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Zetterberg, Evaa,b,*; Neuhaus, Jacquelinec,*; Baker, Jason V.c,d; Somboonwit, Charurute; Llibre, Josep M.f; Palfreeman, Adriang; Chini, Mariah; Lundgren, Jens D.a; for the INSIGHT SMART Study Group
aCopenhagen University Hospital/Rigshospitalet and University of Copenhagen, Denmark
bSkane University Hospital, Malmö, Sweden
cUniversity of Minnesota
dHennepin County Medical Center, Minneapolis, Minnesota
eUniversity of South Florida, Tampa, Florida, USA
fLluita contra la SIDA Foundation, University Hospital Germans Trias i Pujol (Badalona), Universitat Autònoma de Barcelona, Spain
gDepartment GU Medicine, University Hospitals Leicester, UK
hRed Cross General Hospital, Athens, Greece.
*Authors Eva Zetterberg and Jacqueline Neuhaus contributed equally.
Correspondence to Dr Jens D. Lundgren, Copenhagen University Hospital/Rigshospitalet and University of Copenhagen, Copenhagen HIV Programme (21.1), Panum Institute, Blegdamvej 3B, 2200 Copenhagen N, Denmark. E-mail: firstname.lastname@example.com
Received 7 June, 2012
Revised 30 August, 2012
Accepted 4 September, 2012
Clinical Trials.gov identifier: NCT00027352.
Objectives: To investigate the mechanisms of platelet kinetics in the Strategies for Management of Antiretroviral Therapy (SMART) study that demonstrated excess mortality with CD4 guided episodic antiretroviral therapy (ART) drug conservation compared with continuous treatment viral suppression. Follow-up analyses of stored plasma samples demonstrated increased activation of both inflammatory and coagulation pathways after stopping ART.
Design: SMART patients from sites that determined platelets routinely.
Methods: Platelet counts were retrospectively collected from 2206 patients from visits at study entry, and during follow-up. D-dimer levels were measured at study entry, month 1, and 2.
Results: Platelet levels decreased in the drug conservation group following randomization, but remained stable in the viral suppression group [median (IQR) decline from study entry to month 4: −24 000/μl (−54 000 to 4000) vs. 3000 (−22 000 to 24 000), respectively, P < 0.0001)] and the rate of developing thrombocytopenia (<100 000/μl) was significantly higher in the drug conservation vs. the viral suppression arm (unadjusted drug conservation/viral suppression [HR (95%CI) = 1.8 (1.2–2.7)]. The decline in platelet count among drug conservation participants on fully suppressive ART correlated with the rise in D-dimer from study entry to either month 1 or 2 (r = −0.41; P = 0.02). Among drug conservation participants who resumed ART 74% recovered to their study entry platelet levels.
Conclusion: Interrupting ART increases the risk of thrombocytopenia, but reinitiation of ART typically reverses it. Factors contributing to declines in platelets after interrupting ART may include activation of coagulation pathways or HIV-1 replication itself. The contribution of platelets in HIV-related procoagulant activity requires further study.
In the Strategies for Management of Antiretroviral Therapy (SMART) study, HIV-1-infected patients were randomly assigned to either continuous (viral suppression arm) or CD4 guided episodic use of antiretroviral therapy (ART; drug conservation arm). Unexpectedly, the drug conservation strategy was associated with an increased risk of all-cause mortality, largely non-AIDS-related causes, including cardiovascular, renal, hepatic, and non-AIDS cancers [1]. To better understand these findings, biomarker studies conducted on stored plasma samples have demonstrated levels of hsCRP, IL-6, and D-dimer [2] markedly predict risk for mortality in SMART. In addition, stopping ART lead to increases in these same biomarkers that correlated with the rise in HIV replication, suggesting that HIV infection lead to activation of both the inflammatory and coagulation systems [3]. These observations suggest that HIV-induced activation of coagulation pathways might have contributed to the pathologic processes underlying the increased mortality. The findings from the SMART study suggested that interruption of ART and corresponding increase in HIV-1 viral load may directly upregulate coagulation pathways. Most data on HIV-1-induced thrombocytopenia have been obtained prior to the widespread use of ART in patients with early HIV infection [4–6] and there is limited information on how ART affects the incidence and risk factors for thrombocytopenia in treated vs. untreated patients [7,8]. In this analysis of the SMART study we investigated the effect of interruption of ART, and the corresponding increases in HIV-1 viral load and D-dimer, on platelet count kinetics.
Detailed information on the study population and methods of the SMART study has already been published [1]. In short, 5472 HIV-1-infected participants with CD4+ cell count more than 350 cells/μl were enrolled at 318 sites in 33 countries. Patients were randomized to one of two ART arms; the viral suppression (viral suppression) arm involved continuous use of ART while the drug conservation arm (drug conservation) involved CD4+ guided interruptions of therapy when CD4+ cell counts were more than 350 cells/μl and reinitiation of therapy when CD4+ cell counts were less than 250 cells/μl. All the necessary institutional/ethical review board approvals were obtained. The study was approved by the institutional review board at each site, and written informed consent was obtained from all participants. The ClinicalTrials.gov identifier is: NCT00027352 and the EudraCT number is: 2004–000441-38.
Enrolment was discontinued in January 2006 because of the observed increased risk of opportunistic disease or death in the drug conservation arm compared with the viral suppression arm.
This report consists of 2206 patients (1090 from the drug conservation arm and 1116 from the viral suppression arm) participating in the SMART study who were enrolled at study sites wherein platelet counts had been consistently collected. Platelet counts were retrospectively collected at study entry, month 1, 2, 4, 6, 8, 10, 12 and every 4 months thereafter. As it was not possible to retrospectively collect data on all patients, sites with limited data collected on participants who had died or been lost to follow-up were excluded from this report (defined as <20% of dead/lost to follow-up participants), as were sites with less than 80% completeness of platelet levels at randomization. This decision to remove entire sites based on summary characteristics of data from the site, rather than removing individual patients based on patient characteristics was taken a priori. This resulted in all participants randomized at 157 sites (out of 318) being included in this analysis. As randomization was done in blocks at the site level, treatment allocation can be considered as being random in this subset of the entire study population.
D-dimer levels were available at study entry for all SMART participants with a stored plasma sample available (N = 1998 in this report). D-dimer, IL-6, and hsCRP levels at months 1 or 2 of follow-up were available for 75 drug conservation and 99 viral suppression patients from previous reports [2,9]. Serious non-AIDS events were defined as major cardiovascular disease (CVD) events (myocardial infarction, stroke, or coronary artery disease requiring surgery), end-stage renal disease, cirrhosis, non-AIDS malignancies, or death from non-AIDS-related causes. Plasma HIV-1 RNA was collected prospectively at each visit and was required by the protocol. HIV-RNA levels were measured at the site in real time and used as standard of care. D-dimer levels were measured from stored specimens at Laboratory for Clinical Biochemistry Research at the University of Vermont after termination of the study [2].
Thrombocytopenia was defined as having a follow-up platelet count less than 100 000 μl. Participants were censored at the date of the last available platelet count and time-to-event analyses were restricted to those with a platelet count at least 100 000 μl at study entry. The rates of developing thrombocytopenia per 100 person-years were calculated and hazard ratios for the comparison of the drug conservation and viral suppression groups were estimated from Cox models. Adjusted models included the following study entry covariates: age, sex, race, ART and HIV-1 RNA, CD4+ cell count, hepatitis coinfection, prior CVD, smoking, diabetes, blood pressure lowering drugs, lipid lowering drugs, total/HDL cholesterol, BMI, and study entry platelet level. The proportional hazards assumption was tested in a univariate model by including an interaction term between treatment group and log transformed follow-up time.
Spearman rank correlation coefficients were used to assess associations of changes in platelet counts in the drug conservation group with study entry D-dimer, changes in D-dimer levels, and changes in hemoglobin levels and HIV-RNA after log10 transformation.
Predictors for recovery time of platelets to the study entry level from initiation of ART in the drug conservation group were assessed by Cox models. Time zero was redefined to be the time of initiation of ART for the first time after randomization to SMART. The outcome was defined as the first platelet count after initiation of ART that was at least study entry platelet level. Predictors included change in platelets from study entry to ART initiation, time from randomization to ART initiation, HIV-RNA prior to initiation of ART and type of ART initiated.
The risk of serious non-AIDS events in the drug conservation group associated with at least 25% decline in platelets during the first 4 months of SMART was assessed by Cox regression including an indicator for those with and without a 25% decline in platelet count from study entry to month 4. Time zero was defined as the date of the month 4 visit and the model was adjusted for change in CD4+ and log10 HIV-1 RNA to month 4, age, sex, race, nadir CD4+, hepatitis coinfection, smoking, diabetes, and BMI.
The median age was 43 years, 27.5% were women and 85.9% of patients were on ART when entering the study. There were no significant differences between viral suppression and drug conservation arms in respect to: age, sex, race, ART and HIV-1 RNA, CD4+ cell count, nadir CD4+ cell count, prior AIDS, hepatitis coinfection, smoking, diabetes, blood-pressure-lowering drugs, lipid lowering drugs, total/HDL cholesterol, BMI, and hemoglobin (Table 1). However, the study cohort differed significantly from remaining SMART participants for whom platelet counts were not available. The study population included in this study had fewer of black race (26.1 vs. 31.2%; P < 0.001), lower median BMI (24.6 vs. 25.1; P < 0.001), higher percentage of patients on ART (85.9 vs. 82.5%; P < 0.001) and with HIV RNA 400 or less (74.2 vs. 70.0%; P < 0.001), and a lower percentage with prior AIDS (22.1 vs. 25.6%; P = 0.003), hepatitis coinfection (15.7 vs. 17.9%; P = 0.03), current smokers (37.3 vs. 42.7%; P < 0.001), prevalence of diabetes (5.8 vs. 7.9%; P = 0.003), and use of blood pressure (16.7 vs. 20.1%; P = 0.04), or lipid lowering drugs (14.6 vs. 16.7%; P = 0.04).
The median (IQR) platelet count was 236 000/μl (199 000–281 000) at study entry, decreased temporarily within the first year of the study in the drug conservation arm, but remained stable in the viral suppression arm [median (IQR) decline from study entry to month 4: −24 000/μl (−54 000 to 4000) vs. 3000 (−22 000 to 24 000), respectively, P < 0.0001)] (Table 2, Fig. 1). There were 62 thrombocytopenia events in the drug conservation group (rate = 2.6 per 100 person-years) and 36 events in the viral suppression group (rate = 1.4 per 100 person-years). The rate of developing thrombocytopenia (<100 000/μl) was significantly higher in the drug conservation arm vs. viral suppression arm [unadjusted drug conservation/viral suppression hazard ratio (95% CI) = 1.8 (1.2–2.7)]. The excess risk in the drug conservation vs. viral suppression group was evident during the first 4 months [adjusted hazard ratio (aHR) drug conservation/viral suppression = 9.0 (95% CI 2.7–29.5)], but not thereafter [aHR = 1.1 (0.7–1.8); interaction drug conservation/viral suppression vs. time: P = 0.0006]. Of the 62 drug conservation patients who developed thrombocytopenia, 45 initiated after the first date with platelets less than 100 000, 12 initiated before the first date with platelets less than 100 000 and five did not initiate ART during follow-up. Of the 45 that initiated after developing thrombocytopenia, the majority initiated due to protocol instructed reasons (CD4 cell count <250 or Data Safety Monitoring Board recommendation). There were eight patients for whom the site wrote on the form that thrombocytopenia was a reason for initiation. Male sex (P = 0.01), nonblack race (P = 0.02), coinfection (P = 0.006), and higher study entry platelet level (P < 0.001) were all associated with greater declines in platelets.
The early decrease in platelet numbers was neither associated with levels of D-dimer at study entry, nor with change in the hemoglobin levels [correlation = 0.02 (P = 0.66) and −0.06 (P = 0.06), respectively]. However, for drug conservation patients with D-dimer values available at baseline and either month 1 or month 2 (n = 75), the rank correlation coefficient between change in D-dimer and change in platelets was −0.24 (P = 0.04). The association was even stronger [rank correlation coefficient −0.41 (P = 0.02)] for drug conservation patients who were on ART and had a suppressed viral load at study entry (n = 33) (Fig. 2a). For drug conservation patients, the correlations between change in platelets and changes in IL-6 and hsCRP were −0.23 (P = 0.05) and −0.06 (P = 0.59), respectively. When restricting to those on ART with a suppressed viral load, the correlations are −0.29 (P = 0.11) for IL-6 and −0.01 (P = 0.97) for hsCRP.
When restricted to drug conservation participants with HIV-1 RNA 400c/ml or less on ART at entry (n = 738), changes in HIV-1 RNA levels after interruption of ART were inversely correlated with changes in platelet count (Fig. 2b). The correlation between 4-month change in log10 transformed HIV-1 RNA and 4-month change in log10 transformed platelet count was r = −0.34 (P < 0.001).
Of 900 patients in the drug conservation arm (re)initiating ART, 663 had platelet information available thereafter and had a study entry platelet level greater than the value prior to initiation. For these 633 participants, the median (IQR) change from study entry platelet level to level prior to initiation was −47 000 (−79 000, −27 000) and 489 (74%) recovered to their study entry levels during follow-up. Estimated percents recovered by 4, 8 and 12 months after ART reinitiation were 45, 60 and 69%, respectively. Those with the larger declines in platelet counts from study entry to ART initiation [aHR per log10 higher = 184 (56–610)] and those with higher HIV-1 RNA levels at time of (re)initiation [aHR per log10 higher = 1.3 (1.2–1.5)] recovered their platelet counts faster. Those who initiated ART later in the study took longer to recover their platelet counts (Table 3).
In the drug conservation arm 199 of the 1010 participants with month 4 platelet levels (20%) had a platelet decline of at least 25% during the first 4 months. A 25% decline in platelet level at 4 months was not associated with subsequent risk of serious non-AIDS events [aHR = 0.8 (0.4–1.7), P = 0.52]. Developing thrombocytopenia was not associated with subsequent risk of serious non-AIDS events [aHR = 0.9 (0.6–2.6); P = 0.92].
Here we describe platelet kinetics, and the relationship to HIV replication and changes in D-dimer levels, in the context of an ART interruption study (SMART). A significant decrease in the platelet count as well as an increased rate of thrombocytopenia (defined as <100.000/μl) was observed among 1090 participants randomized to ART interruption (drug conservation arm) in the SMART Study, whereas patients assigned to continuous ART use (viral suppression arm) had stable platelet counts. Inverse correlations were seen between changes in platelets and changes in D-dimer or HIV-1 RNA levels, and were strongest among those with viral suppression at study entry who then stopped ART. Most patients recovered to platelet levels seen at study entry after reinitiating ART.
The prevalence of HIV-1-induced thrombocytopenia varies greatly between different studies, with reports between 1.1 and 54.7%, but is generally more than 10% [10]. HIV-related thrombocytopenia is likely caused by accelerated platelet destruction, splenic platelet sequestration, and variably impaired platelet production [11]. Accelerated clearance can be caused by immune-complex-based disease, antiplatelet glycoprotein antibodies, and/or anti-HIV-1 antibodies that cross-react with platelet membrane glycoproteins [12]. Impaired platelet production is probably caused by HIV-1 directly infecting megakaryocytes through the viral CXCR4 coreceptor, inhibiting mature megakaryocytes from effectively producing platelets [13]. HIV-1 can also impair megakaryocyte maturation as shown by reduced formation megakaryocytopoietic colony forming units in HIV-1-infected individuals [14].
The predominant mechanism(s) contributing to HIV-related platelet reductions may differ by HIV disease stage. In the early phase of disease with low viral loads, an immune thrombocytopenic purpura (ITP) like mechanism with presence of antiplatelet antibodies and increased platelet destruction dominates. In advanced HIV-1 infection with high viral loads and low CD4 cell counts (<200/μl) thrombocytopenia is mainly caused by decreased platelet production [15,16].
HIV-1-induced thrombocytopenia is usually responsive to standard ITP treatments (prednisone, intravenous immunoglobulin, anti RhD, splenectomy). Moreover, reducing viral load using ART has also proven efficient [12,17].
Our study is one of the few available wherein incidence and risk factors of incident thrombocytopenia have been systematically compared in the context of continuing/starting and stopping ART within a randomized trial. The findings are consistent with the Agence nationale de recherches sur le sida en les hépatitis virales (ANRS) 106-window trial analyzing 391 patients randomized to continuous or intermittent therapy for 96 weeks, showing that thrombocytopenia (<150 × 103 platelets/μl) was more prevalent in the intermittent therapy arm compared to the CT arm (25.4 vs. 9.8%, respectively, P < 0.001). Decreased platelet counts were correlated with changes in CD4 T-cell counts and plasma HIV-1 RNA levels (P < 0.001 for both) [18]. This study had a relatively small sample size and used a very sensitive endpoint (thrombocytopenia defined as < 150 × 103 platelets/μl) that is clinically not thought of as thrombocytopenia. Whereas in the SMART study, the much larger sample size and the more accurate endpoint (thrombocytopenia defined as 100 × 103 platelets/μl) more convincingly showed the correlation between ART interruption and thrombocytopenia as well as allowing for the study of risk factors in more detail.
An elevated D-dimer reflects activation of the coagulation and fibrinolytic systems and is well known to be associated with increased risk of CVD and mortality from any cause [19–21]. Activation of the coagulation system may in certain conditions also cause thrombocytopenia, best described in syndromes such as disseminated intravascular coagulation, paroxysmal nocturnal haematuria [22], heparin-induced thrombocytopenia [23], thrombotic thrombocytopenic purpura and hemolytic uremic syndrome [24]. These conditions are all characterized by endothelial and platelet activation as well as increased risk of thrombosis in spite of low platelet counts. Also in ITP, a paradoxically increased risk of thrombosis has been described [25]. In-vivo platelet activation, circulating platelet-leukocyte-monocyte aggregates, platelet-derived microparticles, and immature reticulated platelets have all been implicated in the mechanism of a prothrombotic state in patients with ITP [26,27]. Reticulated platelets are immature platelets with increased mass and a greater prothrombotic potential compared with mature platelets [28–30]. In our study, we confirmed the inverse association between D-dimer, HIV-1 RNA levels, and platelet counts in the context of interrupting HIV treatment, suggesting that HIV-1 viremia might activate platelets and coagulation factors.
In the SMART study, reinitiation of ART was not associated with an improvement in inflammatory parameters (hsCRP, IL-6) [2]. However, we have noted that platelet counts increased in most patients with HAART reintroduction, returning to their study entry levels. This lack of association does not support the hypothesis that unspecific inflammation is the sole force driving thrombocytopenia. As seen before, our data point to uncontrolled HIV-1 replication itself (most probable) or an activation in the coagulation pathways as pivotal underlying factors in the genesis of platelet count decreases.
Our study has some limitations that should be noted. Platelet levels were collected retrospectively at sites, only where available. Thus, we did not have platelet data for all SMART participants. By excluding sites that were unable to report platelet data on participants who had died or were lost to follow-up, we exclude 229 participants who experienced serious non-AIDS events. This resulted in our having limited power to study the effect of platelet kinetics on clinical event risk.
In summary, we have shown a significant decrease in platelet counts as well as a higher rate of thrombocytopenia (defined as <100.000/μl) after treatment interruption in SMART, which was related to increased viral replication and D-dimer levels. Most patients recovered to entry platelet levels after antiretroviral treatment reinitiation. Our data give support to uncontrolled HIV-1 replication and/or activation of coagulation pathways as the main factors underlying platelet count decreases.
We thank the participants who participated in SMART, the SMART study team (see below), and the INSIGHT Executive Committee.
The SMART Study Group: SMART was initiated by the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) and implemented in collaboration with Investigators in international coordinating centers in Copenhagen (Copenhagen HIV Programme), London (Medical Research Council, Clinical Trials Unit), Sydney (National Centre in HIV Epidemiology and Clinical Research) and Washington (CPCRA). Participating staff are listed below.
Copenhagen International Coordinating Center: J.D. Lundgren, K.B. Jensen, D.C. Gey, L. Borup, M. Pearson, P.O. Jansson, B.G. Jensen, J. Tverland, H. Juncker-Benzon, Z. Fox, A.N. Phillips.
London Internatioal Coordinating Center: J.H. Darbyshire, A.G. Babiker, A.J. Palfreeman, S.L. Fleck, W. Dodds, E. King, B. Cordwell, F. van Hooff, Y. Collaco-Moraes.
Sydney International Coordinating Center: D.A. Cooper, S. Emery, F.M. Drummond, S.A. Connor, C.S. Satchell, S. Gunn, S. Oka, M.A. Delfino, K. Merlin, C. McGinley.
Washington International Coordinating Center: F. Gordin, E. Finley, D. Dietz, C. Chesson, M. Vjecha, B. Standridge.
INSIGHT Network Coordinating Center: J.D. Neaton, G. Bartsch, A. DuChene, M. George, B. Grund, M. Harrison, E. Krum, G. Larson, C. Miller, R. Nelson, J. Neuhaus, M.P. Roediger, T. Schultz.
ECG Reading Center: R. Prineas, C. Campbell, Z.-M. Zhang.
Endpoint Review Committee: G. Perez (co-chair), A. Lifson (co-chair), D. Duprez, J. Hoy, C. Lahart, D. Perlman, R. Price, R. Prineas, F. Rhame, J. Sampson, J. Worley.
NIAID Data and Safety Monitoring Board: M. Rein (chair), R. DerSimonian (executive secretary), B.A. Brody, E.S. Daar, N.N. Dubler, T.R. Fleming, D.J. Freeman, J.P. Kahn, K.M. Kim, G. Medoff, J.F. Modlin, R. Moellering Jr, B.E. Murray, B. Pick, M.L. Robb, D.O. Scharfstein, J. Sugarman, A. Tsiatis, C. Tuazon, L. Zoloth.
NIH, NIAID: K. Klingman, S. Lehrman.
SMART Clinical Site Investigators by country (SMART enrollment): Argentina (147): J. Lazovski, W.H. Belloso, M.H. Losso, J.A. Benetucci, S. Aquilia, V. Bittar, E.P. Bogdanowicz, P.E. Cahn, A.D. Casiró, I. Cassetti, J.M. Contarelli, J.A. Corral, A. Crinejo, L. Daciuk, D.O. David, G. Guaragna, M.T. Ishida, A. Krolewiecki, H.E. Laplume, M.B. Lasala, L. Lourtau, S.H. Lupo, A. Maranzana, F. Masciottra, M. Michaan, L. Ruggieri, E. Salazar, M. Sánchez, C. Somenzini.
Australia (170): J.F. Hoy, G.D. Rogers, A.M. Allworth, JStC Anderson, J. Armishaw, K. Barnes, A. Carr, A. Chiam, J.C.P. Chuah, M.C. Curry, R.L. Dever, W.A. Donohue, N.C. Doong, D.E. Dwyer, J. Dyer, B. Eu, V.W. Ferguson, M.A.H. French, R.J. Garsia, J. Gold, J.H. Hudson, S. Jeganathan, P. Konecny, J. Leung, C.L. McCormack, M. McMurchie, N. Medland, R.J. Moore, M.B. Moussa, D. Orth, M. Piper, T. Read, J.J. Roney, N. Roth, D.R. Shaw, J. Silvers, D.J. Smith, A.C. Street, R.J. Vale, N.A. Wendt, H. Wood, D.W. Youds, J. Zillman.
Austria (16): A. Rieger, V. Tozeau, A. Aichelburg, N. Vetter.
Belgium (95): N. Clumeck, S. Dewit, A. de Roo, K. Kabeya, P. Leonard, L. Lynen, M. Moutschen, E. O'Doherty.
Brazil (292): L.C. Pereira Jr, T.N.L. Souza, M. Schechter, R. Zajdenverg, M.M.T.B. Almeida, F. Araujo, F. Bahia, C. Brites, M.M. Caseiro, J. Casseb, A. Etzel, G.G. Falco, E.C.J. Filho, S.R. Flint, C.R. Gonzales, J.V.R. Madruga, L.N. Passos, T. Reuter, L.C. Sidi, A.L.C. Toscano.
Canada (102): D. Zarowny, E. Cherban, J. Cohen, B. Conway, C. Dufour, M. Ellis, A. Foster, D. Haase, H. Haldane, M. Houde, C. Kato, M. Klein, B. Lessard, A. Martel, C. Martel, N. McFarland, E. Paradis, A. Piche, R. Sandre, W. Schlech, S. Schmidt, F. Smaill, B. Thompson, S. Trottier, S. Vezina, S. Walmsley.
Chile (49): M.J. Wolff Reyes, R. Northland.
Denmark (19): L. Ostergaard, C. Pedersen, H. Nielsen, L. Hergens, I.R. Loftheim, K.B. Jensen.
Estonia (5): M. Raukas, K. Zilmer.
Finland (21): J. Justinen, M. Ristola.
France (272): P.M. Girard, R. Landman, S. Abel, S. Abgrall, K. Amat, L. Auperin, R. Barruet, A. Benalycherif, N. Benammar, M. Bensalem, M. Bentata, J.M. Besnier, M. Blanc, O. Bouchaud, A. Cabié, P. Chavannet, J.M. Chennebault, S. Dargere, X de la Tribonniere, T. Debord, N. Decaux, J. Delgado, M. Dupon, J. Durant, V. Frixon-Marin, C. Genet, L. Gérard, J. Gilquin, B. Hoen, V. Jeantils, H. Kouadio, P. Leclercq, J.-D. Lelièvre, Y. Levy, C.P. Michon, P. Nau, J. Pacanowski, C. Piketty, I. Poizot-Martin, I. Raymond, D. Salmon, J.L. Schmit, M.A. Serini, A. Simon, S. Tassi, F. Touam, R. Verdon, P. Weinbreck, L. Weiss, Y. Yazdanpanah, P. Yeni.
Germany (215): G. Fätkenheuer, S. Staszewski, F. Bergmann, S. Bitsch, J.R. Bogner, N. Brockmeyer, S. Esser, F.D. Goebel, M. Hartmann, H. Klinker, C. Lehmann, T. Lennemann, A. Plettenberg, A. Potthof, J. Rockstroh, B. Ross, A. Stoehr, J.C. Wasmuth, K. Wiedemeyer, R. Winzer.
Greece (95): A. Hatzakis, G. Touloumi, A. Antoniadou, G.L. Daikos, A. Dimitrakaki, P. Gargalianos-Kakolyris, M. Giannaris, A. Karafoulidou, A. Katsambas, O. Katsarou, A.N. Kontos, T. Kordossis, M.K. Lazanas, P. Panagopoulos, G. Panos, V. Paparizos, V. Papastamopoulos, G. Petrikkos, H. Sambatakou, A. Skoutelis, N. Tsogas, G. Xylomenos.
Funding: Support provided by National Institutes of Health grants (NIH Grants U01-AI068641, U01-AI046362, and U01-AI042170).
Authorship and disclosures: E.Z. and J.N. coordinated the research, supervised by J.D.L. E.Z., J.N., and J.D.L. wrote the first edition of the manuscript and J.V.B., C.S., J.M.L., A.P. and M.C. critically reviewed and revised it. The INSIGHT Scientific Steering Committee has also reviewed the manuscript.
There are no conflicts of interest.
antiretroviral therapy; D-dimer; HIV; platelets; strategies for management of antiretroviral therapy
© 2013 Lippincott Williams & Wilkins, Inc.
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Agency: BETC Euro RSCG, Paris • Director: Matthijs Van Heijningen, Soixante Quinze • Editing: Jono Griffiths
Effects: Mikros Image
Bears have long been among the best-loved creatures in advertising. But this hilarious French commercial for the Canal+ movie channel by BETC Euro RSCG—the third animal spot in our top 10—found a wonderful new role for one furry friend in particular. He's not just the exploited talent. He's the director! The spot opens on a movie set, as the bear—aka "Paul Bearman"—is seen interrupting a violent medieval battle scene to give advice to his actors and crew. The ad proceeds as a mockumentary, with Bearman explaining his passion for cinema. Turns out he's the typical Hollywood director—a bit of a diva, a complete control freak, but a real renaissance bear when it comes to his craft, micro-managing everything from the special effects to the music. This only odd thing is, he looks a bit thin, with a weird, upholstered look to his belly. The ending—perhaps the best of any spot this year—wonderfully explains that he's a taxidermied bear who's been lying prostrate in someone's living room for years, falling in love with the movies from night after night of watching Canal+. "Pourquoi pas moi?" he says. He may not make it in Hollywood, but for now, he's conquered advertising.
Full credits here


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LED Starburst & Ornament String Lights
- Overview
Nothing is more magical and festive during the holidays than twinkling lights. These add lots of star sparkle.
- Starburst: 8' long
- Ornament: 8' long is Catalog / Internet Only.
- 18 LED lights.
- Battery pack for 6 AA batteries (240 hours; batteries not included).
- For indoor use only.
- Dimensions & Care
- Wipe with a soft dry cloth.
- When not in use, store indoors wrapped with tissue paper.
- Shipping & Return Info
This is a general shipping item.
Shipping Information
Hassle Free Returns
To make this gift-giving season a little merrier, we are extending our Returns & Exchange Policy. For all items purchased between Oct. 21 and Dec. 24, 2016, you'll have until January 31, 2017 to return the item for a refund of the merchandise value. Just make sure to bring your proof of purchase or gift receipt. Quick Ship upholstery items are excluded from the Extended Holiday Return Policy. You have 7 days to return your Quick Ship upholstery item for a full refund or exchange.
The following items are non-eligible for returns or exchanges:
- Monogrammed items
- Mattresses
- Gift cards
- Made to Order items, including custom rugs and furniture
- Final Sale items (identified by a price ending in $.X7 or $.X9)
- Items damaged through normal wear and tear.
Delivery fees are non-refundable and prior purchases are not eligible for price adjustments.
For more information, view our full Returns & Exchange Policy.


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As I answer you're problem, I'll show what code was used.
So we are to integrate ?
Note that the region is defined as the area between two circles [when looking down at the xy plane]Code:[tex]\iiint\limits_G x^2+y^2+z^2 \,dV[/tex]
So our limits for the radius would then be from 1 to 2.
The best coordinate system to use would be the spherical coordinate system. We see that is defined between 1 and 2.
would be defined between 0 and
would be defined between 0 and
So our triple integral would be
Does this make sense?Code:[tex]\int_0^{2\pi}\int_0^{\pi}\int_1^2 \varrho^4\sin\varphi \,d\varrho\,d\varphi\,d\vartheta[/tex]


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Shul Crawl: Reading Hebrew Congregation
Two Oxford University students have set out on an ambitious project to review every synagogue in Britain. Danny Kessler and Joshua Felberg will make light-hearted assessments of hundreds of communities, based on the standard of the kiddush, the rabbi's sermon, decorum, and "peculiar customs".
Reading Hebrew Congregation is a small but dedicated community of friends. They might not like Friday night services (when we went, nobody else but the rabbi and his family turned up), but on Shabbat morning there were around 40 Jewish men and women – a rather impressive proportion, given the membership of under 150.
It's a proud synagogue – proud of its 110 year history and its connections to AJEX, its newly revived Cheder and its collection of single malt whisky it serves for Kiddush. It's also surprisingly active – the president announced a WIZO event, friendship club, interfaith and Mitzvah Day, all happening in the next week.
The RHC is under the auspices of the chief rabbi, so its marriages will be recognised by the Orthodox community as a whole – but it's not too frum. For example, a woman on crutches was unable to climb the stairs to the women's section upstairs, and quietly assumed her own row in the back of the men's section. The building itself is a Grade II listed Victorian synagogue, with five sifrei torah on display. We were pleased to see that the community was able and keen to participate in the service – Rabbi Zvi read from the Torah, but the haftorah was done by a lay reader and one of us was asked to lead musaf, which we did splendidly.
With all this in its favour, it must be said that Reading is not as lively and youthful as we would like it to be. Many of the keen twentysomethings have moved to London – either in search of a kosher shwarma, or because a previous rabbi lost faith in the future of Reading and encouraged those who were able to leave. It has set back RHC quite a bit – but the incumbent Rabbi Zvi and his wife Shira Solomons are doing their best to ensure the future of a lovely community. We'd like to encourage all local Jews to consider joining a friendly and welcoming environment. It's a synagogue where new faces are noticed and appreciated.
Also, for the first time yet, our cover as secret JC reviewers was blown. We were eating lunch at the rabbi's.
"What brings you to Reading?" asked Rabbi Zvi.
"Oh, just travelling…" I replied, hoping to change the subject pretty quickly.
"Oh yes? Do you visit many communities?"
"Erm, we've been to a few…"
"Great! Are you writing a book?"
"Well, not exactly…"
"…are you writing for the JC?"
Rats. Our notoriety preceded us, and much to our displeasure we were offered a glass of a spectacular 25-year-old single malt.


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Acelet-Scheduler: Task scheduler for all system and application scheduling.
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Limpid Log: A log system requires no hard-code log statements.
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ESPN.com boxing writer Nigel Collins reflects on the legacy and career of Oscar De La Hoya.
Use a Facebook account to add a comment, subject to Facebook's Terms of Service and Privacy Policy. Your Facebook name, photo & other personal information you make public on Facebook will appear with your comment, and may be used on ESPN's media platforms. Learn more.


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We're told that we succeed when we "believe in ourselves." But in our "self-esteem" culture we rarely hear the truth: research shows that people normally overestimate their abilities.
We also sometimes hear that high-achievers need anxiety and fears to keep pushing themselves. "It's been a two-edged sword," says Carol, a workaholic. "I like the rewards success has brought me, and I know I worked so hard because I worried I was stupid." Does chronic insecurity have any relationship to success? So far, research says no. Fear of failure can lead people to spread themselves too thin, or miss deadlines while seeking perfection.
The middle path between complacency or arrogance and destructive anxiety lies in accurate measurement and feedback.
Don't focus on who you are, your intrinsic intelligence or talent. Think, instead, about your skills and goals. This is true even in areas like writing or the arts where there's a big emphasis on early evidence of talent.
Realistic self-esteem is possible when you set measurable goals, gradually up the ante so that you can see progress, and seek trustworthy feedback. So if you're a writer, you might commit yourself to blogging every day. You might up the ante by making your blogs more complex and then ask an experienced editor for comments.
Let's say you've won a good new job as a HR manager, and you've never had management responsibility before. One common rookie mistake is to walk in thinking you can change all the procedures and boost everyone's morale right from the start.
Better to take it slow. Once you shed your initial (arrogant) high, you may feel you are "winging it" for the first months or even a year or so in a new role. You are, and it's better to be realistic than overconfident. When you're new and don't know the standards, you're especially likely to misjudge. The proof comes as you meet expectations week to week, and rise to new challenges. Then one day you can say "I'm a HR manager with a staff of six," and feel fine.
If you never reach that point, you may suffer from what psychologists define as "chronic impostor" feelings. Some people (often female) believe that they must cover up their ineptitude or stupidity by working overtime, manipulating office politics, or avoiding the more difficult tasks.
As a child in school, my friend Amanda, for example, believed she was "stupid," and that she was fooling all her teachers. "I could synthesize other people's ideas," she says, "but I didn't believe I could come up with ideas of my own." Fearing her lack of creativity would be exposed, she chose not to pursue a degree in English literature, her passion, and became a lawyer instead. Her early feelings of fraudulence led her into a field where she never belonged--and again, she felt fraudulent, As she says: "I didn't believe in it, I did it for the money," she says.
Feeling inadequate can get so extreme it's bizarre. Ellen, an Oxford philosopher, tortures herself over every word of her papers. "It's completely inefficient," she admits, since she typically throws out numerous "first drafts." But she's afraid that if she isn't absolutely careful, she'll look dumb. Dumb? Well, Ellen feels she lacks the "quality of mind" of a true philosopher. In conversation with colleagues, she continually evaluates their "quality of mind" and assumes that they are evaluating hers.
The trouble here is a dramatic version of what happens when we worry about who we are rather than what we're trying to accomplish. Ellen isn't dumb, but her emotions are and she's let them get the upper hand. Your talent will come through when you stop thinking about it.


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Apple supplier Jabil Circuit accused of labor violations
Reportedly involved in producing the iPhone 5C, Apple supplier Jabil Circuit has been accused of numerous labor violations by China Labor Watch. The watchdog group has alleged that Jabil Circuit's factory in Wuxi, China has engaged in infringements including millions of dollars in unpaid overtime wages, more than 100 hours of monthly mandatory overtime, more than 11 hours of daily standing work with no rest other than 30-minute meal breaks, hiring discrimination, and inadequate pre-work training. The full report can be found on the China Labor Watch website. Notably, the company is based in St. Petersburg, Florida.
IK Multimedia debuts iRig Pro interface
IK Multimedia has announced the iRig Pro ($150), a universal digital mobile audio/MIDI interface for iPhone, iPad, and iPod touch. A pocket-sized, battery-powered interface, the iRig Pro is a step up from the company's iRig HD. It "accepts virtually every type of audio and MIDI input" — dynamic or condenser microphones, guitars, line-level sources, keyboards, pads, and controllers are all compatible. The audio and MIDI inputs can be used simultaneously to control guitar or vocal software with foot controllers or pedals, for switching presets, and for controlling effects levels. A suite of IK's music creation apps is also included.
iRig Pro features a 1/4"-XLR combo input connector for use with standard XLR cables, a 1/4" mono line, or instrument signal cables. A switchable 48V phantom power supply can be used with studio condenser microphones. iRig Pro is powered by a 9V battery, and comes with three detachable cables that are compatible with Lightning, Dock Connector and USB connectors. IK Multimedia's newest interface is set to ship this month.
Harman debuts HK Esquire, Onyx, JBL Spark speakers
Harman debuted its fall line of products today, notably including two Harman Kardon speakers and one JBL speaker. Borrowing design elements from the earlier Go + Play speaker system, the Harman Kardon Onyx Wireless Speaker System ($500) can use either Bluetooth or AirPlay to stream music. Built with four speakers and a 60-Watt amplifier, the circular Onyx also has a six-hour rechargeable battery inside. Harman Kardon also unveiled Esquire ($249), a square wireless portable speaker and teleconferencing system featuring dual audio drivers and dual noise-cancelling microphones. Esquire uses Bluetooth for up to 10 hours of wireless operation during music streaming and phone calls. An adapter with three built-in USB ports is also included for charging multiple devices at once.
Harman also announced the JBL Spark ($129), a colorful cone-shaped wireless speaker system. Two 40mm drivers are included in the speakers, which can stream audio via Bluetooth. Spark includes a stainless steel hanging hook and fabric cord with inline controls, as well as a power adapter.
Booq reveals Complete Protection Kit case for iPhone 5C
Booq has revealed its Complete Protection Kit ($35) case for Apple's upcoming iPhone 5C. The bundle is set to ship Sept. 20 — the expected release date for the iPhone 5C.
Booq's Complete Protection Kit is a polycarbonate shell with a tempered glass screen protector and two adhesive Home Button covers. It comes in black, though Booq's website also shows a clear version of the case, which has Oct. 7 listed as a shipping date.
Report: Apple working on product with 17W power supply
A new report claims that Apple is working on a new 17-Watt power supply for a new product. The new product would require around 40% more wattage than the current iPad, but considerably less power than the 11" MacBook Air. Apple has reportedly started to obtain components for the 17W adapter, which could belong to a "portable product which could launch within the next 12 months." The report notes that the new adapter would not upgrade any existing Apple products, and it's possible that such a power supply could be for a new, larger iPad; a July report claimed Apple is testing tablet screens "measuring slightly less than 13 inches," following rumors of a 12.9" iPad prototype. [via AppleInsider]
Apple shipments signal new Apple TV?
Three recent shipments of "set top boxes" received by Apple in August could signify a new upcoming version of its Apple TV. A blog post citing bills of lading documents notes that Apple received a 35,000-pound shipment from Shenzhen, China on Aug. 25 described as "Set Top Box with Communication Function." An Aug. 18 shipment with the same weight was described as "Set Top Boxes," and an initial 15,000-pound shipment of set top boxes was received another week earlier on Aug. 11. The large shipments came from Apple supplier BYD; a previous shipment of "set top boxes" from Apple partner Hon Hai/Foxconn in December 2012 contained prior-generation Apple TVs. It's possible Apple could reveal a new TV product — a refreshed Apple TV or something else — at the company's Sept. 10 event, which is believed to be focused on iPhones and iOS 7. If not, a later expected event for new iPads could bring news of a new TV-related product. [via Panjiva]
Apple sets Sept. 11 Chinese event; China Mobile to get iPhone?
Apple has invited Chinese media for a second special event, set to be held at Beijing's China World Trade Center on September 11. Scheduled to start roughly six hours after the conclusion of Apple's American iPhone event on September 10, it's speculated that Apple will use the Beijing venue to announce a deal with China Mobile to bring the iPhone to the world's largest carrier. Apple CEO Tim Cook met with the chairman of China Mobile about a month ago, and negotiations have been ongoing for some time. The official Apple event will be the first of its kind in China. [via 9to5Mac]
Jawbone introduces $180 Mini Jambox
Jawbone has introduced Mini Jambox ($180), the newest and smallest addition to its line of Jambox Bluetooth speakers. Made from a single piece of aluminum with three drivers inside, Mini Jambox weighs 9 ounces, is just over six inches long, and slightly less than an inch deep. Using Bluetooth 4.0, Mini Jambox streams audio from within 33 feet of a Bluetooth-enabled device. The speaker offers about 10 hours of continuous playback and packs a rechargeable lithium-ion battery. It debuts at a slightly lower price than the original Jambox did, though both models will now sell for $180 due to a post-release Jambox price drop.
Jawbone has also released an app to access saved and streaming music on the new speaker. Offered in nine different color/design combinations, Mini Jambox comes with a micro-USB charging cable and 3.5 mm stereo cable. The speaker will be released late this month.
iPhone 5 32GB and 64GB to be discontinued?
A leaked internal document from Telus appears to reveal that the Canadian carrier will discontinue the 32GB and 64GB iPhone 5 models on Sept. 28.
The document hints—but doesn't confirm—that Apple will discontinue those models, while continuing to sell the 16GB iPhone 5 as a mid-tier option between the upcoming iPhone 5C and iPhone 5S. It's unclear why the discontinuation would take place on the 28th—eight days after the likely new iPhone launch day—but an accompanying report suggests that Apple could stagger the iPhone 5C and 5S release dates by one week, which would be unusual. [via mobilesyrup]
Google Authenticator update erasing user passwords
A recent update to the Google Authenticator app may be causing user's one-time password credentials to be erased, potentially preventing them from accessing online services using two-step verification, according to several user reports in the Google Authenticator project group. Google Authenticator is an iOS app that allows users to store credentials for Google's 2-Step Verification feature, and is also used for two-step verification with other third-party services such as Dropbox and Amazon Web Services (AWS).
Although several iOS 7 beta users had reported problems with losing credentials in the app, it wasn't until a recent update, presumably intended to address the iOS 7 issue, that the app began exhibiting the same behaviour for iOS users upgrading to the new version, resulting in users possibly losing access to some of their online services, particularly in cases such as AWS, where alternative "backup codes" are not made available. Users relying on the Google Authenticator app should avoid installing this update. Note that Google Authenticator uses an open-source one-time password generation method, so alternative apps are available, many of which were discussed in the same thread as a result of problems using the app with the iOS 7 betas.
Update: Google Authenticator appears to have been removed from the App Store, suggesting that Google may have pulled it while it works to address the issue.
Apple updates iLife apps modestly before iOS 7 launch
Apple has released minor updates to its iLife apps for iOS — iPhoto, iMovie, and Garageband. The heavily skeuomorphic apps are all described by Apple as receiving compatibility and stability fixes, without additional details, and continue to run without obvious changes on iOS 6 and iOS 7. While these behind-the-scenes fixes are not a surprise considering the upcoming launch of iOS 7, this may also signal that Apple is not planning to make major visual changes to those apps to coincide with iOS 7's release. [via 9to5Mac]
Apps: ArtRage 1.6, Combo Crew 1.2, Daniel Tiger + Speakeasy Cocktails 3.4
ArtRage for iPad ($5) from Ambient Design Ltd. has updated to version 1.6. The updated art studio app has enhanced stylus support, as the app now supports the Wacom Intuos Creative Stylus and TenOne Pogo Connect Stylus, in addition to the original Adonit Jot Touch. Tap and hold color sampling is now optional, and a number of UI issues have been addressed to make the app easier to use.
Combo Crew ($4), a touchscreen-optimized brawler by The Game Bakers, has added two new special characters in version 1.2.0. Viewtiful Joe of the Capcom series and Lester Knight from the classic action puzzle game Out of this World (aka Another World) join the fray. A $2 in-app purchase is required to unlock Joe, but Lester Knight — an inspired addition — comes unlocked with the update. The game has also added new challenges and missions to King of the Tower mode.
Apple invite officially confirms Sept. 10 iPhone event
Apple has started to invite members of the media to a special event on September 10 at 10:00AM Pacific Time, one week from today. Scheduled to be held at Apple's campus in Cupertino, the event's invitation includes the phrase, "This should brighten everyone's day." It consists of an Apple logo atop a collection of dots, brightly colored similarly to tones seen in both iOS 7 icons and leaks of the iPhone 5C.
The event will almost certainly include the formal announcement of the iPhone 5S and iPhone 5C, as well as the final release of iOS 7—at the very least, for iPhones and iPod touches. Reports have suggested that Apple will use a separate event, most likely in October, to debut new iPad models.
Case-Mate, SwitchEasy case designs leak for iPhone 5C, 5S
A number of alleged iPhone 5C cases have leaked, following numerous other leaks related to Apple's upcoming entry-level iPhone. Twitter account @evleaks tweeted a few pictures of alleged Case-Mate cases earlier today. Evleaks also tweeted that Case-Mate listed a shipping estimate as 8 a.m. Sept. 20, the expected launch date and time of the iPhone 5C and 5S.
Additionally, 9to5Mac has posted photos of promo shots for a number of new Switcheasy cases — new cases from the company's Numbers, Colors, Nude, and Tones lines. Most of the cases are for the iPhone 5C, but the Odyssey case is notably listed as compatible with the iPhone 5 and 5S, according to the image.
iPhone 5C phones, packaging, manuals leak
Following numerous leaks of rear shells and other small components, leaks of complete and boxed iPhone 5C units have hit the web. A photo of iPhone 5Cs in packaging comes from iapps.im, appearing to show a red iPhone 5C inside a plastic box. The packages appear to match those from an earlier leak.
A few other images were leaked and seen on Weibo, showing alleged iPhone 5C packaging materials. One picture shows what appears to be the manual for the 5C, while the next shows instructions for the SIM card ejection tool.


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Norma L. Kemp
HOLDEN - Norma L. (Allen) Johnson Kemp, 83, formerly of Holden, died in the Shrewsbury Nursing and Rehabilitation Center on May 28, 2007.
She leaves her husband, Howard W. Kemp Jr. of Crystal River, Fla.; three sons, Stephen A. Johnson of Windham, N.H., Charles T. Johnson of Holden and Daniel P. Johnson of Rutland; four daughters, Louise N. Howland of W. Boylston; Gayle L. Roy of Winthrop, Maine, Kim E. Oswald of Austin, Texas and Paula L. McCorkle of Holden; 17 grandchildren; and six great-grandchildren. Her first husband, Ralph L. Johnson, died in 1980. She was predeceased by five sisters, Dorothy Locke, Barbara Yanche, Thelma Marean, Ruth Thompson and Gertrude Grenier. She was born in Rutland, daughter of Jesse C. and Florence R. (Johnston) Allen, and lived in Holden for 40 years before retiring to Florida. She graduated from Rutland High School and Salter Secretarial School, Worcester.
Mrs. Kemp worked for Marsh-Kemp Insurance Agency in Worcester for many years. She was a member of the First Baptist Church of Holden where she was active in women's groups and at the annual church fair bake table. She enjoyed knitting and golf.
A memorial service was held June 2, in Miles Funeral Home (www.milesfuneralhome. com), 1158 Main St., with burial in Grove Cemetery, both in Holden. Memorial donations may be made to the Alzheimer's Association, Mass. Chapter, 311 Arsenal Street, Watertown, MA 02472; or to the Beaman Memorial Public Library, 8 Newton St., West Boylston, MA 01583.


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You are visiting a mobile version of the venmar.ca website.
"Ultimate performance"
Venmar V Series range hoods feature one of the slimmest profiles on the market. In addition, these hoods were designed to be the easiest to clean in the industry.
Cooking up a storm grilling, frying or using a wok? The V40E Model offers you the ideal combination of design, performance and effectiveness. Its dual blower and its full-size micromesh filters allow an unsurpassable collecting of greases.
This range hood incorporates state-of-the-art electronic control that makes cooking a real pleasure.Includes fingertip selection of everything from ventilation speed and lighting to the 5-minute delay shutoff.
Further more, this range hood is equipped with our special Heat Sentry™ feature that adds an extra measure of safety.


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A recent survey by the U.S. Fish and Wildlife Service shows a decline in the population of Mexican wolves found in New Mexico, according to a press release.
A January 2008 survey shows 52 Mexican gray wolves in Arizona and New Mexico, although the existing wolf packs offer promise for rebound with the next breeding season, the release stated.
Of 52 wolves surveyed, 23 were in New Mexico distributed among six packs with two or more wolves. In addition, other wolves roaming as individuals could join packs or form new packs in the future. Biologists anticipate substantial pup production from these wolves in 2008, the release said.
The survey documents the wolves alive on Dec. 31 of each year.
The New Mexico Department of Game and Fish is entering 2008 with renewed emphasis on placing and keeping wolves in the wild in New Mexico.
"There were too many losses from the wild wolf population and there were too many unnecessary conflicts reported by people in wolf country," said Bruce Thompson, director of the Department of Game and Fish, in a release.
"The Department will work with citizens to ensure that more innovative wolf management is conducted in 2008, consistent with the multiple-partner wolf reintroduction effort, and any conflicts will be evaluated closely to determine resolution strategies that are most beneficial to wolf survival and conservation."
Innovative wolf management will provide more options for dealing with conflicts and will emphasize a collaborative process for residents and public officials.
The department is working with residents to identify new ways to discourage nuisance wolf behavior and ways to allow wolves to roam where active livestock operations occur, the release said.
Game and Fish has hired a wolf program biologist who will be responsible for identifying more innovative and effective ways to communicate and integrate wolf program needs among people living in wolf country.
A continued emphasis on revising the federal rule for wolf reintroduction is necessary to improve wolf restoration capabilities.
M.H. "Dutch" Salmon, State Game Commissioner for the Southwest district, said, in the release: "New Mexico is one voice among the collaborative group making wolf management decisions, but we are strongly committed to adaptively and more effectively restore Mexican wolves to their place in the Southwest ecosystem."
Other agencies participating in reintroduction of Mexican wolves in New Mexico and Arizona are the U.S. Fish and Wildlife Service, Arizona Game and Fish Department, White Mountain Apache Tribe, USDA Wildlife Services, and USDA Forest Service.
Those interested in suggesting innovative wolf conservation practices are encouraged to submit ideas to the Department's Conservation Services Division at (505) 476-8118; firstname.lastname@example.com/[Marker].


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Four of five Olympic rings are seen lit up during the opening ceremony of the 2014 Sochi Winter Olympics, February 7, 2014. REUTERS/Phil Noble (RUSSIA - Tags: OLYMPICS SPORT)
Editor's Note: The following piece is from the perspective of Metro World News reporter Alexey Shunaev.
"You're a journalist, right? Then let me tell you a story," says a checkout operator in his 50s, grabbing my jacket sleeve to stop me from exiting the 24-hour convenience store. It was 2 a.m., lashing rain outside and I was keen to get back to the hotel. But I stayed a while to hear the cashier's tale.
"My nephew works in the hospital here. About a year ago, he told me that he got an emergency call from the bobsled track, which was being built at the time," he continued. "When the paramedics arrived at the scene, they found the bodies of four construction workers, Uzbekistani nationals, smashed into different parts. Do you know what happened? After a hard day's work, they decided to relax, drank their fair share of vodka and then got the idea to go for a slide down the track. So, they each took a cardboard box, flattened it and bombed down the race course like Russian luger Alber Demchenko, crashing to pieces."
The cashier smiled at me and asked if I liked his "exclusive story." I smiled back, thanked him and left. The sensational story he told me sounded all too familiar. I must have heard it half a year ago but then it transpired as fiction, just a tall tale from someone's mind.
The rain was bucketing down now, but oddly my clothes remained dry. Then it hit me: the deluge was as fake as the shopkeeper's fable. I'm not even sure if he really has a nephew. Day by day, I'm beginning to get the feeling that the entire city of Sochi is one big fabrication.
Is this place the future capital of Russian sport? False! Originally they had decided that after the Games, they will relocate all the sporting facilities to other cities, because nobody here will need a curling center or a 40,000-capacity stadium.
Is Sochi Russia's first completely barrier-free city, giving people with disabilities easy access, as the authorities claim? It's false! Yes, there are plenty of ramps and elevators dotted around, but many are poorly serviced and have been out of order for months.
Inside my hotel room, I have one fake television set, a fake lamp and fake light switcher – that is, they're all in place but don't function whatsoever. Let's say they're there for cosmetic reasons. In some of the sports venues, there are fake Wi-Fi signals that barely give you a connection. And today, I ate a fake hot dog that left me with a bad case of heartburn.
But the sensation the cooked sausage left was a pleasant one. Why? Because it was perfectly real.


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For anybody worried the Sprint Cup series couldn't keep up the excitement and torrid pace with which it started the 2013 season, those fears should be all but gone by now. Penalties, dominant performances, and heartbreaking late-race failures are keeping the excitement level high as the series loads up the haulers and heads to the heartland.
Previously on NASCAR 2013
Last week in Texas, Kyle Busch straight destroyed the competition, winning both the Nationwide and Sprint Cup races, as well as setting a new Texas Motor Speedway qualifying record.[ref]196.29 miles per hour. That's a mile and a half in under 28 seconds.[/ref] He continued showing the maturity and patience that has defined his 2013 thus far, qualities that, if he maintains them, should scare the crap out of the rest of the field.
Elsewhere, both 2012 champion Brad Keselowski and his Penske Motorsports teammate Joey Logano were penalized for rules infractions. Details are still murky, but it appears the groups were using special set-ups in the rear end housing of the cars that had not been submitted to and approved by NASCAR officials.[ref]A major no-no.[/ref] Both drivers were docked 25 championship points and their crew chiefs and car chiefs were suspended for six races, including May's All-Star race. All parties involved will still be present this weekend, though, as Penske will appeal the penalties.
On a related note, Keselowski also went on a verbal rampage following the race, claiming that NASCAR is targeting he and his Penske teammates unfairly, whilst rumors circulated around the garage that Hendrick Motorsports team members, who shared the garage stalls directly next to Keselowski and Logano last weekend, may have tipped off officials to the infractions. This situation's got more drama than a high school prom.
This Week
For the first time this year, the series will hit up 1.5-mile tracks on back-to-back weekends as the teams head to Kansas Speedway for the STP 400. Like Las Vegas, Kansas is a flatter track than Texas, but it is crazy fast, due in no small part to a repave that took place after this race last year. The new surface allows for quicker speeds, and the adding of variable banking means the incline of the track increases as you get closer to the wall. This creates multiple lines drivers can take and with the capabilities of the new Gen 6 car, should allow for side-by-side and three wide battling throughout the race.
Last Year
In 2012, Martin Truex Jr. fumbled an opportunity to win the race, much like he did last week at Texas. He was out front for 173 of the 267 laps run, but his car went away on the final run to the finish line, allowing Denny Hamlin to catch and pass him to take the victory.
- We shouldn't expect to see any of the fallout from the Penske penalties just yet, because NASCAR's appeal process will allow both Keselowski and Logano's crew and car chiefs to be present while appeals are taking place. That being said, we'll see if there's any hangover from the 25-point penalties both drivers were hit with. Keselowski's shown tremendous focus in high-pressure situations, but if he truly believes he's being unfairly targeted by the sport's higher ups, that could cause concentration problems during the race.
- This week's race is only 400 miles, as opposed to the 500 last week at Texas. That's 100 less miles for teams to work on their car and make their way through the pack if they start toward the tail end of the field. The Kansas race is also notorious for lengthy green flag runs, so dialing in your car early during the practice sessions and laying down a good qualifying lap to start up front are critical.
- Although it's only 400 miles, the Kansas race still puts a stress on engines. Toyota's engine development program has shown promise the last couple of weeks after some truly awful months of failures, but Kansas will be a good test to see if the struggles are truly behind them.
Who to Watch
- Jeff Gordon had a great car at Texas and was going to be a part of the battle for the win, were it not for a broken wheel hub with less than 50 laps to go. His team will rebound from that issue and he'll once again be a factor this week.
- Jimmie Johnson was uncharacteristically silent last week, posting a strong finish but never really factoring into the battle for the lead. The #48 team kind of gets butthurt when that happens, so he'll be back up front at Kansas.
- Look for Truex Jr. to once again challenge for the victory. After the Texas race, a clearly dejected Truex Jr. said he was tired of finishing second. His lone win in the Sprint Cup series came in 2007, and his team is poised to finally get back in victory lane.
Who Will Win
You'd be a fool to bet against Kyle Busch right now. He's won four of the six races run in the Nationwide series in 2013, and after last week, two of the seven Sprint Cup races. He's learned to be more patient, not overdrive his car when it isn't working, and allow the crew to tweak the setup until it runs like he wants. If he keeps it up, he'll be unstoppable, and he'll ride his momentum to victory lane this weekend for back to back wins.
How I've Done
As much as it pains me to do so, since my pick for last week (Brad Keselowski) was docked 25 points for illegal equipment, I will assume that penalty in my personal standings as well. Not only have I now failed to pick the winner correctly in all seven races this season, my fictional driver, created by adding up the points of my race winner pick each week, would now be eighth in the standings. I'm falling apart, folks.
Current Record: 0-7
Daytona 500
My pick: Jeff Gordon (finished 20th)
Winner: Jimmie Johnson
Subway Fresh Fit 500 (Phoenix)
My pick: Jimmie Johnson (finished 2nd)
Winner: Carl Edwards
Kobalt Tools 400 (Las Vegas)
My pick: Marcos Ambrose (finished 22nd)
Winner: Matt Kenseth
Food City 500 (Bristol)
My pick: Kyle Busch (finished 2nd)
Winner: Kasey Kahne
Auto Club 400 (Fontana)
My pick: Dale Earnhardt Jr. (finished 2nd)
Winner: Kyle Busch
STP Gas Booster 500 (Martinsville)
My pick: Jeff Gordon (finished 3rd)
Winner: Jimmie Johnson
NRA 500 (Texas)
My pick: Brad Keselowski (finished 9th)
Winner: Kyle Busch
Sprint Cup Standings
1. Jimmie Johnson
2. Kyle Busch -18
3. Greg Biffle -30
4. Brad Keselowski -34
5. Carl Edwards -35
6. Dale Earnhardt Jr. -35
7. Kasey Kahne -37
8. Clint Bowyer -61
9. Paul Menard -63
10. Matt Kenseth -65
The STP 400 takes place Sunday on FOX. Green flag is scheduled for around 1pm EST.


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01, enormous efforts are made to meet the needs of competitors, fans, media and tournament officials. In the world of competition
02Certain aspects, like tools and
equipment, undergo rapid and continuous innovation. Other
elements, like training techniquesthe
tournament design remains unchanged since the
19th century and methodology, evolve more
But one essential component of competition, the design, is unique in that it has remained mostly unchanged since the 19th century.
03Just like 100 years ago, in today's tennis, half of the participants go home after losing in the first round of the tournament. These competitors are equipped with space-age technology rackets, but are deprived of what is most essential, the proper opportunity:
- to prove their strength
- to learn how to compete
04Likewise, since as far back as the 19th century in practically all other sports competitions, a 9:1 victory against a top team is still rewarded exactly as much as a 2:1 victory against a second-rate team. With such severe inaccuracy you may not know how good you really are.
05Innovation in tournament design could have as dramatic an impact on sports as innovation in training techniques and equipment do.
06equTournaments is an example of such an innovation. The ranking computation component of this design is based on advanced mathematical modeling techniques. It produces a vastly more informative ranking of the competitors by exploiting tournament results to their fullest. It is a remarkably powerful and flexible component of our design. innovation in tournament design can have a dramatic impact on sportsIt can be effortlessly combined with countless scheduling schemes, to meet the most fundamental needs of the major stakeholders in any competition:
- Competitors [more]
- Fans [more]
- Officials [more]
- Associations [more]
07Equtar is a
software implementation of equTournaments and equRankings.
You can download and use this edition free of charge.


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View by: Most Popular | Alphabetical A to Z | Map
Aqualand Maspalomas
With more than 40 water slides to choose from, there's plenty of family friendly fun to be had in the water at Aqualand Maspalomas and a variety of activities ... Read more
Calle Triana
Calle Triana (and the district surrounding it) has become the main commercial center of Las Palmas. The pedestrian street running through its heart is lined ... Read more
Casa de Colon
Charming Casa de Colon was reportedly a rest-and-repair stop for Christopher Columbus and his ship, La Pinta, en route to the New World in 1492. ... Read more
Casa-Museo Perez Galdos
Visiting the house where famed author Benito Pérez Galdós was born and lived until 1862 is like taking a journey into his work and times; the ... Read more
Catedral de Santa Ana
As the seat of the Diocese of the Canaries in the Roman Catholic Church, the Catedral de Santa Ana is one of the most prominent monuments of Canarian ... Read more
Elder Museum of Science and Technology (Museo Elder de la Ciencia y la Tecnologia)
Satisfy your scientific curiosities with a visit to Gran Canaria's Elder Museum of Science and Technology. Located in a 19th-century shipping warehouse in ... Read more
Jardin Botanico Canario Viera y Clavijo
A staple of Gran Canarian and Spanish culture, the botanical garden was named after pioneering Spanish cleric and scholar José Viera y Clavijo. It opened ... Read more
Mercado del Puerto
Often considered to be the finest example of iron architecture in Gran Canada, the Mercado del Puerto is one of the main food markets in the city of Las ... Read more
Mundo Aborigen
Mundo Aborigen is a reconstruction of an ancient Canarian village inhabited by the Guanches (the orginal population of the Canaries). Located in a scenic ... Read more
Museo Canario
The Museo Canario (Canarian Museum) houses the most complete archeological collection in the Canary Islands. Its permanent exhibition can trace its beginnings ... Read more
Palmitos Park
Head for the mountains of Gran Canaria to experience a wilder side of the island — wild as in exotic animals, water-bound creatures, and even a collection of ... Read more
Playa de Ingles
Love it or hate it, Playa del Ingles (Beach of the English) is Gran Canaria's largest holiday resort and the second largest resort of its kind in Europe. If ... Read more
Pueblo Canario
Pueblo Canario (Canarian Village) is a complex of traditionally built island houses around a large central square set in the green surrounds of Parque ... Read more
Sioux City
In the sun scorched surrounds of Gran Canaria island lies a recreation of the American Wild West with cowboys and Indians, gunfights and saloons, and even a ... Read more
Teatro Perez Galdos
This 1,000-seat theater in Las Palmas leaves no one indifferent; be it for its prestigious shows or its splendid façade, visitors always enjoy themselves ... Read more


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'Haven': Kate Kelton Talks Jordan's Not-Death And Her Own Talent
SyFy's Haven is back and rolling for another season, so BFTV checked in this week with Kate Kelton - who plays the recurring character of Jordan on the paranormal hit - to find out what it's like to come and go from the mysterious town. Read on for Kate's thoughts on Jordan's survival and to find out what she has in common with Bob Ross and his happy little trees.
Haven has many secrets, and while Kate said she can "absolutely not" tell us how much of Jordan we'll see in Season 4, she did tell us what it's like to try and keep up with the goings-on when you're an irregular player. "We don't get the scripts that we're not in," she revealed, "so I'm constantly writing to the writers and begging and trying to see what's up!" She does get a little bit of help, though, as she added that "When you come into a script, it tells you what happened last episode."
She is beyond thrilled to be back at work on the show, especially since Jordan was in a bit of a predicament the last time we saw her. "It definitely felt pretty amazing when I got that call that I didn't die from my bullet wounds last season," she continued. "I was jumping for joy. It was only supposed to be a six-episode arc last season for me and it got extended." Now we couldn't quite see Haven without her.
What's the best part of the gig? "I've got to say, the travel, because Nova Scotia is so incredibly beautiful," Kate told us. "I remember really busting my hump in the first audtiion for this, because I saw it was shooting near Halifax. The concept of having a paid summer vacation where I get to do what I love, it was sort of an easy sell!"
When Jordan isn't around, though, there are other projects you can catch Kate in, although they're definitely not the same kind of programming. "I still feel so new at this. I still feel like I don't have that many credits to point people to," she said. "Bullet In The Face is a series I did for IFC that I did a few years back. It's sort of action comedy. It's absolutely insane. It was with Eddie Izzard and Eric Roberts and they were such a hoot to work with."
Our personal favorite line on her resume? Back in 2005, Kate guest-starred in the last episode of the CTV series The Eleventh Hour, a news drama that starred Rookie Blue's Ben Bass and Endgame's Shawn Doyle. "That was really amazing to get in on that season finale, because it got cancelled after that," she reflected. "And I believe the following year, it was nominated for like eleven Gemini [Awards] or something like that!"
Coming up, you'll also be able to see Kate in an independent feature film called Unearthing. "it's just beautiful," she said of the script. "It has sort of a mysterious sci-fi type vibe to it, but then at the base of the story, you find out that it's a really beautiful love tale."
Until then, if you're not seeing Kate on Haven, she might be busy watching Orphan Black. "I'm a huge Orphan Black fan now. I'd heard some stories about it, because the makeup artist that worked on it also does Emily [Rose]'s makeup on Haven and did my makeup last season. I just couldn't get enough of all of the different tricks, all of the different characters," she said. Before she knew it, she found herself up at 4:30 in the morning finishing the first season, "and that's never happened to me before!"
And while she may not have any paranormal powers, she does have a not-so-hidden talent: she's an artist. "I love painting. I've been an artist and drawing and sketching and painting since I was like two years old," she told us. "I think that was the first love. The good thing about that is there's no age or weight or height or beauty requirement. I'll be doing that until I'm dead, I'm sure." But hopefully she'll be staying alive on Haven for a lot longer.
Haven is all new tonight on SyFy.
(c)2013 Brittany Frederick. Appears at Starpulse with permission. All rights reserved. No reproduction permitted. Visit my official website and follow me on Twitter at @tvbrittanyf.


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CLASSIC VIDEO: The Hart Foundation wins the WWF tag team titles
The Hart Foundation (Bret Hart and Jim Neidhart) began a feud with tag team champions British Bulldogs (Davey Boy Smith and Dynamite Kid) in early 1987 over the titles. On the February 7, 1987 edition of Superstars, in Tampa, Florida, the Harts defeated the Bulldogs for their first WWF tag team championship when the referee […]Read more
CLASSIC MATCH: Andre The Giant & Sgt. Slaughter vs. Iron Sheik & Nikolai Volkoff from 1984
Here is a classic WWF match featuring Andre The Giant & Sgt. Slaughter vs. Iron Sheik & Nikolai Volkoff from the Meadowlands in 1984. Check it out!Read more
RARE VIDEO: In 1996 the McMahon family was inducted into the CAC
Here is a special moment from 1996 of the entire McMahon family getting inducted by the legendary Lou Thez into the Cauliflower Alley Club. See this speech with presenters Arnold Skaaland, Bruce Pritchard, Pat Patterson, Fred Blassie and more as Vince, Shane and Linda McMahon take part in this historic presentation. Check out this great […]Read more
CLASSIC MATCH: Nick Bockwinkel vs. Billy Robinson – All Japan Pro Wrestling December 11, 1980
Here is a classic match from All Japan Pro Wrestling featuring CAC president and wrestling legend Nick Bockwinkel versus Billy Robinson. Bockwinkel is considered one of the greatest stars of all time and is a WWE Hall of Famer, but here he locks up with Robinson, a star in his own right. Robinson is a […]Read more


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Top Definition
When you make cookies with your mom while getting stoned.
Jesse(Jacob's Step Mom)-"Jacob, pass the cookie dough and the blunt."
Jacob-"Man Jesse, we are getting baked again! You're Baked Mom!"
Jacob-"Man Jesse, we are getting baked again! You're Baked Mom!"
by Shot Gunned December 08, 2007
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One side has the word, one side has the definition. Microwave and dishwasher safe. Lotsa space for your liquids.Buy the mug
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Smooth, soft, slim fit American Apparel shirt. Custom printed. 100% fine jersey cotton, except for heather grey (90% cotton).Buy the t-shirt
Trending Now
Can you define these popular missing words?


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- Home
- News & Multimedia
- News Releases
- Drought Loosens Grip On Flows In The Green River Below Flaming Gorge Dam
Drought Loosens Grip On Flows In The Green River Below Flaming Gorge Dam
Media Contact: Doug Hendrix, 801-524-3837
Barry Wirth, 801-524-3774
For Release: June 16, 2005
Salt Lake City, Utah - Wetter spring snowpack and runoff conditions returned this year to the Green River Basin in northeast Utah and northwest Colorado following several years of drought. Flows in the Green River near Jensen, Utah, peaked at 19,600 cubic-feet-per-second (cfs) on May 26, 2005, and remained high through early June due largely to higher than expected unregulated flows out of the Yampa River. Further downstream on the Green River, mostly unregulated flows out of Ashley Creek, the Duchesne River and the White River increased the peak flow near Ouray, Utah, to more than 30,000 cfs.
While flows observed in some reaches of the Green River were high this year, these flows were not out of the norm in comparison to recent history. For example, peak flows of the Green River near Jensen in 1996, 1997 and 1999, measured 22,000, 24,900 and 20,600 cfs, respectively. In the Ouray reach of the Green River, peak flows measured 29,300 and 31,900 cfs in 1995 and 1997, respectively.
As this season's higher peak flows entered portions of the Green River floodplain at levels not seen recently, some property owners along the Green River expressed concern that the U.S. Bureau of Reclamation (Reclamation) may have changed the way it operates Flaming Gorge Dam to support recovery of endangered Colorado River fish. This was not the case. Dam operations in the spring have remained fairly consistent since the dam was constructed in 1962, with annual peak releases typically at or near the maximum capacity of the power plant (about 4,600 cfs). Releases from Flaming Gorge Dam this year were maintained at maximum power plant capacity during the time of peak flow in the Green River, when inflow into the reservoir was about 5,700 cfs.
Earlier this year, Reclamation, a partner with the Upper Colorado River Endangered Fish Recovery Program, worked cooperatively to arrange to provide additional releases from Flaming Gorge Dam, if needed during spring runoff, to support requested Green River target flows near Jensen. Target flows of 14,000, 16,000 and 18,000 cfs were established according to requirements of planned research studies that had been postponed because of years of drought.
"When the arrangement was made, we were uncertain about how much runoff we would have during the critical time that our research studies needed to occur," said Recovery Program Director Robert Muth. "When we saw the actual and forecasted spring flows for the Yampa River increasing, Reclamation only needed to release an additional 1,700 cfs for two days before the peak to meet our 14,000 cfs target and 2,300 cfs for two days after the peak to meet our 16,000 cfs target."
This small change in dam operations did not result in an unusual spring peak or unexpected levels of water entering the floodplain. Since 1962, peak flows at Jensen of 18,000 cfs or greater occurred 24 out of 44 years, or 55% of the time. During the peak flow this year, more than 75% of the volume of flow in the Green River near Jensen was from the Yampa River and not from Flaming Gorge Dam.
"Inflows to Flaming Gorge Reservoir this spring have also been much higher than in previous years," said Rick Clayton, Hydraulic Engineer with Reclamation's Upper Colorado Regional Office. "Since April 1, 2005, the water surface elevation of Flaming Gorge has increased over six feet and could likely fill to an elevation of 6031 feet above sea level (nine feet from full pool elevation) by the end of the summer. This increase will be nearly 15 feet of elevation by the end of the runoff season."
# # #
Reclamation is the largest wholesale water supplier and the second largest producer of hydroelectric power in the United States, with operations and facilities in the 17 Western States. Its facilities also provide substantial flood control, recreation, and fish and wildlife benefits. Visit our website at www.usbr.gov and follow us on Twitter @USBR.


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San Bernardino, CA Chinese Restaurant
Lotus Garden
Lotus Garden is a 5 star gold award winning restaurant located in San Bernardino, CA. Serving delicious, authentic Chinese fare, stop in for lunch specials or dinner. Our special dinner offers serve 2, and include appetizers, soup and an entrée - vegetarian options are included.
Learn More About Lotus Garden:
- Hunan chicken
- Mongolian beef
- Shrimp
- Vegetarian dishes
- And more
Contact Lotus Garden today at 909-381-6171 for all your San Bernardino, CA Chinese restaurant needs.
Contact Information
Methods of Payment:


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The Young And The Restless Spoiler Video: Leslie's Advice.
"He trusts your judgement."
Leslie tries to be the voice of reason when it comes to Neil and Jack's relationship. Watch this spoiler video for what's coming up Friday on Soap Opera Fan Blog!
Please note the Holiday Soap Opera Pre-Emptions and find out which "OC" alum is heading to "House Of Lies" through Soaps.com's Primetime Dish.
Join us on Twitter @soapoperafan and Facebook.
Fun fact! Amy Mistretta wrote this story just for you on December 20th, 2012 |


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Manju Modiyani
I'm a 22 year old student. I'm from India. I love food and want to explore more and more cuisines gradually. I want to know more about latest things coming up in this field, also learn various tips and techniques about cooking.
- Website
- Location: Nasik, India.
- Favorite foods: Indian cuisine is my first love. However, I'm also exploring Italian and Mexican cuisines lately. I'm also looking into bakery simultaneously.
- Last bite on earth: Daal- Rice with ghee and green chili pickle!
Latest Comments
Can pizza-stones be used while baking in OTG?
An OTG is an Oven-Toaster-Griller
What's your mushroom of choice?
I like button mushrooms the most! Nice post... interesting... :)
Why baking soda is added to Iced Tea?
Thank u all of u for your valuable replies.. :)
Lipton Tea Bags tasting sweet to anyone?
@Nygiants- Hello...As u said your father has been sensitive towards sweetness, I guess there is nothing to worry about. Lipton might have changed the blend.
You can always experiment to find out. Suggest your father to try another tea brand, and see if that's okay.


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Cinnamon Graham Vanilla Fudge
- Prep Time: 10 min
- Cook Time: 5 min
- Ready Time: 120 min
- Yield: 64 pieces
- 2 cups white baking chips
- 1 container Pillsbury™ Creamy Supreme® Cinnamon Bun Flavored Frosting
- 2 tablespoons butter
- 1 teaspoon vanilla extract
- 1/4 teaspoon salt
- 1 1/2 cups coarsely broken cinnamon graham crackers
Preparation Directions
- LINE 8-inch square pan with foil, extending foil over edges of pan.
- MICROWAVE baking chips, frosting and butter in large microwave-safe bowl on HIGH 2 minutes. Stir until chips are completely melted and smooth. Stir in vanilla and salt. Stir in graham cracker pieces just until blended. Spread evenly in prepared pan.
- CHILL 1 hour or until firm. Remove from pan by lifting edges of foil. Remove foil. Cut into squares.
Nutritional Information Per Serving
Serving Size (1 piece of 64), Calories 70 (Calories from Fat 30), Total Fat 3g (Saturated Fat 1.5g, Trans Fat 0g), Cholesterol 0mg, Sodium 25mg, Total Carbohydrate 9g (Dietary Fiber 0g, Sugars 8g), Protein 0g; Percent Daily Value*: Vitamin A 0%, Vitamin C 0%, Calcium 2%, Iron 0%.
*Percent Daily Values are based on a 2,000 calorie diet.
* Ensure all recipe ingredients are gluten free by referencing the ingredient labels, as products may vary. If uncertain, contact the ingredient manufacturer.


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Over 136,000 acres have been set aside for parks in the metropolitan
area. In the evenings and on the weekends, parks are the meeting
places for whole neighborhoods. More than 500 lakes are in
the metro area, mostly in the public park system. Lush green
trees and grassy knolls border more than 100 miles of walking
paths, jogging and biking trails.
These are friendly cities, both cosmopolitan and warm to
newcomers. World renowned theater, distinguished music groups
like the Minnesota Orchestra and the St. Paul Chamber Orchestra,
and sophisticated art galleries set the pace for many experimental
theaters, galleries and music groups.
Minneapolis was crowned "The Most Fun City in America"
by makers of Cranium,
Inc. The cities were ranked on their number of sports
teams, restaurants, dance performances, toy stores, and the
amount of city budget spent on recreations, among other factors.
Minneapolis, the survey shows, has more theaters than Boston,
more parks than Denver, more golfers per capita than any other
city in America, and with 10,000 lakes in the state, Minnesota
has more coastline than California, Florida, and Hawaii combined.
Citizens here have a strong sense of community. There are
more than 600 ethnic organizations operating in the state,
mainly in Minneapolis and St. Paul. Both cities have preserved
their historic neighborhoods, downtowns and quality of life
through rigorous community initiatives. Intent on preserving
city life at its best, both Minneapolis and St. Paul are known
for their personal warmth and dedication to their communities.
Thus, Minnesotans have developed and preserved one of the
most beautiful metropolitan areas in the country. The area
is known for the creative partnership between business, public
sectors, communities and citizens working to change and improve
the quality of life.


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Championship week is here. Eight automatic qualifiers will be earned this week. While the NCAA tournament is only 18 deep, 32 schools have a chance to hit paydirt this week in league tourneys.
In May, every day is gold. Practices must be competitive, fun and run shorter than usual. Put it together when it matters most. Dig in and focus on every shift. Cleaning out your locker with a Hefty bag is a feeling everybody wants to avoid, so make each day count.
20. Ohio State (6-7)
The Buckeyes enter the ECAC Tournament after a low-scoring loss to Fairfield. Last year's NCAA win over Towson and trip to the Quarterfinals provides experience to turn the tables on the Stags. Fixing a 5-for-28 shooting day comes first.
19. Penn State (7-6)
The CAA decision to ban PSU from the conference tournament is one of the great injustices I've seen in lacrosse, rivaling the exclusion of undefeated Bucknell from the NCAA Tournament in 1996.
18. Fairfield (11-3)
The Stags had five stalling warnings in their 7-5 win over Ohio State, but they were plus-11 on groundballs. They're going to have to do it again.
17. Saint Joseph's (11-3)
Saint Joseph's takes on Hobart on Thursday in what equates to an NCAA Tournament round of 64 contest. Conference tournaments extend the brackets and gives mid-major programs a shot at glory.
16. Albany (9-5)
The Great Danes pummeled Siena, 19-11, on Tuesday in the capital district. I wonder who Steve O'Shea roots for in this yearly local rivalry. O'Shea was a cagey feeder for the Saints and then coached the Danes. On Saturday, Albany crushed Binghamton by two touchdowns, 21-7. Lyle Thompson has 98 points and Miles has 90 points — the top two players in that category. The America East title game can be seen on ESPNU on Saturday, May 3 before the Kentucky Derby and NCAA Selection Show. The Danes play Stony Brook on a jam-packed Thursday night.
Next: 15-11
Quint covers college sports for ESPN and can be followed on twitter @QKessenich. He welcomes your emails at email@example.com.


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Summary of Dialogue with Faculty, Staff Regarding UH Sugar Land Transition
We are in the early stages of the UH Sugar Land transition, and have begun implementing some of the strategic steps outlined on the Sugar Land transition webpage.
One of those steps – one that is of great importance to me – is my pledge to engage with faculty and staff of UH Sugar Land and UH-Victoria with transparent dialogue about the UH Sugar Land transition. To that end, I met twice this week with more than 160 faculty and staff to hear their comments, concerns and questions. Paula Myrick Short, senior vice chancellor for academic affairs for the UH System, joined me in these meetings.
Here is a summary of the key points of the discussions:
- The UH System is committed to providing affordable and accessible education to students throughout the region and beyond.
- We will continue to work to make the University of Houston-Victoria a premier destination university, a vision UHV has embraced.
- The UH System Board of Regents accepted the external UH Sugar Land Task Force Report, but did not specify what should be in the UH Sugar Land transition plan.
- The task force report established three guiding principles: No current student will be left stranded, no existing faculty contract will be violated and the University of Houston-Victoria will be furnished with adequate funds to carry out its important mission to become a destination university in the city of Victoria.
- The Sugar Land transition involves complex issues that include programming, accreditation, spatial issues and student access. Therefore, the transition will occur over two to five years.
- The Sugar Land transition website is a resource to submit suggestions and comments about the transition, and a way to make recommendations about who should serve on the transition team.
- I will hire a nationally renowned consulting firm to assist in creating the UH Sugar Land transition team and support its work. I anticipate the transition team will be small, but will include numerous work groups to examine the various issues. I estimate their work could take six to eight months.
- When the draft of the transition plan is complete, it will be shared in the public forums that will be scheduled in Sugar Land and Victoria.
- I have asked Vice Chancellor Short to provide all the support necessary from the UH System to ensure a successful accreditation visit at UH-Victoria.
- I have named Wayne Beran, vice president for administration at UHV, to serve as acting president for the next two to three weeks, at which point I will name an interim president and begin a search for a new president.
I am tremendously thankful and appreciative of the faculty and staff in Victoria and in Sugar Land who took the time to participate in these meetings and share their views. All who attended were extremely courteous, professional and visionary. I will give great consideration to their comments and ideas, and I look forward to receiving additional feedback as we continue to work together during this transition process.
With warm regards,
Renu Khator


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Content :
What We Do
Sanofi Worldwide
Sanofi is a global and diversified healthcare leader commited to patient and consumer needs.
Welcome to Sanofi Australia & New Zealand
We are Sanofi, the most diversified healthcare company in Australia and New Zealand.
Our mission is to have a positive impact on people's everyday lives. To achieve this, we have a culture that encourages curiosity in order to better understand the needs of Australians and New Zealanders who rely on Sanofi to deliver innovative products and services for their health and well-being.
By working together with patients and consumers, we can find new ways of helping them feel better, live longer, keep healthy and stay stronger.
Sanofi, a responsible corporate citizen
Sanofi is commited to acting ethically and responsibly at all times, and across all facets of the business. Our corporate sustainability approach places the consumer at the heart of the Group's business conduct.


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Wendy is a managing partner and entrepreneur who has successfully built a global services business and serves as an advisor on integrated sales and marketing strategies and alliances to venture-backed start-up companies. She serves as Chairman of the Board for EventVue, a service to help event attendees network to find their next business partner, customer, or employee; and a board member for Aegis Analytics, Metallect and The Forum of Women Entrepreneurs & Executives.
Wendy also sits on the advisory board of StillSecure, Sustainable Minds and Amazon Consulting. In addition, she is an active partner for SV2 (Silicon Valley Social Venture Fund), an organization that aims to make a local impact through building the capacity of nonprofit organizations. She is an advisor for Techstars, a start-up fund/incubator founded by a group of Colorado-based entrepreneurs promoting entrepreneurial activity in their home state.
Prior to her entrepreneurial activities, Wendy led Siebel Systems' eBusiness Consulting division, joining them in 1999 as a result of its acquisition of OnTarget, Inc., where she held the position of VP of Marketing and Alliances. Wendy is a graduate of the University of Mississippi, cum laude in Business Administration. She is a guest lecturer at UNC – Chapel Hill, Kenan-Flagler Business School on MultiChannel Strategy.


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Replaced by intrigue, vengeance and chaotic denials, Chris Christie's reelection afterglow has shrunk and gone pale. As the nascent scandal deepens and stories unfold, Governor Christie's mettle and presidential-ness will be poked, prodded and tested under the unfamiliar national spotlight.
The full extent of Christie's role in Bridgegate will eventually come out amid accusations, counter-accusations and lawsuits; but if he's interested in demonstrating he's ready for the the Big Chair he needs to come clean, fire any (and perhaps all) deputies and political lieutenants and appoint an independent investigative counsel. The sooner he can wrest control of the situation the more presidential he'll appear.
With congress back to work it's likely Chris Christie's follies will be overshadowed by something far greater in idiocy and national import; and with enough time between now and sometime in early 2015, when he announces his candidacy for the presidency, most will have forgotten there was ever an issue – except for the woman who died.