program or to receive usual care. The smoking cessation program included 12 two-hour group sessions over a 10-week period. The sessions used behavior modification and nicotine gum. The researchers followed study participants for up to 14.5 years and collected information about smoking status and death from heart disease, lung disease, cancer, or any other cause.
After 5 years, 21.7% of the people in the special program had completely stopped smoking compared with only 5.4% of people in the usual care group. However, despite the relatively small proportion of participants who stopped smoking, the death rate in the group that received the smoking cessation program was lower, by about 15%, than the rate in the group that received usual care. Not surprisingly, the benefit with respect to survival was largest among participants who actually stopped smoking: Their death rates were 46% lower than those of the people who continued to smoke.
This study involved only people with early signs of COPD on lung tests. It is unknown whether the survival benefits of a smoking cessation program would also exist among people without such signs.
Intensive smoking cessation programs can improve long-term survival, even when successful in only a minority of patients.
Please read the other comments before posting. Contributors must reveal any conflict
of interest.
Comments are moderated and will appear on the site at the discretion of The American
College of Physicians editorial staff. Please be sure your email address is
updated in your account, otherwise the American College of Physicians will not be
able to contact you about your comment.
Anyone can submit a comment any time after publication, but only those submitted within 4 weeks of an article's publication will be considered for print publication. One month after publication, editors review all posted comments and select some for publication in the Letters section of the print version of Annals. (Not peer reviewed)
Authors: No more than 5
Text: Word Limit 400 (excludes references), 5 references, no figures or tables
* = Required Field
Disclosure of Any Conflicts of Interest*
(applies to the past 5 years and foreseeable future) Indicate any potential conflicts
of interest of each author below, including specific financial interests and relationships
and affiliations relevant to the subject matter or materials discussed in the manuscript
(eg, employment/affiliation, grants or funding, consultancies, honoraria, speakers
bureau, stock ownership or options, expert testimony, royalties, donation of medical
equipment, or patents filed, received, or pending). If all authors have none, check
"No potential conflicts or relevant financial interests" in the box below. Please
also indicate any funding received in support of this work. The information will
be posted with your response.
Terms of Use
The In the Clinic® slide sets are owned and copyrighted by the American College
of Physicians (ACP). All text, graphics, trademarks, and other intellectual property
incorporated into the slide sets remain the sole and exclusive property of the ACP.
The slide sets may be used only by the person who downloads or purchases them and
only for the purpose of presenting them during not-for-profit educational activities.
Users may incorporate the entire slide set or selected individual slides into their
own teaching presentations but may not alter the content of the slides in any way
or remove the ACP copyright notice. Users may make print copies for use as hand-outs
for the audience the user is personally addressing but may not otherwise reproduce
or distribute the slides by any means or media, including but not limited to sending
them as e-mail attachments, posting them on Internet or Intranet sites, publishing
them in meeting proceedings, or making them available for sale or distribution in
any unauthorized form, without the express written permission of the ACP. Unauthorized
use of the In the Clinic slide sets will constitute copyright infringement.
Learn more about subscription options


text:
Of the industries that require the highest degrees of protection for data resources, the healthcare sector is certainly among the top. Not only is personal health information strictly regulated by law, medical professionals depend on rapid access to comprehensive, up-to-date, accurate information so they can treat patients and make on-the-spot decisions. Although not all companies face the same urgency for data access and protection, most organizations have valuable and sometimes sensitive data that needs to be kept secure while also made available to employees. Therefore, many of the data management challenges the health industry is facing provide lessons that cut across industries, calling for better secure file sharing and managed file transfer solutions.
Data management struggles in medical centers
According to a recent HIMSS Analytics study, hospitals are using outdated and inefficient methods to back up their increasingly large banks of data. In addition to having low-performance, high-cost processes, these medical facilities are putting data and their organizations at risk because their systems do not adhere to regulatory guidelines for information security.
"The amount of data flowing through our healthcare system today has rendered the old ways of managing it obsolete," said Michael Leonard, director of product management of Healthcare IT Services for Iron Mountain. "If you look at this survey, you'll conclude that most hospitals continue to treat all data the same and don't sufficiently tier it based on its importance and access requirements."
Part of the problem consists of how healthcare organizations segregate their data for management and storage, the study found. Whereas about 30 percent of the information is actually needed on a day-to-day basis, the medical centers treat 75 percent as "active," storing it for immediate access rather than maintaining it in a more cost-effective manner. The report also indicated that almost a third of healthcare organizations don't have backup and disaster recovery plans in place, which is particularly crucial for medical facilities that need to keep treating patients during periods of downtime and system failures.
In addition to these data management issues, healthcare providers often resort to insecure methods of sharing information, which departs from regulatory compliance. This includes sending data about patients via text message or email, AudioEducator said. InformationWeek indicated that failure to adhere to best practices, such as strong passwords and optimized networks, is also introducing vulnerabilities into healthcare data centers. Bolstering security across organizations includes making sure systems are updated and running on newer versions of software and operating systems.
"A lot of equipment that you find in hospitals is actually hardware that's running Windows XP Embedded, and it's not getting patched on a regular basis," Craig Young, a Tripwire security researcher, told the source.
Healthcare organizations need better collaboration tools
With over half of healthcare professionals working remotely, the need for secure file transfer and collaboration tools is exceedingly urgent, InformationWeek asserted. Because of the highly sensitive nature of health information, medical facilities need to provide tools for their employees that facilitate cooperation while upholding industry standards for security. The Cooperative of American Physicians advises against texting protected health information because this practice is insecure and violates HIPAA regulations, AudioEducator explained. However, clinicians often need to communicate quickly with their colleagues to consult about a patient's care, so they need solutions that give them the ability to discuss health details within an appropriate environment. Communicating with patients via email or health portal also requires security precautions, the source added.
A SANS Institute study conducted from September 2012 to October 2013 revealed that 375 different healthcare networks had their data compromised by attackers during that time period, InformationWeek reported. These numbers point to the need for better security practices, despite the fact that health organizations already tend to have more protected systems than other industries, the source continued. Data breaches, whether caused by malicious cyberattacks or stolen hardware, can result in significant financial and public relations consequences.
Like the medical sector, organizations in many industries need to protect their information while allowing employees to access, share and collaborate on documents. To create a secure environment, companies should make sure their systems are updated and have top-notch security measures installed. They should also seek file sharing and data management solutions that give employees convenient, intuitive options for completing their tasks without putting information at risk.


text:
Los Angeles Mayor Antonio Villaraigosa has "voluntarily initiated contact" with the city Ethics Commission and City Attorney for a possible review of the way the mayor accepted free tickets to dozens of sporting events, awards shows and concerts since 2005, a Villaraigosa spokeswoman said Tuesday.
Officials in the mayor's office are feverishly researching Villaraigosa's calendars, receipts and other documents to determine what "official" or ceremonial role he played at each of the 81 events they say he was scheduled to attend. They also are trying to determine if tickets to all those events were provided free of charge -- and if so by whom -- or if the mayor or the city paid for the tickets.
Read more on Los Angeles Times
More:Villaraigosa Ethics Violations Antonio Villaraigosa Villaraigosa Lakers Tickets Mayor Antonio Villaraigosa
Get top stories and blog posts emailed to me each day. Newsletters may offer personalized content or advertisements.Learn more


text:
Nobody hurt, but shots fired during pharmacy robberyUPDATED 6:39 PM CST Dec 21, 2012
Oklahoma City police are investigating the robbery of a Walgreens in southwest OKC on Friday. Happened at 60th and Penn, and shots were fired.
CommentsThe views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use.blog comments powered by Disqus


text:
LEWISTOWN - It's been a tough week for Mifflin County field hockey. But there's one thing that cures all: winning.
After the Huskies dropped their first two games of the week - a 2-1 loss to Line Mountain Monday and a 3-1 loss to State College Wednesday - Mifflin County looked like a whole new team Thursday.
The Huskies didn't allow Central Dauphin East to possess the ball on the east side of the field through the first 16 minutes of play. That led to a pair of Whitney Strohecker first-half goals en route to a 6-0 Commonwealth Division win over the Panthers.
Article Photos
Sentinel photo by BRADLEY KREITZER
Mifflin County's Allison Stuck, left, shoots the ball as Central Dauphin East's Tanisha Gonzalez tries to defend Thursday in Lewistown.
"I think we saw a lot better passing angles today and we talked better," Mifflin County coach Tish Maclay said. "Certainly we still have some concerns. But I've been hammering them relentlessly and they came out with a positive attitude."
Mifflin County will have to work hard to get back to postseason form during the second cycle of the season. Right now, the Huskies sit at 4-6 overall and 3-4 in the Mid-Penn. This game may certainly go far in getting them back on track.
"They came out fired up today and that was the difference in the game," Maclay said.
Fact Box
* Mifflin County hosts Chambersburg Monday
Central Dauphin East's lack of possession led to many opportunities for the Huskies. In the first half, Mifflin County had 14 shots. Five of those shots found the cage.
But it took almost 18 minutes for the Huskies to strike.
Sabrina Boring controlled a corner play for Mifflin County. The Huskies senior carried the ball inside the circle before dropping it off to Sara Neff for Mifflin County's first tally with 12:53 on the clock.
Following the goal, Central Dauphin East held possession for about 30 seconds on its end of the field before the Huskies took over again.
Strohecker scored a pair of goals 24 seconds apart to increase the lead to 3-0 with four minutes to play.
Her first goal came off another corner. Then, less than 30 seconds later, Macie Lucas carried the ball deep into the zone on the right side and sent a laser in front of the cage. Sam Peters made a nice rush on the ball and assisted on Strohecker's second goal of the game.
"We're trying to get them to not hold onto the ball so long in the circle," Maclay said. "We need them to take quicker shots and not dribble though there."
And with only four minutes left in the half, it would be easy for Mifflin County to just coast into the intermission. Not so fast, the Huskies said.
Lucas made the same play less than a minute later. She carried the ball down the left side and fed the ball back to the middle again. But this time Peters got the ball back to Lucas who fired it in.
Peters finally got on the board herself with nine seconds left in the half. Kezia Loht and Strohecker assisted on that goal.
Mifflin County got its last goal with 7:13 left in the second half when Boring got a feed from Peters.
It won't take much for the Huskies to get back on track in the Mid-Penn. But one thing Maclay said she needed from her players was intensity. They came out fired up Thursday. But that needs to happen every game.
"They know their backs are against the wall now," she said. "They know they have to have a better second cycle if they want to see the postseason. Hopefully they can progress and see this through."
The Huskies host Chambersburg Monday.


text:
Dear Editor,
I despise the concept of "green jobs" hatched by this dreamer that occupies the White House. It has been a total disaster since Day 1.
Simply, America's biggest problems are separated from America's best solutions by a huge ideological wall. It's called Obscurantism. The Beltway keeps sticking a regulator boot on the necks of entrepreneurs, then turns around asking: "Why aren't you creating more jobs?" Duh!
Exhibit A: Obama and company propose to raise $40 billion of taxes on oil and gas (by excluding them from credits) that go to all domestic manufacturers. Think, Carter's "windfall profits tax".
Exhibit B: North Dakota's and Continental Oil companies were jumped on by the fault-lined Justice Department for the deaths of 28 migratory birds thay supposedly landed in oil waste pits. Maximum penalty on each count: 6 months in prison and a $15,000 fine. But wait a minute: the Omnipotent One's beloved wind companies routinely kill 400,000 birds annually, without a single fine.
As Ronald Reagan famously said: "There you go again!" With millions of Americans out of work and our social problems nowhere near starting being solved, how dare these pompous bureaucrats unendingly expose us to their flatulence?
One more quote: The economist Fredrich Hayek stated in "The Road to Serfdom": "The more the state plans, the more difficult planning becomes for the individual."
Bruce S. King


text:
(Physicians will confer a favor by sending for this department items of news of more or less general interest; SUCH AS RELATE TO SOCIETY ACTIVITIES, NEW HOSPITALS, EDUCATION, public health, ETC.)
Section Officers.
—At the annual meeting of the Illinois State Medical Society, Dr. Wesley H. Peck, Evanston, was elected chairman of the eye, ear, nose and throat section, and Dr. Frank Allport, Chicago, was elected secretary of the section.
Vaccination Rule to Be Enforced.
—On account of the increasing epidemic of smallpox throughout Illinois, the officials of the state board of health are urging stringent enforcement of the vaccination rule. The board suggests that every person not previously vaccinated within a five-year period be vaccinated. A prevention and treatment propaganda by means of moving picture films for use in all theaters has been started by the state department of health.
—Dr. Clarence W. East, Springfield, is reported
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.


text:
This is why you're broke, auto pay edition
|Email Print
Like Wile E. Coyote and those canyon walls painted to look like a wide-open road, I can never seem to stop falling into the auto pay trap.
In theory, it's great; having monthly subscription fees automatically debited from your checking account is so convenient it's almost invisible, especially for smaller charges. But therein lies the problem for me: Even if I never use it I'll wait much longer to cut back or cancel a service that's auto pay compared to one where I actually have to log on and pay by hand, or God forbid, mail in a paper check.
Confession time: I recently sent back two Netflix DVDs that had been sitting in my house for four months. Four months!
We pay $12 a month for the two-DVD plan at Netflix. That means I paid a sickening $48 to hang onto those DVDs for Netflix, and the worst part is, we only ended up watching one of them!
Think about how crazy that is for a second. If someone walked up to me in the street and said, "Hey bro, you want to pay me $48 to hold on to these old movies that you don't even really want to watch for four months?", I'd tell him to go to hell. But because it was auto pay, I just blissfully kept on paying for those DVDs to sit there and gather dust.
The same thing happened to me with my Xbox Live account. Now, I love video games, but I haven't had as much time to play them lately. Because of that, I planned to cancel my Xbox Live Gold account, which costs about $8 a month, a few months ago. But wouldn't you know it, I didn't get around to it until I'd already auto paid for another month twice.
It's no accident that companies often offer lower prices to those who offer to set up auto pay. Inertia — the tendency for objects at rest to stay at rest and objects in motion to stay in motion — works powerfully on humans. That's why experts in behavioral economics say companies should automatically enroll employees in their 401(k) plans; even if they don't care about saving for retirement, they're unlikely to go through all the trouble of quitting the plan.
That's a positive for people's future retirement, but it's also the danger of auto pay — that you'll continue paying for something long after you no longer want or need it just because you can never quite overcome inertia and cancel it.
Sure, we're not talking about huge sums of money here, but left unchecked, these auto pays can become like drips from a faucet, slowly adding up to buckets of cash that I could have spent on something that I actually wanted, or even better, saved for the future. That's why I'm trying to get better about turning off auto pay when I decide I no longer want a service, instead of waiting to see that annoying charge show up on my debit card statement before following through.
What do you think? Do you ever leave an auto pay going long after you've stopped using a service? Or is it just me?
(Photo: Flickr user ozcast){ 11 comments, please add your thoughts now! }


text:
where to look
Community Service Bulletin
May 22, 2013
Jun 1: Improve Belle Isle Marsh Reservation (Sign Up by 5/24)
9:30 AM to 12:30 PM (Rain or Shine)
Belle Isle Marsh Reservation, East Boston
Belle Isle Marsh is a habitat for wildlife such as migratory birds and various ocean fish. With your help, our project will aim to improve trails and restore wetlands for human visitors. Come make a difference in the community's wildlife and enjoy the beauty of our city's wetlands.
To find more information regarding the project visit: http://www.pmd.org/popup.phtml?id=677
To sign up for the project visit: http://s.zoomerang.com/s/pmd060113 Sign up by 5/24/13
Contact: Lori Tsuruda, 781-963-0373, firstname.lastname@example.com
One-Time Opportunities
- Jun 2: AIDS Walk Boston & 5K Run
- Jun 8: Improve Children's Zoo at Franklin Park Zoo
- Oct 5-6: Finish the Fight with Making Strides Against Breast Cancer
Ongoing Opportunities
Fellowship/Internship Opportunities
One-Time Opportunities
Jun 2: AIDS Walk Boston & 5K Run
Where: DCR Hatch Memorial Shell Charles River Esplanade in Boston
Time: 7am-2pm (Volunteer shifts vary)
Calling all volunteers! Volunteering for AIDS Walk Boston & 5K Run is a great way to both support the fight against AIDS and also have some fun! Each year, AIDS Action Committee relies on hundreds of volunteers to help serve the 10,000+ attendees that participate in the AIDS Walk & 5K Run.
We are looking for talented, dedicated and hard working individuals to fill the following volunteer positions on Sunday, June 2nd:
- Walk Course Marshals
- Run Course Marshals
- Crowd Control/Security
- Finish Area Volunteers
- Registration Volunteers
- Cheerleaders
To sign up, please visit www.aidswalkboston.org and choose "Volunteer" as your participation type. If you can't volunteer but would like to still participate in the event, we invite you to join us as a Walker or Runner. For more information about volunteering for AIDS Walk Boston & 5K Run 2013, please contact Sharon Glasser, AIDS Walk Volunteer Coordinator at 617.450.1520 or firstname.lastname@example.com.
Jun 8: Improve Children's Zoo at Franklin Park Zoo
Saturday, June 8. 9:30 AM to 1:00 PM (Rain or Shine)
Franklin Park Zoo, Dorchester
The Franklin Park Zoo, a community resource and recreation center, is unfortunately under-staffed and under-funded; it needs help, your help, making its children's zoo more inviting to the public. Come help make the zoo more enjoyable for the community, and get the chance to explore the zoo afterwards!
For more information regarding the project visit: http://www.pmd.org/popup.phtml?id=678
To sign up for the project: http://s.zoomerang.com/s/pmd060813
Contact: Lori Tsuruda, 781-963-0373, firstname.lastname@example.com
Oct 5-6: Finish the Fight with Making Strides Against Breast Cancer
Hatch Shell, October 5th & 6th, 2013
The American Cancer Society's 21st annual Making Strides Against Breast Cancer in Boston is set for Sunday, October 6, 2013 at the DCR Hatch Shell. The special fundraising walk unites the community to honor and celebrate breast cancer survivors, educates women about the importance of prevention and early detection, and raises funds to help the Society do the most for people with breast cancer today to end the disease tomorrow.
Volunteers are vital to the success of Making Strides in Boston, assisting and supporting 40,000 dedicated participants. Volunteers are needed the day before Making Strides, Saturday, October 5, 3:00 - 6:00 p.m., to help prepare snack bags for walkers, as well as set up for the following day's event. On Sunday, October 6, volunteers are needed to help set up, clean up, cheer on walkers, and act as route monitors. Times vary depending on the volunteer role. All day and hourly opportunities are available.
Please sign up to volunteer, or form a team, for Making Strides Against Breast Cancer in Boston and help finish the fight against breast cancer! To volunteer, to form a team, or for more information, visit http://MakingStridesWalk.org/BostonMA or contact Brianne McNamara; 508-270-4950; firstname.lastname@example.com.
Ongoing Opportunities
Broken Tail Rescue: Seeking event volunteers
Broken Tail Rescue is a nonprofit animal rescue organization. We are looking for event volunteers for our fun summer fundraising and marketing events in the Boston Metro area. Most of our events are on the weekend.
We also need long-term foster homes for cats and dogs.
Please fill out a volunteer or foster application on our website: http://www.brokentailrescue.org.
SAT Tutor/Mentor
Let's Get Ready provides SAT preparatory services and college access guidance for lower-income high school students. In order to provide such a necessary service we rely heavily on college student volunteers. The typical program meets twice a week for 3 hours each session. Volunteers are only required to commit to one of the days, as they are broken up by subject; Math on one day, Critical Reading/Writing on the other.
There are several sites throughout the Boston/Cambridge/Somerville area. Site location and meeting times vary from site to site. Please apply to a specific site through our website, http://www.letsgetready.org
Contact: Amy Lyons, email@example.com, (617) 345-0082
Fellowship/Internship Opportunities
Apply for Code for America Civic Startup Accelerator (due 5/31)
Code for America is now recruiting startups for its 2013 class of the Civic Startup Accelerator.
What's a #civicstartup?
Civic startups are startups that interface with government. There are a few ways, traditionally, to do this:
- provide services on top of open government data
- bring modern web technologies directly to governments
- change the way citizens request or receive services from government.
What do I need to do to apply?
The application is short — and free! Apply here: http://codeforamerica.org/accelerator/#application
The application is due May 31, 2013.
Why should I apply?
Through a competitive, four-month program, the CfA Accelerator "turbo-charges" select civic startups by providing them a springboard to amplify market awareness of their product, funding, business mentoring specific to the Gov 2.0 space, and introductions to a broad network of civic leaders and potential investors.
Every month, accepted teams will attend week-long "retreats" in SF packed with trainings, talks, and networking events; full time relocation is not required.
Any questions?
Contact Dharmishta, the Program Manager for the Accelerator: email@example.com
Embrace Programs Intern
Where: Bangalore, India
Dates are flexible
About the position – Summer Intern
We are currently in the process of developing partnerships with local organizations in order to decrease neonatal mortality and morbidity. One key component of improving neonatal hypothermia management practices is the development and implementation of hypothermia-related newborn health protocols. Embrace aims to recruit a qualified and passionate individual to help understand current practices and protocols within our partner sites, with the ultimate objective of implementing and iterating upon hypothermia management protocols.
Specific Responsibilities
- Assessment: better understand current hypothermia management protocols and practices that may exist among our India-based partner sites
- Protocol development: work with local staff, clinicians, and Embrace staff and advisors to develop a preliminary hypothermia management protocol for use at our partner sites
- Other responsibilities may arise related to program management and development
Required Qualifications
- Master's level candidate preferred
- Experience working on and developing clinical protocols preferred
- Public health background and experience working in a developing country setting required
- Qualitative research background strongly preferred
- Proven ability to work independently and in a team
- Self-starter
- Hindi or Kannada language skills preferred
About Embrace
Embrace is a non-profit organization that has developed an innovative, low-cost infant warmer for premature and low birth weight babies born in developing countries. Our mission is to give every child an equal chance for a healthy life through a low cost infant warmer. Our larger vision is empowering the disadvantaged to improve their lives through disruptive technologies.
The Embrace infant warmer is a unique product that costs less than 1% of the cost of traditional incubators, and does not require a constant supply of electricity. The product has just been introduced in India. Embrace has been featured in ABC's "Be the Change, Save a Life", and has also been profiled in Time Magazine, National Geographic, The Wall Street Journal, Economist, TED, and various other media. Additionally, Embrace has been recognized as one of the top "Innovations in Global Health" in 2010 by the World Health Organization.
The Priscilla King Gray Public Service Center is not responsible for the quality or safety of outside service agencies, and does not screen volunteer placements or projects. The Community Service Opportunities bulletin is published once a week by the staff of the Priscilla King Gray Public Service Center. If you have questions, feel free to call us at 617-253-0742, or stop by 4-104.
To subscribe to or unsubscribe from the email list, please visit mailman.mit.edu/mailman/listinfo/psc-volunteers.


text:
Holiday Cheer Cocktail Cruise
Come aboard a Hornblower yacht to raise your glass and toast the holidays with your team at this year's office holiday party. This two-hour cocktail-and-appetizer cruise offers unbeatable views of the San Diego Bay and is the perfect little holiday "thank you."
Request Informationor call a Sales Manager
Mon. - Fri., 8:30 AM - 5:30 PM; Sat. by appointment.
Get a custom quote for your event
or call a Sales Manager at 619-686-8700
Booking for 20 or more?
Call 888-467-6256
- or -Book Your Group
Working with the event planner at Hornblower made planning my companies holiday party a breeze. The night of the event all our guests were amazed that every minor detail had been taken care of.
– Jen K
So I'm the poor sucker who gets put in charge planning our company holiday partys...I kid, I kid...it's actually kinda fun! But our company didn't decide to have a party until early November! Anyone who knows about this knows that is not enough time to find a great place on a weekend night for over 150 people during the holiday season. Somehow Hornblower had an opening though on a Friday night. They made the event so easy to plan and were totally flexible with custom menus and things like that! Seriously, I got so much cred at work and it didn't feel like I did any work at all. Yay me!
– Annette G.


text:
Baylor center Josh Lomers said he's heard all the big-man insults on the road; Ogre, Shrek, Sasquatch.
"One time they kept yelling go homer Lomers, which I thought was pretty stupid,'' Lomers said.
But Saturday night, Lomers, a 7-foot, 280-pound senior from Boerne, Texas, was being called a star back in Waco as the South Region's third-seeded Bears defeated 11th-seeded Old Dominion 76-68 on Saturday at the New Orleans Arena to advance to the Sweet 16 next week in Houston.
Lomers scored 14 points on 6-of-7 shooting from the field, had eight rebounds -- six offensive -- four steals and three blocks. The 14 points were tied Lomers' career high, and the eight rebounds tied his season high. He came into Saturday's game averaging 6.6 points and 3.6 rebounds per game.
Lomers stepped up big in the lane with the game on the line in the second half.
He scored seven of his 14 points in a two-minute stretch, sparking a 14-4 run that gave Baylor a 70-62 lead with 2:43 to play. He fouled out with 1:05 remaining, but by then the Bears had a comfortable 72-65 lead.
Before Lomers' scoring binge, Baylor trailed 58-56.
"It was just a matter of wanting to win and not letting my teammates down,'' said Lomers, who scored 12 points in the second half. "The fact is they (Old Dominion) had to worry about so many people on our team. When they're concentrating on the other guys, it opens me up. And Coach (Scott Drew) says when we have those opportunities, we have to step up. That's really all I did.''
Baylor guard LaceDarius Dunn, who led the Bears with 26 points, said Lomers has contributed throughout the season, but his contribution was especially crucial Saturday.
"I think today he just came out with something else on his mind,'' Dunn said. "Just being the monster that he is. He did a great job, getting all the offensive rebounds and the putbacks.''
Old Dominion forward Frank Hassell, who guarded Lomers, said Lomers' biggest advantage was his size.
"I mean, he's 7-foot,'' said the 6-8 Hassell. "You can't teach that.''
HOT START: Dunn and Baylor guard Tweety Carter, both from Louisiana, combined to score Baylor's first 10 points as the Bears took a 10-1 lead with 17:58 left in the first half. Both had one 3-pointer and a bucket in the run. The duo was 4-of-4 from the field to start the game.


text:
(based on 16 reviews)
Ratings Distribution
5 Stars
4 Stars
3 Stars
2 Stars
1 Stars
of respondents would recommend this to a friend.
Most Liked Positive Review
Functional, but not what I thought.
I really like Levenger products and I thought this would be a step forward in my daily office organization, but it isn't exactly what I needed. The ability to label pages and quickly flip...Read complete review
I really like Levenger products and I thought this would be a step forward in my daily office organization, but it isn't exactly what I needed. The ability to label pages and quickly flip to what I need is key to my success, but I realized that this just doesn't have enough tabs for all the areas I would need. Maybe if it had come with each tier also layered vertically?Helpfully though there are plenty of online templates you can print out onto high quality paper yourself, so that's the route I ended up taking. :)
Most Liked Negative Review
Refill availability is a must for it to be a useful product!
I like the functionality of the Circa Next Level Notebook, junior. I have been using for quite a while. However, I am very disappointed that I cannot find the refill for the...Read complete review
I like the functionality of the Circa Next Level Notebook, junior. I have been using for quite a while. However, I am very disappointed that I cannot find the refill for the "junior" version. This explain the poor overall rating!
Reviewed by 16 customers
Displaying reviews 1-10
Back to top
Previous | Next »
(2 of 2 customers found this review helpful)
By CB
from OH
Comments about levenger Circa Next Level Notebook JNR:
Bottom Line No, I would not recommend this to a friend
Merchant response: Thank you for your feedback on the Circa Next Level Notebook. Unfortunately, the refills for the Next Level Refills has been discontinued. However, our retail stores have a limited stock available for purchase. You will be contacted shortly with information on how to purchase these refills.
Was this review helpful? Yes / No
- You may also flag this review
(0 of 1 customers found this review helpful)
Useful and organized
By NM
from Canada
Keep myself organized and great for quick reference
Bottom Line Yes, I would recommend this to a friend
Just what I wanted
By phgt
from Florida
The notebook is perfect!! Useful and besides beautiful. I have 2 bosses and also I am an office manager. Now I feel I can really get organized!!!!!!!
(1 of 1 customers found this review helpful)
Perfect for organizing your work
By Artmarble21
from Seattle Wa
I give these to my new managers as a welcome gift. They love the texture of the paper and soon if they are performing well I will give them one of your fabulous pens to go with it.Thank you Levenger for making such high end affordable products.
Really like this notebook
By lisam13
from Hanover Park, IL
Lightweight and portable with lots of room. Will upgrade the cover however to something else.
By Girl
from California
Love This!
By LHTacoma
from Undisclosed
Use this to keep track of each client in one section of my circa, and for task lists in another section - emails/calls, computer, research....my new go to Levenger product!
Love This Notebook and Paper
By SEPs
I am a big fan of the Circa system and the Next Level Notebook is the best yet. I use the sections to organize my clients into categories. The paper is a great weight and makes writing smooth.
By NancyE
Love this little book! I don't know why I waited so long to get one of these. Being able to add and remove pages and items like tabs is brilliant! Now my personal life is organized. I went back and ordered pieces for a letter size book too--haven't received it yet but already know it will enable me to keep meeting notes tidy and in one place but with me when I need them--not in a file folder somewhere. Only (minor) complaint is the subdued colors, but then again, they are soothing and gender non-specific.
Helps me think better!
By holdfast
from La Honda, CA
The Circa Next Level Notebook (Junior size) has solved problems I didn't even knew I had! The dividers, cascading pages, plus the ability to add pages and even punch my own inspiration pages, really help keep my mind uncluttered. Thank you, Levenger.
© Copyright Levenger Company
2016. All Rights Reserved.


text:
firstname.lastname@example.com wrote:
>> Daniel Mandic
did eloquently scribble:
>> I am sure the American can develope an analog-videosystem with
>> outstanding three-dimensional effect. One of the hopeful countries,
>> concerning analogue stuff, IMHO.
> WTF are you on?
> NTSC was developed in the 1950s or 60s, not the 2000s. They made their bed
> and they had to sleep in it once all the TVs were sold. They couldn't just
> move to a new system without totally pissing everyone off. TVs were very
> expensive back then. Usually a few month's wages worth.
By all accounts, Baird had a working 3D system in the '40s.
My guess is that it was actually pseudo-3D using a parabolic mirror,
like that Sega arcade game a few years back (not least because his early
mechanical TVs were often viewed through mirrors, and he might have
stumbled upon the effect more or less by accident).
But we'll never know, because he took the secret with him...
Duncan Snowden.


text:
Welcome to Legendary Marine Yacht Sales & Brokerage!
We are so glad you are here!
If you are looking to purchase a yacht, our team of licensed and bonded brokers in our Florida and Alabama locations are ready to be of service in helping you locate your dream yacht! Please view our current inventory of brokerage boats for sale and if you don't find exactly what you are seeking, we can assist you in locating a yacht outside of our own locations. We have access to co-brokerage yachts throughout North America and the ability to efficiently search based on your specifications.
If you are seeking a high quality yacht brokerage organization to list and market your yacht, you have come to the right place!
Please understand, we fully recognize that there are multiple sources available to market and sell your yacht. However, when you broker your yacht with Legendary Marine, we believe you should expect a different level of service, with a higher degree of professionalism and personal commitment than that which may be offered elsewhere. At Legendary Marine, you won't get lost in the shuffle of a large brokerage organization, or ignored while brokers pursue and focus on larger yachts with higher commissions. Each yacht in our brokerage fleet is highly valued and equally promoted.
Legendary Marine's Yacht Brokerage Division offers five dealership offices on the Gulf Coast in Florida and Alabama, each offering excellent foot traffic and high visibility traffic. Each dealership location is fully staffed with well trained, professional sales teams including licensed and bonded brokers. Each location also utilizes a sophisticated internal inventory tracking system, making it easy to promote our brokered yachts throughout the entire sales organization. A listing agreement out-clause is a unique feature at Legendary Marine, allowing customers to cancel within 30 days if you are not totally satisfied with the quality and level of service provided.
A professional service team and including a fleet of mobile vans is also available to assist brokerage customers on preparing their yacht for sale, or in addressing enhancements or service support for new brokered purchases. First class indoor yacht storage is also available at two of our locations, with 1000+ slip capacity, accommodating yachts up to 50' in length. Some transient wet slips are also available.
In addition, business managers are also on staff at each location to assist with financing insurance and extended warranty options, making transactions a breeze.
To maximize your sales opportunity, Legendary Marine offers an award-winning, world class marketing department in-house, with a strong emphasis on marketing and advertising our brokerage product on a global basis. Upon your listing, quality photography is shot of your boat, selling-oriented content is produced and the yacht is then posted and advertised on the Legendary Marine website as well as to multiple top marine websites including yachttrader.com, among many others.
We would love to discuss your yacht brokerage needs and determine how we can help facilitate your needs.
For More Information Contact A Sales Broker at your local Legendary Marine dealership in Florida or Alabama today!


text:
- Text Size:
- ASmall Text
- AMedium Text
- ALarge Text
A multiple-injury crash along Interstate 80 in Dixon slowed down traffic Thursday.
The crash occurred near Milk Farm Road in the eastbound lanes.
At least two lanes were blocked in the crash.
Traffic was at a crawl just after 6:30 p.m.
The Solano California Highway Patrol said that people suffered minor to moderate injuries in the crash.
The views expressed are not those of this site, this station or its affiliated companies. By posting your comments you agree to accept our terms of use.blog comments powered by Disqus


text:
Shimmering Gem Green Flower Wall Art
Floral Gem Aqua Wall Accent
Floral Gem Purple Wall Accent
Les Fleurs Rose Spray Metal Wall Sculpture Purple
Magnolia Faith Hope Love Wall Accent Ivory
Les Fleurs Mulberry Rose Swag Wall Accent
3 Stars pretty, but came damaged
Anonymous from OH wrote (April 17, 2014):
2 of the rhinestones had already fallen off when we opened the package. We had to use a hot glue gun to put them pack on.
5 Stars
gloira gouge from TN wrote (December 21, 2013):
like the item and am pleased as long as the jewels dont fall out.


text:
Not Quite A Full Bull 0 comments
Not much to go on as Wednesday's light-volume action made for a mixed bag of stock action.
With Tuesday's Follow Through Day notched in we've changed our market bias to Buyer's Caution.
The major indexes need to show us they can hold ground above their 200-day moving averages before we become more aggressive buyers.
The technical resistance obstacles of their 50-day moving averages are the next step up.
Where strong volume from the traditional bull market leadership of Semiconductors (NYSEARCA:SMH) yesterday bodes well for the market's potential, heavy selling from the similar key sector of Retail (NYSEARCA:RTH) today is cautionary. Bullish confirmation from Finance (NYSEARCA:XLF), which remains under its 200-day moving average, is also desired before we become more bullish.
In Growth Stock action, we're pleased to see a number of issues holding ground after breaking out of technical bases: Mercadolibre (NASDAQ:MELI), Akamai Technologies (NASDAQ:AKAM) Chipotle Mexican Grill (NYSE:CMG) and Deckers Outdoor (DECK.)
Lulumon Athletica (NASDAQ:LULU) and Ulta Salon Cosmetics & Fragrances (NASDAQ:ULTA) are the most recent members to join the breakout club.
Disclosure: Long: LULU, HITK, TPX Short: TEXBack To GSRTrades' Instablog HomePage »
Instablogs are blogs which are instantly set up and networked within the Seeking Alpha community. Instablog posts are not selected, edited or screened by Seeking Alpha editors, in contrast to contributors' articles.Full index of posts »
Base breakout on growth stock $ULTA in effect Jun 18, 2010
Major buy volume on Growth Stock $ULTA, up 10%, nearing base breakout Jun 11, 2010
Growth Stock base breakout on $DECK Jun 11, 2010
Latest Comments
- GSRTrades on Runaway Train While we agree that short interest is usually n...
- untrusting investor on Runaway Train www.foxbusiness.com/ma.../See the attached arti...
- GSRTrades on Runaway Train No idea what you're talking about: www.zerohedg...
- untrusting investor on Runaway Train High short interest??? Not likely, any reports ...
- untrusting investor on Pullback Mode Hmmm, low volume down is meaningless, but even ...
- GSRTrades on Bearish Callings We've been buying growth stock breakouts for ov...
Most Commented
- Cautious Buyers ( Comments)
- Runaway Train ( Comments)
- A Follow Through Day ( Comments)
- Bearish Callings ( Comments)
- Pullback Mode ( Comments)
- Base breakout on growth stock $ULTA in effect