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Research Instructorship Honors Life of Treasured Mathematician
The College of Science and the Department of Mathematics at Northeastern University are pleased to announce the creation of the Andrei Zelevinsky Research Instructorship.
Automating Solutions to Side-Channel Attacks
Side-channel attacks are an emerging threat to embedded systems. As a result, mathematics professor Aidong (Adam) Ding and colleagues are creating a tool that automatically corrects for side-channel weaknesses.
Math major co-ops in Israel for start-up
Tali Soroker is soaking up as much of Israel as she can, living close to a massive market and the beach. But she spends much of her time on the job at her co-op.
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Amanda Luken knew when she signed up for co-op, doing something that focused on global health was important.
Northeastern program preps Boston teens for calculus
For six weeks this summer, some 120 students from Boston Public Schools made an early morning trek from across the city to Northeastern's campus, where they engaged in a math enrichment program designed to prepare them for calculus courses in high school.
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Partial differential equations, cloaking, and inspiring students – it's what interests mathematics professor Ting Zhou.
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At Northeastern, an impressive 50 percent of graduates receive a job offer from a previous co-op employer. But in one Boston apartment, that number is a perfect 100 percent.
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An interdisciplinary team of researchers at Northeastern University has received a four-year, $1.2 million grant from the National Science Foundation to develop new ways to study how marine organisms respond to climate related severe temperature stress.
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Students and faculty across many disciplines presented their most recent scholarly research, innovative thinking, and entrepreneurial ventures on Thursday at RISE:2014, Northeastern's Research, Innovation and Scholarship Expo.


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Property for sale in Berries Avenue, Bude EX23
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Kansas Longarm Quilters
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A-1 Singer Sewing Center
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1012 S. Oliver, Wichita, KS
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Joe Arpaio Says He Shouldn't Be the "Poster Boy" of Immigration Protests, Notes MCSO Just Picked Up 54 Suspected Illegal Immigrants
For once, Maricopa County Sheriff Joe Arpaio says he shouldn't be the center of attention.
Six young people -- the oldest 23 years old -- were arrested by Phoenix police Tuesday during a protest at Trevor Browne High School, rallying against Arpaio's methods of immigration enforcement.
To those six people -- and around 150 others who were present -- Arpaio says immigration policies have absolutely nothing to do with him.
"If these students/demonstrators have a concern over the immigration laws they should bring those concerns to Congress, State Legislators, or the White House and not use this Sheriff as their poster boy," Arpaio says.
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By the way, Arpaio wants everyone to know his boys in beige bagged 54 brown folks last week.
For the second time this week, Arpaio notes the MCSO picked up 54 suspected illegal immigrants in three operations spanning a week, between that cockfighting raid, the raid on a vitamin shop, and another event in which deputies arrested six people in an alleged human smuggling plot.
Still, he claims he shouldn't be the focus for people complaining about the immigrant roundups.
"Sheriff Arpaio says he will continue to enforce the Federal and State Immigration Laws regardless of demonstrators, activists, some politicians, and the Federal Government who have concerns over his enforcements of the laws," the sheriff's office says.
Those 150 youngsters, this joint called the Department of Justice, and countless other people tend to think that Arpaio's immigration-enforcement methods aren't exactly the best, but Arpaio's still playing the I'm just enforcing the laws card.
The four adults rested at Trevor Browne the other day were released from Immigration and Customs Enforcement custody yesterday (the two juveniles were reportedly released as well), as an ICE statement said the youngsters "do not fall under ICE's enforcement priorities."
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LiveVox Offers CFPB Compliance Solution Through Recording and Speech Analytics
LiveVox Inc. has announced the launch of their Centralized Call Recording application, a 100% call recording capability that collects all audio recordings, account information and agent data into a single, searchable and secure platform – enabling contact centers to also better leverage enterprise-wide speech analytics.
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Photo Booths for Sale
Visit Our New Showroom In Dallas, Texas
NEW: A Guide to Success: Photo Booth Start-Up
A series on Starting a Photo Booth Business
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Welcome to Photo Booth International
Photo Booth International is a photo booth sales company based in Dallas, TX. After servicing hundreds of events, we noticed an increase in guests asking where they can get their hands on their own photo booth. One year later Photo Booth International was founded and since then we have had tremendous growth in product knowledge and customer support. If you're looking for a turnkey realistic business opportunity, look no further. We have what you're looking for; so call us today to purchase a Photo Booth.
Our customer satisfaction goes hand in hand with our devotion to our clientele. Our photo booth is constructed of durable yet elegant materials, which gives it a very professional appearance. We use professional grade equipment, so your photos will always be lab quality. And to top it off, there are no additional charges for our tech support.
We are committed to provide a more affordable quality product!


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RATINGS: 372 WEIGHTED AVG: 3.58/5 SEASONAL: Special EST. CALORIES: 270 ABV: 9%
To create Victoria Ale, the brewers drew on references to Bucchus, the Thracian god of wine, in the history and artwork of the Victoria Mansion as inspiration for this new beer. One hundred pounds of chardonnay grapes were brought in, crushed on site and added directly to the mash. With a focus on the subtle wine-like character of the grapes, the 9.0% ABV brew boasts a pale copper color, Belgian yeast influence and a medium body with a long finish.
For every bottle of Victoria Ale sold, Allagash Brewing Co. will donate $1 to the restoration of this historic building.
We bottled it in February of '06. 451 cases (6 bottles in each case) were bottled.
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Long awaited Sony A99 II now official, 4K video and 42.4MP sensor
Sony has finally announced a successor to the A99, more than three years since it released the flagship DSLR. The Sony A99 II is a powerhouse of an SLR, with a 42.4-megapixel 35mm full-frame Exmor R CMOS sensor, hybrid phase detection autofocus system... >>
Sony PS4 Slim review: The slim-fit 'Station
When Sony unveiled two new versions of the PS4 during its special PlayStation Meeting in New York it rather glossed over the new, slimmer version of the console, dubbed the PS4 Slim - but which will become the de facto PS4. The company understandably... >>
This is Sony's first Ultra HD Blu-ray player with 4K and HDR support
Sony's really getting into 4K now. The company is officially supporting 4K in a physical format, with the introduction of the UBP-X1000ES. It's Sony's first Blu-ray player capable of Ultra HD Blu-ray playback. It not only brings support for full 4K but... >>
Got a US Sony Xperia XZ or X Compact? You won't be able to use the fingerprint scanner
It seems Sony just can't avoid disappointing its US customers. Sony Mobile US has confirmed the Stateside versions of the latest XZ and X Compact flagship smartphones won't come with a fingerprint scanner, but they will in Europe. It's not the first... >>
PS4 HDR update arrives, download firmware 4.0 right now
Sony has pushed out its latest software for the PlayStation 4 so you should find it waiting for you, either to download or already installed if you have updates set to do so automatically. PlayStation system software 4.0 adds a few new features, including... >>
Xbox One S vs PS4 Pro: What's the difference?
Sony has now revealed its next flagship console, the PS4 Pro, with the added, exciting revelation that it'll be on sale in November. That will put it squarely, if a little unfairly, up against the Xbox One S, which hit stores in August. With Microsoft's... >>
PS4 Pro vs Project Scorpio: What's the difference?
During this year's E3, Microsoft tantalisingly teased Project Scorpio for 2017, a machine Xbox boss Phil Spencer called "the most powerful games console ever". Since that time, Sony has also unveiled a new flagship device, revealing even more details... >>
New PS4 (slim): Release date, specs and everything you need to know
As part of its PlayStation Meeting in New York on Wednesday 7 September, Sony mainly focused on its mid-generation flagship console, the PS4 Pro. However, it also officially announced a newly-styled version of the standard machine too, which is similarly... >>
PS4 Pro ditches 4K Ultra HD Blu-ray player for cost and one other reason...
There's little doubt that the PS4 Pro, announced on Wednesday, is a spectacular 4K gaming powerhouse, but we were shocked to learn that it doesn't feature a 4K Ultra HD Blu-ray player for disc playback. Considering the Xbox One S, which hit stores in... >>
Best smartphones to look forward to in 2016
With the pace of smartphone evolution moving so fast, there's always something waiting in the wings. No sooner have you spied the latest handset, then there's anticipation of something else, the next big thing. We've rounded up the best smartphones for... >>


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Home > News > Forum: Pittsburgh a model for South Korea's emergence as tech powerhous
January 29th, 2007
Forum: Pittsburgh a model for South Korea's emergence as tech powerhous
Statistics compiled by the Pennsylvania Korea Office in Seoul show that Pennsylvania's exports to South Korea have grown steadily over the past five years. In 2005, exports totaled $460 million, up 36 percent from 2000 totals of $338 million.
Ken Yang of the Pennsylvania Korea Office estimates that life science, medical devices and diagnostic equipment have great potential to be hot trade segments, as well as Pittsburgh-based biotechnology, nanotechnology, tissue engineering, robotics, data storage, cyber securities, and advanced manufacturing.
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School of Business Holds 21st Graduation Ceremony
Faculty of Arts Holds Graduation Ceremony
Princess Basma Lays Cornerstone for Women's Studies Centre at UJ
UJ Staff Exchanges Eid Al Adha Greetings
School of Pharmacy Holds Summer Graduation Ceremony
The University of Jordan Amman 11942 Jordan
Call: (+962) 6-5355 000
Fax: (+962) 6-5355 522
The University of Jordan is both a modern as well as old institution of Higher Education in Jordan. Established in 1962, the University has, since then, applied itself to the advancement of knowledge no less than to its dissemination. In its capacity as a comprehensive teaching, research and community-service institution.
Copyright © The University of Jordan 2015


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1. Cercanias - Local Trains
While there is a mainline train station in Malaga connecting with the major Spanish cities, it is the local line that most people are interested in. This runs from Malaga to Fuengirola and has stops...more
2. Airport
Malaga is a pleasant enough airport, albeit thronged (even in the first months of the year) with many UK package tourists and ex-pats. You can expect it to be very busy indeed during the peak holiday...more
5. Local Bus
The local buses were easy to use & seemed to run frequently. To take the bus out of the city the main bus station is next to Maria Zambrano train station but there is also a smaller terminus near the...more
6. Car Rental - Car Hire
Although that it is true that many online booking facilities allow payments per debitcard, fact is that most car hire companies request to be paid by a valid credit card which must be issued on the...more
7. Airport Bus
The cheapest way from Malaga Airport to central Malaga is via the Number 19 bus which costs 1.20 and takes about 30 minutes for the journey. This is far slower than a taxi or train but it is a good...more
8. Long-distance Bus
I was much impressed by the Alsa buses I used, particularly the long-distance ones. Duyring my two visits to this part of Spain I used the Alsa buses to make trips from Nerja to Malaga and to...more
9. Hop On Hop Off Bus Tour
This bus is available at the main station for local buses. It has a tour cycle of 80 minutes to all stops along the guided way; a quick on/off for a lot of places. The buses operate every 30 minutes,...more
11. Parking
If you drive a car in Malaga I strongly recommend you to park in a Public Parking when you visit the city center. It's not expensive (1€/hour aprox) and you'll save time looking for a not existing...more
12. Horse & Carriage
It seems that I see carraige rides in many destinations. I suppose that if you are on a honeymoon, or with someone that you wish to be intimate with, it is a romantic means of transportation. On the...more
13. Segway
May brother-in-law, Gil, was unable to complete the walking tour. We saw people on Segways and thought that a segway might have been good for Gil, though I do not know how they handle stairs. This...more
14. Walking Tour
We took a 4 hour walking tour. Exploring the Alcazaba and the surrounding sights is best done on foot. The Alcazaba is all walkways and stairways. From there you head into a mob of people by the Roman...more
15. Airlines
For national flights, Iberia is the best option to get Malaga. There are flights from main spaninsh airports like Madrid, Barcelona, Bilbao, etc. Other air companies like aireuropa, spanair,...more
16. Cruise
Sailing on an ocean crossing is the best of both worlds, days to relax, and then boom, boom, boom, port, port, port. Málaga was our first Spanish port. This cruise would find us in Spain for semana...more
17. Bus for the City
You can nearly go to everywhere with the bus.The most urbans busses have a stop at "Alameda Principal" in the center of the city. From there you will have to...more
18. Checking times flights on line?
yes...You can check the predicted arrival and departure times of planes flying into and out of Málaga airport by using this link to the official Spanish...more
19. From Madrid to Malaga
Travelling from Madrid to Malaga takes , for most, 6 hours if using the bus, and 1 hour if taking a flight. By planing vacation in advance (6-8 weeks at least)...more
20. Malaga airport plan
This is a map of the arrivals terminal at Malaga. The red shaded section is the refreshment bar. The exit doors are opposite. Go through these and turn right to...more
21. The bus to and from Malaga airport
From Malaga airport you obviously need to get to some other location. Unless your holiday includes airport transfers or you take a taxi, (which can be...more
22. bus to airport
To get to the airport, you can take the public transport or taxi. If you prefer cheap option - then bus 19 is for you - it goes all the way to the airport....more
23. Bus to Gibralfaro
If you don't feel like walking uphill to Castillo de Gibralfaro you can take bus 35 that goes along Avenida de Cervantes and then takes you directly to the...more
24. Save on bus tickets
If you plan to travel by bus more than just to/from airport, I'd recommend buying a ticket for 10 trips which is much cheaper than if you buy one-trip ticket...more
25. If you're lucky enough to have a driver's license
Best way of getting around Malaga, Spain is to rent a car. It may seem like a lot of money, but to get around, it'll be easier and more convenient. There isn't...more
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Home > Sunglasses > Just Cavalli > JC730S (20B)
New Releases
Size and availability
Free outbound and return shipping
30-day money-back guarantee
Low prices
Free outbound and return shipping
30-day money-back guarantee
Low prices
JC730S/20B Ophthalmic Glasses
JC730S is a fashion statement, for which sunshine is not necessarily required, because these sunglasses enhance your natural radiance turning night into day. The JC730S is available in the Edel-Optics online shop in other styles from Just Cavalli collections 2015 and 2016.
These Sunglasses are a guarantee for looking good for both men and women. Eyewear is in. Full rim is extremely popular, because you feel that you get more eyeglass for your money. It is not just about their resilience, but also about the visibility of material and design, which are of the highest quality. The square shape gives round faces a concise form and makes them appear more striking. It sets a highlight in the appearance, drawing attention to itself. Plastic frames like these combine durability and are comfortable to wear. The JC730S is a very snug fit on the ears and nose. You find black too boring and bright colours are not your thing? Then grey is a your perfect alternative! The colour is not only a trend and suits almost every skin type, it can also be combined with any outfit. The fact that the colour grey matches everything, also applies to sunglass lenses. They suit everything in your wardrobe and never go out of fashion. Functionally, you are, of course, on the safe side, too. With 100% UV eye protection, the sun can immediately start shining.
The next shipment is on its way, so we will have your Just Cavalli back in stock very soon. We hope the unbelievably low price will be a consolation for the short wait. If you buy at Edel-Optics you get the best price, because "in the sale" is our standard.
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User/Comment Login
Owner's Title Insurance is not a requirement—it's a good choice.
When you buy a home, you've got moving expenses, homeowner's insurance, fire and flood insurance, hook-up fees for utilities, etc. It's easy to overlook the importance of Owner's Title Insurance amid the required expenses. You've already spent a lot of money on a lot of things, why buy Owner's Title Insurance if it's not required?
Here's why.
03/02/12 - 9:50am
31 Views
You cannot pull an Ace from the sleeve of a lawsuit. And lying is detrimental in court.
It may be easier to start with a Guilty Plea. If you are guilty, you plead Guilty, and then your defense attorney makes sure the prosecution does their job correctly.
03/02/12 - 7:50am
14 Views
Today I continued my walk and covered right at 20 miles. The highlight of my day came at lunch time with a nice group of people at Colby's Bar and Grill in Woodbine Ga.. The staff of Woodbine fed us a nice meal and the picked up the bill. The enlighting part came from a sweet waitress who has guardianship of her nephew and she brought him to me to ask about autism. He showed some traits but it gave me the opportunity to explain the importance of early intervention. He was a beautiful little guy and I hope she takes our advice to get him tested.
03/01/12 - 11:16pm
142 Views
This blog is going to be a little more personal.
First of all it's about the caladium sale the Pilot Club of St. Augustine is sponsoring. I've been a member of the club since 1965 - a club which does many good works in the community. Sale of the brightly colored leafy plants helps make these good works possible.
03/01/12 - 12:42pm
32 Views
Owner's Title Insurance is like a pre-written alternative ending to avoid misfortune. The happily-ever-after of home ownership should be hassle-free. You should be able to own your home and sell your home without any question of your entitlement. You paid for the house—heck, it's your home—and you should have the right to live there and sell "there"…but life doesn't always have a fairytale ending.
03/01/12 - 8:57am
27 Views
Homeowner distress has ten legal stages from loan to post-eviction. None of them are pretty, but it does not necessarily have to be a trail of tears. There can be opportunities along the way for the homeowner to change the course of the outcome.
If you remain in lock-step following the lender, then the lender will control the route and lead you to foreclosure. However, a legal defense could give you options to set your own stride and take a different direction.
03/01/12 - 8:36am
12 Views
I left the great state of Florida today and crossed into Georgia. The amazing thing about this journey is the people I will meet. Today I met a wonderful lady named Lissie. Lissie is mother of an autistic son and brought me supplies for my walk. I feel I have been a little selfish because this walk was about me and my family. Today made me realize it is bigger than that and I am walking for milllions of families. Thanks Lissie for the cookies and what you taught me.
02/29/12 - 10:06pm
103 Views
Get to know your way around St. Augustine and St. Johns County with our monthly NEIGHBORHOOD PROFILE, this month featuring ISLAND LIVING in St. Augustine Beach. Whether you're new to our vicinity or a long-time resident, knowledge of the area not only helps you navigate, but also broadens your perspective on the rich diversity our real estate has to offer. St. Augustine was built on history…and still building.
02/29/12 - 9:18am
1 Comment
82 Views
The Washington Post published a list of useful words you won't find in the dictionary, including:
"Cashtration" (cash-tray-shun) – the act of buying a house, which renders the subject financially impotent
"Reintarnation" (re-in-tar-nay-shun) – coming back to life as a hillbilly
"Dopeler effect"(dope-lur) – tendency of stupid ideas to seem smarter when they come at you rapidly
02/29/12 - 8:43am
26 Views
Boy meets girl. They fall in love. They get married. Then boy finds out that girl is sleeping with his best friend. To get "even," boy sleeps with girl's best friend. Boy wakes up with a rash.
Divorce is sometimes necessary. Once the love is gone, it's only math, and lawyers can help you get through the long division.
02/29/12 - 7:56am
75 Views
St. Augustine Record ©2016. All Rights Reserved.


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Tilt Control
All you need is a bubble in a vial to do your level best
In its most basic form, a level is nothing more than a liquid-filled vial with a free-floating bubble on the inside. When that vial is positioned so the bubble sits between a pair of parallel lines, you can rest assured that your work is perfectly horizontal, parallel with the horizon and square to the earth's gravitational pull. Yet, a level's uses go beyond just getting floors horizontal and walls plumb; they are also indispensable for putting a perfect pitch on gutters, drainpipes, walkways, and patios. A well-made level can do any of these jobs, but most tasks will be easier and the results more accurate when you use one of the specialized tools shown in the following slides.
Hardwood Classics
Purists choose wood because they like the traditional look and feel, and masons appreciate that the protective linseed oil seal keeps mortar from sticking to the sides. Stainless steel bindings cradle alternating strips of cherry and maple on these Crick levels, which come in a range of stock lengths, from 8 inches to 8 feet. Custom levels are also available. Approx. $45 to $145, Crick Tool
Eyeballing a bubble may seem a little crude once you've used this electronic level's LCD screens, located both on the side and the top edge (INSET). The digital displays, which are accurate to within .01 inch per foot, let you program a pitch into memory to get the angle of a gutter just right or store a measurement of rafter slope until you're ready to write it down. Turn on the "sound" feature, and you'll hear the device beep faster and faster until its shrill scream tells you you've hit level—nice for those solo leveling jobs when you can't see the display. 24 inches; Approx. $209, Stabila
Box-style levels are more resistant to twists or bends than levels of the same weight and length shaped like I-beams. This aluminum one has a built-in mirror (INSET) that lets you check the verticality-testing plumb vial by looking through the level's edge rather than pressing the side of your head against a wall. For hands-free work, fit separately sold hooks and hangers into keyhole slots in the level's sides. 24 inches; Approx. $69, Irwin
Because longer levels are inherently more accurate, this 72-inch tool is great for jobs that leave little margin for error: installing tall windows, hanging doors, or setting up a new pool table. Its blue vials stay visible in glaring sun, and their accuracy over 6 feet varies by less than ½ inch, or half the thickness of a dime. Accordion-shaped rubber end caps brace the ½-pound aircraft-aluminum frame against shocks. Approx. $70, Empire
A big, rotating vial on the FatMax Xtreme torpedo level allows you to measure degree-perfect pitches. Strong rare-earth magnets on a V-groove (INSET) let it grip round iron pipes as you adjust them for pitch or plumb. 12 inches; Approx. $23, Stanley Tools
A 90-degree bend and an elastic strap
hold the Postrite level against the
corners of square-edged fence and deck posts, providing a fast, one-position
check for plumb. Magnets on the face hold
it against metal fence posts. The tool also folds onto itself, taco-style, for easy storage. Approx. $6, Kapro
The beefy Mighty Tee has two arms, each fitted with a glass vial. When building, say, a raised planting bed or retaining wall, hook the notched arm over an interlocking masonry block and you can see at a glance if it's level along its length and from side to side. Available in plastic or mahogany (shown); Approx. $48, Portaustin Level and Tool
An age-old (and not highly accurate) tool for landscapers and masons, the line level hangs from a taut string to show if a course of bricks is on the level or a patio or walkway has the right slope. These days, most pros use laser levels, but this one can get the job done and save you about $400 in the process. Approx. $4, Johnson
The solid aluminum Checkpoint torpedo is crammed with features, beginning with vials fixed at
four different pitches: the usual 90 and 0 degrees, plus 45 and 30 (INSET). A bull's-eye level on top simplifies using it on a tripod to create a level line around a room with the built-in laser when installing cabinets or chair rails. Four rare-earth magnets on the bottom maintain a tenacious hold on ferrous pipes and surfaces. 7 inches; Approx. $70, PDP Inc.
Perhaps it's no surprise that a Frenchman, Melchisedec Thevenot, invented the first spirit vial by filling a glass tube with wine. When he lashed the vial to a flat stone ruler in the 1660s, astronomers had an accurate tool with which to orient their newfangled telescopes. Today's vials are still full of booze, because alcohol doesn't freeze.
Vials these days are made out of glass (a), bored-out blocks of solid acrylic (b), or injection-molded plastic (c). Any one of these can do the job, but acrylic block vials are generally the most accurate and durable.
In addition to a bubble, a vial needs at least two lines approximately one bubble's length apart to show us when the level is, indeed, level. Some vials, such as the the Vari-Pitch (c), have extra lines to show gradations of pitch for specialized applications like drain pipes, gutters, patios, or any other job that requires a precise but nonstandard slope.


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Immunologic laboratory tests serve a critical role in the care of patients with rheumatic diseases. Historically, such tests have helped define the immunopathophysiologic basis of various rheumatic conditions, and have allowed more precise classification of distinct diseases with similar clinical features. The results of immunologic laboratory tests have become a key part of the diagnosis for several diseases. These tests may also provide relevant information concerning disease activity, end-organ involvement, and prognosis. Repeated measurement of certain tests has become a means to monitor disease activity and response to treatment.
Although immunologic laboratory tests can have great utility in the diagnosis and management of patients with rheumatic diseases, they can be misused. Improper application of these tests can result in misdiagnosis, inappropriate therapy, and unnecessary health care expenses. In an effort to define the optimal use of immunologic laboratory tests, the American College of Rheumatology (ACR) assembled an ad hoc committee to develop evidence-based guidelines for these diagnostic tests. None of the members of the committee have any commercial interest in any laboratories that would present a potential conflict of interest to the creation of these guidelines. The primary goal of these guidelines is to improve patient care. It is hoped that these guidelines will be practical and useful to clinicians caring for patients with rheumatic diseases. These guidelines are not intended to be a substitute for clinical judgment. In atypical cases, clinical judgment may require deviation from the guidelines. Also, these guidelines should be considered dynamic. Further investigation and research may allow refinement in our understanding of the optimal use of immunologic laboratory tests.
Scope of work
The first group of immunologic laboratory tests analyzed was the antinuclear antibody (ANA) and related autoantibody tests including: anti-double stranded DNA (anti-dsDNA), anti-Ro/SSA, anti-La/SSB, anti-Sm, anti-RNP, anti-histone, and anti-Scl-70/nucleolar/centromere. The tests were divided among the committee members, each of whom primarily reviewed the literature for one or more of the tests. Different committee members provided independent secondary review of a sample of the articles for each topic.
The guidelines were formulated using an explicit, evidence-based approach. Recommendations from the Evidenced-Based Medicine Working Group concerning guidelines were incorporated into the design process (1, 2). The first step in the formulation of the guidelines was the creation of a template (Table 1) that identified the key clinical questions that would need to be answered. Specific points considered for each test included laboratory methodology, indications for use of the test in diagnosis, prognosis, longitudinal followup, and areas that require additional research. Wherever possible, consideration was given to common clinical uses for the tests. For example, it was recognized that some tests may be used to "rule-in" or "rule-out" a diagnosis. The available literature was systematically examined to determinte the best solutions to the key questions of interest.
|I. Definition of the test
|II. Background
|A. Relevant historic considerations
|B. Methodologic considerations
|III. Indications for clinical use of the test
|A. Diagnosis
|1. What is the prevalence of a positive test result in systemic lupus erythematosus, other rheumatic diseases, other diseases, and normal controls?
|2. What are the population statistics (sensitivity, specificity, and positive and negative likelihood ratio) for this test in these conditions?
|3. What effect does titer have on the population statistics?
|4. For whom should this test be used as an aid to diagnosis?
|5. What further testing should be done based on a negative or positive test?
|B. Prognosis
|1. Does a test result correlate with any aspect of prognosis (e.g., disease activity, end-organ involvement, outcome, survival).
|2. What are the population statistics relevant to prognosis?
|3. What effect does titer have on the prognosis?
|4. For whom should this test be used as an aid to determination of prognosis?
|C. Longitudinal assessment
|1. In which conditions do changes in the test correlate with clinical variables longitudinally?
|2. What effect does treatment have on the test result?
|3. For whom should the test be utilized as an aid to longitudinal assessment?
|IV. Areas that require additional research
Selection and grading of literature
A comprehensive literature review was performed for each test. Searches were conducted using electronic databases (e.g., MEDLINE, Healthstar), restricting the references to English-language articles. This was supplemented by thorough hand searching of reference lists. As a result of this search method, a literature database was assembled for each test. Review articles, editorials, individual case reports, case series with less than 10 patients, animal studies, and articles that did not report primary data were all excluded from analysis. Articles that did not report complete data (e.g., those showing data only from "representative patients") were also excluded.
In order to identify studies with the highest methodologic quality, articles in the literature database were critically reviewed according to criteria developed a priori. Five criteria derived from those of the Evidenced-Based Medicine Working Group (3, 4) were considered (Table 2). An article satisfying all 5 criteria was considered an "A" article; those satisfying 3 or 4 criteria were considered "B" articles; those satisfying 2 criteria were "C" articles, and those meeting only 1 or none of the criteria were grade "D." It was decided that in order to create the guidelines, the best available literature would be considered. Thus, for those questions on which there were 10 or more grade A articles, no consideration would be given to lesser quality articles. In other situations, articles of grade B were also considered. Consensus on grading was achieved by independent secondary review. For each test, approximately 10% of the articles in the database were randomly selected and independently reviewed. Interobserver agreement rates were calculated using a kappa statistic.
|1. Are complete data provided? (e.g., likelihood ratios or the data to calculate likelihood ratios provided)
|2. Was there an independent blind comparison with a reference standard (e.g., were American College of Rheumatology diagnostic criteria used? What measure of disease activity was used, etc)?
|3. Did the patient sample include an appropriate spectrum of patients to whom the test will be applied in clinical practice?
|4. What methods were used to perform the test and are they currently available?
|5. Did the results of the test being evaluated influence the decision to perform the reference standard (i.e., was there "work-up" bias?)
Data abstraction
Clinicians may consider ANA and other autoantibody testing for various rheumatologic and nonrheumatologic conditions. Performance characteristics of diagnostic tests (i.e., sensitivity, specificity, likelihood ratios, etc) can only be determined for specific diseases. Therefore, an initial review of the literature was performed to establish the scope of diseases for which there was available literature to analyze concerning the use of each test. For example, initial review of anti-Ro/anti-La testing revealed that there were a large number of articles addressing the use of these tests in both systemic lupus erythematosus (SLE) and Sjögren's syndrome. After the diseases to be assessed in detail were determined for each test, data were derived from the articles to provide answers to the questions in the original template (e.g., what is the prevalence of a positive test in patients with SLE). The proportion of patients with and without particular diseases who had positive or negative results for a given test was abstracted from the articles, and 2 × 2 contingency tables were created (Table 3). From these tables, sensitivity, specificity, and positive and negative likelihood ratios were calculated across all included studies. Where data were available, separate consideration was given to the use of the test in diagnosis, prognosis, and longitudinal followup, in SLE as well as other conditions.
|Test result
|Disease present
|Disease absent
Substantial heterogeneity was noted among the various articles addressing any given topic. Some of the important differences included 1) different methods used to perform the same test, 2) different substrates used to perform similar methods, 3) dissimilar populations from which the patients were acquired (for example, patients seen at a specialty clinic in a tertiary referral center versus those seen in the community at large), 4) various lengths of disease duration at the time of testing, and 5) the use of medications or other therapies that might affect the results of diagnostic testing. Therefore, data from different articles were not combined into a single estimate (i.e., using metaanalysis). Data are presented for each article used in the recommendations. However, to provide a useful guide to clinicians, weighted averages for the performance characteristics are calculated. Recommendations for using the tests in the guidelines are based upon these weighted averages. Formal meta-analytic techniques were not used to combine the studies because of the heterogeneity noted within the sample of studies.
Diagnostic accuracy
The statistics reported are meant to provide the clinician with an estimate of the utility of these tests (4). Many clinicians have some familiarity with the sensitivity (i.e., how often are the results of a particular test positive among all patients who actually have the disease in question) and specificity (i.e., how often are the results of a test negative among persons who do not have the disease) of various tests such as the ANA (Table 3). However, the sensitivity and specificity of a test are not sufficient to calculate the probability of disease for a given patient. The likelihood ratio is meant to provide an additional measure that may be of greater value in daily practice. The positive likelihood ratio and negative likelihood ratio are measures of how the posttest probability is impacted by the test result (Figure 1). In other words, the likelihood ratio allows the clinician to calculate the posttest probability based upon the pretest probability and the test result. The important issue in deciding whether to use a diagnostic test in a particular patient is whether the posttest probability will be significantly different from the pretest probability, given a positive or negative test result.
For example, a clinician may see a 33-year-old woman with arthritis, oral ulcers, and a facial rash. Based upon her age and symptoms, the clinician believes that her chances of having SLE are substantially greater than that of the general population, and he or she estimates that the patient has a 10% chance of having SLE. The clinician then wants to order a test (such as an ANA or related autoantibody test) to help confirm this suspicion. If the test has a high positive likelihood ratio (e.g., 10), and the test result is positive, then the posttest probability of the test will be greatly increased (Figure 2). This test will be very helpful in assisting the clinician to make the diagnosis of SLE. If the likelihood ratio of the test were slightly less (e.g., 5), there would still be a substantial increase in the posttest probability that could be clinically relevant. However, if the test had a small positive likelihood ratio (e.g., 1.2), then the posttest probability will not differ substantially from the pretest probability, and a positive test result would not help the clinician in making a diagnosis.
In a different clinical context, the same test would have different implications. A clinician may order an ANA on a 78-year-old man with fatigue and arthralgias. If there were no other findings suggestive of SLE, but an ANA is obtained to "rule-out SLE," and the result is "positive" with a 1:40 titer, how should this result be interpreted? In this case, based on the clinical presentation, the pretest probability of SLE would be expected to be only slightly greater than the prevalence of SLE in the general population (approximately 0.1% or less). For this patient, even if the test had a large positive likelihood ratio, the posttest probability would not be expected to be significantly different from the pretest probability (Figure 2).
The likelihood ratios allow the clinician to estimate whether there will be a significant change in the pretest to posttest probability of a disease as a result of obtaining the test (4). The determination of a "significant" change depends on a number of factors, including the disease in question, the therapeutic options, and the threshold for starting therapy. A likelihood ratio of 1 implies that the posttest probability of disease will be exactly the same as the pretest probability of disease (Table 4). Thus, the test was of no value in determining the presence of disease. In general, likelihood ratios >10 or <0.1 translate into very large, clinically important differences in pretest–posttest probability. Likelihood ratios between 5 and 10 or between 0.1 to 0.2 often result in more modest, but still substantial differences, in pretest–posttest probability. Ratios from 2 to 5, or from 0.5 to 0.2 generate small differences that may still be relevant in certain clinical settings. Likelihood ratios between 1 and 2, or 0.5 and 1 generate very small differences that are seldom clinically important. In the clinic, the smaller the likelihood ratio, the more important the clinical context becomes in interpreting the test result. Likelihood ratios close to 1 affect pretest probability to a small and generally insignificant degree (4).
|Clinical implications
|Range of positive likelihood ratios
|Range of negative likelihood ratios
|Large, often very clinically significant differences
|Modest clinical differences
|Small, but potentially relevant clinical differences
|Small, rarely clinically important differences
|No difference between pretest and posttest probabilities
An important consideration in the use of these statistics in evaluating diagnostic tests is that the clinician should first have a reasonable estimate of the pretest probability of a disease. Unfortunately, pretest probabilities can be difficult to gauge, and very little data have been collected specifically on this issue.
Guidelines formation
In forming the Immunologic Laboratory Testing Guidelines, tests will be recommended as being "very useful," "useful," or "not useful" based on their diagnostic accuracy and associated likelihood ratios. A test will be considered to be "very useful" in a given situation if the majority of high-quality articles addressing the question have positive likelihood ratios >5 or negative likelihood rations <0.2. A test will be considered "useful" if the majority of positive likelihood ratios fall between 2 and 5, or negative likelihood ratios between 0.2 and 0.5. A test is considered "not useful" if the positive likelihood ratios are <2 or the negative likelihood ratios are >0.5.
For a number of important questions, there was not sufficient high-quality literature to allow rigorous analysis of the utility of a test. Because these guidelines are evidence-based, no recommendation is made in those areas for which there is insufficient literature. Rather, these questions are identified as important areas that require further investigation. This is relevant, because customary practice for some clinicians may include paradigms of diagnostic testing that are neither supported nor refuted by the medical literature. In those areas, additional research is needed to provide guidance as to optimal use of diagnostic tests.
The Committee has attempted to be explicit and evidenced-based in our methods, and objective in our formulation of these guidelines. As has been recently noted, determination of appropriateness of laboratory testing is quite difficult without clear methodology (5). Likelihood ratios were chosen to determine the appropriateness of laboratory testing because they were considered to be truly objective. In addition, likelihood ratios reflect the thought processes used by clinicians when using laboratory tests, although they often do not formally calculate such quantitative measures.
We hope these guidelines are useful to clinicians caring for patients with rheumatic disease. In addition, it is hoped that this format serves as a model for further guideline development, and spurs additional research into the utility of immunologic laboratory tests.


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Hustler publisher Larry Flynt thinks Wikileaks' Julian Assange is a hero-journalist. And he thinks that if Wikileaks had existed back when George W. Bush was spoiling for war in Iraq, the blood spilled, and dollars spent, would have been greatly diminished.
Flynt coming down on the side of the Wikileaks partisans should come as no surprise if you've seen The People vs. Larry Flynt, which chronicled his free-speech court tussle with Reverend Jerry Falwell. He joins other well-known public supporters of Wikileaks, including Michael Moore, director Kenneth Loach, writer Hanif Kureishi, and Bianca Jagger.
Flynt, who is known to use a gold-plated wheelchair, the result of a shooting incident involving a white supremacist who was infuriated by an interracial photo shoot that appeared in Hustler, is putting his money where his mouth is and donating $50,000 to the Wikileaks defense fund.
The porn poobah is staunch in his approbation for the WikiLeaks chief, the odd details of whose personal life have been leaked along with everything else, including your Aunt Tilly's fruitcake recipe. He writes, "Julian Assange should not face a prison sentence. We should have a ticker-tape parade for this brave man."


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Litter In La Marque? You're Going To Jail
La Marque is fed up with litter. The Galveston County suburb sees only one way to address it -- send people to jail.
Starting August 1, city officials told the Galveston County Daily News, "anyone caught littering will go to jail and will have to pay a hefty fine."
Well, that seems a little harsh.
Not to officials:
"We've tried being nice," Michael Duhon, the chairman of the Clean City Commission, said. "It's looking better, but there are people who dump all sorts of stuff. Someone dumped a used diaper on the road in front of my house.
"Two things motivate people. Pain and money."
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Dump a used diaper -- and, we guess, a cigarette butt or a McDonald's wrapper -- and you won't just get a ticket, as in the past.
Now city policy calls for you to be booked into jail before getting that ticket, and the fine can go as high as $297.
Officials plan to "beef up" patrols, and police officers will be told to be on the lookout for the dreaded litterbugs.
And as they're arresting them, taking them downtown, doing all the paperwork involved, we're sure the streets -- the very clean streets -- of La Marque will be perfectly safe.
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21 Easy Sewing Projects: DIY Designs and Sewing craft Ideas
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Make a Small Decorative Sewing Kit
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Portable Decorated Sewing Kit
You will need
1 cleaned out lipstick tube (from your mother)
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3 small safety pins
1 small needle
Several lengths of different colored threads
Attach pins and needle to felt and roll to fit in lipstick tube. Tie the colored threads around the roll and put in the tube. Decorate the tube with glue and small beads or stones. (Or whatever they wish...even paper) This is a cute gift for mother to carry in case she needs to mend something that tears.
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Mar 19, 2011
I have always wondered when I get to the end of a lipstick what to do with the container. This is the first recycle project I have ever seen. Thank you so much.
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About UsEmily Hagedorn
Emily Hagedorn is a Neighborhoods reporter for The Louisville Courier-Journal, covering the Highlands neighborhood in Louisville, Oldham County and part of northeast Jefferson County.
She has also covered Bullitt County for the Courier-Journal and has written for the Bakersfield Californian, the Detroit News, the Lexington Herald-Leader, the Virginian-Pilot, the Cincinnati Enquirer and the now defunct Kentucky Post.
Emily is originally from Florence, Ky., and is a University of Kentucky grad. She lives in the Highlands.
You can find Emily on Facebook at www.facebook.com/ehagedorn2 and on Twitter at twitter.com/CJ_EHagedorn.
Also check out the Highlands/Crescent Hill Neighborhoods Facebook page at www.facebook.com/HighlandsCrescentHillNeighborhoods and the Oldham County Neighborhoods Facebook page at www.facebook.com/oldhamcountyneighborhoods.
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Oldham business owner honored
Kurt Vezner is the "behind the scenes" type, helping non-profits throughout Oldham without asking for anything in return, those who know him say.
"He has really been a great addition to Oldham County," Vezner's friend Bill Howard said.
Vezner, who owns South Continue reading
Tourism expert returns to Oldham to offer ideas
I wrote in April about a man named Roger Brooks who spent a week in Oldham, taking pictures and jotting notes about how the community can bring in more tourists and build business.
He offered a slew of ideas: better Continue reading
Better safe than sorry
Kevin Nuss with Oldham's Emergency Management department sent a long list of winter safety guidelines, and I thought I'd share.
I'm pasting them below.
If you use kerosene heaters to supplement your regular heating fuel, or as an Continue reading
Oldham Sheriff inducted into Atherton's "hall of fame"
Oldham County Sheriff Steve Sparrow is one of 11 alumni from Atherton High School in Louisville who are being inducted into the school's "hall of fame" this year.
Sparrow graduated from the school in 1972 and then launched into a Continue reading
It's not a tutu, but still….
"I KNOW WHAT I'M GOING TO WEAR!" I nearly yelled into my friend Liz's ear Friday after the "Nutcracker in a Nutshell" ballet rehearsal in Crestwood.
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More than 350 teachers, donors and volunteers celebrated the 25th annual Classroom Grant Awards on December 3rd, 2014 at Michael's On East. Susan Scott of the Education Foundation of Sarasota County announced grant awards totaling $185,465 for 227 projects developed by teachers from 41 public schools in the district. Each grant will provide high quality enrichment and experiential learning opportunities for students during the 2014-2015 school year.
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